A survival guide for generalist physicians in academic fellowships part 2: preparing for the transition to junior faculty

A survey of the research practice in general medicine departments of Japanese universities: A cross-sectional study

BACKGROUND

Few studies have focused on research practice in Japanese university general medicine (GM) departments.

METHODS

This is a questionnaire-based cross-sectional study to clarify the research achievement and associated factors of Japanese university GM department. Univariate analysis was performed to compare the number of English-language research publications and explanatory variables.

RESULTS

Forty-seven universities responded. Over a 3 years period, the median number of English-language research publications was 6. Perceived degree of research necessity, staff numbers, collaborative research, conference presentations, and obtaining research grants were significantly associated with a higher number of English-language research publications.

CONCLUSIONS

While GM research output was found to be limited, numerous associated factors can potentially change Japanese GM departments' research environments.

Mentoring up: Twelve tips for successfully employing a mentee-driven approach to mentoring relationships

Effective mentorship is critical for achieving professional success, influencing outcomes such as career selection and advancement, self-confidence and performance, and sense of community and fulfillment. Despite the established importance of mentorship, however, mentoring relationships can be challenging to develop and sustain. 'Mentoring up' is a concept adapted from the business concept of 'managing up' that encourages mentees to actively drive their mentoring relationships to ensure desired results. In this article, we hope to empower mentees with twelve strategies and practical steps to cultivate and maintain quality mentoring relationships, and successfully drive their mentoring relationships in a direction that serves their needs and achieves desired outcomes.

Professional Development Track to Prepare Future Academic Clinicians

Professional development is instrumental in the success of professionals and trainees in academic medicine. In response to medical student feedback requesting additional professional development opportunities, the Foster School of Medicine developed a distinction program, the Pathway for Preparing Academic Clinicians (PPAC), designed to deliver sought-after skill development and foundational knowledge in the three primary activities of academic medicine: medical education, research, and patient care. This distinction program addresses a curricular gap as identified by students and common to many UME curricula and also provides an opportunity for residency programs to identify student achievement within a pass/fail program.

Surviving and Thriving as Physicians in General Internal Medicine Fellowship in the Twenty-First Century

General internal medicine (GIM) fellowships play an important role in the development of physician scientists and clinical educators, as well as leaders in academic medicine. Nevertheless, the challenges of developing another novel aspect to one's career, along with balancing coursework, research productivity, clinical duties, and personal life during fellowship, can be overwhelming. Similarly, successfully securing a job at the end of fellowship can be a daunting process. In this article, we discuss the foundational tenets and themes of the GIM fellowship. These themes include (1) finding your purpose and passion, with a focus on selecting research coursework and developing an area of study; (2) the role and importance of mentorship, including the various kinds of mentorship that fellows require (traditional and peer mentorship, sponsors, and coaches), as well as how to be an effective mentee; (3) securing research funding; (4) landing a job; (5) and protecting time to meet personal goals. There is an increased need for a vibrant, diverse, and successful generation of general internal medicine researchers to advance our understanding of complex issues in clinical medicine and healthcare delivery and to inform health policy. It is our hope that this piece helps to support that mission.

Transitioning back to faculty roles after being a Robert Wood Johnson Foundation Nurse Faculty Scholar: Challenges and opportunities

BACKGROUND

There is a dearth of literature describing factors supporting a successful transition from a career-development fellowship to resumption of the full complement of faculty roles.

PURPOSE

Because little is known about the transition back to the full faculty role, a subset of Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars (NFS) was interviewed to evaluate the self-identified challenges and opportunities that the scholars faced and factors contributing to their success when they reassumed the full faculty role.

METHODS

A subset of scholars from cohorts beginning the RWJF NFS program between 2008 and 2012 (n = 10) was interviewed by members of the NFS National Advisory Committee. NFSs identified challenges and opportunities faced as they transitioned to their faculty roles following completion of the career development fellowship as well as the character of support received from individuals in their organizational influencing the experience of the faculty transition. Evaluation outcomes include recommendations for transition planning for home institutions, colleagues and fellows.

RESULTS

NFSs identified transition challenges including managing multiple responsibilities and increased teaching demands coupled with loss of protected time and funding for scholarly work. Opportunities for career advancement were influenced by effective mentorship, institutional supports including advocacy and allocation of time and responsibilities consistent with continued research productivity. Issues contributing to a more difficult transition included non-supportive relationships among administrators and colleagues and newly assigned responsibilities that detracted from success in meeting expectations for tenure and promotion. Effective transition from fellow to faculty included plans for continued mentorship and stakeholder engagement of administration, mentors and faculty colleagues.

CONCLUSIONS

Effective transition from fellow to the full complement of the faculty role benefits both the home institution and scholar. Positive outcomes may be contingent on scholar support and organizational investment during the transition period.

Thrown into the world of independent practice: from unexpected uncertainty to new identities

One of the most exciting yet stressful times in a physician's life is transitioning from supervised training into independent practice. The majority of literature devoted to this topic has focused upon a perceived gap between clinical and non-clinical skills and interventions taken to address it. Building upon recent streams of scholarship in identity formation and adaptation to new contexts, this work uses a Heideggerian perspective to frame an autoethnographical exploration of the author's transition into independent paediatric practice. An archive of reflective journal entries and personal communications was assembled from the author's first 3 years of practice in four different contexts and analyzed using Heidegger's linked existentials of understanding, attunement and discourse. Insights from his journey suggest this period is a time of anxiety and vulnerability when one questions one's competence and very identity as a medical professional. At the same time, it illustrates the inseparable link between practitioners and the network of relationships in which they are bound, how these relationships contextually vary and how recognizing and tuning to these differences may allow for a more seamless transition. While this work is the experience of one person, its insights support the ideas that change is a constant in professional practice and competence is contextual. As a result, developing educational content that inculcates contextual flexibility and an increased comfort level with uncertainty may prepare our trainees not just to navigate the unavoidable novelty of transition, but lay the groundwork for professional identities attuned to engage more broadly with change itself.

Faculty mentorship during residency and professional development among practising emergency physicians

What is known about the topic?

Mentorship is perceived to be an important component of residency education; however, evidence on its influence in emergency medicine is lacking.

What did this study ask?

We surveyed emergency physicians in Canada to identify the association between mentorship during residency and professional development and attitudes regarding mentorship.

What did this study find?

While many participants consulted their mentor regarding their first job, fewer contacted their mentor regarding subspecialty training or research.

Why does this study matter to clinicians?

Mentorship during residency may have a greater association with the location of practice than with academic scholarship or subspecialty training.

Making the most of mentors: a guide for mentees

Effective mentorship is likely one of the most important determinants of success in academic medicine and research. Many papers focus on mentoring from the mentor's perspective, but few give guidance to mentees forging these critically important relationships. The authors apply "managing up," a corporate concept, to academic medical settings both to promote effective, successful mentoring and to make a mentor's job easier. Managing up requires the mentee to take responsibility for his or her part in the collaborative alliance and to be the leader of the relationship by guiding and facilitating the mentor's efforts to create a satisfying and productive relationship for both parties. The authors review the initiation and cultivation of a mentoring relationship from the perspective of a mentee at any stage (student through junior faculty), and they propose specific strategies for mentee success.