For pediatric hematology/oncology fellows at Baylor College of Medicine, training goes beyond treating and researching childhood cancers and blood disorders. They also have access to a unique leadership program developed by doctors at BCM and Texas Children's Cancer Center.

The Reflective Practice Leadership Seminar is an interactive, case-based initiative that is mandatory for first-year fellows and elective for upper-level fellows.

The program creators say that interest in the seminar is starting to take hold in other departments at Baylor College of Medicine and at other schools of medicine and hospitals.

It was launched in 1995 by Dr. David Poplack, professor of pediatrics at Baylor College of Medicine and director of the Texas Children's Cancer Center, and his colleagues Dr. Ernest Frugé and Dr. Marc Horowitz.

"We believe there is more to being a good doctor than knowing the right medicine for a particular disease," said Horowitz, professor of pediatrics at Baylor College of Medicine who practices at the Texas Children's Cancer Center. "It's also about being able to interact and communicate effectively with patients and their families and with colleagues."

Teaching leadership

Leadership is an abstract quality that has been historically difficult to learn, and to teach. The seminar employs a model similar to that used in other aspects of clinical training and basic science education. Called reflective practice, the model applies a disciplined analysis of complex situations that result in strategic, effective action.

Oncology fellows are taught to make a cancer diagnosis using the information they have, and then generate a treatment plan. They can do the same thing within the leadership realm, said Frugé, associate professor of pediatrics and family and community medicine at Baylor College of Medicine and director of Psychosocial Programs at Texas Children's Cancer Center.

Systematic analysis

The seminars begin with a description of a challenging situation – such as a conflict that arises between physicians in different specialties on how to treat a patient. That is followed by a systematic analysis, the formation of a hypothesis of why the situation is occurring and development of a plan to deal with it.

Faculty guide the leadership seminars, encouraging fellows to tap into their reasoning skills and facilitating discussion among participants.

The seminar helps physicians develop the ability to understand the psycho-social effects of illness and treatment, which in turn enhances their ability to assist the child and the whole family during diagnosis and treatment. They also learn how caring for pediatric cancer patients affects medical professionals and how to work effectively with their colleagues. These are all important leadership qualities, Horowitz said.

Template for other areas

Seminars have been adapted for use in other areas of medicine, Frugé said. Pediatric upper level residents participate in an annual seminar on delivering bad news, and adult cardiology fellows have a monthly seminar on communication and leadership. Continuing medical education courses on such topics as ethical challenges and delivering care across cultures are also based on the pediatric oncology seminar program.

The reflective practice leadership seminar is now also being used at the University of Iowa.

For more information about the seminar visit