Tips for New Faculty

Transition from Resident to Faculty

Transitioning from residency to faculty can be quite challenging, even if you've successfully completed a faculty development fellowship. 

Advice for residents transitioning to faculty:

Share Everything

• Share credit. When something goes well, be sure to give praise.
• Share responsibility. If you are assuming a faculty role, find out what needs to be done from the faculty perspective, not from the resident perspective, and make sure you pull your weight. 
• Share your unique knowledge. You have just been a resident, so you may know things that other faculty members don't about the inner workings of the program. Use this insider information to improve the processes.¹

Play Fair

• Play fair, even if you still socialize with some of the residents. Make sure you hold all residents equally accountable and don't play favorites. Expand your social circle outside the residency so that you have more independence.¹ 

Live a Balanced Life

• While it’s important to jump right in and get involved, it’s also important to take a step back sometimes to reflect on your journey. Your first few years as faculty will go by quickly, so keep a journal of your experiences. You will thank yourself later. Be sure to be true to yourself. Nurture your passions outside of work.¹

Take a Nap Every Afternoon

• Find time in your schedule to rest. Take a short power nap in your office or take a short trip home during lunch.  Your faculty life is a journey, and you need to be well rested to perform well.¹

Ask for Help

• When you’re overwhelmed, ask for help. In addition, always be willing to help a fellow colleague in need.  Even the experienced faculty need help sometimes.¹

Get Involved

• Find a committee to join, and get involved in an ongoing project.  This is a great way to learn more about your institution, and a good way to network as well.

Know Your Resources

• Know what resources are available to you (AAFP, STFM, institution-specific resources, including human resources). Use your CME wisely.

Some other useful tips are: start early, define your role, secure early wins, know your own strengths and weaknesses, identify the hidden organizational culture, know the needs of your organization, reassess your own goals, and use mentors effectively.²

Becoming a new faculty member is difficult. Wanting to teach and knowing how to teach are two separate things. Approach it with a spirit of inquiry, and you will do well.

Take pleasure in patient care, and do your best, but don't take it all personally. There are forces greater than us at work. ¹

References:

1. Fulghum R. All I really need to know I learned in kindergarten: uncommon thoughts on common things. New York: Villard Books, 1988.

2. Gustin J, Tulsky JA. Effective "on-boarding:" transitioning from trainee to faculty. J Palliat Med 2010;13(10):1279-83.

Contributed by Rebekah Collymore, MD  and Lenny Salzberg, MD, Duke/Southern Regional AHEC Faculty Development Fellowship

Negotiation: So You've Got the Job Offer…Now What?

What to consider after an offer

• Is the position an ideal fit both professionally and personally?
• Have you reviewed the components of the offer: salary, benefits, job responsibilities, and hours?
• Do you have other offer/options?
  • If you’re waiting to hear about another position, call and check on the status and let that prospective employer know you’ve received an offer but are still interested in their position.

Actions to take after an offer

• Request the offer in writing.
• Negotiate.

Factors to consider before negotiating

Know your wants vs needs. Prioritize the following:

• Career Alignment. What do you want to do? Is this position the right balance of teaching, research, etc? Will this position help you achieve your career goals? Is the workplace environment the right fit for you?
• Support. Plan to establish parameters for your research, teaching, and/or clinical program. (Will you have access to the right resources? Enough resources? Will you receive mentorship/guidance?)
• Salary. Do research and have data. Account for geographic location and cost-of-living.
• Benefits. Health insurance, life insurance, disability, retirement, vacation/sick leave, holidays, bonuses, tuition assistance, paid sabbaticals, relocation assistance

How to Negotiate

• Be prepared. Do your research. Distinguish wants vs needs. Consider prospective employer's perspectives and potential questions/responses. Practice.
• Act. Convey enthusiasm and be positive. Introduce the area you would like to negotiate (prioritize). Focus on the value you will bring to the position. Listen carefully and ask for clarification, if needed, and take notes.
• Respond. Always send a thank you letter; be gracious, and finalize all negotiations in writing.

Reference

Milgram SL. Evaluating academic job offers and negotiating positions. https://www.training.nih.gov/assets/Slides_1_14_10.pdf. Accessed February 20, 2015.

Running an Effective Meeting

Meetings are a necessary tactic for getting work done. Effective meetings provide participants with energy and a sense of accomplishment.

Prepare

• Set goals. All meetings should have a purpose. In advance of the meeting, decide what you want to accomplish and write it down in a brief and easily understandable statement. Do you want to generate ideas or get a decision made? Are you communicating new information? Be mindful of not trying to get too many things done in a single session. 
• Define attendees. Once you have determined the desired outcome of your meeting you can better identify key stakeholders and necessary participants. Only invite those who have a relevant role in the business to be covered.
• Prepare an agenda. List all discussion topics in the order you want to discuss them. Allot an estimated, but realistic, amount of time next to each item. If the agenda is too full, table some topics for a later meeting. Be sure to include relevant details including time, date, location and alternate options for joining (ie, video conference, conference call, etc.).
• Share the goal and agenda in advance. Emailing this information to attendees allows them to provide input, prepare for the discussion, and bring relevant materials.
• Adjust the agenda if needed. Running a meeting is not a dictatorial role. Be collaborative and ask invitees for their feedback on the agenda.

Manage the Meeting

• Start on time. This includes making sure any conference line or video conference options are up and running a few minutes in advance. Do not spend time recapping for latecomers. As you establish a reputation for beginning meetings on time, attendees will know not to arrive late. 
• Take notes. Ask one person to take detailed notes throughout the entire meeting.
• Lead the meeting. Serve as the meeting moderator and move through agenda items in a timely and effective fashion. If the meeting is going astray, politely remind the attendees of the meeting’s focus. Ask that side concerns be tabled for a later discussion.
• Involve others. If a few attendees are dominating the conversation, make a point of asking others for their ideas.
• Assign tasks. Once tasks are identified, make assignments on the spot. Setting a due date improves the chances that the task will get done.
• Summarize the meeting. At the meeting’s close, quickly summarize what was decided, next steps, and topics for further discussion.  
• Conclude the meeting on time. Allowing meetings to go long is disrespectful and most attendees will mentally stop participating. If you reach the end of your allotted time and still have items to cover, plan for a follow-up meeting.

Follow Up 

• Personally assess the meeting. Take time to determine what went well and what could have been done better. Evaluate the meeting's effectiveness based on how well you met your original goal.
• Share meeting minutes. Email the meeting minutes along with a thank you to the attendees and stakeholders within 24 hours of the meeting’s end. This summary should be a record of what was accomplished and a list of who was assigned what tasks. 
• Ask for feedback. When sharing the minutes, ask participants to provide their perspective on what went well and how to improve future meetings. 

Contributed by: Sally Weaver, PhD, MD, Waco Family Medicine Residency Program

Time Management

Time management is a skill no one really teaches you, but you must learn in order to be successful. With good time management skills you can be in better control of your time, your life, and your stress and energy levels. 

Prioritize

When time is limited and demands seem endless, identify and focus on the activities that give you the greatest return on your time and effort.

• Make sure what you volunteer for is interesting and/or helpful for your career.
• Avoid immediately committing to a request for your time. Ask for more details about the committee, project, etc, so you have a realistic idea of the time requirements of the obligation. 
• Keep “to-do” lists for work and home. Essential items should be at the top of each one. 
• Learn to delegate tasks. Function at the top of your license and education as much as possible.

Schedule

With a little planning you can make the best use of your time.

• Identify the time you have available.
• Block time for essential tasks.
• Schedule time for high-priority tasks and vital "house-keeping" activities.
• Set aside time to handle unpredictable interruptions.

Focus

Learning how to minimize distractions and interruptions can dramatically increase your productivity and effectiveness, as well as reduce your stress.

• Make your work environment as comfortable and welcoming as possible.
• Don’t let email or instant messages dictate your schedule. Rather than responding to each message as it comes in, turn these applications off and have designated times to check your messages.
• Complete your most difficult tasks when you are alert. If you are a morning person, plan to dedicate creative energy to projects during the first half of your day and respond to email later in the afternoon.
• Limit the opportunity for interruptions. Keep your door closed, wear headphones, or play music softly as “white noise” to block out distractions.

No strategy is foolproof, and nothing works for everyone. Try several options and stick with the ones that work. 

Contributed by: Sally Weaver, PhD, MD, Waco Family Medicine Residency Program

Guidelines for Presenting a Research Paper

The purpose of a research talk is to give your audience a sense of what your work is about, entice them to read your paper, and get feedback on your work. Avoid approaching this as an opportunity to share everything you know about a subject or to present every detail of your work.

The following tips can help guide you through a successful presentation of your research paper.

• Plan to present for 20 minutes. Ten to 15 minutes should be allotted for your talk, with another 5 to 10 minutes for questions and dialogue.
• Consider this suggested outline:
• Background and stimulus for the research project
• Brief review of literature (to outline the context)
• Methods
• Results (including overheads or slides of tables)
• Discussion and interpretation of findings
• Conclusions (including further research)
• Do not read your paper. Instead, talk through the major portions of your investigation.
• Use a slide presentation or overheads to assist the audience in understanding your information. Tables, charts, and other visual aids can be helpful for sharing complicated data.
• Think about reproducing and distributing a short synopsis of your study. This handout should include: title of study, an abstract, any tables used in your presentation, and your name and address.
• Practice your presentation. Consider using trusted colleagues as a test audience.

Contributed by: Cynthia Passmore, MA, Texas College of Osteopathic Medicine

Creating Curriculum Goals and Objectives

When designing or revising curriculum, follow these steps for developing goals and objectives.  

Assess Needs¹

Before developing goals, conduct a needs assessment, a systematic process to determine and address the gaps between where you want to be and the status quo. 

Define the type of need for change:

• Normative: An individual or group needs to reach an established standard (e.g., the need to see a certain number of new patients).
• Anticipated: Needs are related to projected demands (eg, the need to change the undergraduate medical education curriculum because of an increasing need for primary care physicians).
• Felt: Perception of the need to change is driven by a particular incident or observation.
• Comparative: Needs having to do with one institution having something while another does not.

Once you’ve clearly identified the issue, determine what finite resources can be directed toward developing and implementing an applicable solution. This analysis will determine whether or not it is feasible to proceed. 

Write Goals¹

An educational goal describes “real-world” performance you want learners to exhibit once they have completed the curriculum. Educational goals describe the overall learning outcome. Subsequent objectives, methods, and evaluation procedures are directed toward achieving the goals. 

Goals should:

• Describe overall outcomes
• Be stated in terms of learner outcomes
• Be realistically attainable by the completion of the curriculum
• Be stated in terms of learner knowledge, behavior, and attitudes
• Describe real world behaviors to be used by the learner

Examples might include:

• Perform a thorough medical and psychosocial history
• Recognize the presenting symptoms of appendicitis
• Articulate the pros and cons of a career in family medicine
• Differentiate between important and/or unimportant information to be recorded in a patient’s medical record

Write Objectives¹

While goals can be expressed in vague terms, objectives must be specific. Educational objectives are statements that describe in precise, measurable terms what learners will be able to do at the end of an instructional sequence. A well-written objective includes the audience for whom the objective is intended, the observed and/or recorded behavior, the conditions of the observed behavior, and the degree to which a behavior must be performed. When writing objectives, consider how you would test learners to determine if they achieved what you want them to achieve.  

Objectives should:

• Relate to a goal
• Answer the question, “What will learners be able to do at the end of the curriculum?”
• Be stated in precise, observable, measurable terms 
• Be realistically attainable during the curriculum

Examples might include: 

• The second-year resident will be able to identify fractures by x-ray.
• The second-year resident will demonstrate correct casting techniques on a partner using fiberglass or plaster.

Reference:

1. Nieman L, Monteiro F, Kizlik B, and Brownfield D. Curriculum Development - Part One. The STFM Resource Library; 2007.

Additional Resources:

Designing a College Curriculum
Lion F. Gardiner; Rutgers University; National Academy for Academic Leadership

Curriculum Review
Lion F. Gardiner, Rutgers University; National Academy for Academic Leadership

College Curriculum Renewal Project
Center for New Designs in Learning and Scholarship, Georgetown University

Family Medicine GME Funding

Funding for Graduate Medical Education comes from many sources, including:

• Medicare (largest amount)
• Department of Veteran Affairs
• US Health Resources and Services Administration
• National Institutes of Health
• Medicaid (in certain states)

In the 1980s, changes were made to establish Disproportionate Share Payments (DSH). This change by Medicare was put into effect to give higher reimbursements to hospitals that treat a higher percentage of indigent patients. Though this is not meant to support GME, it is additional revenue for teaching hospitals in underserved and underinsured areas.

Reimbursement:

In 1983, the federal government divided GME reimbursement into two subgroups: Direct Medical Education (DME) and Indirect Medical Education (IME). Both types of payments are based on the number of full-time equivalent (FTE) residents a hospital has. 

• The more FTEs, the more payments a  hospital receives
• Residents are counted as one FTE during their Initial Residency Period (IRP)
• Residents are counted as half (0.5) an FTE if they serve beyond their IRP
• IRP is determined at the beginning of the residence period and cannot be prolonged. Family medicine IRP is generally 3 years.
• Training in an in-hospital setting allows for DME reimbursement for all approved activities, such as patient care, education and research, and IME reimbursement only for direct patient care. 
• Training in a non-hospital setting will allow for DME and IME reimbursement only for direct patient care.

Direct Medical Education (DME) Reimbursement:

• In hospital settings, it covers residents’ salaries, benefits, and faculty and hospital overhead directly related to the GME program.
• In non-hospital settings, it covers residents’ time spent primarily engaged in didactics and furnishing patient care if the hospital pays substantially all of the cost of the resident’s salary and benefits. The hospital must also have a written agreement with the teaching attendings and pay the portion of their salary attributable to the GME supervision.

Indirect Medical Education (IME) Reimbursement:

• Is paid under the Inpatient Prospective Payment System (IPPS). These payments are designed to cover the higher costs for providing patient care at teaching hospitals in comparison to non-teaching hospitals.  

References

cms.gov

AAMC.org

Medicare Payment for Graduate Education

Medicare Financing of Graduate Medical Education. J Gen Intern Med. 2002 April; 17(4): 283-292

Contributed by: Luigi Tullo, MD, Jamaica Hospital Family Medicine Residency Program

Transforming a Presentation Into a Publication

Most faculty members give presentations on a regular basis; fewer write for publication. Knowing where to start, how to write, where to send an article, how to organize the topic and subject, etc, can all be barriers. By thinking ahead, you can make your lecture a starting point for an article.¹ 

When preparing for a lecture, most people follow these steps:¹

1. Identify a topic
2. Search review articles and then more specific pieces, as needed
3. Outline important points
4. Summarize on slides

When writing for publication, most writers follow these steps:¹

1. Identify a topic
2. Write an outline
3. Conduct research
4. Summarize research
5. Identify a journal for publication and review requirements
6. Write a rough draft
7. Edit and finalize manuscript
8. Submit for publication

By moving step number five–identifying a journal–up to step two, right after identifying a topic, you can gear your outline/research, etc toward the journal. You can create your presentation and research your journal article simultaneously.  

Assess Your Writing Style¹

Understanding your writing style can help you be efficient in your manuscript preparation. If you tend to write like you talk, consider recording your lecture, then getting it transcribed. The transcription can serve as your rough draft. If you need a long period of time to really think about what to write, consider breaking the article into several small parts, then work through them methodically.

Find Time to Write¹

One of the most difficult aspects of writing is getting started. Follow these steps to move past inertia:

• Understand yourself and your writing style.
• Compartmentalize tasks.
• Prioritize. Set deadlines and keep them.
• Carve out time:

• Conduct your literature search while on call.
• Create an outline while you are waiting for something

Follow These Tips to Transform Your Presentation Into a Publication¹

• Put the time in at the beginning of the process.
• Be organized—keep track of all sources.
• Understand yourself and your work style.
• Use the notes section in PowerPoint to help you write what you say. The lecture is your article outline.
• Practice giving your talk and either tape yourself and transcribe it, or type while you talk.
• Go through the presentation multiple times and update the notes.
• Copy the notes into a Word document.
• Edit for readability and flow

Proactively planning to transform a presentation into an editorial will require a time investment at the beginning of the project but will pay off in productivity and tangible outcomes. 

References:

1. Schrager S. Transforming your presentation into a publication. The STFM Resource Library; 2009. Available from https://resourcelibrary.stfm.org//transforming-your-presentation-into

Creating Successful Abstracts

A good abstract is an important part of having your work accepted for presentation at a scientific conference. Before deciding to submit an abstract, make sure you’re available to attend the full meeting.

What Is an Abstract?

An abstract is a short description of your project. It should contain enough information so that the reader can determine:

• The objectives of the study
• How the study was done
• What results were obtained
• The significance of those results

Tips for Preparing Your Abstract:

• Review the submission rules carefully. Pay close attention to deadlines, formatting requirements, and word limits.
• Give yourself plenty of time; don’t wait until the last day.
• Read through prior meeting abstracts. This will give you a better understanding of the style of the abstracts accepted and what is likely to be of interest to conference attendees.
• Focus on a project you have fully or mostly completed. Some organizations allow for “works in progress” submissions.
• Don’t include any results that are not fully analyzed.
• Provide the basic outline of what you did and why. This includes:
• Hypothesis
• Methods
• Results
• Conclusions
• Have a colleague proof your abstract and make sure the information makes sense

STFM conferences and the North American Primary Care Research Group (NAPCRG) annual meeting offer attractive presentation opportunities. You can find deadlines and more details by visiting theSTFMandNAPCRGweb sites.

Based on your teaching and research interests, you may also find niche presentation opportunities at specialty meetings.

Additional Resources:

Tips to Improve Your Abstract (PDF) by the STFM Research Committee

Strengthening Your Research Submission (Video) 

Contributed by: Sally P. Weaver, PhD, MD, Waco Family Medicine Residency Program

Presentation Pearls

Becoming both a competent and confident public speaker requires a lot of practice. The following tips can help you start sharpening your skills.

Preparation:

• Be familiar with your audience. Make sure the material is appropriate.
• Research the topic and stay focused on what you want your audience to know.
• Remember that shorter is usually better.
• Develop a topic slide. This will tell the audience what your lecture is about.
• Present three to five major sections or points per hour.
• Limit each section to 15 to 20 minute blocks.
• Plan transitions at the end of each section. An example is to allow for questions, discussion, activities, or verbally state you are moving to the next section.
• Build in activities wherever possible to make learning interactive.
• Have a summary slide for the end of your presentation.
• Include a reference list. Don’t forget to include websites.

Delivery:

• Stand, don’t sit, during your presentation.
• Dress appropriately. Be slightly dressier than the audience.
• Show enthusiasm for your topic.
• Smile. It helps to relax the audience and yourself.
• Don’t read your slides. Use a conversational tone. Remember that slides serve as the outline of what you want to say, not a script.
• Speak clearly, slowly, and with the appropriate volume.
• Look at the audience when speaking, not at the projection screen.
• Tune into your audience’s needs. Look for nonverbal clues to determine if they are following and understanding what you are saying.
• Avoid using filler words “uh” or “you know.”
• Be aware of fidgeting, swaying, or playing with something while you are speaking.
• Read captions when using cartoons in your presentation.
• Involve your audience. Ask questions or opinions.
• Use the “Ask-Pause-Call” approach. Ask the question, pause 5 seconds, and then call on someone for the answer. The pause gives the audience a chance to process the information.
• Repeat questions from the audience before you answer. This ensures everyone knows what the question was.

Presentation Slides:

• Plan to use one slide per minute for a 40 to 50 minute presentation.
• Include brief, key points on slides. A rule of thumb is no more than seven words per line and no more than seven lines per slide.
• Avoid too much animation.
• Ensure background and lettering has a good contrast. Light text with a solid, dark background tends to be best.
• Use thick, san serif fonts for slides. They project best.
• Use as large a font as possible. Recommendations include:
• Titles: 44-54
• Main Text Titles: 32-38
• Smallest Text Lines: 24-32
• Anything below 24 is too small
• Use pictures and graphics to aid learning.
• Avoid graphs with too much information or with lots of thin lines.
• Don’t use dotted, dashed, or other specialty lines in graphs unless they are very bold and thick.

Handouts:

• Only include pertinent information.
• Provide in an easy-to-read format. Serif fonts are recommended. 

Other Helpful Hints:

• Approach presentation as scholarly work.
• Obtain feedback to improve your presentations skills.
• Rehearse your presentation, using an audience if possible.
• Rehearse with the equipment you will be using.
• Respect the audience.
• Be yourself.

Contributed by: Cynthia Passmore, MA, Texas College of Osteopathic Medicine

Mentorship

At its essence, mentorship is a relationship. The goal of the relationship is to foster professional and personal growth in the mentee.

Key Elements of a Mentor/Mentee Relationship:

• Trust
• Honesty
• Safety
• Accountability
• Transparency
• Confidentiality
• Feedback

Styles of Mentoring Relationships:

• Informal Mentors – These relationships develop from the pursuit of honest feedback from people we trust and respect.
• Formal Mentors – This type of relationship is used to systematically develop careers. It’s a more organized, intentional approach.

Structure of the Mentor/Mentee Relationship:

• Initiated and built in order to serve the goals and needs of the mentee
• Allows both parties to be honest in identifying needs and goals of the mentee
• Fosters an atmosphere where strengths and weaknesses can be discussed and explored
• Explores resources helpful to the mentee at each point in his or her development

The Role of Trust/Honesty

Honest, open feedback is a core element of the relationship.

• Mentor explores difficult issues related to the performance and/or developmental needs of the mentee
• Mentor shares information in a way that can be heard, processed, and acted upon
• Mentors avoid solving problems for the mentee, and instead helps mentee explore various options to solve his or her own problems. This is analogous to the “teaching to fish” approach to guiding learners.

Trust Is Essential

• The nature of sometimes difficult discussions is why a relationship built on trust and the creation of an environment where the mentee feels safe and secure while discussing difficult and personal issues is essential.
• The mentor must maintain conversations in strict confidence.
• The need for confidentiality is the reason that, if possible, supervisors responsible for evaluating the mentee may not be the best choices for mentors.

Contributed by: John Franko, MD, East Tennessee State University

Maintaining Work/Life Balance

Here are some tips for balancing your personal and professional life:

Organization & Planning

• Plan, plan, plan. Home and work both flow much better with planning. At work, have a daily, weekly, monthly, yearly and a 3-5 year plan for your activities. Set goals for yourself and put them on your schedule.
• Be efficient at the office. Get your important work done first and then work on the less important tasks other people need from you. Be careful about the amount of time socializing. In other words, prioritize your workload.
• Don’t check your email frequently. Set 2-3 times a day to deal with email and otherwise leave it alone.
• Be organized at home and at the office. Being able to lay your hands on that piece of paper or bill you need is important and will save time in the long run. Develop a filing system that works for you and use it!
• Consider planning to stay an hour or two late at the office one day a week to complete projects/catch up on charting, etc. When this is the expectation every week, your family will come to think of it as part of your regular routine and not an imposition.
• Plan project timelines around non-work obligations. You don’t want to have, for example, a due date for a grant application interrupt your family vacation to the Grand Canyon.
• Don’t take work home. OK, sometimes this is unavoidable. BUT, by being a good planner and using your time efficiently at work, you should be able to avoid this most of the time. Along the same lines, don’t do work email at night or on weekends if you can possibly avoid it. 99% of stuff can wait until the next day or until next Monday.

Work Priorities

• You will be a much more successful faculty member if you get training that is specific for your position (medical student director, research director, etc.) and anything that makes your job “easier” means you are more likely to leave the office on time each day.
• Say no without saying no. As a new faculty member, you’ll be asked to take on responsibilities that other faculty don’t want. When new opportunities arise, your response should not be an automatic yes. Say, “that sounds interesting” and that you will discuss it with your program director and get back with them.
• Choose committees wisely. If you have some say in this, find out what each committee does, how often they meet, when they meet (might a commitment outside your department conflict with your departmental faculty meeting), and what amount of work will there be in between meetings.
• Make friends at professional meetings. Meetings you go to year in and year out are much more pleasurable to attend if you are looking forward to seeing “old friends.” So how do you make friends at meetings? Attend sessions that interest you and get to know the presenters. Attend dine around groups at STFM meetings. Make the effort to go out to dinner with people NOT from your home program.
• Make some friends at work. You’ll enjoy your job a lot more if you get to spend time with friends there. Also, get to know staff names – not just the nurses, but also the cashiers, appointment handlers, janitors, etc.
• Give up expectations for perfection. We all want to teach well, take care of patients well, be a good communicator, conduct great research, etc., but sometimes good enough needs to be enough. What that looks like for you is very individual. Also, an expectation of perfection can keep us from trying to do things and thus keep us from growing as individuals.
• Just as there are seasons in a calendar year there are seasons in your work year. Late June and early July with new residents tends to be busy at work and may not be the best time to plan a family reunion. Spring tends to be a time of higher energy levels for lots of people and may be a good time to start/complete projects.

Time Off & Vacation

• Use all your paid time off (PTO), vacation, and CME time off each year. Don’t let it expire on you. This means you must plan your vacation/attending schedules well in advance each year. Remember that people who spend money on experiences rather than accumulating things are happier in the long run.
• Schedule medical and dental/orthodontic appointments for you and your family well in advance and use sick leave/PTO for those.
• Use your maternity/paternity leave to its full potential. Remember that by national law, you may take up to 12 weeks off under the Family Medical Leave Act (but your employer does not have to pay you).
• You may want to take time off when your children notice your absence more (such as during the summer vacation months, winter holidays, national holidays, etc). Also, children tend to forget those early summer family vacations, so consider a family vacation closer to when the kids return to school.
• It may sound like a good idea to go to a CME conference and combine it with a 'family vacation’ but this often doesn’t work well because you are torn between going to sessions to get your CME and spending fun time with your family. A better plan is to have the family vacation time before or after the meeting.

Life Priorities

• Exercise regularly to keep yourself healthy. Be a good example to both your learners and your patients.
• Get enough sleep. You need a good night’s sleep (7-8 hours) at least 5-6 nights a week. Getting enough sleep will translate into a more productive you who has a better attitude and outlook on life.
• Eat good stuff. This should go without saying, but let’s say it anyway – don’t eat junk food very often, don’t overdo the caffeine, alcohol or sweets, eat plenty of vegetables and go slow with the fat intake. As teachers of doctors, we need to set a good example by what we put in our mouths.
• Phone calls and texts/pages from your immediate family and/or significant other are the most important messages you receive.(You may have to lay down some ground rules, such as only calling if there’s an emergency but they can text you any time with the understanding that you may have a delay in responding.)
• Outsource as you are financially able. This may mean hiring a housecleaner, using a dry cleaning service that picks up and delivers, contracting with a lawn service for yard care, using a pool service company, finding a piano teacher that comes to your house, etc.
• When you have young children at home, consider trying to arrange for shorter in-patient attending segments. Leaving home early for a week or two is much easier for your significant other/spouse and kids to tolerate then a whole month.
• Family meals are important. Make your best effort to sit down and have a family meal as many nights a week as you can.
• Develop a personal hobby. What do you like to do for fun/relaxation? How can this become a hobby for you? Learn a new skill like painting, gardening, hiking, sewing, family genealogy, photography, or playing an instrument.
• Consider doing volunteer work that is not medical, such as helping at a community garden, assisting with programs at your church, helping at your local family abuse shelter or at an animal shelter. People who do volunteer work are generally more satisfied with life.

Be present in the moment. When you’re at work, be at work and get your work done timely and efficiently. When you’re at home, be at home with your family/kids/pets/friends.

Contributed by: Sally Weaver, PhD, MD, Waco Family Medicine Residency Program

Medical Professionalism

The ACGME uses medical professionalism as a category by which we must rate our learners.

Lynne Kirk, MD, gives a good listing of medical professionalism attributes: "[learner] arrives on time, maintains patient confidentiality, accepts blame for failure, listens well, follows through on tasks, doesn’t make inappropriate demands, is not abuse and critical in times of stress, is never hostile, derogatory or sarcastic, is not loud or disruptive and finally, is patient."¹ This seems like a reasonable list of behaviors for all health care providers, especially faculty, who are setting an example for their learners all the time.

Each residency program likely has its own stated (and unstated) tenets of medical professionalism, setting standards for how residents are to dress, behave, and speak when dealing with patients. Faculty must step in and redirect learners who don’t follow these standards. However, medical professionalism transcends these day to day “rules.”

In 2002, the Physician Charter was penned and has been endorsed by many medical organizations, including the American Board of Family Physicians.

The principles of this treatise on medical professionalism include:²

• Altruism—dedication to serving the best interests of our patients
• Patient autonomy—honesty with our patients and using each individual patient’s care wishes to guide therapy
• Social justice—this includes the fair distribution of health care services and the elimination of discrimination in health care

Additionally, this charter describes professional commitments of physicians and other health care professionals:²

• Commitment to professional competence (Maintaining your license, providing competent care, keeping up with documentation, etc.)
• Commitment to honesty with patients
• Commitment to patient confidentiality (This also means no confidential info in non-password protected emails, no tweeting or texting about patients/patient care, not discussing cases in front of non-involved persons, etc.)
• Commitment to maintaining appropriate relations with patients
• Commitment to improving quality of care
• Commitment to improving access to care
• Commitment to a just distribution of finite resources
• Commitment to scientific knowledge (Reading and studying to advance our knowledge, maintenance of certification through the American Board of Family Physicians, etc)
• Commitment to maintaining trust by managing conflicts of interest
• Commitment to professional responsibilities

References

1. Professionalism in medicine: definitions and considerations for teaching Lynne M. Kirk, MD. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769526/ Passi, V., Doug, M., Peile, E., Thistlethwaite, J., & Johnson, N. (2010).

2. Project of the ABIM Foundation, ACP–ASIM Foundation, and European Federation of Internal Medicine*. Medical Professionalism in the New Millennium: A Physician Charter. Ann Intern Med. ;136:243–246. http://annals.org/aim/fullarticle/474090/medical-professionalism-new-millennium-physician-charter

3. Developing medical professionalism in future doctors: a systematic review. International Journal of Medical Education, 1, 19-29. http://www.ijme.net/archive/1/developing-medical-professionalism-in-future-doctors.pdf

4. Professionalism in Medicine: A Case-Based Guide for Medical Students (Cambridge Medicine) [Paperback] 2009 John Spandorfer (Editor), Charles A. Pohl (Editor), Susan L. Rattner (Editor), Thomas J. Nasca (Editor)

Contributed by: Sally Weaver, PhD, MD, Waco Family Medicine Residency Program