ACADEMIC AFFAIRS COMMITTEE
A Rock and a Hard Place Mary Claire O’Brien, MD FAAEM
“A
few months ago my chair asked me to help with bedside teaching because the clerkship director was overwhelmed. I love medical students and was flattered. Unfortunately it has exploded from once a month to a weekly activity; in addition there are remediation sessions for the students who are struggling. Now the physician who runs our Morbidity and Mortality conferences has retired. The chair wants me to take that over too. One of the residents wants help to write up a case report on a patient we shared. I help with residency interviews; I go to conferences twice a month; I am on a working group about community paramedicine; I never miss a faculty meeting. I want my colleagues to see me as a team player. I understand that junior faculty have to shoulder their fair share of administrative responsibilities. But how am I supposed to do all this while pulling 14 shifts a month, 50 percent of which is evenings and nights? I barely have time to sign my charts! It’s not like I am being paid “extra” for all this other activity.” You, junior faculty member, are between a rock and a hard place. You chose medicine because you like to take care of patients. You chose academics because you enjoy teaching. What you didn’t count on was the heavy burden of all the “extra” tasks that faculty perform as part of institutional citizenship. There’s no way around it: you will never be finished at the end of the workday. But you can achieve a modicum of control over the deluge.
Don’t spend time looking over your shoulder trying to “count” what others are doing in comparison to you.” Rest assured that your fellow faculty members are hip deep in their own institutional citizenship. Don’t spend time looking over your shoulder trying to “count” what others are doing in comparison to you. It will only make you angry. What constitutes your fair share of the department load is a matter of opinion. And while it is probably true that some of your fellow faculty members are not pulling their weight, repeat after me, “That is the chair’s problem, not mine.” It is not your problem! Let it go. How do I say no without looking like a slacker?
“That sounds like a wonderful opportunity. I wish I could say yes. I really don’t have the *bandwidth* right now to give that all the attention it deserves. Thank you so much for considering me.” As an academician, get used to using that word “bandwidth.”
Is there a way to tell early on when I am becoming overwhelmed, before I get totally burnt out?
Yes. When routine annoying things about patient care make you apoplectic, that’s the sign. The patient answers every “yes-no” question with a five-minute ramble. The EMTs forgot the medication list from the nursing home. The family insists you call their doctor in the middle of the night, even though she is not on call, because “somebody around here needs to know what they are doing.” The radiology techs filmed the wrong extremity. It has been 30 minutes and the nurse still hasn’t given the BP meds! Where is the ultrasound machine? Someone just threw up all over the hallway. Are you rolling your eyes, or is your head popping off? If the latter, you are overwhelmed. How do I bow out of something that has become overwhelming?
Ideally, before waving the white flag you have found another person to take your place. Some jobs are so disagreeable or time-consuming that this is impossible. Unless your physical or mental health is at risk, it is possible you’ll be riding this bucking bronco until the end of the academic rodeo year. However, if you are unable to perform a task—for whatever reason—you have an obligation to inform your chair. The chair is interested in your welfare as well as your performance—but more than that, she is interested in the performance of the department as a whole. Whether or not you can complete the job satisfactorily, it is the chair’s responsibility to make sure it gets done. “Dr. Chair, thank you for meeting with me. I came to discuss my committee obligations. I am struggling. I am currently unable to give XYZ the attention it deserves. I’d like to relinquish XYZ so I can focus more on my [other committees/clinical teaching/research/paper writing]. I’d like to ask your help with that.” How do I ask for FTE for a current volunteer (or “voluntold”) assignment?
“Thank you for meeting with me, Dr. Chair. As you know, I have been serving as the department liaison for Trauma Surgery for the last six months. I am committed to that partnership and to streamlining care >>
COMMON SENSE MAY/JUNE 2024
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