Leading by Example: Role Modeling Resilience Helps Our Learners and Ourselves.

The issues of burnout and its consequences are some of the most prevalent topics in conversations about the practice of medicine today. Many reports have focused on the contributors that fuel this epidemic, but the time has come to begin to focus on solutions. Prominent national efforts, including a National Academy of Medicine collaborative task force and the 2017 Accreditation Council for Graduate Medical Education common program requirements' focus on wellness, are presenting opportunities for academic medicine faculty to take the lead in turning this tide. While solutions to the burnout crisis are complex, the foundations of improving this epidemic lie in restoring a sense of purpose and balance in the lives of those who work in academic medicine. The inherent value of academic medicine to improve others' lives through patient care, the advancement of knowledge, and the education of the next generation is a unique opportunity that many other professions do not share. On the best days, academic medicine faculty must remember to look for that joy and to express it to learners, and, on the worst, they must demonstrate to learners how to practice self-care and how to create personal resilience. By taking on the role of becoming resilient, faculty start to foster a culture of well-being rather than burnout and can begin to find solutions instead of continuing to describe the problem.

Enhancing the Voice of Faculty in the Association of American Medical Colleges: The Evolution of Faculty in U.S. Medical Schools and the Transformation of the Council of Academic Societies Into the Council of Faculty and Academic Societies.

Since its inception in 1966, the Council of Academic Societies (CAS) represented academic faculty in the governance structure of the Association of American Medical Colleges (AAMC). As the role of faculty in the academic health center of the 21st century has evolved (e.g., the number of faculty members has increased, contact hours with trainees per individual faculty member have decreased, the faculty has aged), new models for representation have become necessary. Because of the structure and requirements for organizational membership, CAS was not representing faculty as broadly as possible, so a redesign was necessary. In November 2012, the AAMC Assembly adopted changes to its bylaws creating the new Council of Faculty and Academic Societies. The new design increases the opportunity for all schools to be represented by both junior and senior faculty members while retaining society membership and, therefore, representation of the breadth of specialties in academic medicine. The new council's structure better facilitates meeting its charge: to identify critical issues facing academic medicine faculty members; to provide faculty with a voice as the AAMC addresses those issues through the creation and implementation of AAMC programs, services, and policies; and to serve as a communications conduit between the AAMC and faculty regarding matters related to the core missions of academic medicine.

Evolution of faculty affairs and faculty development offices in U.S. medical schools: a 10-year follow-up survey.

PURPOSE: To determine how U.S. MD-granting medical schools manage, fund, and evaluate faculty affairs/development functions and to determine the evolution of these offices between 2000 and 2010. METHOD: In December 2010, the authors invited faculty affairs designees at 131 U.S. MD-granting medical schools to complete a questionnaire developed by the Association of American Medical Colleges Group on Faculty Affairs, based on a 2000 survey. Schools were asked about core functions, budget, staffing, and performance metrics. The authors analyzed the data using descriptive statistics. RESULTS: A total of 111 schools (84.7%) responded. Fifty percent of the offices were established since 2000. Seventy-eight percent reported their top core function as administrative support for appointments, promotions, and tenure, as in 2000. Faculty policies, appointments, databases, governance support, grievance proceedings, management issues, and annual trend analyses continued as major functions. All 11 core functions identified in 2000 remain predominantly provided by central offices of faculty affairs, except support of major leadership searches. Web site communication emerged as a new core function. Similar to 2000, several other offices were responsible for some faculty development functions. Office size and budget correlated positively with size of the faculty and age of the office (P < .05 for all). Thirty-five schools (31.5%) reported formally evaluating their faculty affairs office. CONCLUSIONS: The number of faculty affairs offices and their responsibilities have substantially increased since 2000. Most major core functions have not changed. These offices are now an established part of the central administration of most medical schools.

Folate status of mothers during pregnancy and mental and psychomotor development of their children at five years of age.

OBJECTIVE: There are limited data relating folate nutritional status of mothers during pregnancy to mental and psychomotor development of their offspring. Using an existing data set from a study on the effect of prenatal zinc supplementation on child neurodevelopment, we evaluated the association between folate nutritional status of mothers during pregnancy and neurodevelopment of their children. METHODS: Maternal blood folate and total homocysteine (tHcy) concentrations were measured at 19, 26, and 37 weeks of gestation. At a mean of 5.3 years of age, 355 black children with low-socioeconomic background were given 6 tests: Differential Ability Scales, Visual and Auditory Sequential Memory, Knox Cube Test, Gross Motor Scale, and Grooved Pegboard. The scores of the tests between the 2 groups of mothers with poor versus adequate folate nutritional status classified by blood folate or tHcy concentrations were compared. RESULTS: There were no differences in the test scores of neurodevelopment between the 2 groups. CONCLUSION: Folate nutritional status of mothers in the later half of pregnancy assessed by plasma and erythrocyte folate and plasma tHcy concentrations had no impact on neurodevelopment of their children at age 5. It is unknown whether our findings in a low-socioeconomic population can be readily extrapolated to other populations.

Securing a faculty position: a practical guide for residents, fellows, junior faculty, and their mentors.

Applying for a faculty position can appear to be a daunting project for many residents, fellows, and junior faculty due, in large part, to the lack of readily available information on the process of interviewing and negotiating for faculty appointment in academic medicine. Although this process may seem mystifying to first-time applicants, it has a structure. This article discusses the framework of the application process and recommends an action plan from initial contact to acceptance of an offer. Each step of the process is discussed. Guidelines are provided to assist applicants and their mentors to successfully manage these important steps.

Effect of zinc supplementation of pregnant women on the mental and psychomotor development of their children at 5 y of age.

BACKGROUND: A negative effect of prenatal zinc deficiency on brain function has been well established in experimental animals, but this association in humans is controversial. OBJECTIVE: We evaluated the effect of prenatal zinc supplementation on the mental and psychomotor development of 355 children whose mothers participated in a double-blind trial of zinc supplementation that resulted in increased head circumference and birth weight. DESIGN: The children took 6 tests-the Differential Ability Scales, Visual Sequential Memory, Auditory Sequential Memory, Knox Cube, Gross Motor Scale, and Grooved Pegboard tests-at a mean age of 5.3 y. The scores were compared between the children of women who received a daily oral dose of 25 mg Zn during the second half of pregnancy and the children of women who received placebo. RESULTS: There were no differences in the test scores of neurologic development between the 2 groups. We analyzed the scores in 4 subgroups on the basis of maternal body mass index, because the increases in birth weight and head circumference due to the supplementation occurred only in the children of women with a body mass index (in kg/m(2)) < 26.0 in the original trial. No differences in the scores were found between these subgroups. CONCLUSIONS: Zinc supplementation of women in the latter half of pregnancy had no effect on the neurologic development of their children at age 5 y. It is not known whether our findings of no positive effect in the population with apparently inadequate zinc nutriture can be readily extrapolated to other populations.

Cord serum ferritin concentrations and mental and psychomotor development of children at five years of age.

OBJECTIVE: Our purpose was to evaluate the association between fetal iron status and mental and psychomotor development at 5 years of age. STUDY DESIGN: We evaluated the association of fetal iron status (umbilical cord serum ferritin concentrations) with test scores of mental and psychomotor development of 278 children. Six tests were given, including full-scale intelligence quotient (FSIQ), language ability, fine- and gross-motor skills, attention, and tractability. RESULTS: Compared with children with cord ferritin in the 2 median quartiles, those in the lowest quartile scored lower on every test and had significantly worse language ability, fine-motor skills, and tractability. They were also 4.8-fold more likely to score poorly in fine-motor skills and 2.7-fold more likely to have poor tractability than children in the median quartiles. FSIQ in the highest quartile was slightly, but not significantly, lower than the median quartiles, but the odds ratio for having a FSIQ score of less than 70 for children in the highest quartile was 3.3 (95% CI 1.2-9.1). CONCLUSION: Poor iron status (low ferritin) in utero appears to be associated with diminished performance in certain mental and psychomotor tests. The reason for the association between high ferritin concentrations and low FSIQ scores is unknown.