Education and Generativity

To the YSM and Alumni Communities:

A recent conversation with colleagues in the Faculty of Arts and Sciences caused me to reflect on our education mission at Yale School of Medicine, and the significance that education and lifelong learning are embedded in all that we do, including our research and clinical missions.

When we consider medical education, we often conceive of the integrated medical student curriculum that covers fundamental science, physiology, anatomy, pathology, pharmacology, epidemiology, and health equity as well as professionalism, ethics, and clinical skills. Importantly, all YSM faculty members have the opportunity to teach even when teaching is not a focus of their appointed track (as is the case for the Investigator and Clinical tracks). Teaching distinguishes us as faculty at a school of medicine, rather than scientists in a research institute or clinicians in private practice. Teaching also enriches our professional lives. Any busy clinician has had the experience of gaining a new understanding of a patient after seeing that individual through a student’s or resident’s eyes and taking the time to discuss the differential diagnosis, pathophysiology, and factors influencing therapeutic decision-making. Similarly, what investigator has not become reinvigorated or shifted their research direction because of the novel observation and enthusiasm of a student or fellow?

The variety of teaching opportunities at Yale School of Medicine exceeds that of an undergraduate campus, where classroom lectures and seminars are the usual settings for teaching. At YSM, teaching just as commonly takes place at the bedside or the laboratory bench, in small groups, in simulation centers, and often involves mentorship and coaching. Many of our faculty devote hours as thesis advisors or serving on educational committees, such as the admissions, clinical assessment, and curriculum committees. For this reason, it is paramount that we develop effective ways to evaluate and communicate the educational activities of our faculty. The Teaching and Learning Center offers many resources here. For faculty under consideration for promotion to associate professor with tenure or professor on any track, the TLC provides the teaching summary letter—a standardized summary of faculty members’ teaching activities, including educational leadership, curriculum development and scholarship, mentoring activities, evaluation of teaching by students and residents, and other educational contributions.

How then do we value education? Education is not a commodity for which one can pay a unit price. In fact, commodifying educational efforts can reduce creativity. As Daniel Pink notes in his book Drive, what motivates our educators is autonomy, mastery, and purpose. For this reason, in our recently revised Guidelines for Faculty Compensation Plans, we do not attempt to define a unit of teaching, but instead characterize the effort that is expected to be dedicated to educational and scholarly activity on each of our faculty tracks.

At the same time, we must develop new strategies to provide protected time for leaders in medical and graduate education. In undergraduate medical education, examples of leadership positions include clerkship directors, course directors, and thread leaders. Today a few key positions are supported centrally. In addition, some monies supporting the education mission are conveyed to departments based on a formula set in 2007 and not tied to any specific educational roles within the department. During the coming weeks, Deputy Dean for Education Jessica Illuzzi and her team will be defining specific roles in undergraduate medical education that will be supported through those funds. A similar model is already in place for graduate medical education where residency program directors, for example, receive specific support. We must also standardize support for fundamental roles in PhD programs, such as directors of graduate studies.

Ultimately, those who teach do so because they find reward in learning anew and in developing others. Through teaching we express one of our core values, generativity.

Sincerely,

Nancy J. Brown, MD
Jean and David W. Wallace Dean of Medicine
C.N.H. Long Professor of Internal Medicine