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CFAS Rep Update October 2017


Update on the Work Group on the Definition of Faculty
2018 CFAS Spring Meeting: Breakout Session and Poster Presentation Call Open
Learn Serve Lead Update
New CFAS-Member Societies
CFAS Rep Profiles: Rebecca Andrews, MD, and Barry Kogan, MD
CFAS Society Profile: Academic Consortium for Integrative Medicine and Health

Update on the Work Group on the Definition of Faculty
The Work Group on the Definition of Faculty, led by CFAS Immediate Past Chair Rosemarie Fisher, MD, met in late July at the AAMC's Washington, D.C., headquarters to refine and update the group's previously crafted paper that creates a framework around a definition of medical school faculty. While the group is convened by CFAS, it features representation from multiple AAMC professional development groups, including the Group on Women in Medicine and Science, the Group on Faculty Affairs, the Group on Diversity and Inclusion, the Group on Faculty Practice, the Group on Regional Medical Campuses, and the Graduate Research, Education, and Training Group. The work group has already hosted discussions at Learn Serve Lead: The AAMC Annual Meeting twice, and will present again this year on Monday, Nov. 6, from 3-4:15 p.m. The group has been charged with submitting a white paper on a definition of faculty to the AAMC Board of Directors and making recommendations related to a durable, transferable framework on a definition of faculty that various institutions can use as they set their own policies.

At its most recent meeting, the group focused on creating an opinion paper describing the general framework and the value of creating a definition of faculty. Once completed, the paper will be submitted to one of the major medical journals.

2018 CFAS Spring Meeting: Breakout Session and Poster Presentation Call Open
The 2018 CFAS Spring Meeting will take place April 19-21 at The Westin Chicago River North, in Chicago, Ill. Further details will be distributed in November at Learn Serve Lead, the AAMC Annual Meeting in Boston, but the call for proposals for concurrent breakout sessions and poster presentations is now open. More information about the meeting can be found on the CFAS website. Content proposals should be aligned along the following broad themes:

  • Institutional Wellness
  • Faculty Leadership
  • Communication and Advocacy
  • Faculty Development
  • Medical Education & Training
  • Diversity and Inclusion
  • Governance
  • Funds Flow and Academic Health Center Operations
  • Research/Scholarly Activities

The CFAS Program Committee has met in person twice in recent months, and in a variety of planning calls to develop plenary sessions that appeal to all CFAS reps, including junior and senior faculty, society reps and school reps, and basic scientists, clinicians, and medical educators. Plenaries will focus on institutional wellbeing, faculty development, leadership development, and advocacy (with a specific angle on untangling regulatory burden across the spectrum).

Learn Serve Lead Update
Learn Serve Lead the 2017 AAMC Annual Meeting will happen Nov. 3-7 in Boston. If you have not yet signed up, registration will remain open right up through the meeting. CFAS reps have received some messages outlining recommended sessions, which can also be found on the CFAS website. There’s some excellent representation of CFAS issues and CFAS presenters throughout the meeting, which is noted in the recommended session guide. As a reminder, all CFAS reps have been invited to attend the black-tie AAMC Awards Dinner on Sunday, Nov. 5. If you did not receive an electronic invitation, please reach out to Eric Weissman at eweissman@aamc.org. We look forward to seeing you in Boston!

New CFAS-Member Societies
CFAS welcomes the Academy for Professionalism in Health Care (APHC) and the Association of Directors of Medical Student Education in Psychiatry (ADMSEP) as its newest member-societies. APHC focuses on optimizing patient care through professionalism, education, scholarship, policy, and practice in all health-related fields. APHC's executive director is David J. Doukas, MD. Dr. Doukas also serves as APHC's society rep.

The executive director for ADMSEP is Gary Beck Dallaghan, PhD, and the senior and junior society reps to CFAS, respectively, are Dennis Popeo, MD, and Tamara Gay, MD. ADMSEP is an organization for all educators and administrative staff dedicated to promoting excellence in behavioral sciences and psychiatric education for medical students.

CFAS Rep Profiles: Rebecca Andrews, MD, and Barry Kogan, MD

RebeccaAndrewsRebecca Andrews, MD, Senior Rep; Assistant Professor of Medicine; Director, General Medicine Associates; University of Connecticut School of Medicine:

CFAS: What are some strategies you use to balance clinical time and teaching time?

Dr. Andrews: When I began my career in academic medicine, almost all my time was taken up by clinical demands. The primary care clinic needed a medical director and I was charged with trying to reinvigorate interest in primary care. The challenges were many. One, there wasn’t enough time for me to handle all those responsibilities at first. Two, many residents were dealing with repeated visits from the same chronic care patients who had been “labelled,” so the residents had to learn how to navigate and move beyond such subjective data. A third problem was that residents just didn’t seem to know how to operate in outpatient environments like they did in inpatient environments. Because the residents lacked exposure and knowledge about primary care, we developed two primary care tracts.

I decided to spin a lot of these problems into projects which I submitted for workshops or poster presentations. This allowed me to make changes, but also to go back to my institution and make the case for incorporating the solutions. Essentially that’s how I got into teaching and clinical work at the same time, and that’s how curriculum development became a part of my job.

CFAS: What are some general teaching methods that you’ve found to be effective?

Dr. Andrews: One of the milestones we measure is the ability of a resident to slow down and reflect on the quality of their care, and I’ve applied that lesson to how I teach. If residents aren’t improving on something, I sit down with them and say, “We’ve been working on X and/or the need to do Y. Do you think in the past three months that you’ve improved?” Then I breakdown my analysis and talk with them about the new ways we can approach the problem. I adapted this technique from the patient care milestones. Often when people begin teaching, they model what they’ve learned from those they’ve worked with before. Constantly evaluating yourself and the methods that work is important. When you start out you do everything exactly as you’ve always done it, but then you read your feedback and that’s where you find areas you need to improve on. For example, this year I learned not to spoon-feed the interns based on feedback from residents. The residents said most of their progress in their final years came from when I pushed them to teach me and do more on their own.

CFAS: At the CFAS spring meeting last March, you moderated a session with Kevin Chamberlin on how trainees can successfully navigate opioid discontinuation – what were the highlights from that session?

Dr. Andrews: The medical community is trying to improve and expand teaching on the use and safety of opioids, but with all the news coverage about the epidemic, some residents are afraid to prescribe them at all. I was worried that we would graduate residents who didn’t know when and how to safely prescribe opioids. We created a workshop that focused on three components: first, the history concerning the current opioid crisis; second, the pathophysiology of pain; and third, the treatment options and common side effects, which Dr. Chamberlin talked about. Then I walked through the change continuum (it takes two years to go through the process) and our five step protocol for navigating the most difficult discussion in the clinic, such as stopping opioid therapy. I walked through the difficult conversations and how to preserve the therapeutic relationship while also doing what’s right for the patient in instances when they are suffering side effects of treatment and need to lower their dose or stop therapy altogether. We used role-play to teach and practice our method of having these difficult conversations and navigate it successfully.

CFAS: Tell us about your research on chronic disease education for patients and residents.

Dr. Andrews: We created a chronic disease training model for residents which aims to address the issue from all aspects. The residency, faculty, and chief residents created a PowerPoint slide set for residents to consult in clinic. The slide set helps them figure out what they need to verify and document. The more comprehensive version had education on the different clinical diseases and scenarios, and the shorter one focused on the visit, standards of care, and documentation. The residents now feel much more comfortable in the hospital environment, so giving them a template to work from to master the outpatient environment helps. It provides a standard treatment checklist that they can access anywhere. And, It also provides both active and passive teaching because they have to access it with their own patients to master the information themselves.

CFAS: What are the research trends in preventive health?

Dr. Andrews: The field is becoming a shared conversation with your patients. It’s no longer simply plugging a patient's data into a computer and telling them, “This is what you need.” In the past, different medical organizations have had different guidelines which created ambiguity for clinicians and patients on best practices; now many are working together to standardize those. The most exciting aspect of the current environment is that there is room to address patients as individuals. It’s a great time in health prevention because you do a lot of patient education and can focus on what works for them.

CFAS: What are some accomplishments from the University of Connecticut School of Medicine that would be interesting to CFAS reps?

Dr. Andrews: We are part of the Southern New England Practice Transformation grant from CMMI, so we have a lot of pilot projects looking at transforming care. Many of those pilot projects touch my areas of interest: improving chronic disease management, efficiency of care, and continuous quality improvement. We are also in the second year of working with a completely revised medical school curriculum and there’s a lot of interdisciplinary classroom work involved. Students in different professions such as pharmacy, nursing, and dentistry are learning cases together.

CFAS: What do you like to do in your free time?

Dr. Andrews: I have two wonderful kids – a nine-year-old and a fifteen-year-old who take up most of my time with coaching their sports. I do steal some free time for hiking and photography.

BarryKoganBarry Kogan, MD, Senior Rep for Society of Academic Urologists; Division Chief of Urology in the Department of Surgery at Albany Medical Center:

CFAS: What are some important current issues to division chiefs at academic health centers?

Dr. Kogan: A lot has changed in the past few years. The biggest challenge in the past was finding resources to support my junior faculty’s research. Over the years this has morphed into giving my faculty enough time to do academic work. I think this is mostly because of the increased focus on clinical productivity in almost every academic health center. The second biggest factor that’s affected academic productivity is the amount of time faculty members have to spend on the EHR. Time spent on documentation is time not spent on academic work. Finding protected time for scholarship is one of the biggest challenges.

CFAS: In your career, you’ve gone from an assistant professor to full professor to division chief – what career advice would you give to those who are new to working in academic medicine?

Dr. Kogan: Finding the right mentors is critical to your success. A good mentor allows you to observe others in a leadership role where you can see both the good and bad qualities of different leaders. A good mentor will also give you both positive feedback and inspiration, as well as telling you when you’re off track. I like to think that in this circumstance, plagiarizing is allowed and encouraged. One of my mottos is that “imitation is the highest flattery.” Stealing good ideas from the leaders you respect is a good thing. I had some phenomenal people to work with during my student years and residency (and time as a junior faculty member) and all those people were role models. Cultivating and maintaining those relationships with the leaders in your institution is also critical.

CFAS: Tell us some highlights of your research in pediatric urology and investigative urology.

Dr. Kogan: Urinary and sexual development issues are my current areas of interest. I’ve also done increasingly more health system research too, such as studying patient wait times in the office and delays in the operating room. This type of research is not only important to advancing science, but supports your own institution at the same time.

A bit of research career advice: whatever institution you’re affiliated with, craft your research focus to align with the institution’s research strengths. Every institution has areas of research they excel in as well as areas they have chosen not to focus on. Fetal diagnosis and treatment were huge areas of interest for many people at UCSF when I was a junior faculty member. Hence it became a focus for me. The NIH was interested in research in this area as well, and that was great for me, because it all tied in. When I moved to Albany, there wasn’t as much emphasis on fetal basic science, so I changed my focus to more clinical research.

CFAS: What areas of focus would you like to see CFAS address in the future?

Dr. Kogan: I’ve really learned a lot from my involvement in CFAS so I wouldn’t change much. I would encourage CFAS to focus a bit more on faculty development; e.g. strategies for recruiting, onboarding, and developing junior faculty. Also, the AAMC website is phenomenal and there are great resources hidden in there, but many of us don’t even know they exist. Maybe CFAS could give a tutorial on how to use the website and its resources. Finally, there is great value in the AAMC’s meetings, but they are a bit expensive.

CFAS: What are some accomplishments from the Albany Medical College that would be interesting to CFAS reps?

Dr. Kogan: We have a very successful simulation center that’s used regularly for learning procedures and team building. What’s special is our focus on communication skills. We use simulated patient encounters and video recordings to teach critical communication skills needed during patient care (and life in general). It’s a very valuable resource for our students, residents, and even faculty. We hire a lot of standardized patients for the simulation center and they are very experienced at their role. Most will give you very direct feedback on your communication skills. It is both humbling and educational. Also, we are a relatively smaller academic health center and this can be an advantage, because Albany’s smaller size allows for more interaction between PhDs and MDs, which may be harder at large institutions.

CFAS: What do you like to do in your free time?

Dr. Kogan: I’ve played violin since I was a child, so I joined Albany Medical Center’s orchestra, which is open to students, residents, faculty, and anyone in the community who wants to play. We have a couple concerts every year, and the music and teamwork is both very uplifting and a great distraction from the real world. I also love gardening. We grow organic vegetables in a community garden and donate them to the local rescue missions and homeless shelters. I’m also a long-lost Chicago Cubs fan and I was over the top last year when they finally won their first World Series since 1908.


Academic Consortium for Integrative Medicine and Health logoCFAS Society Profile: Academic Consortium for Integrative Medicine and Health
The Academic Consortium for Integrative Medicine and Health seeks to advance integrative medicine and health in academic institutions and health systems. The Consortium is comprised of academic health centers (consisting of a medical school and at least one other health professional school that must be a formally affiliated degree granting institution) and health systems (such as the VA and Medstar Health to name a couple). The institutions must include integrative medicine or integrative health activities in two of the following three areas: education, research, and clinical care. Incorporated in 2002, the Consortium has experienced significant growth and has 71 academic health systems as members, with a reach to over 3,000 individuals who receive its mailings. Anyone active in integrative health care can be involved in the consortium and receive discounts to its meetings, but the consortium's members are the institutions.

In addition to a biweekly news briefing, the Consortium also holds monthly grand rounds webinars eligible for CME credit for attending. The Consortium additionally hosts an annual members meeting and an International Congress every other year. The 2018 International Congress will be held May 8-11 in Baltimore, Md. The Consortium also offers a Leadership and Education Program (LEAP) for medical students from Consortium member institutions.

The Consortium is engaged in a large initiative promoting non-pharmacological approaches to pain management in response to the opioid epidemic. "The nation needs safe, effective, low-cost approaches to pain management that are patient-centered, involve self-care, and address all aspects of the pain experience. Substantial evidence now exists for the effectiveness of non-pharmacologic approaches to pain management, including physical therapy, chiropractic, acupuncture, massage, yoga, mindfulness based stress reduction, and cognitive behavioral therapy," said Adi Haramati, PhD, the Consortium's representative to CFAS. Dr. Haramati, a former CFAS Ad Board member, is a long-time member of the Consortium and has been a leading voice in sharing data about using mind-body medicine practices to reduce stress, foster self-awareness and build resilience among medical students, residents and physicians and other health professionals.

The Consortium is advancing the field of non-pharmacologic approaches to pain through research, education, new clinical models, and policy. The Consortium recently released a pocket guide it developed in collaboration with several other organizations: “Moving Beyond Medications.” Also, the Consortium will soon be releasing a white paper based on the work of an action team it deployed a year ago to study nonpharmacological approaches to pain. Along with the white paper, there will be one-page fact sheets regarding evidence-based, comprehensive pain care.

The Consortium also focuses on well-being of students, trainees, and practitioners in health professions. Dr. Haramati said members of the Consortium have been active in developing approaches that use mind-body techniques, and reflection that appear to reduce stress, foster self-awareness, and improve well-being.

Dr. Haramati and Laura Degnon, the Consortium's executive director, noted a number of opportunities to collaborate with other organizations through CFAS. The Consortium’s mission is to advance integrative medicine and health through academic institutions and health systems, and CFAS could provide the connections to those institutions. On a more specific level, the Consortium can inform other CFAS representatives from academic societies and medical schools and AAMC staff about advances in integrative medicine. For example, in the education sphere, Consortium members published a paper in Academic Medicine in 2004 that outlined suggested core competencies in integrative medicine for the undergraduate medical curriculum. In the October 2007 issue of Academic Medicine, there was a series of nine papers on curricular initiatives in medical schools in complementary and integrative medicine that were funded by education-focused grants from the NIH.

"It would be exceptionally helpful if CFAS could help us disseminate the previously described information about non-pharmacological approaches to pain to help address the issue of the opioid epidemic, including the Pocket Guide, white paper, and fact sheets, to others involved with CFAS," said Degnon. Degnon also noted that it would be helpful for CFAS to prominently publicize the benefits that societies receive from membership.

A number of options are available for those interested in pursuing training in Integrative Medicine. Georgetown University offers a pre-professional Masters degree in physiology with a concentration in complementary and integrative medicine for those thinking about entering medicine. Many medical schools, especially those in the Consortium, have incorporated integrative medicine into the undergraduate curriculum and also offer electives to students from other schools. The Integrative Medicine in Residency program, created by the University of Arizona, provides 200 hours of teaching on integrative medicine in six online modules, and over 30 residency programs in family medicine and pediatrics include these in their training programs.

For those who wish to obtain further specialization, there are over a dozen accredited integrative medicine fellowships offered in the U.S. at academic health centers. Graduates of accredited fellowships can apply for board certification through the American Board of Integrative Medicine. Listings of fellowship opportunities can be found at the Consortium website. Many Consortium institutions offer continuing medical education opportunities ranging from one to three day conferences to year-long training in medical acupuncture for physicians. Degnon also said that the Consortium is in discussions about whether they should be the accrediting body for integrative health care programs within medical schools.


Looking for information about CFAS? Find what you need on our website, from the names of CFAS leaders, to updates on committee and working group initiatives, to upcoming offerings and meetings, and finally, current and previous editions of CFAS News.

Do you have ideas or suggestions for the newsletter? A recommendation for a CFAS rep or member society to profile? All of your ideas are welcome. Please send them to Eric Weissman at eweissman@aamc.org, or call Eric directly at 202-828-0044. You can also reach out with questions or comments to CFAS Communications Committee Chair, Amy Hildreth, MD.

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