Supporting New Faculty in Family Medicine Cheryl K. Seymour, MD Maine-Dartmouth Family Medicine Residency

A case in point… 31 year old female family physician is looking for career advice, now in 3 rd year of practice s/p FM residency and geriatric fellowship Currently faculty at a community based FM residency in rural Maine Mother of 6 month old infant Partner is also a family physician

Why is this an important topic? STFM Strategic Goal: “Provide premier academic development of faculty appropriate to their level of experience and individual roles” New faculty are the future of the discipline – long term as well as short-term recruitment National statistics of age distribution of FM faculty?

Goals for this session Become aware of the variety of unique challenges facing new faculty Identify specific resources already available to support new faculty in family medicine Reflect on issues specific to you or new faculty in your institution Collaborate with others to generate ideas of local, regional and national interventions

Schedule Introduction 15 min Common Themes & Resources 2 min Reflect on personal challenges 10 min Small groups discuss challenges & interventions – ongoing and future 10 min Share with larger group

Common Themes - Balance Balance TIME between personal & professional goals Maintain personal health Develop better time management skills

Common Themes - Knowledge Need for clinical precepting (while also being the preceptor!) Knowledge gaps in curriculum development, research methods, practice management Different learning or teaching styles

Common Themes - Hierarchy Negotiating hierarchy, advancement in an academic setting Finding a voice to advocate for change within The System

Common Themes - Finances Debt averaged $140,000 at graduation in 2007 Average pay-off date is at 55 yo or older Primary care physicians make 30% less than average physician salary Source: AAMC - Young Physician Indebtedness Report, 6/07

Common Themes - Relationships  Desire for mentorship Frequent feedback & structured expectations Generational differences in values, work ethic, role of family physician

Gen X: Incentives and Motivators Turn offs “Busy work” Rigid rules, systems Schedules/duties Emphasis on process Complex organizations Delayed gratification Seniority authority Work vs family/ other activities Turn Ons Meaningful work Innovation, change Flexibility/choice Data, service NOW Technology Reward by results Earned leadership Life balance This slide borrowed from FMDRL - Anne Walling, John Delzell STFM Annual Meeting 2007

Resources - Balance Balance TIME between personal & professional goals Maintain personal health Develop better time management skills Self–directed resources: Local role models Personal self-reflection Time-management courses Systematic resources: Repository of career models: job-sharing, part-time, etc. Professional work hour guidelines?? National, regional mentoring networks

Resources - Knowledge Need for clinical precepting Knowledge gaps in curriculum development, research methods, practice management Different learning or teaching styles Self-directed: Read journals Attend local grand rounds Overcome fear of asking for help Systematic: FMDRL STFM Faculty Development Series Practice Orientation (FPM article)

Family Practice Management April 2001 Randall Grimshaw, MD Austin, TX

Resources - Hierarchy Negotiating hierarchy, advancement in an academic setting Finding a voice to advocate for change within The System Systematic: Group On New Faculty Faculty Development Fellowships STFM Leadership Database

Common Themes - Relationships Frequent feedback & structured expectations Generational differences in values, work ethic, role of family physician Self-directed: Start dialogue with colleagues about preferences & values “Network” at meetings Systematic: Mentors!!

Resources - Mentoring Established benefits for junior, URM faculty Local vs. regional or national?? Requires: Time / Guidance / Skill? Longitudinal relationship over many years Commitment from both mentor and mentee Virginia Commonwealth online manual

Discussion What are your challenges? What are your ideas?

And the audience said… This talk was presented at the STFM Annual Conference, 2008 in Baltimore. About 30 people attended; there was about equal proportion of new & “not-new” faculty. Ideas generated during the discussion groups are summarized in the next 3 slides.

Challenges – Audience Input Overcoming the stereotype that new faculty are all right out of residency – different challenges face those who become faculty mid-career Community based programs may not have resources or mentors in research Navigating a department with lots of resources can also be overwhelming Learning coding and documentation and Medicare precepting guidelines

Challenges – Audience Input Moving to a new job often involves being immersed in community with a new culture Lack of useful feedback from supervisors Too many options and exciting projects – programs want our help, hard to say no Developing a faculty relationship with residents close in age to ourselves In some programs, mentoring is impossible because the majority of faculty are new

Existing Resources / Best practice Program with an expectation of STFM Annual conference attendance and submission in the first year Pay for all faculty to be STFM members Useful, program specific faculty manual (1 person of 30 came from a program with this) Collaborate to publish with more experienced colleagues (recent FPIN model in several residencies)

Existing Resources / Best practice Mentoring with senior faculty (1 person in the room had experienced this in their career, no one had a formal mentoring program currently in place in their program) Annual new faculty orientation day Seek mentors outside your program through state academies or AHEC meetings Develop one-on-one relationships with your director or chair and meet regularly for mutual reflection

New Ideas – Audience Input Web page designed for new faculty with a FAQ about STFM, general life/career tips Collaboration between the Groups On New Faculty and Faculty Devel to design resources tailored to new faculty Could STFM have a discounted conference fee for first time attendees?

New Ideas – Audience Input Programs could require, pay for, facilitate scheduling such that their newest members attend the STFM annual conference Use PD list-serv to improve outreach to new faculty? Develop a pre-conference with the Group On Faculty Development especially designed for new faculty