From the AATS

Young Faculty Hot Topics: Saying “yes” or saying “no”


The vast majority of us did not end up where we are today by saying “no” to opportunities throughout medical school, surgical training and now early in our clinical practice. In fact, many of us likely said “yes” to just about everything that came our way, and this was reasonable as the number of opportunities was manageable. As you move along your career as a cardiothoracic surgeon, the opportunities increase, especially if you consistently turn in a high performance.

Dr. Lisa Brown is a general thoracic surgeon at UC Davis Medical Center, Calif.
Dr. Lisa Brown
One of the first courses of my master’s degree program in clinical research was titled “Building an Academic Career.” An entire lecture was devoted to deciding when to say “yes” and when to say “no.” In fact, the lecturer made us say “no” aloud as a group several times along the theme of “thank you for this opportunity, but I do not have sufficient time to commit to this project.” The concept of saying “no” seemed foreign at the time, but it is an important skill to have.

A discussion of what to say “yes” or “no” to would be remiss without considering your individual career goals and time management. You’ve heard it before and here it is again: Write down your 5- and 10-year career plan. If you do not know where you are heading, you cannot plot the course. Then, based on those long-term career goals, drill down to your annual goals. Begin by identifying deadlines on the academic calendar each year and then work backward to determine what needs to be done in the months prior to those deadlines. Once you have a clear idea of what needs to be done on a month-by-month basis, on the Sunday of each week, create a list of daily goals. This method turns your long-term career goals into doable-size pieces of a larger puzzle that will keep you on trajectory.

Once you have charted your course using the above methods or some variation of them, you will have a clear idea of what opportunities are aligned with your long-term career plan. For example, if your goals are to build your clinical practice and become a program director, you may prioritize attending a course to introduce a new surgical technique into your practice and becoming the clerkship director for medical students instead of serving on hospital committees. Solicit advice from mentors and colleagues regarding certain opportunities if you are unsure whether these will help you achieve your career goals. Furthermore, identify senior cardiothoracic surgeons who have achieved the goals you are aiming for and ask them how they arrived at their position.

Oftentimes, it’s not about saying “yes” or “no,” but rather seeking out opportunities. Saying “yes” to opportunities that are pertinent to your career goals is critical, but there are other factors to consider when deciding whether to accept an opportunity. A major factor is the ratio of benefit to time commitment; clearly, the greater the benefit and the lower the time commitment, the better. However, there may be some opportunities that are beneficial and require a fair amount of time. Only you can decide whether the time necessary to commit to an opportunity is worth the benefit. Another factor to consider is what academic milestones are necessary for promotion at your institution; this may also vary by academic track within an institution. Be familiar with these requirements, and factor them into your goals as they are the foundation upon which you climb the academic ladder within your department.

Lastly, consider all the potential advantages of certain opportunities. For example, every year the STS solicits self-nominations for committees: Are there any committees that pertain to your career goals that will allow you to network with other cardiothoracic surgeons who may then become a mentor, sponsor, or collaborator?

I’m going to state the obvious: Only you know how you are spending every minute of every hour of each day. Why do I mention this? If you have said “yes” to too many things and are stretched too thin, you are at risk of underperforming and may begin to feel underappreciated; nobody else may realize how many hours you are working, but they will notice if your performance is subpar. Not only that, but you may be at risk of burnout. Unlike residency training, where we sprinted every day (and sometimes all night) and the light at the end of the tunnel was within view, we are now in an endurance race and need to pace ourselves for long, successful, and fulfilling careers. Ideally, we deliver what we promise, but if that balance is tipped, err on the side of underpromising and overdelivering. That scenario is much better than overpromising and underdelivering since the latter not only leads to a performance that might be less than your best but also could decrease your future opportunities.

When offered an opportunity, do not say “yes” immediately; collect some intel regarding the time commitment, determine whether it is aligned with your career goals and, if need be, discuss it with mentors and trusted colleagues before you say “yes.” Once you decide to say “yes,” jump in and hit the ground running! The beginning of your career is an exciting time with some flexibility in terms of choosing your own career adventures. Always be realistic about your goals and time to ensure a long, rewarding career.