What is leadership? Although a dictionary might say that leadership is “the act of leading a group of people or an organization,” such a definition is severely lacking. The daily bombardment of essays and workshops on the topic makes it seem more of a commodity than the stuff of greatness. Everyone seems all too eager to share their version of leadership, for just three payments of $19.99 each.

Many believe that leadership is more adequately characterized through examples of historic leaders. Even then, there seem to be more examples of what leadership isn’t than what it is. With that cynicism, we hope to argue that the difficulty in defining leadership may be because it is different for each of us. Although we often know good leadership when we see it, leadership is a journey that life will insist each of us takes. So the real question isn’t finding a one-size-fits-all definition of leadership as much as seeing what your leadership journey will look like.

As individuals progress through the phases of leadership development—from admiring great leaders, to learning from them, to hopefully becoming one—they encounter many variables. They get to decide the terms of some of these variables, while others are decided for them. This is embodied in the adage, “You can’t choose what happens to you, just how you are going to react to it.”

While we agree wholeheartedly with the second half of that maxim, the first half is only partly true. Individuals may not be able to choose what happens to them, but they can stack the deck in their favor. It is on these controllable variables that we should focus our energy.

Surgeons as leaders
Increasingly, leadership qualities are being discussed at the highest level of orthopaedic organizations. One reason lies in the fact that it is no longer enough to be just a skilled surgeon in the operating room. And although the orthopaedic surgery pipeline is very good at producing technically proficient surgeons, many of the challenges in the modern healthcare arena call for leadership skills outside the operating suite. At the very least, it takes a different set of leadership skills to head today’s interprofessional teams than was required of the surgeon of yesteryear. Professional societies, associations, and accrediting bodies are recognizing this reality and providing unprecedented opportunities to hone these skills.

One example is the newly established AAOS Resident Assembly (RA), which held its inaugural meeting at the 2015 Annual Meeting. The RA joins the milieu of more established opportunities offered by the AAOS, including the Leadership Fellows Program, the Washington Health Policy Fellowship, the Resident Political Action Committee Fellowship, and the AAOS/Orthopaedic Research and Education Foundation/Orthopaedic Research Society Clinician Scholar Career Development Program.

Additionally, the American Orthopaedic Association’s (AOA) Resident Leadership Program has a long list of distinguished alumni. Fairly telling, the theme of this year’s AOA annual meeting was “Leadership: Full Speed Ahead.”

The spectrum of leadership in medicine encompasses the patient encounter as much as it does more formal interactions on a national or international level. Opportunities can involve a patient care team, hospital, community, orthopaedic specialty society, local, state, or national government, and beyond. Leadership opportunities are never far away; on the contrary, they present themselves daily in our families, residencies, and communities. Responding to a pager summons, even when it is intrusive to your personal life (ill-timed or late-night), is a sharp reminder that character is forged by doing the right thing when we don’t want to.

Although leaders are often characterized by the perceptions of others, true leadership is defined by what you do when people aren’t looking. To paraphrase many great leaders: without service, there is no leadership.

Whether we feel as though we are leaders yet or not, we have chosen a profession and job climate that will require us to become leaders. The professional status, characteristic traits, and intense training of orthopaedic surgeons make us uniquely qualified to serve in leadership roles.

In fact, the success of our profession depends on our ability to lead and establish trust with patients and society at large and to steer the massive ship of healthcare delivery through this time of tumultuous change. While each of us is at different stages on the path to becoming orthopaedic surgeons, we all know that it is a long, arduous road. Becoming a great leader is no different. Nothing worthwhile is easy. Own the journey!

Jared L. Harwood, MD is a PGY-5 resident at The Ohio State University in Columbus, Ohio. Jeremy M. Burnham, MD, is a PGY-5 resident at the University of Kentucky, Lexington, Ky. Both are on the Executive Council of the AAOS Resident Assembly.