Sam Dyer, PA-C, MHS, is a NCCPA-certified physician assistant with more than 20 years of practice experience in orthopedics. He also holds a Certificate of Added Qualifications in Orthopaedic Surgery from the NCCPA. He practices at Emerge Orthopedics in Chapel Hill, North Carolina, and Durham, North Carolina. He is the current president of the PAOS, and writes an orthopedic blog on the PAOS website titled the OrthoPA-C. He has also authored an onboarding manual for PAs new to orthopedics, which can currently be read by PAOS members on the PAOS website, and plans to publish the work in the future. He has written numerous forum posts for the PAOS website and PAOS newsletter. He enjoys seeing a variety of patients and conditions in his practice. He also has developed a charity advocacy program for the PAOS titled PAOS CARES, where he teaches primary care providers at community health centers and rural health clinics MSK injection techniques.


BLOG: Being a mentor requires different attributes, skills than what is required to be a protégé

Nearly 4 years ago, I authored a blog called, “Be the Perfect Protégé.” I detailed the qualities I thought were important to being a student of orthopedics, including humility, strong interpersonal skills and an ethic to be a life-long learner. Four years later, I am still honored to consider myself a protégé to many mentors in my group, including physicians, physician assistants and administrators.

A lot has changed in my life both personally and clinically in those 4 years, however. I got married a month after that article was published. My clinical skill set has dramatically increased as I have taken on new roles in the practice, including administrative duties, osteoporosis care and working in our orthopedic urgent care clinic. In 2017, I accomplished one of my professional goals by lecturing at the Annual American Academy of Physician Assistants Conference on the subject of fragility fractures and I have been faculty at a musculoskeletal medicine conference for PAs for the last 3 years. All of these accomplishments are in part due to the mentors I have had in my life, and I continue to be grateful for their place in my life as a clinician and a person.

Nearly a year ago, I became the lead PA of my group. As the lead PA, one job I had been tasked with was the training and on-boarding of new PAs. I jumped at the opportunity. How hard can it be, I thought? Create a training schedule and have them follow it. This is what my mentors had set out for me. I had been a good protégé, therefore, I will be a good mentor. My plan was simple: Develop a reading plan and have them read said literature; expose the new clinician to as much volume of orthopedics during a period of time and they will absorb it; and give them a graduated level of responsibility during a period of time and they will thrive. In an ideal world, this is how I would have loved to be trained.

Suffice it to say, this is not how everyone learns effectively or wants to be trained. It is not that I wasn’t warned, however. Some of my colleagues said my program was “ambitious.” Others said, bluntly, “Do you want them to quit?” I was baffled by these critiques. It gave me great pause to realize that I had gone about this endeavor from the completely wrong perspective.

Being a mentor requires attributes and skills far different than what is required to be an effective protégé. I could not outwork this problem. Doing a few extra shifts on call would improve my evaluation of trauma patients, but it would not make me a better communicator. It would not make me more self-reflective or patient. Learning about the internal motivations of my colleagues, having insights into their goals and understanding how they wanted to learn optimally would not come from a CME course or a textbook. I have struggled with this acquisition of skills and continue to work on it daily. Trial and error have helped. Time and repetition have helped. The greatest impact, however, has come from the perspective given to me from being a father.

Ten months ago, my life changed forever. My wife and I welcomed a healthy baby girl into the world. It was the most single impressive event I have ever witnessed. The adjectives “challenging” and “rewarding” do not adequately describe parenthood. I am so thankful for this experience. It has made me self-reflective: How do I want people to view me? Will my daughter see me the same way? Are there things I need to change in myself so that I can be a better example to her? It also requires extraordinary levels of patience. This is not a quality I, nor many people in medicine, pretend to have adequate levels of or have mastered.

My training programs for my younger colleagues, like my new role in my personal life, are evolving. These are not perfect, but these likely will never be, as every person is different. I do approach things differently now, however. Rather than thinking, “How would I like to learn and grow and mature as a clinician?” my strategy has become, “What is the best style for that particular person to grow and learn and mature?” As a leader, just like as a father, it’s no longer my time to boast, take credit or shine above the rest. It is all about the individuals in your team and providing them the tools and opportunities to become the best versions of themselves. I can only hope that I am setting a good example for my team. Similarly, I hope my actions positively impact my daughter. She has taught me more about myself in the last 10 months than I could have imagined, and I look forward to her impact on my life as a person and a clinician for years to come.