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CardioNerds (Amit Goyal and Daniel Ambinder), join  Dr. Gurleen Kaur (Director of CardioNerds Internship and medicine resident at Brigham and Women’s Hospital),  Dr. Victoria Thomas (Cardionerds Ambassador, Vanderbilt University Medical Center) Dr. Katie Berlacher (Cardiology program director, University of Pittsburgh Medical Center), and Dr. Julie Damp (Vanderbilt University Medical Center Cardiovascular disease fellowship program director) to discuss becoming & thriving as a fellowship program director and more in this installment of the Narratives in Cardiology Series. Special message by Tennessee ACC State Chapter Governor, Dr. John L Jefferies. Audio editing by CardioNerds Academy Intern, student doctor Akiva Rosenzveig.

The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza.

Video Version • Notes • Production Team

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Tweetorial – Becoming & Thriving as a Fellowship Program Director with Dr. Katie Berlacher and Dr. Julie Damp

1/ Episode 212, @PaChapterACC & @CardioNerds Narratives in Cardiology episode featured a discussion w/ @Drvic_thomas, @KBerlacher, & @BoydDamp

Follow this #CardsNarratives🧵on the discussion about Becoming and Thriving as a Fellowship Program Director pic.twitter.com/HgF1GPyqWT

— Gurleen Kaur, MD (@Gurleen_Kaur96) June 30, 2022

Video version – Becoming & Thriving as a Fellowship Program Director with Dr. Katie Berlacher and Dr. Julie Damp

Notes – Becoming & Thriving as a Fellowship Program Director with Dr. Katie Berlacher and Dr. Julie Damp

Drafted by Dr. Victoria Thomas.

1. What does it mean to be a big “E” when people say they are a clinician Educator?

• It can mean teaching students directly at bedside.  However, it is also a sacrifice of daily mentoring and listening to students’ challenges and difficulties.
• Being a clinician educator is just as much of a calling as is serving in medicine.
• Clinician Educators focus on medicine but also the science and best practices of teaching the art of doctoring.

2. What is physician burnout? Why is this important for to CardioNerds?

• Physician burnout is a syndrome of chronic workplace stress that leads to emotional exhaustion and a sense of dissatisfaction and disconnection personally and professionally. 
• 30-45% of cardiologists have reported physician burnout.

3. What factors affect physician burnout?

• Emotional and physical exhaustion often lead to physician burnout. First year of training as an intern or fellow and first year of serving as an attending are particularly high-risk periods. This is largely due to learning a new system and responsibilities mixed with a sense of decreased accomplishment.
• The sense of decreased accomplishment can lead to physicians suffering from impostor syndrome.
• Grit can be defined as a perseverance for long-term goals.  The level of grit was not associated with burnout among first-year Internal Medicine residents.

4. What are some of the solutions to prevent or address physician burnout?

• Physicians need to feel a sense of belonging and should be supported and celebrated when they have accomplished something by their colleagues and administrators. Fellows and attendings want to feel listened to and supported.
• Destigmatizing this idea of “perfection in medicine”. Physician should share with each other their accomplishments but also their mistakes to create a community of personal and professional connection and acceptance.
• Practicing mini acts of gratitude such as exercise or therapy can help with burnout.
• Delegation of work tasks and taking breaks have been shown to improve mental well-being.

5. What support do program directors have to help prevent burnout for themselves?

• Many local graduate medical education (GME) offices will have some resources for program directors depending on the size and funding. 
• The Accreditation Council for Graduate medical Education (ACGME) had developed an on-line series to help new program directors understand their new roles. 
• It is also recommended to network and create community of program directors to work with and bounce ideas from.

6. What are some of the differences found among cardiology program directors regarding support from leadership?

• 45% of men versus 29% of women program directors felt adequate support from leadership.  56% of late-career versus 35% mid-career and early-career program directors felt adequate support from leadership.
• There is no evidence to support this, however, but contributing factors may include the documented history of gender bias, wage inequality, and program size. 

References Team

1. Cullen, M. W., Damp, J. B., Soukoulis, V., Keating, F. K., Abudayyeh, I., Auseon, A., … & Weissman, G. (2021). Burnout and well-being among cardiology fellowship program directors. Journal of the American College of Cardiology, 78(17), 1717-1726.
2. Mehta, L. S., Lewis, S. J., Duvernoy, C. S., Rzeszut, A. K., Walsh, M. N., Harrington, R. A., … & American College of Cardiology Women in Cardiology Leadership Council. (2019). Burnout and career satisfaction among US cardiologists. Journal of the American College of Cardiology, 73(25), 3345-3348.Peckham C. Physician burnout: it just keeps getting worse. Medscape; 2015.
3. Klein, A. J., Grau, T., Spagnoletti, C. L., Rothenberger, S. D., & Berlacher, K. (2021). Grit Does Not Predict Burnout among First-Year Internal Medicine Residents. Southern Medical Journal, 114(5), 272-276.
4. Edwards, S. T., Helfrich, C. D., Grembowski, D., Hulen, E., Clinton, W. L., Wood, G. B., … & Stewart, G. (2018). Task delegation and burnout trade-offs among primary care providers and nurses in Veterans Affairs Patient Aligned Care Teams (VA PACTs). The Journal of the American Board of Family Medicine, 31(1), 83-93.
5. Shanafelt, T. D., & Noseworthy, J. H. (2017, January). Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. In Mayo Clinic Proceedings (Vol. 92, No. 1, pp. 129-146). Elsevier.

Production Team