STEWARDING UNITY IN EMERGENCY MEDICINE

An Interview With Wendy Coates, MD 2023-2024 SAEM President

Wendy Coates, MD, is professor emeritus of Emergency Medicine at University of California, Los Angles – David Geffen School of Medicine and at Harbor-UCLA Department of Emergency Medicine. Dr. Coates served as dean of the UCLA Acute Care College and director of education at Harbor-UCLA where she founded the first fellowship in Medical Education Scholarship in 1997. Dr. Coates earned her medical degree from Case Western Reserve University and completed an emergency medicine residency at Medical College of Pennsylvania/Allegheny General.

Dr. Coates’ research focus is health professions (medical) education with an emphasis on faculty development, mentorship, and qualitative methods. She has been a leader in curricular innovation and evaluation, and the art/science of creativity in medicine. She is a proud recipient of research funding from the SAEM Foundation and has been honored with several education and teaching awards, including a lifetime achievement award from SAEM’s Clerkship Directors in Emergency Medicine (CDEM) academy. Dr. Coates is a founding member of the editorial board for AEM Education & Training (AEM E&T), a member of the Academic Emergency Medicine (AEM) editorial board, and associate editor for the Journal of Dance Medicine and Science. She served as an item writer for the American Board of Emergency Medicine (ABEM) for nine years and was elected to the Council of Residency Directors in Emergency Medicine (CORD) Academy of Scholarship as one of the initial scholars.

Dr. Coates began her service to SAEM as the resident representative to the SAEM Education Committee, which she subsequently chaired for several years. She was the inaugural chair of the SAEM Undergraduate Education Committee, where she led the creation and implementation of the SAEM Virtual Advisor Program and, more recently, the initial Fellowship Approval Committee that developed metrics for non-ACGME (Accreditation Council for Graduate Medical Education) approved fellowships in emergency medicine. Dr. Coates has also served on the SAEM Nominating Committee, SAEM Research Committee, and was the SAEM representative to the national committee on medical student education reform. She led the creation of the new ARMED MedEd (Advanced Research Methodology Evaluation and Design: Medical Education) course for advanced education research methodology and has been its co-chair. Dr. Coates currently serves as president on the SAEM Board of Directors.

Congratulations on your election as the new president of SAEM. What do you hope to accomplish during your tenure?

I would like to be a steward of unity both within SAEM and with our partner organizations in emergency medicine (EM) and to ensure that the academic perspective is always represented. It is important to underscore the value of our specialty with federal and foundational funding entities so that we may continue our trajectory as researchers, educators, and leaders. I am dedicated to facilitating professional advancement for all members on their unique pathways.

What do you think are some of the urgent issues facing academic emergency medicine today? What issues do you feel are most germane to current and future emergency medicine trainees?

This is a critical time for academic EM. All domains of academia present opportunities to redefine our specialty’s importance and to cultivate the careers of our future colleagues as we optimize our recruitment of the best candidates. EM educators are poised to innovate future educational norms with emerging systems such as the Master Adaptive Learner (MAL) Model and reconsidering Competency Based Medical Education (CBME). Health professions education researchers in EM have expertise in research methods to ensure that new models are evidence-based. Emergency Care Research is growing, and we are partnering with the National Institutes of Health Office of Emergency Care Research (NIH OECR) to facilitate further development of EM researchers and increased funding to our researchers. We will remain a supportive home for those interested in academic EM, including those who are seeking to join our EM family and those who recruit, support, and mentor them in research and education. Our thousands of volunteer committee, academy, and interest group members demonstrate expertise across the wide spectrum of EM and with this depth and breadth of expertise, SAEM is ready to address the challenges and opportunities that may come our way.

You have served in many leadership positions with SAEM. Which do you consider your favorites, and why?

This may be a trick question, because I have always been “allin” with each leadership opportunity, and each was my favorite during its time. The common thread has been collaborating with other passionate academicians to work together on something meaningful.

The creation of ARMED MedEd was very satisfying since it is the first of its kind cohort program for advanced training and will enable the formation of a capable specialty-based network of Health Professions/Medical Education researchers. In 1997, I was fortunate to have been able to create the first post-graduate fellowship in medical education and scholarship. There, I could mentor one fellow per year; with ARMED MedEd, a team of experts can offer a similar outcome for 20 or more colleagues at a time!

Serving on the SAEM Board of Directors has been especially meaningful. Through this service, I have met new colleagues and have gained a new appreciation for the depth of expertise within our society. As the president, I feel a deep responsibility to be a steward in supporting all my colleagues in academic EM by making progress on SAEM’s strategic plan that focuses on our mission “to lead the advancement of academic emergency medicine through education, research, and professional development.”

What led you to choose emergency medicine as your specialty and, specifically, why academics?

I could easily write the same personal statement that many of our applicants share about liking all the specialties, being the first to see the patients, enjoying procedures, etc. While all these things are true, I chose EM because of the people. I always felt at home in the emergency department (ED) and marveled at how diverse and acute the clinical conditions were, how many outside interests EM physicians had, and how it was possible to have a meaningful impact on the patients. As for the academic part, I’ve always been involved in discovery and education and my biggest high is enjoying the successes of the people I’ve trained.

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What is it about working with learners that you most enjoy?

Learners are the antidote to complacency. I worked hard to attain excellence and want to share best practices with trainees so they can bypass my mistakes and begin their learning journey in a supportive environment. Learners keep me fresh and teach me about their ever-evolving world — technology, pop culture, new ways to look at wellness. It’s very refreshing! Tell us about a particularly satisfying moment you had while training a learner or mentee.

At a national conference one year, all the research presentation awards went to my fellows — best plenary presentation, best poster presentation, best presentation by a fellow. I’ll never forget the look on the upcoming fellow’s face, worried just a bit about starting in a few months and what expectations there were going to be! These talented education researchers were self-motivated, worked very hard, and I am particularly proud as I watch them take the helm as leaders in health professions education scholarship and MedEd research.

What is your education philosophy?

Creativity should be at the center of developing excellence. It’s important to meet learners where they are and to give them the tools for self-advancement in a safe environment where they know they’re being supported and not judged. I’m going to expect you to be the best you can possibly be, and I’ll do my part to facilitate your journey. There’s rarely only one way to do things and I might learn something from your approach that will help someone else someday.

What experiences in your life outside of medicine do you feel have made you a better educator?

I’ve been a dancer since I was a kid. It’s very difficult to excel, but dedication is a must. My colleague, Chris Martin from ABT, used to say, “Becoming a competent ballet dancer is like moving a 5000-foot-tall mountain from here to there… one plastic teaspoonful at a time.” The results of daily hard work may not be obvious in the moment, but persistence and teamwork eventually pay off. As a new professional dancer, I was assigned to teach a beginning ballet class to 6–8-yearolds, where grand jetés were a means to escape lurking imaginary alligators on the stage, and other forms of imagery abounded. I taught in many academic venues: high school Physics; adult GED classes; and Russian refugees from the USSR who came to America in the 1980s with absolutely nothing. The latter group was incredibly motivated, and their vulnerability reminded me that I was lucky, despite challenges in my youth. All learners are different and it’s very important to meet each on their terms to enable them to take charge of their growth and destiny.

Do you have any advice/pearls to share with those who are just beginning their journey in academic emergency medicine?

You don’t need to figure anything out by yourself, but you must figure yourself out. Saying “yes” to opportunities can introduce you to new networks and expand your skills. But saying “no” to activities that don’t advance your career is just as important to prevent frustration and delay in substantive advancement. It’s a good idea to make a long-term (~5 years) plan and a one-year plan that details how you’ll get started on your way to your envisioned future. Repeating the exercise every year is refreshing and allows you to refine your longerterm goals and appreciate how your short-term plans have advanced you. It’s always helpful to find mentors to guide you along the way, give you opportunities, and introduce you to people who have shared interests and can invite you to their professional networks.

What do you think is the future of emergency medicine education research?

Education research can have a profound impact on patient outcomes and on the efficiency and quality of training of EM physicians. While it is difficult to predict trends, a few topics are gaining interest for researchers, such as Assessment Science, Competency Based Medical Education (CBME), Social EM, and Wellness. As our specialty trains more health professions education researchers, opportunities will exist for partnerships with Emergency Care researchers who have translational and implementation objectives; across specialties to develop research based models of education with demonstrable patient outcomes; and in partnership with the highest level of health professions educators around the globe who are engaged in discovery for learners at all levels.

You’ve been a powerful advocate of the mentor/mentee relationship. Why should established physicians seek out protégés to mentor?

We are at a critical time to encourage dynamic and thoughtful medical students to choose a career in EM. All of the existing research points out that the most influential factor in choosing a specialty is one’s mentor. EM faculty can shape the career of aspiring doctors by offering opportunities to shadow them in the ED, to become engaged in short- or longer-term research projects, and to develop a healthy relationship. As a mentor of students, residents, or other faculty members, you can see things through younger eyes and become rejuvenated in your practice. You can learn from your protégés too! They’re awfully good at technology and have new ways of looking at old problems. You can help them launch a meaningful career and rest assured that when you’re no longer at-it all the time, someone is carrying a small piece of you to every patient or teaching encounter. Mentors come in all varieties – peers, people who are senior or junior to you.

Who are the mentors or peers who most shaped your thinking, and how?

A good mentor will challenge you to think for yourself and might open doors for you. They key is that when you walk through the open door, it’s on you to excel – in addition to your own advancement, it’s not a good idea to let your mentor down. I’ve been fortunate to have had many people who cared throughout my life and career. I think I’ve kept a bit of each close to my heart and still want to make them all proud.

At the end of your career, for what would you most like to be remembered?

I really care about the people I’ve taught, worked with, and treated. I’m passionate about making sure EM leads the pack in faculty development to create capable EM education researchers who can work together to take us into the next era.

Up Close and Personal

1. Please complete these three sentences:

• In high school I was voted most likely to… be a professor

• A song you’ll find me singing in the shower is… Cecilia by Simon & Garfunkel or some classical guitar concerto by Villa Lobos.

• One quote I live by is… “I never lose. I either win or I learn.” Nelson Mandela

• Something I wish I was good at, but am not, is… singing a cappella

2. Who would play you in the movie of your life and what would that movie be called?

“Dancing to Doctoring” I would really want Meryl Streep to play me because she always does such a good job capturing the essence of her characters, and that might give me insight into who I am!

3. Name three people, living or deceased, whom you invite to your dream dinner party.

Rosalind Franklin, Mary Cassatt, and my grandfather.

4. What is your guilty pleasure (book, movie, music, show, food, etc.)?

Going to live theatre — Broadway, music, dance, plays, whatever.... I could actually go every day.

5. You have a full day off — what do you spend it doing?

I’d drink a latte in the backyard and then go hang out with friends at dance classes (ballet, rhythm tap) and perhaps sit in on a tech rehearsal of an upcoming production. Someone else would make dinner that I could enjoy with my husband and all three kids who would all be in town at the same time. Then, we’d take a walk on the beach and I’d read a novel until it was time to go to sleep.

6. Name one thing on your bucket list. Hike the Via Emilia Romagna trail in Italy and take in all the art and culture along the way.