Working with Friedrich Mohr—the Resident's View
27 February 2017
27 February 2017
07 April 2017 (online)
Prof. Friedrich-Wilhelm Mohr was a trainer, mentor, and role model for more than 100 residents and fellows during his time as an active cardiac surgeon and clinical director at the Heart Center Leipzig. Not everyone who started in cardiac surgery completed the training in this fascinating field. But, independent from their decision for or against cardiac surgery, Prof. Mohr was a distinguished mentor for all of them.
Prof. Mohr's experience during his own training in general and cardiac surgery played a leading role in his attitude toward the youngsters. He was trained by not very well known, but impressive mentors, Prof. Paul Gerhard Kirchhoff and Dr. Gottfried Michael Maintz. Both, Prof. Mohr always called them “real gentlemen,” trained him in surgery with a balance between support and expectation. His mentors told him to solve problems with calmness and caution. They had confidence in him, also in situations when he made mistakes. This experience taught him that mistakes and dealing with them are an integral part of the development of an outstanding surgeon.
He passed this experience on to his own residents in an impressive manner. His key characteristics as a mentor can be described as follows: trustful, open minded, straight forward, honest, and friendly. His personal confidence and support during all phases of one's training were the central columns in the working relationship with the residents. He understood his mentorship as “helping hands.” Prof. Mohr supported his staff during the whole training, but on the other hand, he demanded adequate knowledge and competence on the respective education level. It was a balance between “helping hands” and increasing expectations during the training.
For most of the residents, the application interview was the first personal contact with Prof. Mohr. During this conversation, he was more interested in their private life and interests as in their school grades. But two questions were very important for his decision. “Do you really want to be a cardiac surgeon?” and “Why do you want to be a cardiac surgeon?” Retrospectively, he was only looking for the right “guys,” both male and female, for the job. Endurance, purpose, and passion for cardiac surgery were the character traits for which he chose his residents.
The integrated curriculum in cardiac surgery in Leipzig is very special and significantly differs from the rest in Germany. It was Prof. Mohr's philosophy to keep the whole department in surgeons' hands. This curriculum is also known as the “Leipzig School of Cardiac Surgery.” He believed that, to become good in cardiac surgery, you “have to broaden your horizon” and that it is crucial to learn not only cardiac surgery but also everything around it, including echocardiography, intensive care medicine, etc. For a junior resident, the clinical rotation started with a 6- to 12-month training on the normal care ward. In this phase, the resident should learn and practice the basic concepts of pre- and postoperative patient care. Afterward, the trainees rotated for 12 months to the intermediate care unit, followed by a 24- to 36-month rotation on the intensive care unit. In this phase, the trainees learned to handle the whole range of critical patient care. The special feature of that rotation was that all decisions regarding the therapy, invasive and noninvasive diagnostics, and all interventions must be performed by the resident under the supervision of two senior intensive care specialists. The basic idea behind this concept was that the trainees learned how to work independently and to develop treatment plans to handle the intra- and perioperative complications, and to become aware what can happen during cardiac surgery. Furthermore, the trainees developed confidence in making their own decisions. So, during the first years, they became rather intensive care specialists instead of surgeons, but Prof. Mohr always insisted “to do the less important things with the same commitment as the important things.”
Afterward and finally the “real” surgical training during a 24- to 36-month rotation in the operating room began. “Stay calm, operate step by step, do not be disturbed by the length of cross-clamp or the perfusion time” was one of his famous sentences before a resident performed his first pump case. Knowing what to do, but finally learning by doing was the way to go. He trusted the residents and let them work independently. Therefore, it was not rare to hear from Prof. Mohr: “Just start the operation without me and call me when you need help!” When eventually things became tricky and one urgently needed help, he came and solved the problem in a calm and friendly manner. Afterward, he said: “In cardiac surgery, it is OK to make a mistake, but you have to be able to sort it out by yourself.” Everyone inhaled his surgical wisdom and will always remember his tips and tricks.
Another important point for Prof. Mohr was innovation and research. It was mandatory that the residents did not only follow their medical career, but also their scientific advancement. He was always open to new ideas and supported proposed projects. Some outstanding residents got the chance to do a research fellowship for 1 to 2 years, either in our own research laboratory in Leipzig or even abroad where one could benefit from Prof. Mohr's international connections. We believe this is not common practice everywhere and one should be grateful for these opportunities.
Taking everything together, being a resident under Prof. Mohr's supervision was a great pleasure. He was never just the boss, but more of a fatherly friend. Someone whom you respected at any time, but whom you could also enjoy having a beer with. He was always open-minded toward the residents and listened to their ideas and concerns. He asked a lot from his colleagues, but he also gave back a lot and always shared the credit of success. “Work hard and play hard” was his motto and that is what happened in Leipzig.
After a work-filled day in the operating room, he often came to the ward for the daily evening round. After every round, he took the time for discussions with the residents about cardiac surgery, clinical cases, but, even more important, about life. Once he spoke about light and shadow of our profession and after a few minutes he closed with the words: “We really have the most fascinating job in the world.”