Time Stamps

  • 02:32 Write emails that people ACTUALLY read!
  • 06:49 Receive feedback, make necessary changes, and MOVE ON…
  • 11:06 Create meaningful relationships that stick!
  • 15:21 Gratitude

Show Notes

  • What microskills can we refresh ourselves on to navigate the professional world with grace and intention?
    • MICROSKILL #1: Write emails that people ACTUALLY read!
      • People spend 15-20 seconds on an email before deciding to delete it!
        • Do…
          • Add headline upfront
            • Example: “We have 2 updates, 2 asks, and 2 wins”
          • Strategically bold
          • Strategically use white space to avoid large, chunky paragraph
            • Outline if possible
          • Ask yourself…“does this email need to be sent?”
            • Be mindful of other people’s inbox!
          • Suggest/offer meeting times upfront for people to choose from
            • Example: “Does Thursday or Friday at 9 am work for you?”
    • MICROSKILL #2: Receive feedback, make necessary changes, and MOVE ON…
      • Constructive criticism can be shocking and upsetting
        • Usually because it is unexpected
        • Consider incorporating feedback and moving on
          • Caveat: You don’t always have to create change based on feedback
            • Consult your “Board of Directors”
              • People who know you well and support you
                • “Gut check” the feedback
                • Will support you through implementing constructive criticism
        • Constructive criticism can be helpful!
          • Especially in a career that requires ongoing growth
          • Consider your environment and growth if your have NOT received constructive criticism in some time
        • Pro tip: Receive feedback, gut check it with people you trust, make necessary changes, and move on!
    • MICROSKILL #3: Create meaningful relationships that stick!
      • Not all mentor-mentee relationships stick
        • May not be right personality match
        • May not be the right time
          • Keep in mind – relationships can always form in the future!
      • Manage/lower your expectations
        • It’s okay if people don’t reply
        • Normalize the come and go relationship process as you build your network
      • Not all relationships are the same
        • Core mentors you talk to often
        • Peripheral mentors you meet with less frequently
    • MICROSKILL #4: Gratitude
      • Call to Action! 
        • Thank role models and mentors who have taught you a skillset or helped during a challenging time
      • TIP: Showing gratitude MORE and SIMPLER:
        • Titrate it to your schedule!
          • Text
          • Email
          • Direct message a consultant’s program director
          • Tell the person in the moment
      • Appreciating others makes yourself also feel better!
  • Link to FULL book: “Microskills: Small Actions, Big Impact”


Dr. Shreya Trivedi: Happy July everyone! Or summer, depending on when you’re listening to this. It is THAT time of year again. I’m Dr. Shreya Trivedi.

Dr. Marissa LoCastro: And I’m Dr. Marissa LoCastro.

Dr. Shreya Trivedi: And a s everyone transitions in a new role or thinks about the new year ahead in maybe the same role, we’ve been thinking about micro skills – these are small actions but can have a pretty big impact. 

Dr. Marissa LoCastro: And Shreya, honestly, I think these are micro skills that everyone needs a refresher on from time to time. 

Dr. Shreya Trivedi: Yeah! I agree. I think when it comes to life microskills you never really graduate from then. You’ve got to learn them and practice them over and over, especially when they present themselves in unfamiliar settings and sneak up on you. And you’re like, wait! I knew that! So, yeah, I found it really refreshing to hear And in full transparency, the reason why this topic came to mind is because two friends from the EM world wrote a book about microskills to navigate the workplace and thriving in medicine. And we had a lovely interview with them and picked out a select few that caught our eye.

Dr. Marissa LoCastro: What I really liked about the book was that each microskill started out with a real life story to draw you in. And so we ended up picking 4 stories and microskills to share. So without further ado, let’s hear from our discussants and the authors.

Dr. Adaira Landry: My name is Dr. Adaira Landry. I’m an emergency medicine physician at the Brigham and Women’s Hospital and Assistant Professor at Harvard Medical School. I am also a co-founder of a nonprofit called writingincolor.org where we teach people of color how to write for free. I am a healthcare contributor for Forbes and I’m a mother of three. 

Dr. Resa E. Lewiss: Hi, everyone. My name’s Resa Lewiss. I call myself Dr. Resa E. Lewiss, and I’m a professor of emergency medicine. My current academic affiliation is University of Alabama at Birmingham. I am a point of care ultrasound specialist and the creator and host of a podcast called the Visible Voices where we design conversations covering healthcare equity and current trends. So glad to be here.

Dr. Shreya Trivedi: Yes! And now let’s dive into the 4 microskills that stood out to us. For each of these microskills we’re going to start out with that real life story. And for the first microskill, it actually has to do with a very practical thing – emails. We do them all the time. We get them all the time, but how do you do them well so people don’t just ignore your email and maybe even appreciate you for it?


Dr. Adaira Landry: So, 10 years ago, I was co leading this very large, um, initiative called the chief resident incubator, where we brought chief residents from across the country all together.  We wanted to have an initial onboarding email and, um, I was tasked to write this initial email and at the time, I didn’t know anything about email writing. So I wrote, like, really long paragraphs about all of the information. And I sent it to my supervisor, and, um, she read it and she said, no one’s going to read all of this. This is way too long. 

Dr. Marissa LoCastro: I can so relate to this story. In medicine we put a lot of effort into writing the perfect email. We add all of this information hoping it’ll feel more personal or impressive to the reader, but in reality a lot of people are just gonna put it right in the delete bucket because it’s a lot to comb through.

Dr. Shreya Trivedi: Or for me, I get overwhelmed and quickly click on the mark as unread and, unfortunately, never get back to it.

M: Haha, totally!

Dr. Adaira Landry: Avoiding very large, chunky paragraphs that in itself is like an immediately actionable skill. Right? Like, if you’re listening to this. Now, you know, so your next email, you wouldn’t do that, right? And then we have a little tagline. We give them, um, we say we have two updates, and then we have two asks, and we have two wins. And underneath each of those categories, we just have number one, number two, and then number one, number two, number one, number two, and that’s, and that’s it. So there’s no big chunky paragraphs. And so she showed me how to like trim out the fat and just make it so that it’s super lean and you can easily discover the details. And just the idea of, like, understanding that people really only spend 15 to 20 seconds on an email before they decide they’re deleting it and putting all that valuable information up top.

Dr. Shreya Trivedi: I can’t tell the number of time an emails come through my inbox, and it might not even be long but that is just one big blob of text. No bolding, no strategic use of a white space and just bland. I’m like “please make me make actually want to read this.”

Dr. Marissa LoCastro: Shreya! I think we’ve all been there. So takeaway is putting up front what are the high level needs updates, asks, dates. Even in subject line, put that request or action item. And of course, Shreya’s favorite, bolding can be super helpful.

Dr. Resa E. Lewiss: There’s a lot written about having a 0 inbox and we thought. About flipping it, rather than being concerned about your own inbox, think about other people’s inbox. So, first of all, you know, thinking, does an email even need to be sent and then who needs to be on that email? Uh, who is in the 2 line? Who’s on the CC? Who’s in the BCC? Um, and then just, you know, um.  Writing emails that people want to read, because a good percentage of emails don’t even get read by people and people feel really, really inundated with their email inbox. So it’s just always thinking about protecting other people’s inbox, uh, and in that way, being a good team player. One example that came to mind for me is when you’re trying to set up a meeting and rather than saying, well, when do you want to meet? When do you want to meet that? Basically, you can cut down the email volume by just starting with, you know, um, “let’s meet next week here are 2 days and times at work for me.” So, rather than that extra communication that would have been required to let the other person. We actually consider it kind to go ahead and make an offer. And already there’s a day and a time and the person can respond to that.

Dr. Marissa LoCastro: I love this! I actually did it just this week when I was asking what times worked for a group meeting. Took a shot in the dark and wrote “Would Wed or Thursday afternoon at 4pm work for everyone?” I got replies really quickly, set up the meeting, and it was THAT easy!

Dr. Shreya Trivedi: Ah, yeah! I love that for you. I think, for me, all of this comes down to empathy. I think great emailers are also people who have great empathy for other people receiving it. And thinking how will this person best receive this info  and setting them up for success.

Dr. Marissa LoCastro: So that was microskill #1 on how to write emails that people will actually read, onto microskills #2 on receiving feedback & moving on. And this starts with a story that might hit home for many.

MICROSKILL 2: Receive feedback and move on

Dr. Adaira Landry: So, um, when I was in residency, we have our annual review with our residency leadership team and most of mine were forgettable because nothing happened, but I remember one of them, um, stands out to me because something went wrong in my, in my opinion, which was that I got feedback, um, that I was not kind to one of our techs, like one of our, one of our aides. Someone had witnessed it and then put it in my peer to peer evaluation. I could not get past that nugget of constructive criticism or feedback, negative feedback. And I just, I couldn’t even focus and come up with like the goals for next year, because I was just so focused on the fact that, “Oh my God, I got this terrible feedback” for the first time that really, really made me feel bad that someone out there potentially doesn’t like me. And so, you know, the, the ability to hear something and incorporate it and then move on was, I didn’t have that skill. Not in that moment, at least. I was dwelling. I made the whole moment about myself versus like, okay, this is something I’m gonna work on. Let’s move on.

Dr. Marissa LoCastro: And I appreciate this story because as a recovering overthinker, I often find myself ruminating when I get constructive feedback.

Dr. Shreya Trivedi: Yeah, and you know, I think one of the reasons why we kind of feel surprised or off guard when we do get this type of feedback is because, if I’m being honest, I think TRUE constructive feedback is rarely given. Or not given as much. I think it;s interesting because if you contrast that to the fact that, like, yes we do all try to show up with our A game everyday, but nobody is perfect, and medicine is complex. And yes, we will fall short with a specific patient or management in the shuffle of things. And so if we put that into perspective, then of course, we should be open and kind of expect that constructive feedback more.

Dr. Marissa LoCastro: Yeah and I like to remind myself that growth is not linear. And this may sound corny, but I do love a good food analogy. But growth is like a pile of spaghetti. It has lots of twists and turns, and the sauce can be a mess, but overall the meal is delicious and all the highs and lows are totally worth it in the end. 

Dr. Shreya Trivedi: Yeah, yeah. The lows sometimes feel really bad!

Dr. Adaira Landry: When that feedback comes directly to us, we have to also be able to process it and move on. You don’t have to always create change based off of the feedback you get, but the ability to receive it and process it and move on is very important to do. We emphasize assessing the source and having a board of directors or your go to people, because it’s really important to fact check your gut and what you’re hearing and going to people who are not just your cheerleaders and champions. Like you really want people who, if this is an issue can say, yes, that corroboration, like, yes, actually I’ve noticed this before, but I thought maybe it was just me, but now that you’re bringing it up, let’s talk about how to make this better.

Dr. Resa E. Lewiss: It’s human and it’s normal to take things personally. And I think if you really want to run it by some people you trust, your personal board of directors is a good membership group. Um, not every single one of them, but you know, people that you, that people that have known you over time, people you trust, people that will  reflect things to you lovingly in a, in a place that you, in a place and in a way that you can hear it. I think it’s always good to, I mentioned gut check yourself, but also gut check it with other people that know you.

Dr. Shreya Trivedi: So I think my takeaway is two things – one is when we do receive something that is constructive or catches you off guard, receive it, gut check it with people you trust, make a plan, move on. And the second is to re-evaluate. If you haven’t gotten constructive feedback for improvement, then ask yourself what kind of environment you need to set up to make sure you are getting input for improvement. 

Dr. Marissa LoCastro: So that was microskill #2 on receiving feedback and moving on. Now onto microskills #3 about creating meaningful relationships that actually stick!

MICROSKILL 3: Meaningful relationships that stick

Dr. Resa E. Lewiss: I was attending a conference outside the city where I lived and worked, and I saw this person and I thought, Oh my gosh, I want to be just like them. Their professional career trajectory is exactly what I want. So I spoke with the person at the conference. Asked if it was okay if I followed up when we got back to our home cities. He said yes. And when I followed up and tried to have a meeting, it really just kept getting delayed, delayed, delayed. And finally, I realized, I think they’re really not into this mentor mentee relationship. 

Dr. Marissa LoCastro: This story is too relatable! Especially when you are just starting your career, sometimes it can feel like you are sending endless emails into a dark hole of no return. And while everyone validates that this is often the norm, it doesn’t make the radio silence hurt any less.

Dr. Resa E. Lewiss: It’s important when you’re developing relationships, you know, realizing at what point do you just say, okay, this is not happening organically. And it really spoke to the fact that both people have to be interested in whatever the terms of the relationship are. And so after that lesson, and I’m very appreciative of the experience, although at the time it really felt personal, uh, that, um, I was quicker to recognize the next time it happened when the relationship just wasn’t meant to be, and it just wasn’t sticking. And also realizing that that might be just right now and it doesn’t mean sometime in the future, it might be the right timing for the relationship.

Dr. Shreya Trivedi: So true. And this  is a tough microskill for me because I’ve definitely been on both sides. And nowadays more on the side of the mentor, who wants to show up for everyone in my best way, but often feeling just so stretched thin. I think, for me, this especially when I get an email or someone comes up to me at a conference or after a talk with this vague, like very excited, “will you be my mentor.” And I can just sense this expectation of this idealistic mentor-mentee relationship, but I’m not really sure what it entails. How often are we meeting? Can I really help this person? And I think with all that inertia and unknown I kind of just, things just get lost in the shuffle. 

Dr. Marissa LoCastro: Haha! I actually remember the first time I was looking for a mentor. And honestly, Shreya, I don’t even know if I knew what I was asking for! I was just told to go find one.

Dr. Shreya Trivedi: Right! So it’s kind of setting you up for what I’m going to feel on the other end.

Dr. Marissa LoCastro: Exactly!

Dr. Adaira Landry: I do think the pressure can be a big barrier for people to start or to continue because they’re like, not sure what’s expected of them or what to expect of the other person or they have, their expectations are too high. I think just like, taking it easy, I really tell people to take it easy. And like, if they don’t reply, it’s okay. We’ll, we’ll find someone else. We’ll move on and just sort of normalize, like the come and go, to and fro relationship process that can happen as you’re building your network.

Dr. Marissa LoCastro: And learning sooner rather than that the person might just not have bandwidth right now is often a gift! It gives you time to meet a different mentor or advisor rather than being stuck on something that may have not been a good fit for either party.

Dr. Adaira Landry: We also have this diagram in there that really sort of speaks to the fact that you can have people who are really close to you in your network. And those are your core people. And then some people who are further out your peripheral folks who maybe you only connect with once a year, if that. And then you have people who are really, really distant. You’ve met them once. It might have been years before you reach out to them.And so not everyone has to be on speed dial.

Dr. Shreya Trivedi: And sometimes I do find that it’s the people whoI have a loose association with, not that close idealistic close mentor-mentee relationship. Sometimes it’s those people that are actually pivotal in the next phase of my career or my research. And it reminds me, it’s important to cast that wide network of different types of relationships. Be open to how that relationship might unfold, keep trying, and eventually some relationships WILL really stick!

Dr. Marissa LoCastro: So that was microskill #3 on creating meaningful relationships that actually stick. Now let’s move onto microskills #4 on something subtle that we can all do a little bit more of …

MICROSKILL 4: Gratitude

Dr. Resa E. Lewiss: So I was working a shift as a resident and a woman came in and she had metastatic cancer and it was very clear to me and to my attending that she was dying. What was not clear, was this same sense to her family. So she came in, uh, there was no plan, no advanced directives and again, no appreciation of really how and stage and, uh, near death. So, it was time to have a family conversation. And I was blown away by how the conversation was conducted. And what I saw, what I witnessed was really this level of understanding and facility with getting the family to a point of being able to make a decision and where everybody was comfortable. Everybody appeared relieved and it wasn’t just verbalizations, but I could see it even in body language. So, fast forward, I was now a new attending working at a hospital and a patient came in and he also had cancer, a different kind of cancer. And he came in and he was sick, near death. And he was accompanied by his female partner. And this time he didn’t look so good. And, uh, again, I noticed this and his partner did not. And so she said, you know, doc, I’m going to go get, um, get something to eat. Do you think he’ll get admitted to the hospital? And I didn’t react externally, but internally, I was like, wow, she really doesn’t recognize this. And I said, you know, can we, can we talk for a minute? And I basically paralleled the exact conversation I had witnessed as a resident doctor. I then was the one leading and holding that conversation as the faculty member. And I talked her through, um, how sick he was, uh, this time, um, what I expected to be the hospital course that yes, he definitely was going to be admitted to the hospital, but I also gave her a heads up that sure, go get something to eat, but you shouldn’t be gone for long. And so I really kind of just laid it out and she, you know, was appreciative of the conversation. And the next day I wasn’t working, however, she came down and spoke to the nurses. So the next time I was on shift, those nurses said she came down and, uh, wanted to make sure that we told you how thankful she was that you had that conversation with her. And, I definitely really felt very comfortable and confident in holding that conversation, and how it looked because of what I had witnessed when I was the resident doctor. So I wrote a thank you note to that faculty member with whom I had taken care of, uh, that first patient, the, the woman with metastatic breast cancer. And he, uh, has told me that he has kept that thank you note, and he has, uh, taken it out from time to time to read it. 

Dr. Shreya Trivedi: There is so much in there! But the microskill we really loved was actually the ending, which was going out of our way to thank someone who role modeled something important or helped us through a dark space. And I think it’s something we can do more often.

Dr. Marissa LoCastro: Yeah! And I like to think about all the moments when we suddenly realize we’re using skills or phrases that we learned from role models we admire.

Dr. Shreya Trivedi: Yeah, but how often do we reach back out and thank them?

Dr. Resa E. Lewiss: It doesn’t have to be. You don’t have to get nice stationary and a nice pen and it  can be as simple as a text. It can be an email. It depends on the relationship of the situation, but there are many ways to do it. We just encourage people to do it.

Dr. Adaira Landry: Whenever I have a consultant who just, I feel like it’s just amazing and I need that to be set to the person. Um, I usually share that also with their program director.

Dr. Shreya Trivedi: I wish I did that more. I have these thoughts to send it to their PDs. And then, I wish, Siri could read the genuine thought I had, cause it’s so genuine, and so sincere, why I had that thought. Like, I was grateful. And I could write it. And press send. If only, maybe AI will get there!

Dr. Adaira Landry: Titrate to your schedule, right? Like, like your mileage may vary. Adjust to who you are and what you’re capable of doing. So if the email is too much, then take that off your plate. And maybe instead you just say it to the consultant directly. Right? And like, that’s a lot easier for you. 

Dr. Marissa LoCastro: And there is actually data showing that appreciating other people also makes us feel better. So there really is a dual benefit there!

Dr. Resa E. Lewiss: I’ve written a thank you note to my primary care doctor and explained, you know, that I did not feel rushed that all my questions were answered. That I just love how clear she is with what tests do need to be done versus what don’t. You know, and she told me that she  has never received that kind of note. She loves receiving the note and just how, you know, meaningful it is to her. It’s meaningful to me.

Dr. Shreya Trivedi: And so we purposefully ended with this microskill because we wanted to end with a call to action. We wanted everyone to take a second to think about someone that helped them through a dark time, or role model something that they do everyday. And go and thank them! And we just thought about how powerful it would be if even a fraction of the 50,000 listeners sent a thank you to someone. And just the bidirectional positive impact it would make on both people and even just medicine at large.

Dr. Marissa LoCastro: And last but not least, don’t forget to feel some gratitude and celebrate YOURSELF for how far you’ve come this July!

Dr. Shreya Trivedi: And so true! I love ending on that. Thank you, Marissa! And that is wrap! Please share this with colleagues or anyone else you think may find this helpful and may appreciate some of the microskills and stories. Thank you Dr. Adira Landry and Dr. Resa Lewis for writing this book. We will link “MicroSkills: Small Actions, Big Impact” in the show notes. Opinions expressed are our own and do not represent the opinions of any affiliated institutions. Thank you, take care!


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