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- •Preface
- •References
- •Contents
- •Author Biographies
- •About the Series Editors
- •Family Medicine Advocacy Summit
- •Robert Graham Center Workforce Studies
- •HealthLandscape
- •Residency Resources
- •Medical Education Policy Development
- •Residency Program Solutions
- •Residency Leadership Summit
- •Chief Resident Leadership Development Program
- •Educational Resources
- •Continuing Medical Education (CME) Tracking
- •Graduate Medical Education Awards
- •Summary
- •References
- •AAFP Structure
- •AAFP Governance
- •Workforce Mission
- •AAFP Workforce Advocacy
- •Residency Redesign
- •References
- •Osteopathic Recognition Requirements
- •Osteopathic Recognition Program Essential Personnel
- •Osteopathic Faculty
- •Osteopathic Recognition Resident Requirements
- •Osteopathic Educational Program Core Competencies
- •Osteopathic Program Evaluation
- •References
- •Reference
- •5: Association of Family Medicine Administration and the Key Role of the Residency Program Coordinator
- •Appendix 1
- •References
- •References
- •Membership Categories within NAPCRG
- •The AAFP Robert Graham Center
- •AAFP National Research Network (NRN)
- •Family Physicians Inquiry Network (FPIN)
- •The Family Medicine Physician-Scientist Pathway (PSP) Program
- •NAPCRG Grant Generating Project
- •Building Research Capacity (BRC)
- •Conclusion
- •References
- •Reference
- •9: Family Medicine Residency Accreditation
- •Why Accreditation Matters
- •ACGME Organizational Structure
- •The Family Medicine Review Committee (RCFM)
- •The Clinical Learning Environment Review (CLER)
- •The Site Visit
- •Initial Accreditation Period
- •Subspecialty Fellowship Application
- •The Annual Program Review
- •The Next Accreditation System Annual Review Process
- •Accreditation Data System (ADS)
- •Citations
- •Accreditation Status
- •Program Requirement Development
- •Competency-Based Medical Education (CBME)
- •References
- •10: Graduate Medical Education Funding
- •Introduction
- •Residency Operating Costs
- •Medicare GME Funding
- •Residency Caps
- •Rural Track Programs
- •Inpatient Prospective Payment System (IPPS) Subtype Hospitals
- •Rural Referral Centers
- •Sole Community Hospitals
- •Medicare-Dependent Hospital
- •Medicaid GME Funding
- •Teaching Health Center Funding
- •Veteran’s Administration GME
- •Children’s Hospital GME (CHGME)
- •State Line Item Funding
- •Hospital Supplemental Funding
- •Patient Care Revenue
- •Philanthropy
- •Conclusions
- •References
- •Introduction
- •Informed Self-Assessment
- •Faculty Development
- •Summary
- •References
- •12: Core Competencies, Milestones, and Entrustable Professional Activities
- •Entrustable Professional Activities
- •Entrustment
- •Pearls
- •Pitfalls
- •References
- •Objectives
- •Educational Strategies
- •Implementation
- •13: A Practical Approach to Curriculum Development
- •Introduction
- •Cognitive Learning Theory
- •Behavioral Learning Theory
- •Humanistic Learning Theory
- •Goals
- •Conclusion
- •References
- •Introduction
- •Preparation Phase
- •Information Technology Systems
- •Medical Student Rotations
- •Interview Season
- •Application Screening
- •Interview Day
- •Second Looks
- •Postinterview Communication
- •Ranking
- •Using R3®
- •Match® Week
- •SOAP®
- •Conclusion
- •References
- •Preboarding
- •Planning New Resident Integration
- •Baseline Assessment
- •Individual Learning Plan
- •Integration Components
- •Longitudinal Integration
- •Learner/Residency/Institutional Goal Alignment
- •Conclusion
- •References
- •Introduction
- •History
- •Residency Application
- •Conclusion
- •References
- •References
- •Introduction
- •Identifying Performance Issues
- •Medical Knowledge
- •Patient Care
- •Interpersonal Skills/Communication
- •Professionalism
- •Systems-Based Practice
- •Remediation
- •Medical Knowledge
- •Patient Care
- •Interpersonal Skills/Communication
- •Professionalism
- •Systems-Based Practice
- •Conclusions
- •References
- •19: Faculty Recruitment: Best Practices
- •Background
- •Seeking Out Suitable Candidates: Recruitment Methods
- •Unique Challenges: Faculty Who Are New Residency Graduates
- •Concluding Thoughts: Always Recruit!
- •References
- •20: Faculty Performance
- •Faculty Performance Concerns
- •Appendix 1: Sample Family Medicine Residency Program Director Job Description
- •Job Summary
- •Educational Delivery
- •Evaluation
- •Administration
- •Appendix 2: Sample Family Medicine Residency Core Faculty Job Description
- •Job Summary
- •References
- •21: Faculty Development
- •Introduction
- •Clinical Skills
- •Scholarly Work
- •Tasks that Family Medicine Residency Faculty Perform
- •Role Modeling
- •Faculty Peer Support
- •Teaching
- •Training Courses
- •Workshops
- •Learning by Doing
- •Self-Directed Learning
- •Career Development
- •Organizational Resources
- •References
- •Introduction
- •Promoting Loving Accountability
- •Clinical Setting
- •Curriculum
- •Social Connection
- •Assessment
- •Vision Forward
- •Handling Microaggressions
- •Financial Investment
- •References
- •Building Trust
- •Positionality
- •Set the Stage
- •Normalize Not Knowing
- •Probing, Not Prodding
- •Accurate
- •Addressing Implicit Bias
- •Micro-Level
- •Macro-Level
- •Conclusion
- •References
- •Introduction
- •Background
- •Risk Factors
- •Stigma
- •FSMB Recommendations Regarding Licensing Questions
- •Physician Health Programs (PHP)
- •Individual-Level Actions
- •Conclusion
- •References
- •References
- •The Clinical Learning Environment
- •Feedback
- •References
- •27: Teaching Maternal Health Care
- •ACGME Requirements
- •Obstetric Family Medicine Faculty Shortage
- •Maternity Care Curricular Elements
- •Preconception Care
- •Prenatal Care
- •Immunizations
- •Common Conditions Which Complicate Pregnancy
- •Breastfeeding
- •Intimate Partner Violence (IPV)
- •Substance Use
- •Food Insecurity
- •Inpatient Obstetrical Care
- •References
- •Introduction
- •Family Medicine Residency Advocacy Curricular Development
- •Evaluation
- •Conclusion
- •References
- •Faculty Leadership
- •Resident Leadership
- •Patient Satisfaction
- •Professional Conduct
- •Ethical Considerations
- •Curriculum Development
- •The Hidden Curriculum
- •Conclusion
- •Context Matters
- •References
- •30: Teaching Behavioral Science
- •Introduction
- •Core Mental Health Topics
- •Patient-Centered Communication Skills
- •Contextual Care
- •Integrated Behavioral Health Care
- •Master Adaptive Learner
- •Clinic-Based Learning
- •Classroom-Based Learning
- •Interprofessional Education
- •Balint Groups
- •Conclusion
- •Appendix 1: Sample Behavioral Health Rotation (Myerholtz 2023)
- •References
- •31: Teaching Evidence-Based Medicine
- •Introduction
- •Longitudinal Deep Dives
- •Journal Club
- •Family Physicians Inquiries Network
- •Case-Based Learning
- •Day-to-Day Integration
- •Curriculum Development Tips Summary
- •Institutional Involvement
- •Summary
- •References
- •32: Teaching Practice Management
- •Background
- •Current Curriculum
- •Activities
- •Quality Improvement Project
- •Virtual Practice Instructions
- •Presenters
- •Topics Covered
- •References
- •Overview
- •Why Training Is Needed
- •Stressing Communication
- •Balint Group
- •Putting It All Together
- •References
- •Introduction
- •Broad Scope
- •Primary Contact
- •Emerging Technology
- •Rural Generalism
- •Public Health Advocate
- •Rural Practice Systems
- •References
- •Introduction
- •Basic Logistics
- •Operational Considerations
- •Billing Requirements
- •Additional Funding Considerations
- •Engaged Leadership
- •The FMC-Residency Partnership
- •Scheduling
- •Data-Driven Improvement
- •Empanelment
- •Panel Weighting
- •Panel Transitions
- •Team-Based Care
- •Population Management
- •References
- •Introduction
- •Personnel Management
- •Meeting Management
- •Communication Management
- •References
- •37: Managing Change in Family Medicine Residency Programs
- •Introduction
- •What Is Change Management?
- •Change Management Case Study
- •Kotter Model
- •Step 1: Create Urgency
- •Step 4: Communicate Buy-In
- •WIFM Worksheet
- •Step 5: Empower Others
- •Step 6: Generate Quick Wins
- •Step 7: Consolidate Gains
- •Conclusion
- •References
- •Negotiating Styles
- •Collaboration
- •Summary
- •References
- •Anticipating Task Cycles
- •Residency
- •Home Life
- •Seize Control
- •Delegate
- •Delegate Residency Chores
- •Delegate Domestic Chores
- •Exercise
- •Lunch
- •Organizing
- •Summary
- •References
- •Introduction
- •References
- •Introduction
- •Anticipate Common Disasters
- •Learn About Your Regional Emergency Infrastructure
- •Learn Your Organization’s Command Center Structures
- •Here Are Some Alternative Care Site Scenarios That May Arise
- •Regional Emergency Infrastructure
- •Managing Your Program During Disaster
- •Community Recovery
- •Consolidate Your Learning
- •Author Background
- •References
- •Conclusion

182
Fig. 18.2 Example of
potential progression toward
disciplinary action against a
resident [14]
S. M. Carek et al.
By approaching dismissal with transparency, fairness, and
a commitment to support residents’ well-being, training programs can balance the need to uphold high standards of
patient care and professionalism with the responsibility to
guide residents toward successful careers in medicine.
Figure18.2 outlines a proposed progressionfrom informal
constructive advice to formal counseling to warning, probation, and termination of employment that a program may
have totake when helping a resident through their training.
Conclusions
Family medicine resident performance issues are an integral
part of the learning journey, offering opportunities for
growth, development, and transformation. By recognizing
and addressing these issues with empathy, support, and
evidence- based strategies, mentors, supervisors, and educators can play a pivotal role in guiding medical residents
toward achieving their full potential. As stewards of medical
education, our commitment to fostering a culture of continuous improvement ensures that helps residents overcome
challenges and emerge as skilled, compassionate, and competent physicians who positively impact patient care and the
broader healthcare landscape.
References
1. Mitchell M, Srinivasan M, West DC, etal. Factors affecting resident
performance: development of a theoretical model and a focused literature review. Acad Med. 2005;80(4):376.
2. Reamy BV, Harman JH.Residents in trouble: an in-depth assessment of the 25-year experience of a single family medicine residency. Fam Med. 2006;38(4):252–7.
3. Dupras DM, Edson RS, Halvorsen AJ, Hopkins RH, McDonald
FS.ENT of the 25-year experience of a single family medicine residency. Literature Review. Am J Med. 2012;125(4):421–5. https://
doi.org/10.1016/j.amjmed.2011.12.008.
4. Svystun O, Ross S. Difculties in residency: an examination of
clinical rotations and competencies where family medicine residents Most often struggle. Fam Med. 2018;50(8):613–6. https://
doi.org/10.22454/FamMed.2018.794779.
5. Chandler N, Henderson G, Park B, Byerley J, Brown WD,
Steiner MJ.Use of a 360-degree evaluation in the outpatient setting: the usefulness of nurse, faculty, patient/family, and resident
self- evaluation. J Grad Med Educ. 2010;2(3):430–4. https://doi.
org/10.4300/JGME- D- 10- 00013.1.
6. Dudek NL, Marks MB, Regehr G.Failure to fail: the perspectives
of clinical supervisors. Acad Med. 2005;80(10):S84.
7. Guerrasio J.Remediation of the struggling medical learner. 2nd ed.
Association for Hospital Medical Education; 2017.
8. Kalet A, Chou CL, editors. Remediation in medical education: a mid-course correction. Springer; 2014. https://doi.
org/10.1007/978- 1- 4614- 9025- 8.
9. Hauer KE, Ciccone A, Henzel TR, et al. Remediation of
the deciencies of physicians across the continuum from
medical school to practice: a thematic review of the literature. Acad Med. 2009;84(12):1822. https://doi.org/10.1097/
ACM.0b013e3181bf3170.
10. Cleland J, Leggett H, Sandars J, Costa MJ, Patel R, Moffat M.The
remediation challenge: theoretical and methodological insights
from a systematic review. Med Educ. 2013;47(3):242–51. https://
doi.org/10.1111/medu.12052.
11. Guerrasio J, Garrity MJ, Aagaard EM. Learner decits and
academic outcomes of medical students, residents, fellows,
and attending physicians referred to a remediation program,
2006–2012. Acad Med. 2014;89(2):352. https://doi.org/10.1097/
ACM.0000000000000122.
12. Warburton KM, Goren E, Dine CJ.Comprehensive assessment of
struggling learners referred to a graduate medical education reme-

18 Addressing Medical Resident Performance Issues: Strategies forImprovement
183
diation program. J Grad Med Educ. 2017;9(6):763–7. https://doi.
org/10.4300/JGME- D- 17- 00175.1.
13. Frazier W, Wilson SA, D’Amico F, Bergus GR.Resident remediation in family medicine residency programs: a CERA survey
of program directors. Fam Med. 2021;53(9):773–8. https://doi.
org/10.22454/FamMed.2021.546572.
14. Smith J, Lypson M, Silverberg M, etal. Dening uniform processes
for remediation, probation and termination in residency training.
West J Emerg Med. 2017;18(1):110–3. https://doi.org/10.5811/
westjem.2016.10.31483.

Part V
Faculty Issues

Faculty Recruitment: Best Practices
RebeccaMartin, ShantieHarkisoon, andLondonMuse
19
Key Points
• A number of signicant challenges exist in the recruitment of qualied family medicine faculty, including salary gaps between academic and private practice settings,
insufcient support for protected faculty time, inadequate
skill set development for full-spectrum training, and
nationwide shortages in the family medicine faculty
workforce.
• Attention to diversity, equity, and inclusion and the fostering of a culturally diverse climate are increasingly being
recognized as vital factors in robust family medicine faculty recruitment and retention as well as in physician
workforce diversity more broadly.
• An inclusive recruitment framework for diversifying
GME training programs includes building on strong institutional support by setting diversity as a priority, implementing inclusive recruitment practices, seeking out
suitable candidates, investing in trainee success, and
building the pipeline.
• Led by the program director, every department member
and individual within the sponsoring institution, who can
contribute to the successful recruitment of faculty, residents, and students, is a stakeholder in the residency program; the program director must have a vision for the
program that is aligned with that of the institution and
R. Martin (*)
Palliative Medicine, Westchester Medical Center, New York
Medical College, Valhalla, NY, USA
e-mail: rebecca.martin@wmchealth.org
S. Harkisoon
Family Medicine Residency Program, Garnet Health Medical
Center, Middletown, NY, USA
e-mail: sharkisoon@garnethealth.org
L. Muse
MercyOne Adel Family Medicine, Adel, IA, USA
Des Moines University, Des Moines, IA, USA
e-mail: London.muse@mercyoneiowa.org
which cultivates and guides each member of the institutional team in shared ownership and synergistic teamwork
toward the program’s success.
• The “what’s on your plate” framework is a helpful way to
track individual faculty portfolios while simultaneously
facilitating cross-training of faculty skill sets; in this
framework, faculty maintain a list of their individual
responsibilities and scope of practice, ranging from clinical and academic to administrative. When faculty are out
on leave for extended periods (such as maternity/paternity
or sick leave), the program director can divide their “plate”
among the remaining faculty (who can develop additional
strengths) and then gradually reintroduce tasks to the faculty member when they return, to minimize overwhelm.
• Residency leadership is continuously recruiting at every
level, including through student recruitment where mentorship and role modeling efforts can help expand students’ imagination of what an academic career can look
like. When students encounter positive family medicine
faculty role models, they share those experiences with
other students and retain favorable impressions even later
when pursuing faculty and/or clinical positions; even if
they are not recruiting a particular person, such efforts can
serve as a means of effective marketing, thus helping
spread word about their program (and family medicine
more generally).
• Faculty with prior clinical experience contribute invaluable insights, practical wisdom, complementary procedural skill sets, and increased condence and are often
able to step right into their patient care role, generally
offering a fresh perspective and new creative ideas; at the
same time, seasoned clinicians may struggle to develop a
robust faculty skill set from scratch or appreciate established paradigms for approaching learners in a graduate
medical training context.
• New residency graduates joining faculty offer the advantage of reduced intimidation as teachers, familiarity with
resident-related concerns including board certication,
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2025
R. Kellerman, G. Irwin (eds.), Graduate Medical Education in Family Medicine, Excellence in Medical Education 2,
https://doi.org/10.1007/978-3-031-70741-4_19
187

188
R. Martin et al.
licensure, and job searching, and the absence of generational differences; however, they also have growth edges
unique to their relatively limited clinical and teaching
experience, often related to issues of insecurity, underdeveloped skill sets, or inexperience in navigating institutional frameworks and partnering effectively with
management-level leadership.
• There are signicant advantages when programs retain
their own graduates by focusing their efforts on internal
recruitment, ranging from cultivating a healthy program
culture and supporting student and resident recruitment
efforts to optimizing cost savings; robust advising of
potential future faculty members within a residency
program, and providing opportunities for faculty development during training, can support a smooth transition for
“growing your own” faculty.
Background
Recent years have seen an alarming nationwide shortage in
family medicine faculty [12], medical school primary care
preceptorships [2], family medicine preceptor training sites
[8, 15], and, more broadly, the family physician workforce [1,
10]. These shortages have the potential to impact graduate
training opportunities for a generation of family physicians to
come and underscore the imperative of high-quality faculty
recruitment practices to mitigate these concerning trends.
A number of challenges have been identied in the
recruitment of qualied family medicine faculty. (1) These
include:
• Marked salary gaps between private and academic
practices
• Insufcient nancial or institutional support for protected
faculty time
• Inadequate skill set development (ranging from teaching
and scholarship to procedural and obstetrics)
• Insufcient overall pool of family physicians, owing to
nationwide shortages from which to recruit clinical
faculty
It is not uncommon for residents and graduates to assume
(or even be told) that their priority should be to pursue private practice before they might ever consider joining a faculty. Starting their careers and paying off debt is their priority,
and academic medicine is often the last thing on their mind—
especially if there is limited family medicine faculty role
modeling and academic medicine scholarship opportunity
and encouragement. It is incumbent on the residency program director and faculty to shift this mindset by igniting
curiosity and interest in clinical academic medicine and by
enlisting the support of the institutional stakeholder team.
While members of the “stakeholder team” are traditionally
thought of as department heads, physicians, administrators,
and executive staff, it is helpful to remember that ostensibly
anyone at the institution can reasonably be considered to
hold a stake in the interests of a residency program and its
outcomes, given its integral role in the ourishing of the
institution and community.
Setting Priorities: Diversity, Equity,
andInclusion
Attention to diversity, equity, and inclusion and the fostering
of a culturally diverse climate are increasingly being recognized as vital factors in robust family medicine faculty
recruitment and retention [11] as well as in physician workforce diversity more broadly [7]. Best practices based on current evidence have been proposed for recruitment, retention,
and representation in leadership of a diverse faculty workforce. One proposed framework offered the following strategic priorities [5]:
• Identify diversity as a clearly articulated commitment in
the institution’s mission statement and on the program or
departmental websites.
• Ensure that the recruitment efforts conscientiously expand
the pool of underrepresented minority (URM) candidates
through inclusive language in position advertising and
marketing, set minimum thresholds for URM candidate
interviews, and support targeted outreach efforts to URM
candidates across the spectrum of medical education and
training.
• Create diverse recruitment committees, drawn from both
the family medicine faculty team and interdepartmental
institutional leadership, through either committee
appointment or peer nomination.
• Incentivize stakeholders (all involved parties) to create
accountability for diversity efforts, and develop specic
metrics to track the rates of recruitment, leadership development, and academic promotion of URM faculty
members.
• Incentivize URM physician candidates through recruitment packages that include targeted funding initiatives,
competitive salaries, debt reduction programs, and loan
forgiveness incentives.
• Ensure a holistic review of applications, emphasizing the
behavioral traits and characteristics valued by the institution, and utilize objective tools and scoring systems to
support a standardized evaluation process.
• Connect candidates with current URM faculty ambassadors for additional insights shared.
• Evaluate for biases in the faculty promotion and tenure
process and consider mandating training in implicit bias.

19 Faculty Recruitment: Best Practices
189
To help address healthcare disparities and promote
high- quality, culturally sensitive care in the United States,
the Accreditation Council for Graduate Medical Education
(ACGME) and other governing bodies propose cultivating
a more diverse physician workforce. In addition, improved
training and patient outcomes have been demonstrated for
diverse care teams. However, prioritizing graduate medical education (GME) diversity and inclusion efforts can
be challenging, with the need to attend holistically to multidimensional considerations to achieve the greatest success [13].
Limited literature exists regarding actionable steps to promote diversity in GME.Building on the existing literature
and the authors’ experiences at different institutions, we propose a ve-point inclusive recruitment framework for diversifying GME training programs. This chapter details each of
the ve steps of the framework, which builds on strong institutional support by setting diversity as a priority by ensuring
adequate attention. Forming a cycle, the other four steps are
implementing inclusive recruitment practices, seeking out
suitable candidates, investing in trainee and faculty success,
and building the pipeline (Fig.19.1).
Practical strategies for each step and recommendations
for measurable outcomes for continued support for this work
are provided. The proposed framework may better equip colleagues and leaders in academic medicine to prioritize and
effectively promote diversity and inclusion in GME at their
respective institutions.
Implementing Inclusive Practices:
Cultivating aShared Team Vision
Faculty recruitment is an institutional effort led by the program director. Every department member and individual
within the sponsoring institution and its partners, who can
contribute to the successful recruitment of faculty, residents,
and students, is a stakeholder in the residency program. One
unanticipated example is the impact of environmental services (ES) on recruitment. ES staff can have a signicant
inuence on resident satisfaction and recruitment success by
ensuring the tidiness and cleanliness of the hospital and the
“call room” environment. The authors found in their own
medical institution that the personable and friendly relationships established by their staff with ES team members frequently led to warm hallway greetings that contributed to an
inviting work atmosphere—a collegial tone that impressed
recruits during interview tours. A similarly welcoming work
climate can be achieved between family medicine faculty,
residents, and staff with other specialty departments and hospital staff.
To harness and maximize the collective contributions and
inspirations of the institutional stakeholders toward the success of the residency program, the program director must
have a vision for the program that is aligned with that of the
institution and that which cultivates and guides each member
of the institutional team toward the achievement of the residency program goals. One such vision could be “train the
Fig. 19.1 The ve-point
inclusive recruitment
framework for diversifying
GME programs

190
R. Martin et al.
best and brightest physicians” or “bring family physicians to
[the local community].” The more department heads, administrators, and staff enlist in the program’s vision and value
their own contribution to the vision, the greater their positive
impact will be on the program and recruitment. From environmental services to the C-suite, every department can be
engaged in the recruitment process.
There are several ways to engage institutional departments. Faculty can present program highlights at hospital
meetings and publish updates in institutional newsletters.
The program director and faculty can attend departmental
meetings of other institutional departments and meet one-onone with department heads and administrators. Department
physicians and staff are often surprised by the enthusiastic
interest in their involvement and engagement in the family
residency program. Contexts like this can be an excellent
opportunity to educate and raise awareness of their important
role in the recruitment and overall residency program success. Potential questions to ask when engaging with potential
stakeholders in each department could include:
• What do you think is needed for a successful residency
program?
• What do you see as potential barriers?
• What do you envision for the program?
• How could our program help you?
Relationships with institutional administrative leadership
can be pivotal to the success of the program and recruitment.
For example, establishing professional relationships with the
CEO and vice presidents in the C-suite can help facilitate all
aspects of the program, including budgets, grants, marketing,
and benets. A direct connection with individuals in the marketing department can facilitate program director (PD), faculty, and resident involvement in outreach efforts and
simultaneously enhance support for the program website,
social media, and recruitment material development.
Engaging the development department can provide them
with a vision that can be used to engage donors and generate
grants, which, in turn, can create funding to support endowments, faculty development, conference attendance, special
equipment, and more. The PD, faculty, and residents can participate in development meetings with individuals and groups
and thereby support their institution’s nancial goals and
well-being and shore up the residency program’s stake and
role in the institution.
The same engagement process can be applied within the
residency program, especially since every element of the
program can enhance recruitment. Program leadership works
on creating and sustaining a healthy, successful clinical environment to support faculty supervision and direct patient
care. Ample research evidence shows that faculty are role
models for residents and that their happiness and well-being
deeply impact resident engagement, education, recruitment,
and more [13]. Similarly, engagement of nurses, medical
assistants, and other clinical support staff as stakeholders in
the family medicine program (FMP) and all clinical settings
afrms them as vital elements of resident education, recruitment, and patient care. Soliciting their feedback as to what is
working and what is not and including them in quality
improvement initiatives alongside residents and faculty will
augment success. This type of collaboration also fullls
important ACGME program requirements for interdisciplinary collaboration and teamwork.
This mindset that engages and values others in the institution as family medicine residency stakeholders feeds a sense
of shared ownership and synergistic teamwork toward the
program’s success, with effects that can amplify outcomes
and create ripples far beyond recruitment. Cultivating and
implementing a team vision creates an environment in which
faculty (and all others) will want to work and, more importantly, seek to contribute to this shared vision.
Seeking Out Suitable Candidates: Recruitment Methods
Traditional recruitment methods include advertising in academic journals and on specialty-specic websites, although
such advertising is typically done in short increments of time
and can be cost-prohibitive, often with less-than-ideal results.
Maintaining an ongoing relationship with the institutional
physician recruiter can help garner support for faculty
recruitment, especially when demonstrating cost savings
associated with hiring graduates [4, 9, 14] and also by ensuring a clear appreciation for the value of the program and faculty within the larger context of the institution’s advancement.
A relatively easy way to increase visibility and connection to
potential hires is to encourage all members of the program,
including residents, to establish and maintain an updated
presence on various social media outlets, particularly professionally focused ones. A robust online network can pay dividends decades later when programs boast a vast, strong
network of successful faculty and graduates. Such outcomes
speak more powerfully than most recruitment spiels, and
maintaining the connections can result in the recruitment of
program graduates and qualied individuals within their networks. Other options for recruitment include listing positions on faculty organization email message groups, and this
is incrementally more powerful when the PD and faculty
interact with the email group on a regular basis. Individuals
who contribute meaningful questions and solutions are more
likely to benet from word-of-mouth recommendations or
other program PD’s encouragement of their graduates to
apply for a position. Seeking out and applying for grants that
can support faculty recruitment and development efforts are

19 Faculty Recruitment: Best Practices
Table 19.1 Faculty recruitment resources
ACGME job board: https://web.cvent.com/event/0b33fe58- c838- 4586- 8f89- 6462b6795cd5/
websitePage:460aea77- d3a3- 4288- 81e4- fbbfe29be9b9
AAFP career link posts jobs via various outlets: https://www.aafpcareerlink.org/
American College of Osteopathic Family Physicians Career Center (American College of Osteopathic Family Physicians (ACOFP), ACOFP
Career Center|Find Your Career Here)
Association of Family Medicine Residency Directors (AFMRD) job board: Job board main page
Grants: Seek and apply for grants that can support faculty recruitment and development
Hospital/institutional recruiter: Maintain an ongoing relationship and demonstrate the value of the program and faculty
LinkedIn: Maintain an updated prole
Post position on AFMRD, Association of Family Medicine Administration (AFMA), and other listservs
Social media: Maintain active social media pages for the program and/or PD
The STFM Preceptor Expansion Initiative: https://www.stfm.org/about/keyinitiatives/preceptorexpansion/preceptorexpansioninitiative/
The STFM Residency Faculty Fundamentals Certicate Program: https://www.stfm.org/facultydevelopment/certicateprograms/
residencyfacultyfundamentals/overview/
The STFM Faculty Skills Course (online): https://www.stfm.org/facultydevelopment/onlinecourses/faculty- skills- course/overview
Volunteer as a mentor (https://www.stfm.org/about/keyinitiatives/antiracism- and- health- equity/urm- initiative/urmmentorship/; https://www.
stfm.org/publicationsresearch/cera/ceramentors/
AAFP American Academy of Family Physicians, STFM Society of Teachers of Family Medicine
191
another way to help attract and retain faculty members for a
multitude of reasons: faculty value faculty development,
grants lead to publicity that attracts attention, and enhanced
resources lead to a more supportive environment in which
faculty are fullled, which is highly valued by all program
members and recruits. Finally, engagement with specialty
organizations, including conference presentations, committee membership, and faculty development initiatives, such as
those offered by the Society for Teachers of Family Medicine,
can be a great way to network with other programs and meet
potential faculty members at conferences, trainings, and
mentorship events (Table19.1).
Investing inFaculty Success: What’s onYour
Plate?
The authors propose the framework, “what’s on your plate”
as a helpful way to track individual faculty portfolios while
simultaneously facilitating cross-training of faculty skill
sets. The goal is to support all faculty team members in creating and achieving their dream jobs. In this framework, faculty maintain a list of their individual responsibilities and
scope of practice, ranging from clinical and academic to
administrative. Junior faculty should start with increased
clinical time to build condence and gradually add responsibility and leadership roles with sufcient guidance and support via regularly scheduled meetings with the program
director. When new faculty members join the team, faculty
“plates” can be reorganized and tasks redistributed based on
each faculty member’s interests, strengths, needs, and areas
of expertise.
When faculty are out on leave for extended periods, the
program director can divide the absent faculty’s plate among
the remaining faculty (who can develop additional strengths)
and then gradually reintroduce tasks to the faculty member
when they return, to minimize overwhelm. Such a clear,
structured system of support for absences or other changes in
faculty makeup can enhance diverse faculty recruitment and
empower faculty members while also allowing crosspollination within the team and ensuring a shared understanding of each member’s various roles. Similarly, all
program director responsibilities and roles can be shared
among faculty with the appropriate allocation of administrative time. This helps engage faculty and prepares them to
take on additional leadership roles. It also supports optimal
job satisfaction for program directors, which, in turn, supports faculty and program morale.
Practically speaking, the following is a list of sample
“what’s on your plate” headings and ideas for a given faculty’s responsibilities. They can track their duties from year to
year, such as in an online shareable, and live-edit the document, by copying forward their list year to year and editing
accordingly; the list also serves as a way for faculty members
to capture and track items to update on their curriculum vitae
and support academic promotion efforts.
Sample “What’s On Your Plate” Headings
• Outpatient clinical (direct patient care, annual training
requirements, and other maintenance of institutional
privileges)
• Inpatient clinical (including inpatient care supervision,
hospitalist duties, annual training requirements, and other
maintenance of institutional privileges)
• Residency teaching/precepting
• Medical school teaching/precepting
• Mentoring/advising initiatives
• Specialty-specic initiatives (i.e., women’s health, global
health, sports medicine, palliative medicine, etc.)
• Grant work

192
R. Martin et al.
• Scholarly activity (current institutionally-sponsored
research/posters/manuscripts/presentations/peer reviews)
• Committee service/leadership
• Professional and faculty development (including
Continuing Medical Education and Maintenance of
Certication events)
• Program administration (resident recruitment, standing
meetings)
• Volunteering/community service/outreach participation
• Personal commitments
• Future goals and aims
Unique Challenges: Faculty Transitioning
fromClinical Practice
Faculty with prior clinical experience contribute invaluable
insights and practical wisdom. Those transitioning from
ambulatory, hospital-based, maternity care, and other settings can be exceptional mentors and role models, especially
for residents who plan to pursue related practice models
upon graduation. Such clinicians often have a skill set that
can complement the existing team, adding potential procedures, curriculum, and approaches from which the residents
and existing faculty can learn. They are also more likely to
bring a sense of increased condence, based on their previous clinical experiences, as well as have no preconceived
notions about residents based on memories of them as fellow
trainees. In the transitional period, such a clinician is more
likely to be able to step right into their patient care role and
can dedicate the typical “ramp up” period of more junior clinicians to build their faculty development skills. Finally, clinicians coming from outside an institution, with experience
in other health systems and settings, can bring a fresh perspective with a new set of creative ideas.
Despite these benets, physicians transitioning from clini-
cal to faculty practice may nd that they face unique, even
unexpected, challenges in this new role. Program directors
may receive pushback from those who are unfamiliar with the
rules of graduate medical education (GME) or even the application of evidence-based guidelines to clinical care. It can be
helpful to start with a “plate” that accounts for this knowledge
gap, arranging to meet often with the faculty member to review
the GME structure, faculty development resources, and additional support for other identied areas of need. Placement
with other faculty attendings in a shared ofce, or as co-preceptors collaborating on resident supervision in various clinical settings, can be a helpful bridge and source of faculty skill
development while also recognizing that it can be a two-edged
sword, offering both inspiration and intimidation.
It can be difcult to assign curriculum responsibilities to
someone who is unaccustomed to them, especially when
they are “starting from scratch” with regard to the realm of
GME.Seasoned clinicians may nd it challenging to learn
whole new paradigms for approaching graduate medical
training, particularly when they were not previously privy to
all that is involved in teaching. Those outside of academia
may discover that there is a great deal involved in developing
a robust faculty skill set, including, but not limited to, creating actionable goals and objectives for rotations, supervising
ACGME milestone achievements, advising resident mentees
(particularly when it comes to addressing the needs of troubled learners), completing rotation evaluations, executing
Clinical Competency Committee and Program Evaluation
Committee responsibilities, attending to scholarly activity
commitments, participating in institutional committee service and leadership, and fullling program administrative
duties such as those required for residency recruitment and
standing meeting responsibilities.
Program directors will likely nd it helpful to manage
expectations prior to hire. Every faculty member must be
open to learning this range of faculty-specic skills and
should be willing to prioritize and address learner needs
according to the established ACGME program requirements.
Successful integration of new faculty contributes to successful recruitment because to achieve otherwise may result in
consequences that also have a far-reaching impact. Failed
integration may contribute to a negative reputation within the
family medicine community and affect faculty, resident, and
student recruitment.
Unique Challenges: Faculty Who Are New Residency Graduates
Just as seasoned clinicians face their own challenges when
transitioning into an academic role, new residency graduates
have growth edges unique to their relatively limited experience. Issues of condence, both over- and under-, can also
create the potential for conict. Whether motivated by insecurity or owing to a lack of experience and an underdeveloped skill set in working with management-level leadership,
this inexperience can lead to friction within residency
teams—both among faculty members and between faculty
members and residents.
One author, who transitioned from early career practice to
a role in residency faculty, reected on her initial challenges
in this area, recalling that her rst few anonymous faculty
evaluations by resident learners indicated a trend toward an
overly critical or harsh manner of teaching. In her desire to
teach with excellence and high standards, and owing in part
to her own self-critical attitude and undercondence in her
own clinical and teaching abilities, she tended to project
unattainably high standards without simultaneously creating
a supportive learning environment. Over time, she intentionally practiced articulating what her learners were doing well

19 Faculty Recruitment: Best Practices
193
when precepting cases in the clinic or bedside and sought to
cultivate an awareness of the profound vulnerability of resident learners who are generally only too aware of their own
gaps in knowledge and skills and nd those deciencies in
themselves threatening or scary. In so doing, she was able to
soften her expectations, without lowering them, in light of
this awareness of learner insecurity. Such self-reection,
especially considering any feedback received, can aid new
graduate faculty members in balancing critique with
support.
Another challenge for more junior faculty members is the
lack of lived clinical experience. This can make it difcult
for faculty to appropriately gauge levels of “alarm” in managing clinical conditions or to judge optimal follow-up recommendations in patient care. At one extreme, a faculty
member may have insufcient concern for true emergencies
and fail to recognize the need for close-interval follow-up,
further testing, or referral to a higher level of care. At the
other extreme, a faculty member’s excessive anxiety around
their own clinical uncertainty may risk a patient going for
unnecessary testing, cumbersome follow-up schedules, or
expensive referrals. All of this can make it hard for junior
faculty to lend practical shading to their recommendations to
learners. Additionally, newer faculty members may struggle
to allow resident learners to have some autonomy in their
medical decision-making; this is especially likely when precepting patients “from a distance,” that is, offering indirect
supervision such as in the ambulatory ofce. All this highlights the need for ongoing faculty development aimed at
clinical skill-building to effectively and supportively translate their own fresh clinical knowledge in learner-centered
ways.
Particularly if staying in the same program after graduation, a new faculty member may struggle with bridging the
transition to a faculty role, perhaps because they nd themselves more closely aligned with their resident peers than
with faculty. It is not uncommon for a new graduate to feel
reluctance in addressing former teachers on a rst-name
basis. They may also have difculty being recognized as a
peer by some senior faculty, or even other residents, with
whom they worked while in training themselves. Often, time
itself is a helpful antidote to this challenge and requires
patience on the part of the junior faculty member. Such transitions can be made smoother and less burdensome when a
program director is able to recognize, name, and normalize
this process in the context of routine faculty mentoring, in
both individual and group settings. Based on their understanding of what would best support resident needs in their
own team culture, program directors may also choose to
encourage their junior faculty to align with resident learners
in their experiences, and even engage them at a peer level,
instead of assuming a superior role according to their perception of whatever traditional hierarchy “ought” to apply.
Residents frequently cite various benets of having recently
graduated faculty, including reduced fear and intimidation,
familiarity with resident-related concerns including board
certication, licensure, and job searching, and the absence of
generational differences.
Building thePipeline: Recruitment
fromWithin
We know that programs can also “grow their own” when it
comes to faculty recruitment and that such programs have a
larger proportion of their own graduates on faculty when
they focus efforts on internal recruitment, particularly if they
have a faculty development or other clinical fellowship afliated with their program [16].
While the same challenges outlined above apply to these
newly minted attendings, this approach can also have signicant advantages.
As graduates of the program, such faculty members are
likely to have a deep sense of loyalty and ownership stake in
the program’s success. They are likely to be trusted as a
known entity in the program and, because of their longevity,
are well-positioned to build on close relationships with other
system stakeholders. They will have established connections
with other clinicians, including consultants, hospitalists, and
community-based family physicians, through committee service and clinical encounters over the course of their training.
As an example, one writer rotated as a resident with a family
physician not previously afliated with the program, and,
because that attending had such a positive experience, she
was interested in precepting with the residents and eventually assumed a leadership role as core faculty with the program. Similar relationships developed at the program enabled
expansion of rotations, ranging from medical and surgical
subspecialties to women’s health.
When supporting faculty development for residents, it is
good practice to explore and cultivate areas of their passion.
Residents are able to create strong curricula when they work
on things they are enthusiastic about; because they know what
works within the institution, they can tailor trainings appropriate to a given level of learner, they will want to use their relatively limited free time for their passions, and they possess a
beginner’s mind that allows for new levels of creativity and
openness. Empowering residents to participate in curricular
development initiatives helps build their faculty skill set and
grow condence in their abilities while simultaneously keeping curricula fresh and learners engaged. Residents may also
have specialty-specic interests (i.e., underserved care, women’s health, sports medicine, hospital medicine) that align with
the program’s identied areas of need in the faculty team.
Alternatively, they may have developed particular skills (i.e.,
uency in a particular language, certication in performing
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