Training the Teachers. The Clinician-Educator Track of the University of Washington Pulmonary and Critical Care Medicine Fellowship Program

Abstract

The University of Washington was the first pulmonary and critical care medicine fellowship training program accredited by the Accreditation Council for Graduate Medical Education to create a dedicated clinician-educator fellowship track that has its own National Residency Matching Program number. This track was created in response to increasing demand for focused training in medical education in pulmonary and critical care. Through the Veterans Health Administration we obtained a stipend for a clinician-educator fellow to dedicate 12 months to training in medical education. This takes place predominantly in the second year of fellowship and is composed of several core activities: fellows complete the University of Washington's Teaching Scholars Program, a professional development program designed to train leaders in medical education; they teach in a variety of settings and receive feedback on their work from clinician-educator faculty and the learners; and they engage in scholarly activity, which may take the form of scholarship of teaching, integration, or investigation. Fellows are guided throughout this process by a primary mentor and a mentoring committee. Since funding became available in 2009, two of the three graduates to date have successfully secured clinician-educator faculty positions. Graduates uniformly believe that the clinician-educator track met their training goals better than the research-based track would have.

Bridging the gap for future clinician‐educators

“…Participants provided informed consent at the time of their enrolment. We chose topics to provide a sampling of those in similar programmes, emphasising career development and teaching strategies . The sessions included:…”

Emerging Subspecialties in Neurology: Medical education

“…A study showed that "resident as teachers" curricula (residency integrated programs focusing on teaching) significantly improve teaching abilities, reinforce resident knowledge, and bolster postresidency placement. 4,7 Accordingly, neurology training programs (e.g., UCLA, Yale) are beginning to offer longitudinal clinical-educator tracks (combining didactic series, education electives, leadership of small groups, bedside teaching, and mentored scholarly projects) within the residency. Ideally those developing educational tracks will reflect the AAMC's findings that relationship-based, noncognitive skills are a core feature of effective teaching, 8 and include enhancement of a resident's "softer" skills, including leadership by example, teacher-student communication, and providing feedback, not just theoretical knowledge.…”

“…A number of articles lament the difficulty of using T-32 or R25 grants in fellowship toward a clinician educator path. 7 A review of Google (search terms: "neurology medical education fellowship," "neurology education fellowship"), the AAN fellowship directory, ACGME, and United Council for Neurologic Subspecialties databases showed only 1 neurology-specific education fellowship. The AAN Institute Medical Educator fellowship 10 is a research-based, stipend fellowship for AAN members who have completed neurology/child neurology or neurodevelopmental disabilities residencies or fellowship in the last 5 years.…”

“…A number of reasons are cited for this change, including competitive research funding, increased numbers of trainees, and increased clinical care needs. 7 The acceptance of the clinician-educator is seen in clinical professorship tracks. Promotion criteria on these tracks vary, but generally require longitudinal dedication to teaching activities and mentorship, with demonstration of quality and quantity of teaching exceeding that of peers.…”

Response

“…1 Not every fellow needs formal education training; however, fellows who wish to become clinician educators should consider formal training opportunities. These include a variety of activities, including advanced degrees in medical education or fellowship tracks designed specifically to produce specialists not only in pulmonary and critical care, but also in education (one example is the University of Washington's clinician educator fellowship 5 ).…”