If you are interested in a career in medical education, your timing couldn’t be better! Opportunities await as medical education reinvents itself. You can be part of the change and fuel innovation as the need for skilled medical educators grows. Some institutions now offer formal career paths in medical education. But let’s not get ahead of ourselves.
In a recent NEJM Resident 360 online discussion (Apple for the Teacher: Careers in Medical Education), medical educators assessed the “lay of the land” in medical education and discussed changes in medical education, career paths, training, and opportunities. In this blog post, I review some highlights of that discussion and offer tips to help set you up for success.
Changes in Medical Education
Medical education must change for the following two reasons:
- the needs of adult learners have shifted
- health-care delivery is evolving
Since my time in medical school, information delivery has gone through a transformation. In the 1990’s, medical curricula were lecture- and conference-based because the only other sources of medical information were in textbooks, dusty library stacks, or on the wards. Now that a seemingly endless amount of information is instantly available on the Internet, the needs of students have changed. Educators must help today’s students acquire skills to evaluate the quality of evidence and select the best evidence. Students should then be able to apply their knowledge to improve patient care. Lecture-based curricula do not meet these needs and medical education has been slow to respond.
Blended Learning and Flipped Classroom Models
In the flipped classroom, students personalize learning on their own time outside of the classroom and are given the opportunity to apply their knowledge with the assistance of content experts in the classroom. This model enhances learning both inside and outside the classroom and makes learning more memorable and meaningful. The role of medical educator shifts from “deliverer” to “facilitator.” Blended learning integrates web-based online learning with face-to-face instruction.
Characteristics of Flipped Classrooms
- students study before class with:
- carefully selected/produced videos (e.g., Khan-Academy style, prerecorded lectures)
- curated learning materials (e.g., original research articles, review articles)
- active learning in the classroom includes:
team-based learning (TBL): strategically formed student teams; the process consists of preparation, readiness assurance, and a team application exercise where students “simultaneously respond;” guided by a facilitator
just in time teaching (JiTT): students complete web-based assignments prior to class, the instructor assesses their submissions "just-in-time" and adjusts an active classroom activity to suit the students' needs
problem-based learning (PBL): groups of students work in and out of class to solve problems guided by a facilitator
- interactive sessions (e.g., peer-teaching, active inquiry)
- use of standardized patients
Meaningful Integration of Technology
- audience response systems (e.g. Turningpoint Cloud, Poll Everywhere, Socrative)
- videos with interactive questions
- innovative apps (e.g. interactive dissection manuals)
- online discussion boards for peer-education (e.g. Piazza, NEJM Resident 360)
- web-based interactive cases and virtual patient care
- experiential learning using virtual reality
- adaptive learning technology (e.g. online teaching and questioning at Macrophage)
Focus on Changes in Healthcare Delivery
- interdisciplinary care
- value-based care
- quality Improvement and patient safety
- point of care medicine
- precision medicine
Medical education and training must not only encompass these areas, but also prepare students to become leaders and innovators. We can’t let rapid changes in healthcare delivery get too far ahead of us. Medical educators know that caring for the patient is the purpose of medicine. Therefore, despite all of the technological advances, we must also continue to focus on bedside teaching, professionalism, and humanism in medicine. Programs in narrative medicine, ones that address cultural competency and health disparities, and initiatives empowering future physicians in “self-care” will help doctors provide better patient care.
How to Get Started
“Think of educational opportunities as a 'tapas' spread when you start out your career. Try many things and then decide where your passion lies.” —Dr. Subha Ramani
Three major themes emerged from the discussion of how we, as medical educators, arrived at our current careers:
Mentorship: Every medical educator I know identified a mentor or network of mentors early on. Seek out mentorship from medical educators you admire. Listen to their stories and learn how they got to where they are.
Opportunities: Along with mentorship comes opportunity. Many of us entered medical education serendipitously. We were offered the opportunity to teach a class or give a chalk talk after rounds. Volunteer your time and take advantage of a variety of teaching opportunities. Be open-minded and don’t limit yourself. You can even create your own opportunities — innovate, execute, and evaluate your ideas.
Passion: Medical educators love their work. You will learn whether or not you are passionate about medical education by doing the work. You will discover where your talents lie and what your interests are by doing. Go that way.
|“Some find it easier to focus on a specific group of learners: medical students, residents, fellows; others find it easier to focus on programs/skills: scholarship in medical education, curricular design, faculty development, or coaching programs. As with so many things in medicine, the pathways are rarely linear and rather are informed by the experiences that you gain along the way!” — Dr. Karen Law
Dr. Ramani shared a taxonomy she uses to organize medical educators: the clinical teacher, the clinician educator, and the educationalist. Depending on the role you wish to pursue, you may or may not seek more training. For example, engaged clinical teachers may read the literature, invite peer observation, or attend workshops. Clinical educators take on leadership roles and engage in educational scholarship. In both cases, the consensus is that you do not need a degree in medical education to be successful. However, educationalists specialize in the theory and science of education, teaching, and learning (e.g., evaluate the effectiveness of teaching methods, use data to develop new learning tools) and may want to pursue degrees in education. If you are considering a career focused on medical education, explore programs and professional societies with explicit educator pathways or Master’s programs and institutions with official medical education promotional tracks.
Setting Yourself Up for Success
What should you do regardless of your exact career path? Focus on "quantity, quality, and engagement with the education community." Reflect on and evaluate your teaching. Do scholarly work and share it. Start building a dossier from the get-go and add absolutely everything to your curriculum vitae. Here’s a summary list of activities to get you started:
- read the literature (see list of medical education journals below)
- find mentorship and mentor others
- engage your local community of educators; network
- teach your peers
- evaluate your work
- disseminate your work (e.g., presentations, workshops, publications)
- listen to your learners — partner with them to optimize their learning
- explore education-oriented social media and online resources (see list of related twitter handles and hastags below)
- be open to inspiration (I infuse music into my educational tools!)
- document absolutely everything you do to optimize your educator portfolio
- and finally…have fun!
As a final note, I would like to declare a call to arms: Medical educators cannot just be valuable; we must be valued. Reforming, innovating, and optimizing medical education to meet the needs of the evolving healthcare system requires significant time, training, and effort. Institutions must support medical educators. In the short term, we may not bring in the most dollars, but we are an investment that will pay off in spades.
Medical Education Journals
Advances in Health Sciences Education
BMC Medical Education
The Clinical Teacher
Medical Science Educator
@AAMCtoday (Association of American Medical Colleges)
@AmerMedicalAssn (American Medical Association)
@AcadMedJournal (Academic Medicine)
@AdvocateforEd (The Edvocate)
@GoldFdtn (The Gold Foundation)
@macyfoundation (Macy Foundation)
@StudentEdition (Med Student Edition)
@studentdoctor (Student Doctor Network)
@Teach_Institute (Teaching Institute)
Education and Medical Education Hashtags
#FOAMed (Free and Open Access to Medical Education)
#OER (open educational resources)
|Rachel J. Gordon, MD, MPH is Associate Professor of Medicine and Epidemiology at Columbia University Medical Center. Follow her on Twitter @MIDGordon.