(The ICE blog is growing! We’ve reno-ed our offices, purchased some bunk beds, and car pooled to work in order to add two new editors. This post is from a new editor Mike Gisondi. You can learn more about him here. Please say hi on Twitter. On Monday, we’ll introduce our second new editor… [insert teaser here]
By Michael Gisondi (@MikeGisondi)
In July 2003, Academic Medicine published two important articles: The UCSF Academy of Medical Educators by Cooke, Irby and Debas, and The Academy at Harvard Medical School: nurturing teaching and stimulating innovation by Thibault, Neill, and Lowenstein. These papers described new faculty development programs aimed at recognizing and supporting outstanding teachers of medicine, through membership in an ‘academy’ of medical educators.
Both articles acknowledged an observed change in the central nature of medical schools, a shift from an exclusive focus on teaching to our modern system that favors clinical productivity and research. Medical educators were being overlooked. Through the development of academies of medical education, universities could highlight their distinguished teachers and facilitate educational scholarship. This idea caught traction. According to the Academies Collaborative, there are now over 60 such academies at medical schools in the United States and Canada.
Membership in an academy of medical educators is generally reserved for those faculty members who excel in one or more professional domains. As an example, the UCSF Academy of Medical Educators recognized five such domains: direct teaching, curricular development, mentoring, educational program leadership, and educational research. While the definition of excellence varies among schools, most academies utilize a similar eligibility. In these honorific organizations, academy membership confers a special recognition of sustained achievements and dedication as an educator.
Honorific academies have ‘pros and cons’. In the ‘pro’ column, those who are inducted in an academy may find great personal satisfaction in the achievement, which may serve to validate past efforts and promote continued engagement at work. Academy membership is also a recognized honor within a school of medicine that is easily understood by promotions and tenure committees.
However, honorific academies suffer from two serious ‘cons’: (1) by definition, they don’t do anything, and (2) the exclusive nature of the membership structure creates winners and losers. Honorific academies systematically limit the overall membership to a certain percentage of the total medical school faculty.
Let me offer my personal experience, both as a former member and director of an academy.
In 2010, Northwestern University created the Feinberg Academy of Medical Educators (FAME), and I responded to the initial call for members. The application was complicated and utilized a matrix of domains similar to the one described above. Fortunately, I squeaked in, and I had the privilege of joining 32 other Feinberg faculty members in the inaugural year. I have to admit, it truly was an honor to be inducted in FAME. But if I didn’t get in… I doubt I would have reapplied. The time-consuming application took many days to complete and I wasn’t certain that the effort was worth the honor.
Fast forward five years, and I find myself in the office of Dr. Diane Wayne, Vice Dean of Education at Feinberg School of Medicine, being offered the opportunity to serve as the director of FAME. She made two brilliant statements during our conversation: “FAME needs to do more than just induct members. And it needs to be more inclusive.” Had she not presented those conditions, I likely would have turned down her kind offer. Instead, I spent close to 6 weeks deciding whether to take on the role. I used this time to identify examples of “active” academies and understand their organizational structure. (Many thanks to Dr. Helen Loeser at UCSF, Dr. Eva Aagaard at University of Colorado, and Dr. Amy Sullivan at Harvard Medical School for their time and counsel during my fact-finding mission.)
I served as the director of FAME for three years, before moving to Stanford University in 2017. Early on, I took it as a challenge every time someone asked, “what does FAME do?” I spent a great deal of time working with other academy members to answer that question. In the organization’s first five years, FAME had grown to 70 members, comprising some of the most talented educators at the medical school. Now that those individuals were identified, shouldn’t we call on them as a group to do something special? Could we not evolve from an honorific organization to a service organization? Our academy was at a crossroads.
The organizational identity crisis of FAME was not unique. I have since heard a similar narrative described for many of the academies that were initially established as honorific organizations. Schools want to honor their best educators, they go to great lengths to identify them… and then what? The answer isn’t so simple. As I learned, some academy members applied just for the honor – they were not interested in devoting their time to new academy initiatives. Other members were eager to participate, but were now too busy – remember, these were the best educators — it made sense that their careers would advance and new administrative responsibilities would dominate their time.
FAME matured in two distinct ways. First, we began to sponsor numerous faculty development programs open to all members of the medical school community. These included a monthly medical education grand rounds series, certificate programs in medical education, and a year-long faculty development lecture series for junior faculty. FAME therefore became a rich source of faculty development opportunities, and certainly did something. Second, and as important, we revised the membership criteria to include not only distinguished senior educators, but junior faculty and trainees with aspirations of becoming distinguished themselves. The revised membership structure allowed senior members to interact with junior members, making FAME a potential rich source of mentorship, too.
I return to the title of this post, “Does Academy = Community?” I hope that the natural life cycle for all academies of medical education can be traced from honorific organizations, to service organizations, and ultimately to active communities of practice. Academies can serve as a reward for medical educators, not simply through the honor of being selected, but through the individual’s enrichment derived from inclusion in a defined community of practice. Positive social interactions drive human happiness, not brief honors that live as a line item on a CV or a certificate on a wall. Many educators feel isolated in their respective departments, outnumbered by the clinicians and the researchers. Academies allow educators the opportunity for positive social interactions within a community of their peers, improving their morale through a sense of belonging and inclusion.
Jean Lave and Etienne Wenger defined the community of practice as a collection of individuals who share a common domain or interest, and through engagement with each other, community members strive to learn, grow, and better practice their craft. Academies of medical education can certainly meet this definition, if structured properly.
It was an honor for me to be inducted in FAME, but even more meaningful to be an active participant as FAME matured into a community of practice.
Does your Academy of Medical Education = a Community of Practice?
Acknowledgements: The author is forever grateful to Dr. Diane Wayne for the opportunity described above.