So You'd Like to Teach?

Recalling the teachers and mentors they encountered during the course of medical training, many young doctors
express an interest in teaching opportunities after they complete their fellowships. So, exactly how does one seek out
and obtain such positions, and, moreover, how does one integrate teaching responsibilities into a clinical career?

I sat down with Tara A. Uhler, MD, residency program director at Wills Eye Hospital/Thomas Jefferson University Hospital, and James P. Dunn, MD, past residency program director at Wilmer Eye Institute (1998–2002) and current director of the Uveitis Unit of the Retina Service at Wills, to gather insights and recommendations for those truly interested in making medical education a career.

— M. Ali Khan, MD​

How did you come across your first formal position in medical education? Did you seek it out, or were you offered the position?

Tara A. Uhler, MD: I was offered the position of residency program director at Wills. I had previously expressed interest in medical education, and, when the position became available, I was asked to be considered as an internal candidate. Institutions want to hire or advance a known commodity (eg, someone who has worked there and has a track record or who comes highly recommended by a trusted colleague), so hiring internal candidates is common.

James P. Dunn, MD: I am old enough that I heard about my first real job in academic ophthalmology through an ad in a journal. I was always interested in medical education, but that was not a formal part of my job description. I sought out as many opportunities as possible to work with residents, such as assisting in the OR, making myself available for clinic and curbside consultations, and giving lectures. Then, when the position of program director opened up about 7 years into my appointment, I was in a good position to apply for it.

Did you have formal training in medical education? Do you feel an advanced degree in education is necessary for these positions?

Dr. Uhler: As of now, secondary degrees are not necessary, but they are becoming more common. It may depend on the role you wish to pursue. Also, these advanced degrees do not have to be in education per se. Experience, however, may be more important. Faculty with training or experience in quality improvement, business, and public health are filling the needs of the changing face of health care practice, including academic medicine. Departments may look at a candidate who has a specific additional skill set desired by the department; secondary degrees do help in these cases.

Dr. Dunn: It is definitely not necessary to have a secondary degree, but late in my career I started pursuing a masters in education in the health professions at Johns Hopkins University. I wish I had had something like that available to me earlier; it would have made me a much better program director. I was able to use tuition remission as a faculty member, which was crucial because I could not have done it on my own. I would recommend for young educators to consider something like that and to ask their chairperson to fund it if possible. Nearly all these programs are given online, so there is great flexibility.

Many medical schools offer short courses in education for faculty that are useful. I took a program in curriculum development for one semester while I was program director, and it was fantastic. My favorite meeting every year while I was program director was the Educating the Educators conference held in the winter in conjunction with the Association of University Professors of Ophthalmology (AUPO) annual meeting. It is the best place to get ideas, collaborate, and network.

Did you have a formal mentor in medical education who helped guide your career? What advice do you have for finding such a mentor?

Dr. Dunn: I was fortunate to have several wonderful mentors, in fellowship and in my first job. Young academicians should make it a priority to find a mentor when looking at jobs out of fellowship. My mentor in my first job was not personally all that interested in resident or medical student education, but he knew my passions, and he made sure that he promoted me for the right committees to facilitate my opportunities. He also steered me away from committees that would not help my career.

Keep in mind that mentors do not necessarily have to be older than you; sometimes a peer who has been through the same process can be just as helpful as someone more senior. Attending the AUPO annual meeting and the AUPO Educating the Educators meeting is a good way to meet more senior educators who are gracious with their time and advice.

Dr. Uhler: Once you join a department, my advice would be to seek out mentors in similar roles. Academic departments increasingly emphasize mentorship, which is required not only internally for faculty retention and recruitment, but also externally for accreditation of programs.

Often, it seems as though positions in medical education fall into the laps of the people who end up with them. What are good ways to inquire about positions that exist in medical education?

Dr. Uhler: Many positions that appear to fall into someone’s lap are really those offered to in-house applicants when an opening arises. Positions may be urgently vacant and an interim person is needed. Supervisors may then recommend faculty members for the openings. Just like openings in private practice, postings for positions in medical education are publicized online by the American Academy of Ophthalmology (AAO) as well as in journals and through notices sent by departments. Word of mouth among those in similar positions is also a common way to learn of openings.

Dr. Dunn: It is easier now with the internet. Look at websites that post academic positions, including AAO, AUPO, and the Association for Vision in Research and Ophthalmology. Finally, seek out faculty members in your department who are well-connected around the country.

How much clinical time did you sacrifice for dedicated medical education and teaching time?

Dr. Dunn: The reality is that everything has to be funded in some way. Try to work with your department ahead of time to carve out “protected” teaching time that is part of your salary, just as a clinician-researcher needs protected research time.

How much time you can devote to teaching will be a function of departmental resources. Some programs have stipends given out to certain faculty to cover costs of teaching. And of course, if you do get research funding or protected time from your chair, be sure you follow through. Always create a portfolio of your teaching so you have something to show for it. This obviously includes publications, but it also includes abstracts from meetings at which you present. Do not forget to list lectures or workshops you have given and keep a record of the evaluations you receive from your students.

Dr. Uhler: Most institutions have a specific algorithm for time based upon program size and education duties, and these are described in the role description when posted. Requesting more time is difficult, especially with the increasingly tough financial pressures on institutions requiring them to do more with less.

What are some of the ways that one can begin preparing for a career in medical education while still in training?

Dr. Uhler: Serving on committees in medical school or during training might add weight to your application, particularly in demonstrating that you wish to be a faculty member at an academic institution. Any academic pursuits (including research, publications, serving on an editorial board, etc.) support the expression of interest in a faculty role. Ultimately, what you do as a faculty member will be most important.

Dr. Dunn: Nothing prepares you for teaching better than actually teaching. Make yourself available to junior residents and trainees while you are a fellow. Offer to give Ophthalmic Knowledge Assessment Program review sessions for junior residents. Above all, make it clear in your job search what you are looking for. Every academic department has a residency education committee or some variant thereof, all of which have trainee participation to some degree. Those interested in education should definitely ask to join this committee during their training.

How should one express interest in a formal medical education position when looking for one’s first job?

Dr. Dunn: Absolutely make your interest known as a part of your contract discussions with whoever is hiring you. If you do not make your interests known, you may find yourself in a position where you have no time and no opportunities to teach. As part of your interview for a position, consider meeting with the dean of medical education (or comparable person) at the affiliated medical school, or at the very least do so after you have been hired. Ask about opportunities to serve on committees involved in medical education or to partner with other faculty members on innovations in teaching and education. There might be positions related to curriculum development or Accreditation Council for Graduate Medical Education oversight.

Any last words of advice for those interested in pursuing a career in medical education?

Dr. Uhler: Demonstrate commitment to education as a junior faculty member. Hiring in academics is no different from hiring in private practice, where employers want the best fit and track record.

Dr. Dunn: The ability to pursue education as a career still largely comes down to the culture of the individual department. If senior leadership meaningfully values, supports, and rewards educators, residents will benefit enormously, and the ability of a faculty member to become a true clinician-educator will be enhanced. If you get the sense that there is not going to be support for you as an educator, consider looking elsewhere for a job. n

James P. Dunn, MD, is director of the Uveitis Unit of the Retina Service at Wills Eye Hospital, Philadelphia, Pa. Dr. Dunn may be reached at jdunn@willseye.org.

Tara A. Uhler, MD, is the director of resident education at Wills Eye Hospital, Philadelphia, Pa. Dr. Uhler may be reached at tuhler@willseye.org.

Bryan Kun Hong, MD; M. Ali Khan, MD; and Jayanth Sridhar, MD are second-year retina fellows at Wills Eye Hospital in Philadelphia, Pa. They are members of the Retina Today editorial board. Dr. Hong may be reached at bhong@midatlanticretina.com. Dr. Khan may be reached at akhan@midatlanticretina.com. Dr. Sridhar may be reached at jsridhar@midatlanticretina.com.