After completing my year as a chief resident in internal medicine, I knew in my heart I wanted a career as a medical educator. I spent the next 3 years of my fellowship and early years as a clinician educator trying to align my interests and articulate my vision to myself, my division, and my institution. Below, I reflect on my own experience and offer practical tips on how trainees can navigate the often nebulous path to a successful career in medical education.
Many fellows’ interest in medical education often begins well before the first day of fellowship. Brilliant, dedicated, and inspiring faculty abound in undergraduate and graduate medical education. These faculty hold the medical educator roles coveted by trainees and junior faculty and serve as tangible examples of what is possible in academic medicine. My inspiration came from a respected master clinician and exceptional educator within the Division of Pulmonary and Critical Care Medicine. He taught me pulmonary physiology in medical school (including the greatest lecture on acute hypoxemic respiratory failure of all time), ran the 4th-year intensive care unit clerkship, and was a model of professionalism and astute clinical acumen during our shared clinical experiences during my residency and fellowship. A fellow can look to these mentors and aspire for a similar career, yet the pathway is arduous and can be difficult to articulate even by those who have succeeded. My pathway has been equal parts serendipity and deliberate determination.
Lack of career clarity can be paralyzing for a trainee. I found the linear path of medical school, residency, and fellowship required less introspection than that required when contemplating the numerous potential career paths ahead of me after training was complete. I was terrified I would make the wrong decisions that would disappoint my mentors and close doors prematurely. While mastering the clinical skills necessary to safely care for patients in a challenging specialty, fellows must also articulate their desired career and seek the opportunities and mentorship necessary for success. Unfortunately, roadblocks are plentiful – institutional culture may not value the medical educator, pathways of mentorship may not exist, divisional expertise may not align with the interests of the fellow, and salary-supported faculty positions for medical educators may not be possible. My career certainty depended on experiences and opportunities that constantly evolved during the course of my training, leaving me unsure how to prepare for a position that did not currently exist.
As I begin my new role as a fellowship program director, I offer 4 tips for others considering careers in medical education.
1. Be an excellent physician.
First and foremost, I am a pulmonary and critical care physician and I strive for excellence in my clinical care, communication, and professionalism. As articulated by my mentor, you must be “nice, hardworking, and smart.” This phrase encapsulates who I want to be, the type of fellow I want on my team, and the physicians I want as my colleagues. Medical knowledge and patient care will improve over the course of training but professionalism must be present and consistent at all times. Without these core fundamentals which allow for excellence in patient care as an essential member of a healthcare team, my career as a medical educator could not exist.
2. Take initiative.
In retrospect, this is where I have struggled and subsequently developed the most. As I have gained confidence and assumed a variety of leadership roles, I can more clearly identify the immense opportunities for self-directed learning that exist during fellowship. As a junior faculty member and rising associate program director, I identified a gap in our training program’s approach to career development. In response, I created a fellow’s professional development retreat which is now in its third year and highly regarded by our fellows and faculty participants. Recognizing and filling educational gaps demonstrates initiative and marks one as an innovative problem solver. Creating or improving learning opportunities or curriculum within the fellowship, teaching in the medical school and residency, and volunteering in medical education leadership roles for local, regional, and national organizations allowed me to establish myself as an educator while developing a broad network. A consistent track record of success across a variety of medical education volunteer roles and the network of support that this work creates will be invaluable when seeking funded educational roles or protected time.
3. Seek stepping stone roles on the pathway to a dream job.
My dream job upon completion of fellowship was to serve as a residency or fellowship program director. Yet, there were other fantastic roles that I had not previously considered and it was a medical director role in continuing medical education that afforded me my first funded position. It was this unexpected role that has been most influential in my career development. Dream educator positions are unlikely available as a fellow finishes training and setting realistic expectations while balancing personal and divisional needs will be necessary. Fellow medical educator colleagues shared the following additional compromises that may be required along the pathway to a dream job: low salary, heavy clinical load with little or no protected time for education, night shifts, clinical service time on sub-specialty services that do not align well with one’s personal career goals, performing procedures for other faculty members, or clinical work as a hospitalist or general medicine attending. Some of these citizenship olive branches will almost certainly be required to open doors to opportunities and relationships not previously recognized, and will allow one to be ready when funded educator roles become available.
4. Say goodbye to impostor syndrome.
Impostor syndrome, nicely described here and here, left me feeling under qualified and unsuccessful compared to my colleagues. Saying goodbye to impostor syndrome will be a continuous work-in-progress yet is critically important to name and face head-on. When opportunities arise that I feel under qualified to accept, my natural instinct is to retreat to self-doubt and wonder what seemingly more qualified individual must be available. As it turns out, this perception of under-qualification is false and the right person for the job is me. With the strong support of mentors, I have been able to more clearly articulate my strengths, recognize the unique qualities I have, and confidently accept roles that align with my career goals.
Having sought out the stories of other medical educators and heard their successes, failures, and uncertainties, I can confirm there is no one right way to succeed as a medical educator. It helped immensely when my mentor created the safe space I needed to articulate what I wanted from my career rather what I thought others expected of me. My certainty that a career as a medical educator was the only role within academic medicine that brought me joy allowed me to put my head down and focus step-by-step on what I needed to achieve. When serendipity struck, I wanted to be in the strongest position possible to be considered for the role.