In this edition:
- Message from the Chair
- AAMC Statements on Recent Societal Issues
- CFAS Connects May 25
- CFAS Society Profile: Association of Program Directors in Internal Medicine (APDIM)
- CFAS-related Programming at LSL 2022
Message from the Chair
Dear CFAS Colleagues and Friends,
We are approaching summer, and many of us are busy with bringing the Spring Semester to a close. The frenzy of preparing and grading exams is in the air, but also the anticipation of celebrating the significant milestone of graduation for those who have been with us for several years.
On a personal note, I am preparing for another milestone: traveling to my first in-person scientific conference in over two years. The International Congress for Integrative Medicine and Health is a biennial event convened by the Society that I represent at CFAS, the Academic Consortium for Integrative Medicine and Health, and is taking place in Phoenix, AZ. I must admit that I can’t wait to see colleagues in person and catch up with many without the need for a screen or Zoom. However, it has been a bit of roller coaster, as our Organizing Committee tried to navigate the protocols (vaccination, boosters, what level of masking, distancing, etc.) in response to yet another unwanted surge in infections. Clearly, we are not yet over the pandemic and its impact on our behaviors and ways of interacting. Nevertheless, I am excited to meet with colleagues in person.
CFAS also has something to look forward to in the coming weeks. The Nominating Committee, chaired by our past-chair, Gabriela Popescu, has completed its work and proposed a slate for the next CFAS Administrative Board. The Committee’s task was very difficult this year, as there were many outstanding candidates for only a few open positions on the Board. Members of the Committee do their very best to create a diverse slate of individuals, and for that we should all express our gratitude to them. The slate requires election by the representatives, so please cast your vote for the slate, which was opened last week. I look forward together with CFAS Chair-elect Nita Ahuja to working with this wonderful group of people. The new Administrative Board will formally take office after Learn Serve Lead 2022: The AAMC Annual Meeting in November.
And on the topic of the AAMC’s annual meeting, I am pleased to share that several sessions that will take place at the meeting were ideas that germinated from CFAS activities, such as CFAS Connects, the work of CFAS Committees, and from members of the Administrative Board. My sincere thanks to Eric Weissman and his team (Alex Bolt, Anne Berry, and Stephen Barry) for helping to put our best ideas forward. The meeting in November promises to have much content that is timely and relevant to faculty, and I do hope most of you are making plans to gather, IN PERSON, in Nashville. I know I am looking forward to it very much, but first I need to catch a flight to Phoenix.
Yours in good health and wellness,
Aviad “Adi” Haramati, PhD
CFAS Chair
Representing the Academic Consortium for Integrative Medicine and Health
AAMC Statements on Recent Societal Issues
The AAMC has issued a number of statements and responses to recent events, such as mass shootings in Texas, New York, and California; and news that the Supreme Court may overturn Roe v. Wade.
"The tragic murders throughout our nation at the hands of gun violence over the last several days are heartbreaking. We stand with the families and loved ones of the victims in Uvalde who are grieving in pain today, as well as those who were affected by the recent racially motivated shooting in Buffalo and the recent shooting in Southern California. We express our profound sympathies for the senseless loss of lives. ... We once again call on Congress to work in a bipartisan manner to take decisive action on commonsense policies and reforms, such as background checks, investments in hospital-based and other community violence interventions, and other tools that so many Americans support. Gun violence is not political. It is a public health crisis that must be addressed. How much more can our nation endure?” wrote AAMC President and CEO David J. Skorton, MD on May 25.
And on May 6, Dr. Skorton issued a statement on the released draft opinion in Dobbs v. Jackson Women’s Health Organization:
“Given the Supreme Court’s authentication of a draft opinion in Dobbs v. Jackson Women’s Health Organization, the AAMC reaffirms its commitment to the critical relationship between patient and physician as the basis of safe, effective, and evidence-based health care. As we indicated in our September 2021 statement, policies that interfere in that relationship by limiting access to legal abortion care put the patient at risk and will exacerbate existing health inequities. As we await the Supreme Court ruling in this pending case over the coming weeks, we reiterate that the country must protect a patient’s access to quality health care and the ability for clinicians to provide such care.”
CFAS Connects May 25
CFAS Connects returned on Wednesday, May 25 with a debrief of the 2022 CFAS Virtual Spring Meeting, which was one of our most successful spring meetings to date. After reviewing the meeting evaluation and feedback, a poll was launched to gauge participants’ interest in collaborating with other AAMC groups. Based on the results of the poll, the other AAMC groups CFAS reps wanted to collaborate with the most were the Group on Faculty Affairs (GFA), the Council of Deans (COD), and AAMC groups engaged in issues related diversity, equity, and inclusion, including the Group on Diversity and Inclusion (GDI), and the Group on Women in Medicine and Science (GWIMS). Later in the session, CFAS reps participated in an interactive word cloud exercise to identify the topics they would like to see CFAS address in the future. Terms that showed up the most related to research, promotion, wellbeing, faculty as educators, climate, communication, and productivity, among others.
CFAS reps in attendance also expressed concern about the future role and changes in the landscape of basic scientists in academic medicine, noting that the funding environment has become increasingly complicated, as has the role of science educators. Several reps – both clinicians and scientists – expressed the belief it was critical to maintain a strong science environment in medical schools, and it was not simply in the interests of the scientists, but all faculty in academic medicine.
Summary resources will be made available on the CFAS Resources webpage this week. The May event will be the last CFAS Connects program of the academic year. We will resume the program in September.
CFAS Society: Association of Program Directors in Internal Medicine (APDIM)
A Conversation with President Susan Lane, MD
CFAS: Tell us about APDIM and some of the benefits of membership.
Dr. Lane: APDIM is part of the Alliance for Academic Internal Medicine (AAIM), so we are able to work collaboratively with other member organizations such as Clerkship Directors in Internal Medicine (CDIM), Association of Specialty Professors (ASP), Administrators of Internal Medicine (AIM) and the Association of Professors of Medicine (APM). We are currently working with our clerkship director colleagues to try to solve the issue of residency application inflation. Program directors (PDs) are receiving an unprecedented number of residency applications, and while we strive to perform holistic reviews, it’s very difficult given the huge volume of applications. Over-applying creates difficulties for students and their advisors as well.
As someone who has been a member of APDIM for nearly 20 years, I can attest that this is an outstanding organization and serves as the professional home for the vast majority of its members. Because the roles of the program director, associate program director, and program coordinator are unique positions, and because regulations and processes change so often, it’s essential to our day-to-day functioning that we have support from other members who have faced similar challenges or who can help support and deliberate when challenges arise.
PDs in internal medicine rely on the wisdom of those who are experienced and have served in the roles for some time because we are often faced with novel and complex challenges. APDIM has a robust and active listserv where people can ask these hard questions. We are a sharing, collaborative, and dedicated community.
Being a member of APDIM is a great way to develop scholarship. You can meet other PDs with similar interests to collaborate, advance your scholarship, and build connections. There are committees to join that will produce publications, which is another way to network and build your educator portfolio. All of these activities help program directors with academic promotion.
One example of a successful, impactful initiative that originated in APDIM by a PD is creating a repository of academic women who write support letters for other women seeking academic promotion. This fills a significant area of need – because there are fewer women at the rank of associate and full professor, it is harder for women to find colleagues who will write letters of support for them.
CFAS: What are some of the big issues facing program directors in internal medicine?
Dr. Lane: PDs are experiencing a lot of burnout, as are many physicians and health care workers these days. There are many contributing reasons for this, including increasing regulatory and administrative burden. The ACGME has heard PD concerns about these issues and recently released revised program requirements that provide more core faculty support. However, even with the new requirements, being a program director can feel like a heavy burden at times. An annual APDIM program director survey in 2018 showed that 30% PDs met criteria for burnout. Less than half of program directors in 2012 were still in their positions in 2016. The average tenure of program director is 4-6 years; this is a problem because it takes about that long to understand the role of the PD and build competence in it.
So PDs are experiencing burnout and leaving their positions before they become competent and secure in their role. This negatively impacts the residency programs and the residents. To address this problem, a few PDs on the APDIM Council started a series called “SAVE PDs” (Sustaining, Advising, Valuing, and Engaging PDs), which is a series of workshops delivered to program directors to provide support, encouragement, and tools to help new PDs get over the 3-5 year hump until confidence grows.
APDIM is also dedicated to diversity, equity, and inclusion by seeking to eliminate bias in resident assessment, strengthen mentoring and coaching, and support residents experiencing bias from patients. We strive to recruit a diverse pool of residents; this requires support not just at the medical school and residency level, but starting all the way back in elementary, junior, and senior high school in order to build a diverse physician workforce.
CFAS: How has internal medicine education been impacted by the pandemic?
Dr. Lane: The pandemic has exacerbated burnout for everyone and COVID has added to stress for everyone in health care, but as program director, we have the additional challenge of trying to make sure residents are safe and cared for and that their schedules are manageable. We’ve all changed our didactics and precepting and have adjusted to the world of virtual learning and telemedicine.
Internal medicine continues to provide care for patients with acute COVID. When a hospital experiences a significant surge in COVID cases, physicians, including residents, may be pulled from ambulatory settings and put in acute inpatient care settings. For internal medicine physicians, we’ve noticed that even after we make it through a surge, the acuity level of patients in our hospitals has remained very high, because a lot of routine care has been put on hold during the pandemic.
CFAS: What are some of the legislative and policy issues APDIM addresses?
Dr. Lane: For advocacy, APDIM (and AAIM) partner with other organizations including the American College of Physicians (ACP), the AAMC, the Graduate Medical Education (GME) Advisory Coalition, and the AAMC-convened Ad Hoc Group for Medical Research. We focus primarily on GME funding. For example, we supported the recent congressional increase of 1,000 GME positions and the distribution of those positions. We consistently support the Resident Physician Shortage Act. We also endorsed newly released guidelines from the National Academies of Science, Engineering, and Medicine (NASEM) on implementing high quality primary care.
CFAS-related Programming at LSL 2022
CFAS has once again been successful in proposing breakout sessions at the AAMC’s annual meeting, which will take place this year in Nashville from Nov. 11 – 15. In addition to CFAS-specific programming, including a business meeting, in-person CFAS committee meetings, a new rep orientation, networking breakfasts, a reception, and a knowledge sharing session, breakouts that include CFAS reps as either speakers or moderators include:
- Facilitating Effective Allyship: Creating Safe Spaces for Dialogue
- Linking Principle and Principal in Academic Health Systems: A Bridge How Far?
- Science, Credibility, and Strategies for Addressing Health Misinformation
- Compassion and Respect in Medical Education: COVID-19 as Instructor
- Valuing Faculty in a Post-Pandemic World – Do Advancement Pathways Match the Needs?
- The Great Resignation in Health Care is Here
- Zoomed Out and Covid Fatigued: What to Keep and What to Change as We Move Forward, Post-Pandemic
- Equitable Competency Assessment: Implementing Recommendations of the UME-GME Review Committee
- Leadership Education in Undergraduate Medical Education
- Med Ed Strategies for Ensuring Gender Affirming Learning Environment and Gender Inclusive Care
- Empowering Wellness by Implementing 10 “Well Being Champions” Recommendations
- The Great Resignation in Health Care Is Here
Much more information about these sessions will be available in the coming weeks – and as CFAS customarily does, we will distribute to reps a guide to “recommended programming” to help you make the most of the LSL schedule. This year will be the first year the AAMC’s annual meeting will be an in-person event since the pandemic began and we are all looking forward to seeing each other again beyond a Zoom call! For any questions related to LSL programming, please reach out to Eric Weissman at eweissman@aamc.org.
Tell Us How You’re Doing
During the pandemic, we ask you to keep the lines of communication open so we can provide you with the resources and information that would be most useful. It is helpful for the AAMC to understand in detail what is happening on the ground at the medical schools, teaching hospitals, and academic societies we serve. Please email Eric at eweissman@aamc.org, or call directly at 301-437-2572 with updates or feedback from your perspective. You can also reach out with questions or comments to CFAS Communications Specialist Alex Bolt.
If you are 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 an article or study coming out? A new promotion or professional accomplishment? Let us know and we'll feature it in an upcoming edition of the CFAS Rep Bulletin.