EDITORIALS A Foothold for Clinician Educators Jennifer W. McCallister The Ohio State University Wexner Medical Center, Department of Internal Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Columbus, Ohio
The face of academic medicine in North America has changed significantly over the last 40 years (1, 2). Traditional promotion tracks requiring comparable achievement in research, teaching, and patient care are being replaced by more specialized pathways that focus on one, or at most two, of the three traditional missions of academic medicine. In 1987, survey data indicated that 61 (54%) of 112 medical schools offered nontenured clinicianeducator track pathways for promotion (3). By 2011, this had increased to 106 (79%) of 134 schools (4). The current career milestones for clinician-educators vary widely across academic medical centers. At some institutions, the focus remains on recognizing demonstrated achievement in the provision of quality patient care and excellence in meeting teaching requirements. At others, there is greater emphasis on achievement in clinically relevant original and collaborative research. At still other universities, clinicianeducators are now recognized foremost for academic expertise in education and for leadership roles in curriculum design and evaluation. Clinician-educators at these institutions are expected to be skilled teachers in a wide range of settings, from small groups to large classrooms, and from the outpatient clinic to the bedside in the operating room or intensive care unit. They are experts in curriculum development, evaluation, and assessment, and are often expected to assume leadership roles in the implementation of innovative educational techniques. Clinician-educators may hold additional leadership positions in education, where they direct individual courses or large components of a curriculum, whereas
others may assume the responsibility of leading a training program. Finally, clinician-educators increasingly participate in educational research and the dissemination of educational scholarship related to their work. Despite heightened expectations, clinician-educators continue to struggle with a lack of social identity within some academic medical centers (5), and local resources to support the track record of achievement needed for successful promotion may be limited (6). As the numbers of clinician-educators joining the ranks of medical schools and allied health professions faculties continue to increase, sponsoring institutions and professional societies must be prepared to respond. Together, they must create a culture that promotes success both through mentorship and by creating opportunities for collaboration on projects that lead to discovery, innovation, and dissemination of knowledge within a specialized field of medicine. This can no longer be a pathway of chance but, rather, requires planning and establishment of a framework that allows individuals who choose this career pathway to develop to their full potential. The American Thoracic Society (ATS) has long provided infrastructure for the science of investigation and clinical excellence and is well positioned to use this same culture to promote success for the growing number of career medical educators. Not unlike other members of the ATS, educators must be identified and targeted early to begin the mentoring process that is needed to cultivate a successful career, especially if they lack local resources. Although promotion criteria
for clinician-educators vary widely across institutions (6, 7), the ATS offers great value to this emerging group of members. It provides opportunities for educators to develop their national reputation in subspecialty education by offering opportunities for dissemination of scholarship, supporting educational research, and encouraging leadership positions in those areas that are focused on education. Those interested in joining the growing community of educators within the ATS will be well supported by joining the Medical Education Section of the Behavioral Science and Health Services Research Assembly. Newly formed in 2014, it includes members from the 13 assemblies of the ATS and at least eight different healthcare disciplines. The Medical Education Section aims to promote the practice and science of education within the ATS while enhancing opportunities for career development. It also hopes to encourage networking and mentorship between its members, provide a framework for collaboration, and develop content for faculty development. Most importantly, the Medical Education Section will begin to attract and retain those members who are interested in education as a career, providing a talented pool of educators from which the ATS can develop future leaders in the field and support the investigation of education. The ATS has three committees that offer clinician-educators additional opportunities for engagement and networking within the society: the Education, Members in Training and Transition, and Training committees. Although each has its own unique purpose and goals, the committees work collaboratively to focus on the educational
(Received in original form February 15, 2015; accepted in final form February 23, 2015 ) Correspondence and requests for reprints should be addressed to Jennifer McCallister, M.D., The Ohio State University Wexner Medical Center, 201 Davis Heart Lung Research Institute, 473 W 12th Ave, Columbus, OH 43210. E-mail: [email protected] Ann Am Thorac Soc Vol 12, No 4, pp 465–466, Apr 2015 Copyright © 2015 by the American Thoracic Society DOI: 10.1513/AnnalsATS.201502-092ED Internet address: www.atsjournals.org
Editorials
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EDITORIALS mission of the ATS. Together, they uniquely focus on training the next generation of medical educators within the United States and worldwide. The groups develop programs that promote excellence in clinical and research training, support career development, and recognize the accomplishments of early career medical educators. Participation in these committees provides an excellent opportunity for professional growth and development within the ATS while allowing members to establish themselves as potential leaders at the national level. As momentum continues to build in this direction, it will become increasingly
important for educators to be recognized for their success and to have ample opportunity to publish their work. Clinician-educators will look for programming at the International Conference to meet their own educational needs and share their work. Arguably the most essential support the ATS can offer clinician-educators is a forum to share ideas and disseminate high-quality scholarship on subspecialty medical education for publication. When the Annals of the American Thoracic Society was reformatted in 2013 to be more relevant to clinicians, clinical researchers, and medical educators, it included the addition of a recurring series, ATS Reports:
References 1 Jones RF, Gold JS. The present and future of appointment, tenure, and compensation policies for medical school clinical faculty. Acad Med 2001;76:993–1004. 2 Coleman MM, Richard GV. Faculty career tracks at U.S. medical schools. Acad Med 2011;86:932–937. 3 Jones RF. Clinician-educator faculty tracks in U.S. medical schools. J Med Educ 1987;62:444–447. 4 Mayer AP, Blair JE, Ko MG, Hayes SN, Chang YH, Caubet SL, Files JA. Gender distribution of U.S. medical school faculty by academic track type. Acad Med 2014;89:312–317. 5 Sabel E, Archer J; Early Careers Working Group at the Academy of Medical Educators. “Medical education is the ugly duckling of the
466
Medical Education. Things have advanced quite a bit in the short year since Roberts and colleagues (8) launched that series with practical advice for planning an academic career in medical education. It is my privilege to have served as guest editor of the first full issue of the Annals dedicated to medical education. A career in medical education will still require thoughtful planning and initiative at the local level, but the infrastructure for success is also building rapidly within the ATS. n Author disclosures are available with the text of this editorial at www.atsjournals.org.
medical world” and other challenges to medical educators’ identity construction: a qualitative study. Acad Med 2014;89:1474–1480. 6 Yeh HC, Bertram A, Brancati FL, Cofrancesco J Jr. Perceptions of division directors in general internal medicine about the importance of and support for scholarly work done by clinician-educators. Acad Med 2015;90:203–208. 7 Beasley BW, Wright SM, Cofrancesco J Jr, Babbott SF, Thomas PA, Bass EB. Promotion criteria for clinician-educators in the United States and Canada: a survey of promotion committee chairpersons. JAMA 1997;278:723–728. 8 Roberts DH, Schwartzstein RM, Weinberger SE. Career development for the clinician-educator: optimizing impact and maximizing success. Ann Am Thorac Soc 2014;11:254–259.
AnnalsATS Volume 12 Number 4 | April 2015
The face of academic medicine in North America has changed significantly over the last 40 years (1, 2). Traditional promotion tracks requiring comparable achievement in research, teaching, and patient care are being replaced by more specialized pathways that focus on one, or at most two, of the three traditional missions of academic medicine. In 1987, survey data indicated that 61 (54%) of 112 medical schools offered nontenured clinicianeducator track pathways for promotion (3). By 2011, this had increased to 106 (79%) of 134 schools (4). The current career milestones for clinician-educators vary widely across academic medical centers. At some institutions, the focus remains on recognizing demonstrated achievement in the provision of quality patient care and excellence in meeting teaching requirements. At others, there is greater emphasis on achievement in clinically relevant original and collaborative research. At still other universities, clinicianeducators are now recognized foremost for academic expertise in education and for leadership roles in curriculum design and evaluation. Clinician-educators at these institutions are expected to be skilled teachers in a wide range of settings, from small groups to large classrooms, and from the outpatient clinic to the bedside in the operating room or intensive care unit. They are experts in curriculum development, evaluation, and assessment, and are often expected to assume leadership roles in the implementation of innovative educational techniques. Clinician-educators may hold additional leadership positions in education, where they direct individual courses or large components of a curriculum, whereas
others may assume the responsibility of leading a training program. Finally, clinician-educators increasingly participate in educational research and the dissemination of educational scholarship related to their work. Despite heightened expectations, clinician-educators continue to struggle with a lack of social identity within some academic medical centers (5), and local resources to support the track record of achievement needed for successful promotion may be limited (6). As the numbers of clinician-educators joining the ranks of medical schools and allied health professions faculties continue to increase, sponsoring institutions and professional societies must be prepared to respond. Together, they must create a culture that promotes success both through mentorship and by creating opportunities for collaboration on projects that lead to discovery, innovation, and dissemination of knowledge within a specialized field of medicine. This can no longer be a pathway of chance but, rather, requires planning and establishment of a framework that allows individuals who choose this career pathway to develop to their full potential. The American Thoracic Society (ATS) has long provided infrastructure for the science of investigation and clinical excellence and is well positioned to use this same culture to promote success for the growing number of career medical educators. Not unlike other members of the ATS, educators must be identified and targeted early to begin the mentoring process that is needed to cultivate a successful career, especially if they lack local resources. Although promotion criteria
for clinician-educators vary widely across institutions (6, 7), the ATS offers great value to this emerging group of members. It provides opportunities for educators to develop their national reputation in subspecialty education by offering opportunities for dissemination of scholarship, supporting educational research, and encouraging leadership positions in those areas that are focused on education. Those interested in joining the growing community of educators within the ATS will be well supported by joining the Medical Education Section of the Behavioral Science and Health Services Research Assembly. Newly formed in 2014, it includes members from the 13 assemblies of the ATS and at least eight different healthcare disciplines. The Medical Education Section aims to promote the practice and science of education within the ATS while enhancing opportunities for career development. It also hopes to encourage networking and mentorship between its members, provide a framework for collaboration, and develop content for faculty development. Most importantly, the Medical Education Section will begin to attract and retain those members who are interested in education as a career, providing a talented pool of educators from which the ATS can develop future leaders in the field and support the investigation of education. The ATS has three committees that offer clinician-educators additional opportunities for engagement and networking within the society: the Education, Members in Training and Transition, and Training committees. Although each has its own unique purpose and goals, the committees work collaboratively to focus on the educational
(Received in original form February 15, 2015; accepted in final form February 23, 2015 ) Correspondence and requests for reprints should be addressed to Jennifer McCallister, M.D., The Ohio State University Wexner Medical Center, 201 Davis Heart Lung Research Institute, 473 W 12th Ave, Columbus, OH 43210. E-mail: [email protected] Ann Am Thorac Soc Vol 12, No 4, pp 465–466, Apr 2015 Copyright © 2015 by the American Thoracic Society DOI: 10.1513/AnnalsATS.201502-092ED Internet address: www.atsjournals.org
Editorials
465
EDITORIALS mission of the ATS. Together, they uniquely focus on training the next generation of medical educators within the United States and worldwide. The groups develop programs that promote excellence in clinical and research training, support career development, and recognize the accomplishments of early career medical educators. Participation in these committees provides an excellent opportunity for professional growth and development within the ATS while allowing members to establish themselves as potential leaders at the national level. As momentum continues to build in this direction, it will become increasingly
important for educators to be recognized for their success and to have ample opportunity to publish their work. Clinician-educators will look for programming at the International Conference to meet their own educational needs and share their work. Arguably the most essential support the ATS can offer clinician-educators is a forum to share ideas and disseminate high-quality scholarship on subspecialty medical education for publication. When the Annals of the American Thoracic Society was reformatted in 2013 to be more relevant to clinicians, clinical researchers, and medical educators, it included the addition of a recurring series, ATS Reports:
References 1 Jones RF, Gold JS. The present and future of appointment, tenure, and compensation policies for medical school clinical faculty. Acad Med 2001;76:993–1004. 2 Coleman MM, Richard GV. Faculty career tracks at U.S. medical schools. Acad Med 2011;86:932–937. 3 Jones RF. Clinician-educator faculty tracks in U.S. medical schools. J Med Educ 1987;62:444–447. 4 Mayer AP, Blair JE, Ko MG, Hayes SN, Chang YH, Caubet SL, Files JA. Gender distribution of U.S. medical school faculty by academic track type. Acad Med 2014;89:312–317. 5 Sabel E, Archer J; Early Careers Working Group at the Academy of Medical Educators. “Medical education is the ugly duckling of the
466
Medical Education. Things have advanced quite a bit in the short year since Roberts and colleagues (8) launched that series with practical advice for planning an academic career in medical education. It is my privilege to have served as guest editor of the first full issue of the Annals dedicated to medical education. A career in medical education will still require thoughtful planning and initiative at the local level, but the infrastructure for success is also building rapidly within the ATS. n Author disclosures are available with the text of this editorial at www.atsjournals.org.
medical world” and other challenges to medical educators’ identity construction: a qualitative study. Acad Med 2014;89:1474–1480. 6 Yeh HC, Bertram A, Brancati FL, Cofrancesco J Jr. Perceptions of division directors in general internal medicine about the importance of and support for scholarly work done by clinician-educators. Acad Med 2015;90:203–208. 7 Beasley BW, Wright SM, Cofrancesco J Jr, Babbott SF, Thomas PA, Bass EB. Promotion criteria for clinician-educators in the United States and Canada: a survey of promotion committee chairpersons. JAMA 1997;278:723–728. 8 Roberts DH, Schwartzstein RM, Weinberger SE. Career development for the clinician-educator: optimizing impact and maximizing success. Ann Am Thorac Soc 2014;11:254–259.
AnnalsATS Volume 12 Number 4 | April 2015
