In medicine, we are all familiar with the lofty ideal of the “triple-threat” academic physician. This concept, introduced back in the 1960s, defined the pillars of academic medicine as clinical care, research, and education. As the landscape of medicine evolved over the past few decades, this old paragon is disappearing. Especially in the field of hematology and oncology, with its rapidly evolving new therapies and increased sub-specialization, academicians are unable to distribute their time evenly amongst those three pillars, often focusing their efforts on one or two.
Research productivity is gauged via measurable scholarly metrics such as successful grant applications, procurement of funding, establishment of clinical trials, and indexed publications. Clinical care translates into relative value units (RVUs) and an expectation to accommodate a certain number of patient encounters in clinic. The educational pillar, however, often poses a significant measurability challenge. How can one capture the impact of an effective educator on learners’ competency and career advancement? How do you record hours spent on mentorship and support of trainees? How can you quantify bedside teaching during patient encounters?
Academic promotions, tenure, and recognition in the field are usually dependent on research productivity, with a mounting pressure on academicians to conform to that specific niche, occasionally going as far as stigmatization and delays in promotion of those devoting their careers to non-research endeavors. This leads to a talent drain of clinician-educators who are passionate about mentoring and teaching the next generation of physicians. It also contributes to the ongoing epidemic of physician burnout as some are forced to conform to job descriptions that do not fit their talents or passions.
As a currently job-seeking third-year hematology oncology fellow, I wonder about the best way to establish myself as a clinician-educator in today’s academic landscape. As an academic internist prior to pursuing my subspecialty fellowship, I reflect on what I learned back then and attempt to incorporate these lessons moving forward. Here are a few thoughts for anyone on a similar career trajectory.
First, you must determine what your ideal job description looks like.
Often in fellowship, there is a limited exposure to various practice settings and career paths. Trainees may think that it is a choice between either a traditional private practice devoted solely to patient care versus a clinician-investigator or physician-scientist academic track. The reality is that various hybrid models exist in between, and job roles can be tailored according to your skill set and the institutional needs. Based on the type of clinician-educator you envision yourself to be, you may decide on working at a bigger academic institution with trainees at various levels or at a community practice with academic affiliations and a faculty appointment at an associated medical school or training program. Ultimately, an honest reflection on what brings you joy is a must! You are looking for the appropriate cultural fit and institutional structure that conforms to your long-term career goals.
Create and maintain your “teaching portfolio.”
A teaching portfolio serves to showcase your various education-related activities. Maintain a log of local and national presentations and grand round talks. Have you worked on relevant curriculum design or performance improvement? Have you served as a mentor for junior trainees? All of this highlights your commitment to the field and paints a picture of your career development over time. Draft out a teaching statement with that in mind as you apply for specific jobs. This can be a separate document in addition to your CV, or can be incorporated into the latter under a “Teaching/Mentoring” section. This is to emphasize your accomplishments thus far and to discuss the vision you wish to bring to your educator role, ultimately building a case for obtaining dedicated protected time.
Pursue relevant committee work and leadership positions.
Explore current opportunities at your organization such as Graduate Medical Education, Residency Advisory Council, and Quality Improvement Committees. This helps you network with likeminded peers and allows for the exchange of ideas and potential collaborations. Delve into new roles that can help you develop new skillsets and discover new interests. What may start out as a voluntary, part-time commitment can lead to further opportunities and leadership positions. When looking for jobs, learn about the new organization’s structure and what available positions are there that can be of relevance.
Explore available professional development opportunities.
Perhaps an advanced degree in education or quality improvement is relevant to your specific focus. Many institutions provide tuition reimbursement to their faculty members. On a national level, there is an increased focus on providing tailored resources towards professional development in this arena by various societies. Examples include ASCO’s Education Scholars Program and ASH’s Medical Educators Institute.
Your work can be translated into research productivity.
As publications remain a cornerstone of academic merit and promotion, remember that there are avenues to showcase your work. Explore relevant journals, societies, and conferences that support educational research. Did you redesign a curriculum and measure its impact on learners? Did you implement an innovative educational measure? This work can be published and can serve to guide other clinician-educators. Funding is also available through various educational grants, both on an institutional and national level. Quality and performance improvement work is increasingly recognized and can serve as the cornerstone of various educational initiatives, providing measurable outcomes.
Furthermore, “digital scholarship” is emerging as a platform that is nowadays accepted for its impact potential. With the evolving role of social media, educators are finding a wider audience to connect with via “Tweetorials”, blog posts, and podcasts. Some include that as a separate heading in their CV.
Seek out mentorship and collaboration prospects.
Remember that you are not alone. There are others who share your interests. If you cannot find a mentor or collaborator at your institution, then seek one outside via networking during conferences, through social media, or within professional societies. There are active communities on Twitter that can be found through hashtags such as #MedEd and #MedTwitter. @HemOncWomenDocs is a community of subspeciality hematology oncology physicians with women providing support and mentorship to other women. The #HeForShe movement is also active with men mentoring and supporting junior women. Professional societies offer various networking opportunities that can fit your career goals. Explore ASCO’s array of mentorship opportunities.
There is often pressure during fellowship training to focus more on research productivity over other metrics, and trainees may feel that the pathway to academia lies solely within a clinical-investigator track or a research-scientist track. The reality is that there are multiple paths, and each of us can carve out a specific niche. There is a need for clinician-educators, and while the job description and criteria for promotion are less straightforward, you can create and develop your role. In a recent job interview, I was asked to talk about my “favorite educator moment” and I could immediately think of several highlights along my career. It was a reminder of the joy of pursuing what one is most passionate about.
What is your “favorite educator moment,” and what tips do you have for someone pursuing an academic clinician-educator path?