What can the University of Michigan’s Cardiology Fellowship training program teach companies like Uber, Lyft, and Airbnb? A lot, as it turns out!

Like Uber and its counterparts, the Cardiology program is part of a fluid “gig economy,” centered on a workforce that is “here today, gone tomorrow.” The Cardiology program is three years long, so a third of its participants leave each year and are replaced by a new cohort of student-employees.

And just as Uber and its counterparts are creating a new approach that runs counter to the way business has “always” worked, Michigan’s medical school decided to create a program that runs counter to the entrenched cultural norms which have defined medical training across the country for decades.

How do you create—not to mention sustain—a healthy, coherent, culture in such an ever-changing environment, in the face of entrenched modes, without a road map from previous pioneers? What does culture really mean and how does it get defined in a fluid organizational setting?

The University of Michigan Cardiology Program’s story

Program Director Dr. Peter Hagan’s solution was to empower the program’s fellows to build the program and the culture they wanted. “You need some people who are going to be your champions, who see the vision or have the ideas,” he says. Hagan created forums for discussion and idea generation, and started with small projects suggested by the fellows—barbecues with faculty and alumni, more time for informal socializing with peers, even a fleece emblazoned with the program logo. “Basically, fellows came up with ideas, and said, ‘I want to do this,’ and off they went.”

Small wins led to deeper-rooted projects involving curriculum, redesign of workspace for greater peer collaboration, and incorporating culture as a core component of the recruiting process.

“We want to empower and leverage our fellows to be builders,” says Hagan. “We want to develop a strong culture, a culture of ideas, a culture of support and openness. We want to improve that sense of community and energy.”

Culture take-aways for fluid organization

What can Uber, Lyft, et al learn from the University of Michigan’s Cardiology Fellowship training program? Here are five “thought starters” about how to create and sustain an organizational culture in a fluid employment environment.

1. Identify the story-tellers in your organization. Even in fluid workplaces, there are idea champions everyone listens to. Get them on board. Get their perspectives. Help them shape the narrative.
2. Cultivate a vision of an Organization. Help those who view the job as a “gig” see themselves as members of a community—members with an explicit role in furthering that community’s goals.
3. Find the people who have energy, and hand them the keys to the car. The work has to spread beyond the story-tellers. You won’t reach everyone, and you won’t have the luxury of a slow assimilation process. You need to give the doers a rhythm for reflection and dialogue about the culture and show them how to translate ideas into action.
4. Use the rapid employee life cycle to energize the culture work. Fluid organizations have an employee lifecycle on steroids. Embrace this reality as an opportunity to define many touch-points to the culture work: during recruiting, onboarding, and exit interviews. You could even consider asking former employees to come back to reflect on their experiences.
5. Study the impact of the culture work. Experience suggests that the work will be judged by the degree to which it empowers people to address some of the real challenges they face and do better on the real outcomes they care about.

Whether or not the gig economy survives is yet to be seen. But if it does, it will need to address internal cultural challenges. The University of Michigan’s Cardiology Fellowship training program has pioneered an approach they can all learn from.

This post was adapted from a new article in the Denison Transform series. Download the full article here.