Article In Brief
In this new series from Neurology Today, which is focused on career advice for neurologists at all levels, our experts share advice and direction on becoming a clinician-educator.
Question: I have an interest in pursuing a clinician-educator track. Where do I start and how do I proceed?
Jeremy Moeller, MD, FAAN, associate professor of neurology at Yale School of Medicine, doesn't have to think long when asked to explain the essence of being a clinician-educator.
“What I would say to anyone interested in this career is that it starts and ends with a love for teaching in all its forms,” said Dr. Moeller, associate vice chair for education and neurology residency program director at Yale.
“An aspiring clinician educator should say ‘yes’ to as many teaching opportunities as possible,” he said, whether that means leading a discussion group or journal club or mentoring an undergraduate student interested in preparing for medical school or overseeing medical students or residents rotating through your practice or clinic.
“Getting involved in those types of teaching activities helps you develop your skills as an educator,” he said. “It also allows you to understand how teaching and learning happen. The more you teach, the more you get involved with learners, the more ideas you get about how learning happens.”
Dr. Moeller, who is an epilepsy specialist, said that some residency programs, including the one at Yale, have clinician educator programs and tracks, which allow for a more formalized approach to gaining didactic skills and an understanding of educational theory.
“There are also faculty development programs in education that are offered at many medical schools, and very interested individuals can pursue part-time graduate training as well,” he said. While it is not critical for every clinical teacher to participate in one of these programs or tracks, he added, “additional training is very helpful for those who want to work on education research or curriculum development, and for those who want to move in leadership roles in medical education.”
“There is a lot of research in medical education,” said Dr. Moeller, who incorporates medical education research into his role as clinician educator. His research interests include assessment and curriculum design.
Dr. Moeller said the ultimate goal of being a clinician-educator is not simply to turn out smarter doctors, but to improve the care of patients. “The goal is to make sure that the person (student, resident) develops the knowledge, skills and attitudes to give the best care,” he said. “It's just an incredible privilege to be able to play any sort of role in the career development of someone who cares about the same things I do.”
Find A Mentor
K.H. Vincent Lau, MD, associate director of the neurology residency program and director of the neuromuscular fellowship program at Boston University School of Medicine, said no matter what point a person is on the path toward becoming a clinician educator, having a mentor is critical.
“I have had mentors at every stage of my training and that was very instrumental,” said Dr. Lau, who counts Drs. Jeremy Moeller and David Greer as his mentors. Some mentor-mentee relationships are casual, while others are more formalized, such as when a medical student or resident collaborates with an attending physician on an education research project.
“People who declare themselves educators tend to be very approachable,” he said. “They are actually very happy to be asked for advice,” or other support. He has found that the best medical educators tend to have “a very strong mastery of neurology,” said Dr. Lau, adding: “You have to be a great clinician before you become a great clinician educator.”
Dr. Lau, a neuromuscular specialist and assistant professor of neurology at Boston University, said he realized early on in his medical training that he wanted to understand more about the process of teaching, including how to quantify whether a teaching method or modality is effective or not. He completed his residency on the education track at Yale-New Haven Hospital.
“I enjoyed teaching a lot and was also interested in the theory behind teaching,” he said. One of his key areas of research is the use of technology in medical education.
He has published on computer-based teaching modules, learning analytics, and other aspects of e-learning.
Dr. Lau said educators need to resist the urge to “to implement something because it's new or different without having a rationale for why it is being added to the curriculum.” He recently closed out one year of a biweekly podcast he produces alongside two residents called Neurology Clinical Pearls. He says it has garnered approximately 20,000 plays to date. “My favorite projects are the ones I do with trainees,” he said.
Look for Opportunities
Veronica Santini, MD, MA, who recently moved from Stanford University, where she directed the neurology clerkship and was an educator in a student learning community, said it is important to make your goal of being a clinician educator clear in job interviews and subsequent professional assessments with department leadership.
“First and foremost, you need to define yourself as an educator. If you want to become a clinician-educator you have to make that known to potential employers,” said Dr. Santini. “Make it known that this is something important you want to do with your career, that it's not a side goal.”
She said that if the desire to be involved in medical education is not clear to your institution, “you're not going to be supported in that career goal. Practically speaking, it's going to be very difficult to balance that desire to be an educator with everyday clinical practice.” Not having a defined education role could be particularly problematic in today's health care environment with its emphasis on billable hours.
Dr. Santini, who is now the clinical division chief and inaugural director of the Comprehensive Parkinson's Disease Center at Yale, advises those interested in exploring the possibility of being a clinician educator to “see where there may be an education gap or practice gap” at their institution and then think creatively about how it could be filled.
“There are so many levels of opportunity in education,” she said, from providing community-based education around a neurologic topic to leading a seminar on neurologic practices for non-neurologists or allied health professionals. Such experiences help to demonstrate “that you're ready to engage in a more formal world of medical education,” Dr. Santini said.
Once a person has demonstrated a commitment to education and built an educational portfolio, “then they should broadly apply for compensated positions, within and outside the field of neurology,” Dr. Santini said. “This will allow dedicated time to work on educational endeavors and to advance as an educator.”
Dr. Santini said she believes that neurologists are ideally suited to be educators because “as neurologists we are indeed master clinicians.”
“We are masters of taking the medical history, we are masters of the clinical exam, we are masters at figuring out complex situations,” all essential skills in medical education. Being compassionate is also an important characteristic of being a successful medical educator, she added.
“The further and further you get away from (medical school, residency) you might lose compassion for the learners. But as a leader and educator you have to put yourself in the learner's shoes. ‘What is going on? What are your thoughts? How are you understanding this?’ she said.
And it isn't a one-way street. “I learn all the time from my students and trainees,” Dr. Santini said.
Develop Formal Expertise
“Teaching isn't just a passive sort of thing that you pick up over time. Rather, ideally you gain formal skills as you develop a career,” said Patrick M. Chen, MD, a neurocritical care fellow at Massachusetts General Hospital.
In addition to the residency training tracks, professional conferences and organizations such as the AAN and Neurocritical Care Society are offering more sessions and resources relevant to medical educators, he pointed out and the availability of on-line courses is expanding.
Dr. Chen said the development of outstanding clinician educators is vital to the future of the neurology workforce, which is expected to experience a significant shortage in the next decades as the population ages and more people live with chronic neurologic conditions. Expanding diversity in the ranks of clinician educators is important also.
“I think the educator is sort of the poster child for the representation of the field as a whole,” he said. “If there's an enthusiastic program director, that can have a big downstream effect.”
Dr. Chen's education work at Mass General involves identifying knowledge gaps and implementing practical learning sessions among non-neurology and non-physician hospital teams including medical ICU teams, nursing, and advanced practice providers.
Opportunities for Earning Money
Moises Dominguez, MD, neurology chief resident physician at New York-Presbyterian Hospital/Weill Cornell Medical Center, said medical students and residents might also make some money from teaching-related jobs. When he was in medical school, he took on assignments for a medical education start-up company that involved writing questions for learning modules and doing illustrations. He discovered in the process, “I truly enjoy making complex medical issues into something digestible.”
Under the mentorship of Dr. Moeller during residency training at Yale, he began to develop teaching videos on various topics.
Dr. Dominguez said that given the tremendous growth in the understanding of the brain and a host of neurologic conditions, the potential topics for medical education are endless. One of his goals as a clinician-educator is to figure out ways to use the video-based model of learning to teach evergreen topics more efficiently in neurology, so that time is freed up for students and trainees to delve more into specialized topics.
Dr. Dominguez will soon begin a headache fellowship at NYU.
Neurology Today is launching a new series focused on career advice for neurology providers at all levels—from those just entering the field, through to midlevel and senior providers. In this and future issues, look for answers and guidance on common questions from experts in the field. If you have a career-related question or challenge you'd liked answered, email your question to [email protected].