Association for Academic Surgery (AAS)

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Adult Learning, Truth About Multitasking, and a Thing or Two About Clarity, Concentration, and Equanimity

I received a NIH-funded KL2 Career Development Award in May of this year. The Award gave an option of pursuing an advanced degree or taking courses to obtain a certificate during the 2-year award period. One of my career goals is to become a leader in cancer research in the field of racial disparities; I thought pursuing a degree in Master in Public Health (MPH) with an emphasis on epidemiology would accelerate my growth as a cancer epidemiologist and a researcher.

There are an increasing number of surgeons with dual degrees (MD/MBA, MD/PhD, and MD/MPH), especially in leadership positions.1  However, there are limited data on the impact of having a dual degree on the career of an academic surgeon.  According to Hall, surgeons with a dual degree, whether in MBA, PhD, or MPH, experience a greater level of professional success in various areas of academia; ranging from achieving leadership positions, to more number of publications and also better chances of obtaining NIH/federal funding or higher level reimbursement.2 So I thought an MPH degree will put me on the right track for success. I was ecstatic when I found out I got accepted to online MPH program at Texas A&M and I was counting the days until the first day of school.

School officially started on August 19, 2020 and oh boy, little did I know the intensity and the vigorous content of the lectures, reading materials, and the amount of homework!  Just to give an example, there were 8 “pre-course” modules, each with a mini assignment, which I had to complete even before the official start date of school. It has only been a couple of weeks since school started; and I feel like I have already learned so much and have spent every waking minute on school while I am not doing work-related things.

As with the paucity of data on the impact of having a dual degree for surgeons, I could not find any data on pursuing an advanced degree while in practice. The question that came to my mind while completing a biostatistics homework was “has anyone successfully completed an advanced degree while in practice?” After some virtual introductions to my fellow classmates, I was comforted to learn most of the students pursuing this degree work full-time.  However, the term “full-time” carries a different meaning to surgeons as most of us work more than the standard 9 am to 5 pm.  I saw a glimpse of doubt about my decision to pursue an MPH degree when I struggled to complete one of the pre-course modules on time.

The notion of Andragogy -adult learning and education- was first developed by Eugene Rosenstock-Huessy, a German social philosopher and a historian, and was made popular by an American educator Malcom Knowles.  According to Knowles, there are six assumptions related to the motivation of adult learning:3

  • Need to know: Adults need to know the reason for learning something
  • Foundation: Experience provides the basis for learning activities
  • Self-concept: Adults need to be responsible for their decisions on education
  • Readiness: Adults are most interested in learning subjects having immediate relevance to their work and/or personal lives
  • Orientation: Adult learning is problem-centered rather than content-oriented
  • Motivation: Adults respond better to internal versus external motivators

I certainly have all 6 motivations but I realized I needed more than motivation. It took me couple of weeks in school to realize that I need to re-frame and re-structure my mind and my schedule in 2 ways: 1) start saying no, and 2) no more (or at least less) multi-tasking. Saying no may be contrary to what I advocated on the blog I wrote in 2017 but I am at the point of my career where saying no will get me more dividends than saying yes. Additionally, I need to learn how to do only one task at a time.  The first week of school, I watched a few lecture videos while completing patient charts, and there were more than one occasion where I had to pause, go back, and watch the video again, which ultimately resulted in slower charting and spending more time on each lecture video.  As surgeons, we claim we are good at multi-tasking, but multi-tasking does not always equate efficiency. Many would argue that multi-tasking does not exist, but instead you are “switch tasking” back and forth between tasks and this leads multi-taskers to lose their ability to block out distractions as they are constantly invoking more of their brain than is necessary.4  Some would even argue that multi-tasking affects productivity as you are paying subpar attention to each of the tasks.5

Another method that helped me re-structure and re-frame my mind was meditation. I started consistently meditating in the midst of the pandemic.  I have had prior attempts to meditate and have done them inconsistently and poorly through the years, using guided meditation apps. I had actually signed up for a one-week silent meditation retreat in April, which was cancelled due to the pandemic.  Instead, I attended a week (1 hour daily) of guided group meditation in June. They used the Unified Mindfulness training method and after this experience, I no longer need guided meditation. I started meditating more consistently on my own without an app. My prior resistance to meditation was the notion that there is not enough time in a day, and that I could be doing work in the time I would be meditating.  What I have learned is that meditation distorts time, in a good way, and it allows me to concentrate with heightened mental clarity and use my time more efficiently and effectively. The three pillars of the Unified Mindfulness training are 1) concentration, 2) clarity, and 3) equanimity and I hope to master these skills with continued practice, which I think will help me to manage my time more effectively.

The upcoming two years will be challenging but I am up for the challenge. So was it a good idea to pursue an advanced degree while in practice? Well, ask me in 2 years and I will tell you if it was worth it.

 

 

  1. Zheng F, Mouawad N, Glass N, Hamed O. Advanced degree for surgeons and their impanct on leadership. 2012; https://bulletin.facs.org/2012/08/advanced-degrees-for-surgeons-and-their-impact-on-leadership/.
  2. Hall JF. Advanced degrees in academic colorectal surgery. Clin Colon Rectal Surg. 2013;26(4):250-253.
  3. Andragogy (Malcolm Knowles). http://www.instructionaldesign.org/theories/andragogy/.
  4. Belle. The Truth about multitasking. 2014; https://exist.io/blog/multitasking/#:~:text=The%20truth%20is%2C%20multitasking%20is,so%20is%20bad%20for%20us.&text=What’s%20actually%20happening%20when%20we,full%20attention%20to%20each%20one.
  5. Orad T. The Truth About Multitasking. 2017; https://medium.com/startup-grind/the-truth-about-multitasking-cd7c78b21359
Mio Kitano MD, MS

Mio Kitano MD, MS

Dr. Kitano is a Surgical Oncologist at UT Health San Antonio and she is board-certified in General Surgery and Complex General Surgical Oncology. Dr. Kitano’s clinical interests are focused on management of upper GI malignancies, neuroendocrine tumors of the gastroenteropancreatic tract, and endocrine surgery. Her research interests include racial disparities and molecular epidemiology, and she is currently studying molecular and epidemiological risk factors in the development of gastric cancer in Hispanics in South Texas. She completed a research fellowship at the National Caner Institute at the National Institutes of Health and graduated from General Surgery Residency from Albert Einstein College of Medicine. She completed a Complex General Surgical Oncology at The Ohio State University.