Emotional intelligence in the medical world: An interview with Dr. Nina Ahuja

Dr. Nina Ahuja and David Cory talk stress management and other EI competencies in the context of practicing medicine and Nina's new book.

This spring, David Cory, president of The Emotional Intelligence Training Company, sat down to interview Dr. Nina Ahuja. 

Dr. Ahuja is an eye surgeon based in Hamilton, Ontario. Having gotten her medical degree from McMaster University, she is currently the McMaster Ophthalmology Division Head. She is also an EQ-i 2.0® Certified Practitioner. Her book, Stress in Medicine, speaks about the unique stresses that physicians face in their line of work, as well as challenges they have expressing those stresses in a work culture that is often silent about these stresses. She also started the initiative Docs in Leadership, a leadership development program for physicians that incorporates emotional intelligence as a key factor in its training.

David and Dr. Ahuja sat down to talk about her new book, Docs in Leadership, medical practice under COVID-19, the evolution of medical practice, how emotional intelligence has been beneficial in Dr. Ahuja’s practice, and how the field of medicine could benefit from a greater awareness around emotional intelligence.

Transcript

This transcript has been edited for length and clarity.

David Cory: Hi, Nina. Welcome. It’s so great to see you. Thanks for agreeing to do this today. I just can’t wait to dive in and learn more about you and learn more about your book. Why don’t we start with you telling us a little bit about yourself. I mean, you did a great job in the book. I thoroughly enjoyed it, by the way.

Let’s start by getting to know who you are, what you do, and what prompted you to write the book. 

Nina Ahuja: Sure. Well, first of all, thank you David, very much, for the invitation to chat about this. To give you a bit of background, I’m actually an eye surgeon. I graduated from medical school in 1998 from McMaster University in Hamilton, did my residency at University of Ottawa, and then after that, came back to Hamilton and started my surgical practice, and I’ve been here ever since. During that time I was involved in a number of leadership roles, both at the university and hospital. So that gave me really good exposure to leadership. Physician leadership, particularly, recognizing that we don’t get a lot of training and leadership in medical school and that’s a definite gap. So that led me into more projects — one organization particularly which I created, called Docs in Leadership, where I promote and deliver a leadership education with the healthcare context in mind for physicians and health professionals.

And then that led me into writing this book, which was really triggered by the COVID pandemic, where in the first wave, as ophthalmologists, we were told to close because our procedures are elective. So we were only working in those areas where it was required for emergency care: trauma, emergency room consults, things like that. But as far as regular practice went, my office was closed for three months. And during that time I was still engaged with my academic leadership role as division head for ophthalmology at McMaster. Through that, I was seeing that the residents and medical students were facing a huge amount of stress, just with the uncertainty that loomed with the pandemic and disruptions in their curriculum and things like that. 

When I was learning about that and hearing about that, it actually helped me and forced me to reflect back on my own experience in medical school. And I realized that a lot of the challenges and stresses that I faced back then were still very much alive and well, unfortunately, today. And so for me not having had an opportunity to really focus on one thing because — I have always been involved in multiple things — the closure with the pandemic really gave me a chance to sit, put my thoughts together and write this book as a passion project, really. So that’s how that came about. 

David Cory: That is awesome. I love that you took that opportunity and you made the best of a bad situation. You couldn’t go to your office and couldn’t do your practice in the regular way, and so you took the opportunity to write a book. I think that’s the thing. Congratulations, by the way. It’s a wonderful book and I hope that a lot of people read it, and I hope that a lot of people can gain some really great things from it. 

You talked about the students, but who do you hope reads this book?  

Nina Ahuja: The audience actually for the book is broad. So, if you look at the primary audience, it’s certainly students in all health professional programs:  medical students, nursing students, residents, even early career physicians. And part of the reason I think it’s important to them to be exposed to it is the idea that it’s normal to have ups and downs, but to also offer that tool where people have a way to look at stress and hopefully turn it into something that’s more positive and growth oriented.

The secondary audience… I would love for health policymakers to read the book. I think it’s important for them to have insight into what happens on the front line, so that when they’re making various decisions, they’re aware that what they decide actually impacts us in very tangible ways on the front line — in the course of delivering patient care, but also in our own experience of what we’re doing as well.

The next audience is the general public and anyone who is dealing with stress, because it’s presented in a medical context that shouldn’t feel limiting to anyone. Because the principle behind the book is really to break that culture of silence where we’re not necessarily comfortable about talking about the stresses and challenges we face. So the idea is that whether you’re in medicine or not in medicine, we all face stress, especially now with the pandemic in so many ways. And so we should feel comfortable talking about it and then seeking support for that as well. So in that sense, the audience really spans everyone. It just depends on where you’re at and if you’re in the position of being able to receive that idea of breaking that culture of silence. 

David Cory: I totally get that. I got a lot from the book and I’m not a physician, and, have physicians in the family and certainly have my experience of being a patient. And through our company, the Emotional Intelligence Training Company, we have done a lot of work with physicians in medical associations and in hospital settings. So from that perspective, I totally agree that I think you could be pretty much anyone and get something from the book. It’s like, “oh, that’s interesting, because I have that experience of healthcare,” and “oh, that’s what it’s like from a physician’s perspective,” and also I have my own challenges and stresses and struggles, and being more aware of how those, how I respond and react to those stresses, is just going to help me out. I think you did a really great job of that. 

Nina Ahuja: Thank you. 

David Cory: So the book came out on what date? 

Nina Ahuja: It was released officially December 1st.

David Cory: Okay. And what’s been the feedback so far? What kind of response have you gotten from people who’ve read the book? 

Nina Ahuja: To be honest with you, it’s been overwhelming in how positively it’s been received. People generally — whether they’re in medicine or not — they’ve received it in a way that is somewhat personal, in that people say “you know, we’ve come to understand you in a different way,” for those who’ve known me. For those who don’t know me, the reviews that I’ve been getting, the feedback I’ve been getting, has also been really positive and just supportive of the fact that I’ve been very open and honest in the book — in ways I never thought I would be, to be quite honest with you. I talk about some major disappointments that I did not think I would ever talk about openly, but I’m glad that I did. It seems to be helpful to people. 

And I’ve also had students approach me and say that, “you know, I’m at a juncture right now where I’m looking at what direction I want to go in and in terms of my career, and it’s really opened my mind up to how to think about things and you know, what is my motivation, what are my priorities? How does what I’m thinking or planning align with my values?” So it’s been really fascinating and humbling to have a lot of these conversations where people are clearly being impacted by the book in a positive way, which is what I was hoping for. So that’s been an amazing experience.

David Cory: Well, you were really vulnerable, and it’s a fascinating choice. You know, we often talk in our courses about this idea that there is a risk reward equation in operation with vulnerability, and the greater, the risk that you take, the greater the reward. Have you experienced that? 

Nina Ahuja: You know, that’s a great question. I feel like the vulnerability aspect for readers has given permission for people to talk about it. Not necessarily as openly as I did, obviously, within their circles and trusted, you know, amongst trusted friends and family. That’s some of the feedback that I’ve gotten for myself in terms of the risk reward ratio.

Writing those things was actually quite healing. To be honest with you, I was surprised how much I still carried with me some of the issues and topics that I talk about. I didn’t realize that a lot of that was actually impacting my own sense of self regard where you would really never think so. Outwardly, everything’s great: I’ve been blessed with a wonderful career, wonderful family, my health is stable, which is wonderful. But there were lots of things inside that I still carried with me that actually impacted how I looked at things and I didn’t quite realize it until I put pen to paper and really expressed my experiences.

It’s funny too, because some of those experiences I’ve spoken about in my trusted circles. But it was different putting it on paper and putting it out there. It’s healing in a different way. It may also be, I’m at a different point in my life where I feel if people are not able to understand, it’s okay, because I’ve done my own processing with it. But it was a good journey to go through, actually, for me, in terms of my own personal growth and development. 

David Cory: Now Nina, do you think that things are changing in medicine? What have you seen since you started your career to now? I mean, surely things have evolved somewhat.

Nina Ahuja: Yes, absolutely. I’ve been in practice now for 17 years, and over that time, I’ve definitely seen an evolution in general. And then also more specifically towards the physician experience in medicine. So in general, I would say that we’ve obviously had a lot of technological advancements; we’re now into the digital era, where virtual care is becoming mainstream, especially with the pandemic — lots of benefits to that. But there are also some downsides to some of the digitalization, I feel. 

For example, with electronic medical records— I talk about this in the book— it’s great for data gathering, but really impacts that interaction, where you’re not necessarily engaging person to person the way we used to, when you weren’t always having that computer screen in front of you. And to me, I think that there’s definitely value in sharing information between providers on different sites, especially for those centers that have regional EMR systems. It’s extremely helpful, but the day-to-day experience as a care provider is different. To me, that’s impacted the relationship with patients in a way that’s a little less satisfying as a healthcare provider, for myself anyway.  

David Cory: So you think it’s gotten worse at patient-physician relationships? 

Nina Ahuja: I think it’s twofold. From an access standpoint with virtual care, it’s certainly helped, because we’re now able to do assessments where we couldn’t before. For those people who, for example, had limited mobility, or transportation issues where they couldn’t reach out or come to the offices to seek care. It’s also offered more flexibility in terms of if a physician is able to do assessments from home. That can sometimes open things up. The expectations on the flip side, though, can be that physicians are always accessible, and we’re not, because we do have our lives as well. But I think that the benefits really do outweigh the disadvantages in that particular scenario. 

In terms of the interaction with patients, it depends on the personality. For myself, I’m very much aware of how that patient interaction is so important; to convey warmth and connection is so important. I can say that as a provider and as a patient myself. So I’m very mindful of those things in my practice. I think many of us are — I do think, though, that in the busy-ness of everything, where so much more time is having to be put into doing that recording, where writing something on a piece of paper would take me five seconds, and putting it into the computer takes me a minute because I can’t find the file. Those things impact the interaction that you have with patients. I don’t think they’re bad interactions necessarily; I just don’t think that they’re as connecting as they could be, particularly when you’re dealing with people who are in vulnerable states. To have that warmth is sometimes quite healing.  

David Cory: How are we teaching medical students more about emotional intelligence, about how to handle stress and how to understand more about their emotional impact on patient care? 

Nina Ahuja: The Royal College of Physicians and Surgeons of Canada does have a framework. They call it the CanMEDS framework, which outlines different competencies that they expect their residents to be competent in by the time they graduate. The College of Family Physicians Canada has a similar framework, if it’s not the same; I would have to double-check that. So there are competencies built in, but they centre more on things like medical expert, communicator, collaborator, leader. Not so much specific to wellness though, or emotional intelligence. We don’t really have formalized curriculum in medical education (around those topics) at this point in time. That’s one of the things that I’m trying to drive through Docs in Leadership. Some of the leadership curriculum that I’m delivering is trying to incorporate the ADMIT framework, which is my approach to looking at stress, as well as the emotional concepts with emotional intelligence, with the EQ-i 2.0® framework. I’ve attended your program and I’m thankful to have been certified.

So I’m trying to pull that all together and offer that to people. I’m also trying to engage the medical schools and post-graduate programs to bring this into curriculum. I think there’s more awareness now, which is helpful both on the education side and in the advocacy organizations. For example, the Canadian Medical Association now has a physician hub for wellness, which is wonderful. So the awareness is increasing. That’s certainly an evolution as well in medicine over the years, but there’s still work to be done to bring it formally into curriculum so that our residents, medical students, nursing students, and every health professional student, really, is aware of the concepts, how emotional intelligence impacts them, and how it impacts their interactions with patients and their colleagues.

David Cory: So ideally when would medical students begin learning about emotional intelligence in their training? 

Nina Ahuja: I believe that the earlier the better. I do believe that you have to have a certain level of maturity and acceptance to really be able to use the concepts of emotional intelligence and to develop them wholly. However, being aware of the concepts early on is important, so that as they move through their training and through their interactions with patients, and then working with mentors, coaches, and supervisors within the various programs, they can be taught how to assess, consider, and evolve in those competencies over time.

I actually think that emotional intelligence is good to teach to children as they’re being raised, so that they are aware of their surroundings and their emotions within those surroundings, and how what they do and say really matters in the world, right from when they’re as early as they can understand.

David Cory: Yeah, I think it’s the future. I think we’ll get there eventually.

Tell us about Docs in Leadership. How did you come to form this intriguing-sounding website, how did you come up with the idea, and what is your goal there?

Nina Ahuja: Docs in Leadership is also a passion project of mine. That originated through my observations in leaders over the course of about 15 years or so in leadership at both the university and hospital settings. Through my observations, I saw that some leaders — in particular physician leaders — were excellent at what they did: they were able to create really productive environments, bring teams together, and deliver those measurables that we were trying to deliver. But others were really underdeveloped and created toxic work environments — poor morale — and basically were also role-modeling behavior that was being observed by learners.

That was a major concern for me because I felt that certain behaviors are being accepted because someone’s in a leadership role. That is not the way to be, and certainly not a model to follow when it comes to them establishing and delivering their own careers and patient care. So for me, I recognize that there was a gap where there there’s no official formalized leadership training in medical education at this time. So that’s where I thought, “I’m going to establish an organization to promote it and also to deliver curriculum incorporating the different elements that I feel are very important,” one being health system literacy. So understanding, how is the health system structured? How does the money flow? What does it mean to be a regulated profession? And then leading into emotionally intelligent leadership, so that the skills that we’re using when we’re interacting with people as leaders are evolved enough that it’s taking that component into account. And then now with writing my book, I’m adding the stress management element to that, sort of layering things so that as leaders, we’re able to look at stress in a way that is considered productive from a growth mindset perspective. So that those who we lead and those who we teach can emulate that and hopefully learn that as well. 

So it’s a project that’s evolving. As time’s going on, I’m noticing a shift more towards leadership and emotional intelligence and stress management. That development, with the health system literacy part being something that I’m trying to relay a little bit more through posts and things like that, since those are more concrete things, whereas the leadership and stress management, emotional intelligence, are things that really do benefit from a true facilitation. 

David Cory: And is it just for docs?

Nina Ahuja: No, it’s not for docs. It was originally created for docs, just because, you know, in medical education, we lack that, but it’s certainly open to all health professionals. It’s certainly open to anyone really, because again, the concepts are universal. The examples are rooted in medicine, just because that’s what I know and that’s where we really need that development. But it’s certainly open to anyone who is interested. I’m actually going to be releasing the virtual dates for programming within the next few weeks, which will be offered four times a year, I’m thinking, as basically open registration programs. 

David Cory: Awesome. So will these be live online or will they be asynchronous? How would you plan to deliver those? 

Nina Ahuja: Initially I plan to do it live online and just sort of see what the response is, and hopefully getting a time that is cross-country friendly. So I’m thinking 10:00 AM to 1:00 PM on a Saturday, so people don’t have to worry about time off work as well. And then it’ll evolve. What I’ve seen with Docs in Leadership is it’s really been evolving. My first year, I delivered a full series curriculum to our medical staff at St. Joe’s, and then with COVID, unfortunately, the second year of that was canceled. And now just with everything that’s been happening with the pandemic and where the needs are and how they’re shifting, I’m now focusing more on the other side. So it’ll be four live sessions posted within the next couple of weeks for the dates. 

David Cory: Awesome. So Docs in Leadership, it’s kind of like you’re offering training or workshops or educational programs. Anything else that Docs in Leadership does? 

Nina Ahuja: Yeah, so right now it’s basically also in the role of advocating to bring this programming into different medical programs. It doesn’t have to be my leadership programming; I just want some sort of leadership programming in there. But by offering what I think is important, if programs want to engage within that, that’s fantastic. But the idea being that we have to have something in there not only for patient care, which is obviously of utmost importance to us, but also in interacting within the system; to be around the decision-making tables, you have to have certain skills and a certain knowledge set to really be able to contribute. So I’m advocating for that as well.

It’s also informational. I am doing blogs right now; I’m actually going to be working with Psychology Today, I’ll be doing a blog for them on high achievement and just the unique joys and stresses of high achievers. So that’s exciting. All of those things tie into all of that work. 

David Cory: Awesome. What’s been the response so far? I mean, has there been some uptake, people wanting to integrate more leadership into their medical education? 

Nina Ahuja: Yes, there’s been lots of uptake, actually. The session that I had run with St. Joe’s, there was a very good response, we had great attendance on that. I’ve been invited to give different talks at different universities across the country as well, to focus on leadership and stress. And in the medical programs at the post-grad level, I’m actually delivering formal curriculum to the residents at McMaster on what is physician leadership, conflict management, communication, different main topics like that. That is definitely something that the university has been very open to, which I’m hoping will cross universities over time. So it’s been good. 

The programs that are being offered right now — there are a number of organizations actually that do offer leadership programming — but the integration into medical education is now something that I would say is getting a lot more notice, and I’m certainly working very hard to make that happen more and more. We’ll see. But so far the response is good, but then the universities don’t have any money. So that’s a problem too, so you do what you can, right? But at some point the programs have to see the value in it and then invest in it for their students, with whoever they choose to invest in it for us. But yeah. 

David Cory: So Nina. We’re talking about healthcare. We’re talking about medicine. We’re talking about what was then, what is now. Comments on diversity in healthcare? Certainly with greater diversity, that’s going to solve some issues and create others. What do you see from your perspective?

Nina Ahuja: I think diversity, and the equity, diversity, inclusion (EDI) world is booming right now. It’s just exploding in both hospital organizations and the academic institutions. There’s definitely value in that. There’s no question about it. In terms of creating opportunities for diverse engagement at both the faculty level, as well as for admissions into different programs. 

The challenge gets to be where universities and hospitals — institutions in any organization — they have the policies, but it’s nice to have the policy, (but) you actually have to follow through with it. A lot of these policies have been existence in some form or another, but now with the attention that’s being brought to it, there seems to be a real drive and motivation to really look at these things and see what can be done on a practical level and on a large scale where it’s possible to really bring these policies to life. I think that it’s going to have a huge impact. I think it will be fantastic in terms of having the various voices at the table, and also for patient care as well, to make sure that there is representation in that patients, and physicians have that awareness that you know, you’re always going to be dealing in diversity.  There has to be that acceptance from the health care professional side, but also from the patient general public side, where attitudes overall, there is that movement that I’m seeing, which I think is going to be very, very positive if it’s really, truly authentically embraced by the people who are involved with it, which should be everybody, actually.

David Cory: It should be! Nina, How are hospitals and universities doing with respect to providing diversity, equity, and inclusion resources for staff?

Nina Ahuja:  It’s doing a good job. I would say that at our centre, we’re definitely on that road. I’m actually lead on a national EDI initiative for ophthalmology for Canada, as part of the group for academic chairs for ophthalmology nationally. With that, we’re looking right now at the admissions process; how we can bring equity, diversity, and inclusion into those processes, coming up with recommendations. We’re also doing that for faculty and student engagement, as well and potential student engagement. 

At the university at McMaster, they’ve definitely, within the different departments, are also creating EDI initiatives, goals, and objectives, and putting together resources for faculty so that they are accessible. What we’re pushing for, though, is that some of this training, at least core training, should be mandatory for everybody. I think there’s certain pieces that really need to be broadly implemented and implemented in a way that is absolutely a requirement.

The question and challenge then gets to be though that, okay, people have done these courses. How do you assess and measure that the follow through is there and that that behavior is consistent in day-to-day interactions as well? That’s where it comes to people, right? We’re always dealing with people with different personalities and we’re all within institutions and different groups that we engage within, and we all know what’s socially appropriate and what’s not. So how do you really get inside to bring those changes forward? I think that’s going to be the biggest challenge, beyond just having policy and resources available for people to access.

David Cory: Yeah. And some of those effects might not be known. For example, you mentioned some of the comments that come right from ignorance of diversity in your book, and hopefully there are less of those. Fewer of those kinds of comments and those kind of ignorant statements. I was absolutely shocked and disappointed when recently we had a Sikh physician commenting on the vaccination roll out. And the comments that came in following that, you know… “couldn’t they find a white Canadian doctor?” or something. It was just ridiculous, ignorant comments. And I think, “it’s 2021!” I mean, how are people still having those bizarre, crazy, ignorant ideas in 2021? I mean, don’t you just shake your head sometimes?

Nina Ahuja: Yeah. Absolutely. I wish I knew the answer, but you’re absolutely right. It’s present. Racism is present today and it’s a very disappointing thing. I do think things are progressing, but it’s definitely present today. We’re seeing that in so many different scenarios, right? With so many various populations. There’s a lot of work to be done. 

David Cory: On a more positive note, tell us about ADMIT. I love your little acronym, I think it’s great and I think people will definitely benefit from knowing about ADMIT. So tell us about that. 

Nina Ahuja: ADMIT is a five phase framework that I created that summarizes my approach to managing stress that I’ve developed and learned over the years. It’s an acronym where each letter stands for something — which I’ll go through in a second — but the idea is the reason it’s coined ADMIT is it encourages people to admit what you’re feeling. 

David Cory: You know, right there, having known a lot of physicians in my professional career, isn’t that a challenge? And physicians are not the only professional group to have this notion that it’s difficult to admit things, it’s also a bit of a challenge, isn’t it? 

Nina Ahuja: It is. And so much of it is because in medicine and other professions, it’s such a competitive environment; you’re surrounded by very high achievers, everyone’s done really well. And for you to be open about challenges that you’re facing, it’s often not something that we feel comfortable with because we don’t want to be judged by the people around us, who we respect or admire. So that’s really where part of that hesitation comes from.

So the ADMIT framework. Going into it, the A stands for adapting to new ways; D stands for doing the work; M is measuring success; I is for introspection; and T is for transformation. So the idea is that what I noticed — over the course of my career and just reflecting on different challenges that I faced personally and professionally — I found that my primary struggle was in one of those five categories. For example, it may have been adapting to a new idea. So the idea that, for example, when I was diagnosed with rheumatoid arthritis, it was adapting to that idea that “wait a second, I have a condition here that could significantly impact my surgical career.” So how do you change your perception to say “okay, this is something I have to accept. What can I do to drive that acceptance, what drives my motivation to do things and to adjust to things? Is it because I’m worried about what everyone else is going to say? ‘Here’s someone who’s got this condition and we don’t want to see her,’ or is it that I’m going to do everything that I can to make sure that I feel satisfied that I’m doing the best that I can and providing the care that I can, regardless of what others say about the fact that I have this condition?”

And I’ve done very well with that, but it was a real mindset shift in terms of, how do you accept that new idea and new reality? And then from there it’s, “okay, now I’m accepting this idea. So what am I going to do about it?” How am I going to go about that so that the outcome that I see for myself, which is to be a successful surgeon, step-mom, wife, daughter, family member, community member, what am I going to do to really make that happen? And then what is my measure of success going to be; what am I going to look at internally to make me feel satisfied that I did the best that I could? And then if there are external measures that need to be taken into account, then what are, what are those going to be like? So that it’s reasonable, given my reality as compared to someone else’s. 

And then introspection, you go on to that phase where it’s really thinking and reflecting within yourself to understand what emotions are coming up. This is where the emotional intelligence piece is so important. What emotions are coming up? How am I responding to that? How is that impacting my interactions within myself and with other people, and how can I adjust and develop that side of myself so that it is productive and supports that growth that I’m trying to go through and all the other phases. And then that leads to T, which is transformation. We really try to internalize those different elements so that the next time you face a similar circumstance you’ve got that “muscle memory” to deal with that situation. And then you just build from there so that the next challenge, whatever phase is primary, you go into that.

So if it’s, you know, you’ve got so much work to do, how am I going to get this done? You go into that doing phase, and then you can kind of track it with the other elements of the ADMIT framework to really try to pull it together. And overall, hopefully minimize stress, because you’re coming out with somewhat of an action plan that’s rooted in growth. So that’s the idea of the framework and how it can be applied. 

David Cory: That’s fantastic. Thank you, Nina. One thing that you mentioned that I just want to talk about for a bit is that you’re doing a blog about high achievers. And I find the emotional intelligence that the EQ profile of high achievers fascinating. In some cases, and I don’t know if this is true for you — you can tell us or not tell us, it’s completely up to you — but sometimes self regard, one of our components of EQ, is a bit low for high achievers. And the reason is because they set the bar so high for themselves that it’s never enough. There’s always that gap. Can you speak to that? Is that true for you?  

Nina Ahuja: So that is definitely true, I think, and has been true for myself up to a certain point. And the reason I say that is a lot of the times, I think as high achievers, you don’t even realize that that’s the case, because you’re just constantly driven to achieve and you’re driven to produce and perform and all of those different things. The reason I say up to a point for myself is that I think the first actual conscious realization I had that that was the case is probably about 10 years ago. In my book, I write about how I’m twice married, my second marriage, I’m so blessed to have a wonderful marriage. My first marriage was not successful for other reasons. But within that, subsequent to that, I was working on projects where I was keeping myself busy and I was trying to develop skills and I was, you know, doing different things professionally to really regain a sense of self regard that I felt that I had really lost as a result of my interactions in my first marriage. Unintended or intended, that was just the outcome that that happened.

And so I remember a close friend actually said to me that, you know, “when is enough gonna be enough?” And that’s when I realized, and it made me really think about what is my motivation for what I’m doing? And at that point, I realized that I did still carry some insecurities with me and that perhaps this was my way of getting some validation. And that actually became even clearer when I wrote the book, and I realized, when I talk about my licensing exam, I realized that I still carried that with me. And so it made me think how much of what I was achieving was rooted in that need to fulfill that piece of self regard. 

What I did notice when I was reflecting though, as I wrote the book is that that element of self-regard was no longer a motivating factor for me once it had been identified way back when. Because when it was brought to my attention, I started looking at things differently and pursuing things more from kind of an internal motivation aspect, as opposed to an external measure aspect. And so when I made that shift, I found that my bucket, so to speak, was becoming more and more filled so that now when I’m doing different initiatives — and this has been the case for the last number of years — it’s really about maximizing my potential and saying, “Oh, what can I do? And how can I contribute? what is it that is going to make me feel connected to what I’m doing and make me feel as though there’s purpose to what I’m doing beyond what anybody else says, but what’s driving me internally?”

So I would say that the high achievement connection with questionable self regard, whether it be a high level of questionability or lower, it’s variable in people. I don’t think it’s universal, but I would definitely say that that’s a part of it that you really don’t realize unless you stop for a minute and say, “wait a second, what am I doing all of this for?” And like I said, that entire process was triggered when, when someone actually asked me that question. 

David Cory: Awesome. So what other EQ competencies, are you willing to speak about, Nina, in interview format? What are some strengths of yours, Nina? What do you rely on? 

Nina Ahuja: I think that for myself, one of the things that I really feel I’m very strong in is empathy. I think that I really do have an ability to understand where someone is coming from, or at least trying to put myself in their shoes to understand their feelings and how it’s impacting them. Not to say “oh, I know what you mean,” but to just have that space where they can express what they need to, and then to actually be in that with them. So, you know, hold the space and create that safe zone where they can express themselves. 

I do think that my self-expression also — as you can see, I’m talking a lot— I think that that’s fairly strong. And then I also believe that my problem solving ability is very strong, where I’m able to look at things from various perspectives. I’m flexible, which I think is another strength: open to different ideas. And then all of that basically feeding into, or demonstrating the fact that I do have that self regard, where I’m open to and secure enough to be challenged on different things.

I think that the self-affirmation part is also very very strong, where it’s not affirmation, but actualization where it’s very strong. Where I really do believe in doing things that help me feel that I’m contributing and that I’m really reaching my highest potential. So I think there are areas that I can definitely work on: assertiveness, for example, being one of them in certain circumstances.

But I think overall I’m very mindful of my interactions and how I engage, and I’m always trying to develop them. So hopefully they’re more or less balancing, as we talk about in our assessments. So yeah, but you could ask people around me. They could probably tell you more. 

David Cory: Yeah. You could do an EQ 360 and find out!

So Nina, what else would you like to speak about? What would you like anybody who’s watching this video to know more about you, or about the book, or about Docs in Leadership, or about medicine? What would you like people to know?  

Nina Ahuja: I think that one of the big things that I’ve learned is when you’re in a career, there are lots of possibilities within that career that really go beyond what your expectation is of what that career is. Never wouldI have thought when I started in medicine, that I would be teaching, be an academic leader, be in leadership at a hospital, start an organization, write a book. Those are things that were not really in the realm of possibility— that I’d be writing a blog for Psychology Today, I mean, I never in a million years dreamt that and I’m so grateful for the opportunity. 

So I think that that flexibility element, is really, really important, and to be assertive, in ways that you don’t hold yourself back from. Looking for new opportunities that can build on what you’ve already created for yourself, I think that that’s really, really important, along with the idea that seeking support, getting mentorship and coaching, and being willing to talk openly about the challenges that you’re facing. It’s so important because that’s when you’re able to draw in the perspectives of others, and doing so can open up worlds that you never would imagine. And with that, it all comes to communication and being open-minded and empathetic to other people’s positions in that everyone has their own point of view, but each point of view is valuable. 

So I think that those things are important and all basically root in being open-minded and flexible. I think those would be the key things that I would like people to take away; that anything’s possible if you’re willing to look for it, and if you’re willing to put in the effort. 

David Cory: Thank you, Nina. What drew you to the EQ-i, the emotional quotient inventory? Why were you looking for something like that? 

Nina Ahuja: I’ve come to learn over the years in my various interactions that emotional intelligence is absolutely central to having productive relationships, and productivity in general. I really do think that in order to be able to work together in ways that are most constructive and productive, people need to be able to relate. So that was one key reason.

The other thing is with the curriculum I was delivering in Docs in Leadership, having learned what I just mentioned, I thought it was really important to be solid in that framework and to have a really good understanding of the concepts — how it applies, how you can coach people through that — so that when I can incorporate that into my curriculum, it’s coming from a real place of understanding and knowing. So I can relay that information appropriately to those people that I’m working with. That was the draw.

David Cory: The online assessment?

Nina Ahuja: The online assessments with the EQ-i 2.0®, you mean?

David Cory: Yeah, yeah. 

Nina Ahuja: Online assessment is really valuable. I think it’s accessible to many people; it’s something that you don’t have to physically be able to engage in. The other thing is the EQ-i 2.0®, I think, is a fantastic tool because it really does talk about the balancing aspect of the different competencies, which is unique. I see that as unique compared to some of the other tests where it’s got evidence behind it, and it really is something that can be applied and utilized by people in their day to day where it’s tangible, almost. Concepts of emotional intelligence and emotional growth otherwise are kind of abstract concepts. So I like the fact that this roots it into something concrete, where you can actually measure and remeasure, over periods of time, to see where that growth has actually happened. So I think it’s a really important tool. 

David Cory: Are you getting a chance to use it much?

Nina Ahuja: I have to some degree. I’ve actually been using more of the concepts; I did some coaching early on after the certification with a number of physicians and really got some insight and confirmed what I thought a lot of the concerns and areas of development were where they were required. So now I’m kind of hedging a little bit more out of the assessments and getting more into the actual curriculum, and let’s incorporate it and get this out there.

David Cory: Awesome. Nina, I think those are pretty much all my questions. Thank you so much for agreeing to do this once again. And we’ll put up the information about the book and the title, and tell people where they can get it. Anything else that you want to add?

Nina Ahuja: No, I would just say thank you so much for the opportunity, and also for your fantastic certification course that I thoroughly enjoyed in Ottawa. It was great meeting you and your team was just fantastic. I just really appreciate everything you’ve given me. That’s allowing me to then pass it on. So thank you. 

David Cory: Thank you, Nina. And thank you for all the wonderful work that you’re doing and in helping to evolve healthcare and medical education. I think it should be mandatory reading for every physician on stress in medicine. I think it’d be very, very helpful.

Nina Ahuja: Thank you. 

David Cory: So thanks, Nina! All right. 

Nina Ahuja: Thank you! Bye. Have a great day. 

David Cory: Bye for now. Take care. 

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