STFM Emerging Leaders’ Fellowship and Learning to Transition Gracefully

Katherine Hastings, MD

Katherine Hastings, MD

The first time I heard about the STFM Emerging Leaders’ fellowship was while I was struggling to write a letter of intent for my application for a position with the University of Utah. I was trying to explain why they should invite me to join their faculty fresh out of residency. I was procrastinating by scrolling through my email, and the subject line “Emerging Leaders” struck me as a fairly inspiring phrase in the midst of junk mail and recruiting advertisements.

I can’t remember if I read the email immediately or if I simply used the inspiration from “Emerging Leaders” to complete my application letter. But at some point I opened the email, clicked the link, and read about the fellowship.

I wanted in.

You see, applying for my first job after residency presented a conundrum. I had been told to be confident, that I was a competitive applicant, even if I was a green, young physician just out of residency. But I felt intimidated, naïve, and afraid of the unknown. I did not want to give up the safety net of residency.

The Emerging Leaders Fellowship presented itself as a perfect bridge. It gave me the language to describe how I felt, no longer a resident, not yet feeling like an attending, but growing somewhere between the two. And it offered an opportunity for guidance and support as I set out on the transition.

So I applied.

I wrote about how I wanted to work in academic medicine and needed to learn how to be an inspiring teacher. I wrote that I wanted to be intentional in the habits I developed as I entered my career. I was honest about my fears of being able to be a leader as the youngest colleague in my department. Something striking must have come through my application because they said yes.

Next thing I know its May, and I’m sitting in a conference room at the STFM Annual Spring Conference in San Antonio. I am surrounded by family medicine’s emerging leaders—some of us in residency, some of us in faculty positions, some of us between the two. I had no idea what to expect. We spent the next 2 days learning and listening and discussing leadership.

Now, before eyes roll at seemingly intangible advice on how to be a leader, I have to tell you, this was different. We discussed having vision, and making plans, and inspiring others to move. We were encouraged to dream big and have the confidence to share those dreams. I was excited. When given the charge to find a project and a group to lead over the next year, I was full of ideas.

In August, I traveled to Kansas City for our second meeting. I entered a room of friends and colleagues from across the United States, no longer the strangers they had been a few months earlier in Texas. The timing was perfect. I had just completed my first few days as an attending physician and was starting to put my proposed project into action. It was a relief to have the full day to discuss, trouble shoot, and encourage one another. I was urged to be intentional about the members I invite to my team, merging the skills I have and the skills I think my team will need. I was given advice on how to maintain my vision while working within a large university system with goals of its own. I was told not to give up. Once again, I left excited and full of ideas.

The coming months will be filled with work on my project. There will be regular phone conferences before the fellows meet again in Orlando, FL at the STFM Annual Spring Conference. There I will get to present the work I’ve done through the year and share what I’ve learned about leading, through both successes and failures. Although I’m not sure exactly how my project will play out in the end I am so thankful for the Emerging Leaders Fellowship. It is helping me start my career with effective habits of leading based on a personal commitment to a vision. I can’t wait to see where this takes me!

The Emerging Leadership program is accepting fellows for its 2015-2016 class. Applications are due January 31, 2015. 

Top 10 Pieces of Advice for New Behavioral Science Educators

Jennifer Ayres, PhD

Jennifer Ayres, PhD

I graduated 14 years ago with a plan. I envisioned a lifelong career devoted to the clinical care of underserved children, adolescents, and their family members. Pursuing a career in graduate medical education was not part of the plan. But a need to move closer to family and an interesting job description caught my attention and changed my career course.

During my phone interview, I was honest about my lack of experience in resident education. I believed my clinical skills and experience teaching mental health graduate students would generalize to family medicine residents. And they did…after a steep learning curve.

I learned a lot in the first few years. Here are top 10 pieces of advice I give to a new family medicine behavioral science faculty member:

  1. There are resources available that will make your job easier. There are two excellent websites to peruse for presentation ideas, research findings, and references: the STFM Resource Library and the Behavioral Science Wiki.
  2. Teaching residents and teaching mental health students require different strategies and techniques. There is a big difference between what a resident and a therapist need to do in a treatment room. Teach residents to be therapeutic in their patient encounters, teach mental health students how to conduct therapy.
  3. Join a community of peers. The STFM Behavioral Science/Family Systems Fellowship is taking applications for next year’s class. I joined the fellowship in its inaugural year. We became family through the fellowship and remain connected through that unique experience. This is a family you want to join.
  4. Reach out to others by joining a local consortium of behavioral science educators or an STFM Group. Connect with others who also struggle to integrate behavioral health into programs that are focused on the medicine aspects of teaching family medicine.
  5. Be patient. It takes at least 3 years to have a resident cohort that does not remember the program without you and is unable to compare you to your predecessor.
  6. Be flexible. If you thrive on a planned schedule and a predictable day, get over that quickly! Clinical care hours will be scheduled between intern application reviews, evaluations, didactic preparation, and “Hey there, do you have a minute for me to run something by you?” interruptions. Being overwhelmed is actually a good sign. It indicates integration into the program and respect for your perspective and contributions.
  7. Resist the urge to prove your worth. Some residents will not be ready for what you have to teach and will need several years of professional practice before they realize that behavioral health is a necessary component of family medicine. But perspectives change and someday you will receive requests from past residents for the same handouts they left on the table after your didactic.
  8. Don’t try to fill someone else’s shoes. They will not fit. Recognize that there will be people grieving the loss of your predecessor while you are trying to make your own footprints. Be respectful of that process and try to minimize your defensiveness by being aware that everyone is adjusting to the change. Not just you.
  9. Get to know your fellow faculty members. Make genuine connections based on who you are–not who you think they want you to be. Remember that long-term relationships develop over time and some connections are quicker and some slower to develop. Invest and be patient. I was fortunate to join a faculty that welcomed me and made it clear that I was wanted. Others were not as fortunate. As with the residents, some faculty members are not ready for what you have to contribute—yet.
  10. Attend the Forum for Behavioral Science in Family Medicine conference. This conference occurs every September in Chicago. Most presentations will apply to your work and you will emerge with new ideas to improve your teaching and your program. More importantly, you will meet wonderful people who will mentor you through the difficult times and generously share their resources and knowledge with you.

There is no single path to becoming a successful behavioral science educator. Success will be determined by your ability to acculturate into your program while holding onto your inherent skills and interests. Using this definition, you cannot be successful based solely on the quality of your work. In my situation, much of my success is attributable to the relationships I share with my fellow faculty members. We worked together to integrate behavioral health in a manner that fits my skill set and meets our program needs. As we move into another intern interview season, our integrated behavioral health and resident support groups will be identified as unique strengths of our program.

Graduate medical education was not part of my original career plan. Fortunately, plans change.

What advice do you have for new faculty? Let me know in the comments below.