Advice for New Faculty: When the Road Less Traveled Ends in Thorns

Richard F. Mitchell, MD,

For many clinicians, the path of medicine is a comfortable one—well-worn, made by many feet before your own. From college to residency and beyond, the courses to take, exams to pass, and applications to fill out have been laid out for us in a nice, orderly path. There is some room for brief excursions off the path, but the route to our prescribed life of clinic medicine, hospital medicine, specialty care like sports med, OB, or geriatrics, or some combination thereof is a well-marked trail with lighted signs to guide us all the way.

Until the day you decide to teach. I recall talking to our program director on the first day I had administrative time and asked, “What should I do?” His response: “I don’t care.”

I was at a bewildered loss as to what to do with myself. I asked other faculty, and was met with chuckles and smiles. “I can’t remember what it was like to be able to do whatever I wanted during admin time…”

My path ended painfully here in the brush. There were a few faint paths I could see—precepting, lecturing, and administration. I could mentor and advise residents. There was nothing more obvious for me to do.

The other faculty had their niches, like geriatrics, sports medicine, or residency administration. But I had none of those skills or ambitions. And the longer I spent without a clear path, the more lost and useless I felt.

As an East Coast person, I run to Robert Frost poetry when I get stuck, as I often find inspiration there. In his poem “Two Tramps in Mud Time”, he discusses the vital importance of not allowing what you do for a living to be separated from what you love to do. I have known I wanted to teach for a long time; early experiences with creative teaching got me excited about teaching in the first place, and I still get really excited about mixing learning and fun. So, despite no one in my residency focusing on the specifics of how education is delivered, I figured that this would be a good place to start whacking at the bushes.

I took a class run through the Association of American Medical Colleges (AAMC) to earn my Medical Education Research Certificate, thinking that maybe I could try medical education research to feed my passion. I have taken a faculty development course to learn more about different facets of medical education, such as curriculum design, evaluation methods, and the politics of education. In doing things like these, I have felt that some inner tank is being filled with generative ideas.

What has come out of these thoughts and experiences has been fascinatingly unexpected. I’m not currently doing education research as I expected, but clinical research in spirituality. My past in bench research helps me bring a certain level of research savvy to clinical research which is helpful, not just to me, but also to other people in the faculty with research interests. I am pursuing creative teaching methods, but I’m trying to impart them to our residents to help them improve their teaching skills.

And unexpectedly, I’m writing. I have seen that the struggles I’ve had in my own clinical practice are mirrored in the struggles of our residents, and my frustrations with the state of medicine are shared by many of my colleagues. In writing, I’m trying to tease apart some thorns for others as I wear my own path through the woods.

So if you’re a new faculty member who is feeling a bit stuck at the seeming end of a well-worn path, I offer this advice. Remember where your passions for teaching lie and let them be your compass. While you may not end up where you expected, you’ll still end up somewhere wonderful. Fill your inner reserve with new knowledge from colleagues, journals, conferences, and classes. Alchemy happens when you’re full of that good stuff. Finally, don’t let the lost path throw you. The thorns you’re teasing apart have some of the most beautiful blooms in the woods if you’re bold enough to look for them.