Dr. Garcia is a freshly minted faculty member at Big Name University Medical Center. She’s excited to have finally finished residency and dive into her career as a full time (and fully paid) attending. After spending her first year acclimating to the new department and achieving board certification, Dr. Garcia finds herself at a bit of a crossroad. She likes teaching, but are not sure residency or medical student education leadership is for her. The same goes for clinical operations and research – interesting, but there hasn’t been any “a ha” moment to illuminate her calling. She heard that “saying yes” to opportunities is important, but after a year of “saying yes,” Dr. Garcia feels swamped: she is serving on the residency clinical competency committee, a department committee for managing boarding, and collaborating on a departmental research initiative. Despite this, she receives no salary support to lower her clinical time, and is starting to feel like there is no real forward progress in her career.

It ain’t easy being an attending

Attending life has its challenges.

New residency graduates suddenly have to adjust to the daunting responsibility of independent practice and meeting clinical performance metrics. Those who take the academic route face unclear promotion expectations, uncertainty about their niche, and a double-whammy of high clinical burden and a tacit expectation that you “prove” your worth as a teacher by taking on more tasks before being rewarded with salary support. Senior faculty face entirely different challenges; once-sharp clinical skills may have dulled over time, or the academic career hits a dead end – be it through stagnation, boredom, or waning interests. And as study after study tells us, everyone is susceptible to burnout. It should be no surprise that academic clinical educators are at high risk for burnout, stalled career advancement, and abandonment of academic medicine altogether [1, 2].

Systemic changes are undoubtedly needed for these system-wide issues. But what can Dr. Garcia – or you – do? Well, instead of passively waiting for Godot, you can seize the initiative and bend the arc of your career into alignment with your values, strengths, and passions, and, by extension, toward fulfillment. And that’s exactly the purpose of a coach.

A coach? Aren’t they for learners, or leaders, or long-jumpers?

Yes… and also for faculty just like you. Each of those groups has their own flavor of coaching (academic, executive/leadership, and performance, respectively). But in your case, professional development coaching might be just what the doctor ordered.

Let’s start with the obligatory definition of coaching. The International Coaching Federation defines a coach as partnering with clients:

“…in a thought-provoking and creative process that inspires them to maximize their personal and professional potential. The process of coaching often unlocks previously untapped sources of imagination, productivity and leadership.”

Personally, I like keeping it simple:

When you’re stuck in life, a coach is a great tool to help you get unstuck.

By working in partnership with you, they ask thought-provoking reflective questions; help you discover your core values and develop valuable personal insights; guide you to creating authentic and actionable goals; and help you be accountable to achieving those goals. This Journal of Graduate Medical Education article “Choosing When to Advise, Coach, or Mentor” [PDF] provides a succinct review [3].

But isn’t coach just another name for “mentor?”

In short, no.

Mentorship can be incredibly beneficial to one’s career, and many mentors use coaching skills while guiding their mentees. But mentorship differs from coaching in a number of ways.

Mentors are typically senior, have shared expertise in a content domain, and serve as a font of knowledge for their benefit. Unfortunately, evidence shows that many, if not most, faculty struggle to find, receive, or maintain satisfactory mentorship [4, 5].  What’s more, what happens when you’re more established? When you’re advanced in your career, correct answers are less clear, and there might not be any senior mentor to guide your hand.

Coaching, by comparison, starts from the premise that you are the world’s foremost expert on your own life, and that within you lies all the creativity and resourcefulness to overcome any challenge. Sometimes, though, we can’t see the forest from the trees. A coach helps you gain insight and illuminate the obstacles in your way. Once your perspective is clear, you can create a plan to succeed. A coach, then, acts as a partner (not a guide), helping you think, reflect, and act. Figure 1 is a helpful idea of how a coaching partnership will look, but the key difference from mentorship is that you are the source of all insight and action, not the coach.

Figure 1: The Coaching Partnership

Clearly there can be overlap between these important academic relationships, but, at its core, coaching is distinguished by: [3, 6]

1. Being driven by an agentic coachee that is ultimately responsible for choosing to take action
2. Not requiring the coach to be in the same field as the coachee
3. Not being centered around transfer of expertise from a more knowledgeable or experienced party to the recipient

So what should coaching be used for?

The most supportive data for coaching in medicine is for physician wellness and mitigating burnout [7]. Beyond that, evidence suggests that coaching is positively associated with:

• Achievement of professional goals and personal empowerment [8]
• Self-confidence [9]
• Stress management [9]
• Reflective capacity for interpersonal interactions [9]
• Better teaching skill transfer [10]
• Teacher identity development [10]
• Better learning environment [10]
• Faculty academic productivity [11]

The breadth of associated outcomes here show the multifunctional and flexible nature of coaching. When you’re stuck, a coach is a great way to help you get unstuck.

What should I look for in a coach?

Before jumping into details, it’s important to share 2 important and interrelated points.

1. The bedrock that undergirds the work of coaching is the relationship between the coach and coachee. Thus, think of a finding a coach as akin to finding a partner. You wouldn’t settle down with the first person you go on a date with, right? Seek out multiple coaches, talk about your needs with them, and see which one is the best fit for you specifically. Similarly, successful coaching requires you, as the coachee, to feel psychologically safe with your coach. Internal coaches may be free and easy to access, but you may not feel comfortable being truly vulnerable with someone at your institution or, worse, to whom you report. Conversely, external coaches may provide complete anonymity and psychological safety, but they will require some kind of financial remuneration – be it from you, your CME funds, or your department/institution.
2. There is very little regulation in the coaching world. You, after reading this article, could think this coaching thing sounds swell and launch a business tomorrow calling yourself a coach. In order to make sure you’re working with someone who has received specialized training or has sufficient coaching experience, ask for a certificate from a training program and/or accreditation by one of the governing bodies of coaching, like the International Coaching Federation or Center for Credentialing and Education.

The following table provides a brief guide of the responsibilities that can also help guide your search for a prospective coach:

Ok, I’ll bite. How do I go find a coach?

Because coaching is still in an “early adoption” phase within medicine, you’ll have to be proactive to find a suitable coach. This short Journal of Graduate Medical Education article, Coaching for Clinician Educators [PDF] covers how to prepare for, find, and succeed with a coach [12]. Full disclosure: I am one of the authors, so take my recommendation under advisement!

With that aside, here are some general tips for finding a coach:

1. Look internally: Many institutions are starting internal coaching programs. Ask around within your department to see if this is an option.
2. Contact a coach training programs: There are numerous coaching programs that train professional coaches, possibly even at your home institution. Coach trainees are required to accrue many hours of practice, and often do so at a discount from market rates. This could be an excellent way to have a coach outside of your immediate orbit, but also not have to pay a significant amount.
3. Look online: A casual internet search will connect you to any number of coaches. You can seek coaches who are emergency physicians, physicians of other specialties, or have no affiliation or background within healthcare. The more you look, the more options you’ll find.
4. Ask around: Some of your colleagues may have used a coach, know a coach, or are themselves a coach, without you ever knowing.
5. Remember your CME stipend: Check with your institution, but in most instances coaching is an acceptable form of CME or professional developmet expenditure.

The Takeaway

Coaching is one of many tools at your disposal to unlocking success in your career. It’s especially useful when you’re stuck, be it through gaining a new perspective, making a hard choice, or breaking the paralysis of analysis. Give it a try and see if it can help you!

References

1. Chapman AB, Guay-Woodford LM. Nurturing passion in a time of academic climate change: the modern-day challenge of junior faculty development. Clin J Am Soc Nephrol. 2008;3(6):1878-1883. PMID 18945997
2. Elster MJ, O’Sullivan PS, Muller-Juge V, et al. Does being a coach benefit clinician-educators? A mixed methods study of faculty self-efficacy, job satisfaction and burnout. Perspect Med Educ. 2022; 11(1):45-52. PMID 34406613
3. Marcdante K, Simpson D. Choosing When to Advise, Coach, or Mentor. J Grad Med Educ. 2018; 10(2):227-228. PMID 29686766
4. Jordan J, Coates WC, Clarke S, et al. The Uphill Battle of Performing Education Scholarship: Barriers Educators and Education Researchers Face. West J Emerg Med. 2018 May;19(3):619-629. PMID 29760865
5. Bentley S, Stapleton SN, Moschella PC, et al. Barriers and Solutions to Advancing Emergency Medicine Simulation-based Research: A Call to Action. AEM Educ Train. 2019 Nov 27;4(Suppl 1):S130-S139. PMID 32072117
6. Wolff M, Deiorio NM, Juve AM, et al. Beyond advising and mentoring: Competencies for coaching in medical education. Med Teach. 2021; 43(10):1210-1213. PMID 34314291
7. Boet S, Etherington C, Dion PM, et al. Impact of coaching on physician wellness: A systematic review. PLoS One. 2023 Feb 7;18(2):e0281406. PMID 36749760
8. Pearce MJ. Professional Development Coaching for Health Professions Graduate Faculty: A Pilot Implementation. J Contin Educ Health Prof. 2022; 42(4):291-293. PMID 34966110
9. McKnight R, Papanagnou D. Coaching junior faculty for the uncertainties of academic professional practice. Int J Med Educ. 2021;12:179-180. PMID 34592715
10. Bajwa NM, De Grasset J, Audétat MC, et al. Training junior faculty to become clinical teachers: The value of personalized coaching. Med Teach. 2020; 42(6):663-672. PMID 32130055
11. Schulte EE, Alderman E, Feldman J, et al. Using the “Coach Approach”: A Novel Peer Mentorship Program for Pediatric Faculty. Acad Pediatr. 2022;22(7):1257-1259. PMID 35381378
12. Branzetti J, Love LM, Schulte EE. Coaching for Clinician Educators. J Grad Med Educ. 2023;15(2):261-262. PMID 37139204

Disclaimer: The author, Dr. Jeremy Branzetti, is the founder of Academic Educator Coaching and is a certified professional coach.