The New Generation of Pediatric Faculty
Article Outline
The academic pediatric community is becoming increasingly aware of the changing demographics, perceptions, and expectations of the women and men entering our workforce. At the 2007 annual meeting of the Association of Medical School Pediatric Department Chairs (AMSPDC), a session was devoted to these issues. We focused on the increasing proportion of female residents and faculty,1 the need to fully engage them in the entire spectrum of career opportunities,2 the recognition that most junior faculty members (regardless of gender) demand a “balance” between their professional career and family/personal life,3 and the importance of matching these factors with the needs and complexities of a busy pediatric department. Indeed, identification with the evolving generational culture may prove to play a greater role than gender in determining an individual’s navigation through a career in academic pediatrics.4, 5
The AMSPDC commentary on women in pediatrics emphasized the need for flexible work schedules, part-time options, and modified tenure “clocks.”1 Faculty members need to be encouraged to be full “citizens” of the department even if employed part-time. The challenges of providing onsite child care need to be addressed by each institution. There is a need for increased mentoring and training of women to assume and succeed in leadership positions.6, 7
The perspective of the junior faculty was shared by Dr Christine Johnson (F. Edward Hebert School of Medicine) and Dr Karen Fairchild (University of Virginia). There is inherent conflict in the demands on faculty members with young children, who are torn between their responsibilities to their patients and department on the one hand and their family on the other hand (Figure 1; available at www.jpeds.com).8 Personal time for the individual also must not be neglected; activities can include but not be limited to reading, meditation, or physical exercise. This is an arena for strong mentoring and role models, demonstrating specifically how the competing worlds can be incorporated. Examples could include bringing family members on trips to professional meetings and the option of working from home. Child care presents one of the greatest challenges to maintaining a balance of work and family; services must be safe, affordable, and flexible, and should provide for sick care and weekend coverage. The stresses of both spouses or partners balancing respective careers and responsibilities for elder parents add to the competition of 3 generations of family members versus the time needed for a successful academic career. Part-time or “flexible time” work may be a more desirable alternative than taking extended leaves of absence, because reentry may prove difficult, particularly with ever-tightening constraints on professional credentialing.9
Figure 1.
From the perspective of the faculty member (heavy circle), family responsibilities and interactions absorb much time and attention, whereas community responsibilities are variable. These responsibilities must be balanced with the multiple professional interactions depicted in the smaller circles. Note that little space remains for personal time and attention (arrow).
The transition of academic progress and advancement can be as challenging as the initial adaptation to an entry-level faculty position.10 This is a time to develop a clinical or academic focus of excellence, aided by networking and solid advice from multiple faculty members. Also paramount are supportive leaders, colleagues, and “significant others” to provide the time and environment conducive to success. Effectively managing the allocation of time among clinical, research, and family demands requires forethought, and the weighting of allocation may need to change as an individual’s career progresses and children grow older. In many institutions, the development of “national recognition” is an important factor in academic advancement. This may require allocation of time for some travel away from home to visit other institutions or participate in national organizations. It is not enough for the mentee to identify the right mentors and to use them wisely—she or he also must learn to serve as a mentor and to develop leadership skills early in her or his career. Conversely, some faculty members need to be reassured that choosing to function as a member of a team is equally acceptable, if a position of leadership or independent investigation is not desired.
The institutional implementation of mentoring programs was described by Dr Sharon Hostler (Senior Associate Dean for Faculty Development at the University of Virginia). Expectations of the job should be explicit; the job description should be detailed and updated yearly if necessary. Junior faculty members need advice in tracking and documenting the elements of their careers; their curriculum vitae and teaching portfolios must be clearly crafted and regularly updated. Leadership must recognize and reward the value of contributions in all missions (ie, clinical care, education, research, and administration). Quality teaching can be evaluated by compiling a detailed faculty portfolio of educational activities (including feedback, evaluation, and outcomes), and institutional recognition (eg, Academy of Distinguished Educators).
The importance of effective communication and feedback tailored to different generational preferences cannot be overemphasized. This entails regular evaluation of faculty by supervisors and evaluation of the leadership, resources, and environment by the faculty. This can be accomplished by one-on-one meetings, small group meetings, and faculty surveys. Surveys can be especially helpful if space is provided for text comments. To enhance retention as well as recruitment, exit interviews should be held with every departing faculty member. Institutions should have accessible programs for physician wellness, integration of humanism in practice, and personal reflection. Programs targeted at women faculty should cover negotiation, conflict management, executive coaching, and networking with colleagues from other institutions. The latter include programs sponsored by the American Association of Medical Colleges (Women in Medicine) and Drexel University (Executive Leadership in Academic Medicine).
The perspective of the department chair was explored by 1 of the authors (R.C.) and Dr John Driscoll (Professor and Chair of Pediatrics at Columbia University). There must be a balance between top-down direction from the administration and bottom-up initiatives from the faculty; both should be in step with the institutional goals and opportunities (Figure 2; available at www.jpeds.com). The needs to be fulfilled by the department are generally based on clinical care and teaching, with research contributing a greater or lesser role depending on the institution or particular division within a department. As with all aspects of medicine, there is an increasing focus on quality and outcomes for each mission and an attempt to match financial resources with the desired outcomes. It is up to the chair to foster a culture of mutual respect for a wide variety of activities and to deal with fairness in a transparent manner. The departmental leadership should explain the rationale for decisions and policies and provide regular feedback to each faculty member. This may require particular attention to ensure equity across sexes and to actively foster diversity.
Figure 2.
From the perspective of the department chair, the multiple missions of the department must be fulfilled by the faculty and staff, maximizing the talents of each faculty member while maintaining equity. Moreover, the collective contributions of the faculty, through departmental organization, must meet the needs of the institution. More broadly, the regional, national, and international interactions serve to define the culture and professional reputation of the individual faculty and provide opportunities for contributions and collaborations.
All of us agree that a career in academic pediatrics can be a most enriching and rewarding pursuit. It is up to us to share our passion for what we do, and to match every individual’s inner motivation with the needs and expectations of the department, the institution, and the national and international medical community. We need to constantly remind one another of the inherent value of all that we do to promote and maintain child health. We must pay equal attention to mentoring and encouraging our colleagues to aid in the development of the next generation of pediatricians, while being mindful of the needs and contributions of the generation preceding us. Finally, with the aging of the “baby boomers,” we must inspire the new generation of men and women to prepare for leadership positions.5
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The opinions and assertions contained here are the private ones of the authors and are not to be construed as official or reflecting the views of the Department of Defense or the Uniformed Services University of the Health Sciences.
PII: S0022-3476(07)00907-9
doi:10.1016/j.jpeds.2007.09.047
© 2007 Mosby, Inc. All rights reserved.
