A Day in the Life of a CE: Jason Frank

By: Jamiu Busari

Jason Frank, MD, MA, FRCPSC

Director of Specialty Education, Strategy and Standards at the Royal College of Physicians and Surgeons of Canada

Vice Chair, Education, Department of Emergency Medicine, University of Ottawa

Emergency Physician, The Ottawa Hospital

What is your clinical and/or educational background?

I would describe myself as a clinician educator (CE); that is my identity. I have one foot in the clinical world, and the other in the educational world. In my clinical role, I work as an emergency physician, which in Canada is a specialty, and in my academic role, I am a medical education health professions specialist.

By the age of 7, Jason Frank knew that he wanted to become a doctor when he grew up. He describes himself as one of those unusual people who always knew what he wanted to do. Jason hails from a very rural, Northern part of Canada, which he describes as very cold- a place where few people get to enjoy a post-secondary education. He entered medical school at the University of Ottawa in 1990, and at that time, the school was undergoing a major transformation. Jason was elected first-year class president and was involved in a lot of committees as they rolled out the new, innovative, problem-based learning curriculum. “I was on all of these committees where people were debating various questions like ‘should PBL tutors be experts in PBL or experts in content?’ and I would go to the library often where I discovered there was research on a lot of these questions. After a while I decided, you know what, I’d really like to go and study this.” So, Jason got permission from the medical school to go on a sabbatical and pursue a Masters in Medical Education at the University of Toronto. In order to be accepted as a medical student (without another higher degree), Jason had to enroll in the M.A. program instead of the M.Ed. program, which required a thesis.  As a medical student, Jason needed to find a way to fund that year (including feeding himself), so he looked for a job and found the Royal College, an old building overseeing a canal in Ottawa and as most would know, the rest is history. His project ended up being CanMEDS, which he wrote as a first author (while a medical student) with about 100 other co-authors. Dr. Frank has continued to be involved in medical education ever since.

Jason went back to medical school in Ottawa and completed his program in 1997. He later entered a residency program for emergency medicine at the University of Toronto which he finished in 2002. On his first day out of residency, Jason returned to the Royal College as a senior staffer to help shape the system. “I have been at the Royal College for more than 25 years now,” he says, “and time flies” (smiling). Jason continued, “I have also had the joy of working on all sorts of interesting projects that have influenced health professions, education, and health care.” Since his graduation in 2002, Dr. Frank has been practicing as an emergency medicine physician at The Ottawa Hospital. He is currently the vice-chair of emergency medicine, as well as the vice-chair of education in the department of emergency medicine.

Dr. Frank is currently the Director of Specialty Education, strategy and standards at the Royal College. His tasks at the Royal College include: working on curricula, faculty development, the system of specialties, the flagship conference (ICRE), accreditation, as well as other special projects that involve developing new innovations (i.e. CBME implementation in Canada.)  Dr. Frank considers all of these activities to be fun and has about 7 teams he works with.  In addition to his primary responsibilities at the Royal College, Dr. Frank is also involved in various National and International networking activities. He co-founded the international CBME collaborators network, helped found and runs the international accreditation collaborators, is involved with the Canadian network of accreditation collaborators (CANRAC) where he serves as one the chairs, is the chair of the PGME section of AMEE, co-founder and co-chair of the international clinician educator network (ICENET) among others… oh yeah, and he’s a hockey coach!

In his spare time, Jason coaches his sons in ice hockey 5-7 times in the week and claims that he learns a lot about clinical teaching by being a hockey coach. Aged 11 and 14, he describes his boys as extremely bright, with lots of interests. They are avid readers, often walking around the house with their noses in books. In addition to hockey, one of his sons plays soccer and the other is a scout. “Our family is busy with a lot of activities,” he says, “my wife is a family physician with an interest in Geriatric medicine and is also an avid marathon runner. We have a busy household, it’s rich with lots of great conversation, and I love participating in sports with my kids.”

Considering that his work requires him to travel often, Jason was asked how he manages to spend sufficient time with his family. Responding pensively, he said “like everybody, every clinician educator and clinician for that matter, I just do my best. I have had great mentors who have taught me how to be efficient, to focus on what is important and organize my ‘big rocks’ first. For example, family dinners and coaching the kids are a big rock in my week.” In addition, he sometimes sleeps less than most people.  Jason goes on to say that “sleeping less is probably not the healthiest choice,” but it is a choice he has made for the past decade while the kids are around, to be able to spend sufficient time with them.  Jason has managed to limit his traveling this year to about half of what he normally does (150,000 air miles/year) and is making strategic choices between the meetings he should, and those he must, attend.

What percentage of your time is spent for clinical practice, teaching activities, educational research and administrative work?

When asked about how he divides his time among the various tasks, Jason responded asking if we could split the division into hours. In a typical week, Monday to Friday, Jason starts work at 0800hr with meetings for the Royal College, which typically last until about 1700hr.  Family time is scheduled between 1700hr and 2100hr, including homework, dinner, sports, and spending quality time together.  Between 2100hr and 2400hr Monday to Wednesday, Jason typically has other calls booked with collaborators all over the world, and in other time zones (e.g. Australia or Europe), or will otherwise do homework for the Royal College. On Thursday and Friday evenings he heads off to the emergency department, where he does two 9-hour shifts per week.  Jason enjoys seeing patients, although admittedly, he is sometimes very tired after a very long and heavy week. The clinical work, he says, is rejuvenating and explains that “sometimes it is easier to help a complicated patient than it is to lift 40,000 stakeholder physicians in a healthcare system,” because the politics are so intense. Sometimes the nurses are surprised that he is still smiling at work, but this is, as he said, a different page.

Like many others, Jason loves medicine and is very passionate about how the body works and is excited by the things we can do to help it. As an emergency physician, he considers himself an “adrenaline junkie.”  He loves being able to fix things with his hands, intubate people, and especially save lives when he can. He finds it intellectually interesting and is not ready to give up his clinical tasks yet.  His weekends are filled with his kids’ hockey and homework (whether it is the kids’ homework or his). Jason guesses that he works between 80-100 hours per week, and says that it is a joy and a privilege.

With respect to the ongoing discourse on the residents’ duty hours, patient safety and physician wellbeing, and in light of his very busy schedule, Jason was asked if he would describe himself as an ideal role model for residents in this regard.  Jason responded saying “I would not necessarily consider myself the example to follow.” At the same time, he argued that we have learned from the resident duty hour debate that fatigue is not caused solely by time on task, but rather time on task multiplied by various variables that include: cognitive load, emotional load, and the individual’s attitude towards the task.  It does not mean, however, that the hours worked do not take a toll on your body- we all need to sleep.  Jokingly, he says that were he able to give his younger self some advice, it would be to sleep and run more. Instead of “work life balance,” Jason suggested an alternative phrase: “Work-life-integration on the best possible terms,” which entails making a deliberate choice about the things you do.  He believes that everyone should use their autonomy to make decisions, including weaving activities through their week that are proportional and aligned with their goals. Put your “big rocks” in your calendar first.

Do you enjoy the diversity of your work/career?

Jason’s response to this question began with a chuckle. He describes his personality type as someone who is “very curious;” someone that is very interested in many things. He explained that he would be unhappy as a subject specialist who knows a lot about a little, or as an educator who knows a lot about one thing. “That is not my personality, and because I have an insight into that, I have arranged my work in a way that involves several activities. I am a generalist educator as well.”

Jason enjoys designing curricula, program evaluation, and all the technical stuff involved, and does not experience them as ‘heavy.’ With respect to challenges that are ‘heavy’ however, what he considers heaviest for him are conflicts at work, and politics. On a daily basis, his job is to steward change through the health care system, whether it is big or little. The hardest part is to steward big change, where lots of elements of the system are pushing back in a non-collegial way.  “I find that heavy,” he says, “it is heavy on the heart! As I get older, I get wiser,” he continues, “and my skin has gotten a little thicker- thanks to my many mentors who have helped me get better at that.”

Jason describes himself as an individual with a steady personality. “I have highs and lows just like everybody else and am quite sensitive when it comes to people’s stories and the patients I see. I have learned to be much less concerned by political challenges than when I was much younger.” Jason has an antenna for peoples’ interests- in both a political and academic sense. For example, in the academic sense, Jason can intuit what people care about, what motivates them and can sense what would be engaging for them- he looks for these things all the time.  He also has a sense for talent, which others have also noticed about him and have pointed out. Jason says he can successfully look into a room and search for what peoples’ talents are.  He truly believes the maxim that: “Everybody you meet is better than you at something.” He believes that we are surrounded by wonderful people who are so talented and he loves going into a room appreciating how some people are good at x and others at y and yet again, others at z. According to Jason, some people are good at publishing, some are famous scholars, but he thinks his gift is being a “multiplier.” He enjoys finding talent and giving that talent a platform. In some ways, it is like creating a movie, with actors upfront and producers offstage behind the camera. “I am like the producer and director” (he smiles).

Do you experience difficulty with the diversity in your work? If yes, how do you handle it?

Jason acknowledged that he does face challenges in his current role as a CE, however he acknowledged that not all challenges are negative ones. The first thing he does when posed with a challenge is to reframe the situation. Sometimes challenges are truly opportunities, and he believes that dealing with them is how we grow individually and move forward. Jason finds that problem clarification is an essential step in conflict resolution. Labelling situations to identify what needs to be addressed is important. For example, some people may be angry with you due to the nature of a decision you made.  Sometimes, just labelling the situation and the emotions involved could help defuse an escalation. Labelling things internally or sharing with others (externally) helps with problem clarification and this can help prevent difficult situations or conflicts. We all have our trigger points that make conflicts heavy, but the more insights we have into ourselves and the more we can label things, the less energy that gets put into the situation and the easier it is to resolve.

Asked which 3 tips he would like to offer junior CEs, Jason responded with the following:

  1. Know yourself and what you want to achieve. Make sure your goal is aspirational as well as plausible.
  2. Have meded “chops.” You need to have expertise which is reflected through a credential like a graduate degree, diploma, fellowship, or a portfolio. You need a set of competencies to be a CE (i.e. the scope to be a contributor, otherwise you cannot play).
  3. Be scholarly. Share your contributions to academic discourse. (i.e. through publications in journals, abstracts, and presentations). Get your contributions out there!
  4. You need a mentor. It does not matter what stage of your career you are in, you need at least one. Preferably, you will have a “personal board of directors” to help you deal with all the different challenges you will encounter in your career. Asked how many mentors he has, Jason said he has about 10 mentors he has accumulated over the years. He went on to say that they are all superstars in their fields, and are always there to help him when needed. They are his personal board of directors.

 

Feature image property of the Royal College of Physicians and Surgeons of Canada