Guests Dr. Sue Farrell, Harvard University and Dr. Caroline Okorie, Stanford University, discuss careers as clinician educators. They share their own roadmap for advancement in academic medicine while reflecting on the concept of ikigai. We review tips for success for academic clinicians across the spectrum- how to create your strategic plan, think about advancement, and integrate scholarship into your work.
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Dr. Susan Farrell, MD, EdM, is the Associate Dean for Assessment and Evaluation at Harvard Medical School (HMS). She has worked in medical education at HMS since 1998, as the Director of Student Programs in Emergency Medicine, as a course tutor and lecturer, as the Director of the HMS 4-year OSCE Program, and co-leads the interprofessional education societal theme. She also co-directs the Harvard Macy program for post-graduate trainees who aspire to clinician educator careers. She is also actively engaged in certification efforts at the National Board of Medical Examiners and a Director of the Board of the American Board of Emergency Medicine. Dr. Farrell’s interests are in curriculum development, methods for assessing clinical skills and program evaluation, and interprofessional faculty development related to clinical teaching, assessment skills, teaming, and leadership.
Dr. Caroline Okorie, MD, MPH, is board certified in pediatric pulmonology, sleep medicine and general pediatrics and joined the Division of Pediatric Pulmonary, Asthma and Sleep Medicine in 2018. She obtained her medical degree and Master’s in Public Health at the University of Arizona before going on to a residency and chief residency in pediatrics at Oregon Health & Science University. She completed her fellowship training in both pediatric pulmonary medicine and sleep medicine at Stanford University. She has a passion for medical education and serves as an Associate Program Director for the Pediatric Residency Program at Stanford.
Medical training is linear with typically a clear path from pre-med to medical school to residency/fellowship. This quickly changes after graduation, when early clinicians have many options for their careers. Hearing stories of how mid-career clinician educators progressed through their careers can help early clinicians consider their future options.
Big C (clinician), little e (educator) suggests the clinician is focused on clinical care who have medical trainees working with that at times. Little c (clinician) big E (Educator) suggests that the physician is centering their academic career, scholarship work, or professional roles around medical education while still providing clinical care (Chang 2021). Dr Farrell highlights that we are, as physicians, here to provide patient care first and foremost; so even a cE physician should still have attention to optimal patient care as the foundation of their career.
Ikigai is a Japanese concept for ‘a reason for being’ which is the intersection of one’s passion, mission, profession, and vocation- finding a balance of what you love, what is needed, what you can get paid for, and what you’re good at. Dr. Farrell highlights that it may not be easy to find a perfect fit for all of these, you will need to make choices and trade offs along the way.
Find a mentor for writing. Having a successful career in academic medicine requires that the educator shares their skills beyond their immediate learners via publication. Writing can allow you to teach to a broader audience, and doesn’t mean you need to have new projects; instead, you share the work you are already doing.
Find a sponsor who can help elevate you to goal positions.
One person cannot make change in a large institution. Find like minded educators and build a coalition to shape your goals. Clinician educators need to work within a community- cooperate, be humble, and build consensus
You do not need to say yes to everything; there are only 24 hours in a day! Many early career CEs are trying to prove their value, want to collaborate, and are naturally hard working. Recognize where you have the greatest impact and what you most enjoy, and move toward that to find your niche and make a name for yourself. Having mentors can let you narrow these goals and decide what opportunities will bring you toward this. Pro-tip! When you say no to an opportunity, you can become a sponsor for someone else.
Your path can (will) change. You may think your career is heading in one direction and it may pivot over time; that’s ok!
Ask peers what they are doing. Gain inspiration from others.
A mid-career CE has been in practice for 5-10 years. In their early career, they have had time to explore a lot of options, and now need to hone in on primary interests or niche. They have developed some skills, expertise, and recognition in areas of focus. Dr Okorie encourages CEs in this phase to explore and apply for leadership roles. While there may be uncertainty, she reminds listeners to feel confident that they are experienced enough to apply and succeed.
These ACGME Milestones were published in 2022 to support clinician educators’ self reflection and individual growth. They are not meant to be used for promotion or monetary reward.
5 Competency Statements
The milestones can both help push CEs to evaluate their teaching in a more holistic way and help CEs narrow in on goals or identify next steps in development (Heath 2023).
After training there are different career paths for academic clinician; having a strategy for progression is important (Santhosh 2019). One approach is to narrow primary areas of interest. Take the first years out of training to explore options for your career. Meet with mentors, peers, and division chiefs to help weigh options. Dr Okorie recommends, “see where you come alive.”
Look at institutional requirements for promotion; learn what is expected at different levels. Everyone’s path will look different; there are many options. Try to consider a 2-3 year plan or a 5 year plan, even if a 10 year plan feels too abstract.
Learning from other professions can be helpful too. Dr Okorie recommends Essentialism by Greg McKeown to help center what is important and build agency around shaping your future. When offered new opportunities, your response should be a “Heck yes!” Or a “No.” “Give up really great things to do amazing things.” She also suggests Atomic Habits by James Clear to help think about re-making habits. Mid-career work can be an exciting time but also a scary time. Bounce ideas of friends, mentors, and senior faculty. Getting perspectives from multiple people can be valuable; learn from others. Dr Okorie recommends cold emailing people whose positions you admire and ask for 15 minutes to talk about how they built their career.
Dr. Okorie is looking into more fellowship leadership/teaching opportunities. As a pediatric pulmonologist, she wants to inspire other pediatric specialists and to help trainees reconnect with the joy of clinical medicine or research. She wants to focus on educating and empowering parents more- helping parents take back control of their child’s health. Dr. Okorie considers what she is doing now, what she is spending her time on, and asks, are these furthering her passions or are they roles she should transition to others as they don’t align with her future focus?
Start thinking about advancement early, check in with a mentor or division chief sooner than you think (6 months into a new position). Join in institutional workshops or webinars to review institution guidelines or requirements very early on. Explore professional society career development resources.
Feel comfortable moving out of the trainee mode, accept your role as an expert (or building toward becoming an expert). It is ok to take on new roles or opportunities while scared or uncertain; everyone has a first time.
Evidence shows bias does exist: being a woman or a person of color contributes to inequities in career advancement (Lee 2023, Crown 2021). Forming a community and learning from mentors can help mitigate this. Talk to others about how they overcame this.
Dr. Okorie reframed scholarship as not just writing to write. Scholarship is meant to share knowledge and advance ideas. If you have a new way of doing something- curriculum design, promoting an inclusive environment– you can share your pilot and allow others to build off of that. She appreciates all the helpful resources she has found in the literature and wants to (add to it and) pass that assistance on (Sherbino et al 2014, Roberts 2020).
Dr. Okorie has found it helpful to focus on topics for publication about which she is already passionate. She suggests focusing on something you are already doing, highlighting work that will be most valuable for others in the same academic community. Partner with colleagues for accountability.
If you want to be a clinician educator, you are so wonderful for wanting to do this! It is an important and valuable career.
There is a path for progression and advancement in a CE career. Consider the CE milestones for reflection. Get support or advice from peers, mentors, and those you admire.
Use your early career to explore many options. As you move into mid-career, be more of an essentialist–say no to things that don’t align with your path.
Feel ok that your path might change.
For faculty: Program for Educators in Health Professions.
Listeners will identify strategies to launch into and advance in clinician educator careers.
After listening to this episode listeners will…
Dr. Sue Farrell and Dr. Caroline Okorie report no relevant financial disclosures. The Curbsiders Teach report no relevant financial disclosures.
Ue F, Farrell S, Okorie C, Heublein M, Kryzhanovskaya E, Connor M. “#36 Launching a Clinician Educator Career. The Curbsiders Teach Podcast. https://thecurbsiders.com/teach June 27, 2023
Script, Guest Selection: Frances ue MD MPH
Infographic, Cover Art: Megan Connor MD
Hosts: Frances ue MD MPH, Era Kryzhanovskaya MD, Molly Heublein MD
Show Notes/CME: Molly Heublein MD
Editor: (audio materials) Podpaste; Frances ue MD MPH, Era Kryzhanovskaya MD (written materials)
Guests: Sue Farrell MD EdM, Caroline Okorie MD MPH
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