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A foothold for clinician educators.

The face of academic medicine in North America has changed significantly over the last 40 years (1, 2). Traditional promotion tracks requiring comparable achievement in research, teaching, and patient care are being replaced by more specialized pathways that focus on one, or at most two, of the three traditional missions of academic medicine. In 1987, survey data indicated that 61 (54%) of 112 medical schools offered nontenured clinicianeducator track pathways for promotion (3). By 2011, this had increased to 106 (79%) of 134 schools (4). The current career milestones for clinician-educators vary widely across academic medical centers. At some institutions, the focus remains on recognizing demonstrated achievement in the provision of quality patient care and excellence in meeting teaching requirements. At others, there is greater emphasis on achievement in clinically relevant original and collaborative research. At still other universities, clinicianeducators are now recognized foremost for academic expertise in education and for leadership roles in curriculum design and evaluation. Clinician-educators at these institutions are expected to be skilled teachers in a wide range of settings, from small groups to large classrooms, and from the outpatient clinic to the bedside in the operating room or intensive care unit. They are experts in curriculum development, evaluation, and assessment, and are often expected to assume leadership roles in the implementation of innovative educational techniques. Clinician-educators may hold additional leadership positions in education, where they direct individual courses or large components of a curriculum, whereas others may assume the responsibility of leading a training program. Finally, clinician-educators increasingly participate in educational research and the dissemination of educational scholarship related to their work. Despite heightened expectations, clinician-educators continue to struggle with a lack of social identity within some academic medical centers (5), and local resources to support the track record of achievement needed for successful promotion may be limited (6). As the numbers of clinician-educators joining the ranks of medical schools and allied health professions faculties continue to increase, sponsoring institutions and professional societies must be prepared to respond. Together, they must create a culture that promotes success both through mentorship and by creating opportunities for collaboration on projects that lead to discovery, innovation, and dissemination of knowledge within a specialized field of medicine. This can no longer be a pathway of chance but, rather, requires planning and establishment of a framework that allows individuals who choose this career pathway to develop to their full potential. The American Thoracic Society (ATS) has long provided infrastructure for the science of investigation and clinical excellence and is well positioned to use this same culture to promote success for the growing number of career medical educators. Not unlike other members of the ATS, educators must be identified and targeted early to begin the mentoring process that is needed to cultivate a successful career, especially if they lack local resources. Although promotion criteria for clinician-educators vary widely across institutions (6, 7), the ATS offers great value to this emerging group of members. It provides opportunities for educators to develop their national reputation in subspecialty education by offering opportunities for dissemination of scholarship, supporting educational research, and encouraging leadership positions in those areas that are focused on education. Those interested in joining the growing community of educators within the ATS will be well supported by joining the Medical Education Section of the Behavioral Science and Health Services Research Assembly. Newly formed in 2014, it includes members from the 13 assemblies of the ATS and at least eight different healthcare disciplines. The Medical Education Section aims to promote the practice and science of education within the ATS while enhancing opportunities for career development. It also hopes to encourage networking and mentorship between its members, provide a framework for collaboration, and develop content for faculty development. Most importantly, the Medical Education Section will begin to attract and retain those members who are interested in education as a career, providing a talented pool of educators from which the ATS can develop future leaders in the field and support the investigation of education. The ATS has three committees that offer clinician-educators additional opportunities for engagement and networking within the society: the Education, Members in Training and Transition, and Training committees. Although each has its own unique purpose and goals, the committees work collaboratively to focus on the educational