The "Pygmalion Effect" and Surgical Mentoring.

The first year of surgical residency was overwhelming. My floor work was disorganized, discharge summaries were incomplete, and sleepless nights were starting to get the better of me. Dr. Venkataramani Sitaram, the chief of surgery at my alma mater, demanded and expected only the very best from the residents, and I knew I was falling short. He ushered me into his office after a particularly inadequate presentation on rounds. BDo you know what the Pygmalion effect is?,^ he asked. BThe more you expect of people, the better they perform,^ he said without waiting for an answer. He proceeded to explain that he knew that I was diligent and sincere, but I could do more. I would have to rise to the challenge. I strived hard to meet the exacting demands of Dr. Sitaram and gradually developed efficiency and agility in thought and action. However, a curious thing happened. Every time I thought I had made the grade, the bar would be set higher. The stains on a patient’s gown and the intern’s illegible handwriting were now somehow under the purview of my responsibility. BTrifles make perfection, and perfection is no trifle,^ I was reminded. These minutiae seemed trivial at the time, but the point was well taken. The emphasis on excellence was not limited to patient care and the operating room. Surgery residents were groomed to be well turned out, punctual, and polite. Anything less that the Queen’s English was inappropriate in matters of professional communication. Teamwork and mutual respect were integral to the success of the department. The occasional honest admission of ignorance was not frowned upon. A dependable resident was more important than an unreliable know-it-all. We were not penalized for mistakes as long as we learned from them. Dr. Sitaram may have seemed regimental at times, but his intentions were never in question. The trust he built over the years reassured us that he always had our best interests at heart. Furthermore, he was more than able to walk the talk. He only expected from us what he expected of himself. His integrity, dedication, and stamina were an inspiration to us all. Dr. Sitaram understood his unique role in the mentoring of residents. The acquisition of surgical skills was a lifelong process. However, the foundation for a successful career in surgery needed to be laid during the formative years of residency. At the core of his teachingwas the development of the surgical mindset. A surgeon is obligated to give his or her one hundred percent at all times. We own our patients and they deserve nothing short of the best. We take pride in every aspect of our work, from the mundane to the extraordinary. We constantly strive to improve, improvise, and innovate, never resting on past laurels. We cultivate the ability to thrive under pressure and over time develop an unwavering confidence in our own skill. I am grateful to teachers like Dr. Sitaram who remind us of the great privilege and responsibility we have as surgeons. Their dedication to mentoring ensures that the next generation is well equipped to overcome the diverse challenges of our great profession. (Dr. Venkataramani Sitaram is former Professor and Head of the Department of Surgery at the ChristianMedical College in Vellore, India). * Mohan Mathew John mmjohn@bronxleb.org