Career development for academic medicine—a nine step strategy
Authors: Linda Pololi
Publication date: 28 Jan 2006
Make sure your career goes to plan by using Linda Pololi's innovative form of career development guidance
“Self-reflection is the school of wisdom”
Baltasar Gracian, 1601-58,
Spanish philosopher and writer
Academic medicine depends upon talented and vibrant faculty members, but reports of difficulties in recruiting to academic posts in the United Kingdom,  and career dissatisfaction in the United States,  have led to calls for action to improve careers in academic medicine. Supporting the professional and personal development of the medical faculty is fundamental to strengthening and renewing achievements in patient care, teaching, and research.
Most faculty members report a lack of effective mentoring, particularly for under-represented groups such as women.  The academic development plan (ADP) was developed by the author for use in the mentoring programmes of a designated National Center of Leadership in Academic Medicine.  The ADP was very positively evaluated by two cohorts of medical faculty who used it as part of a peer mentoring programme over eight months.
Academic development plan
The ADP provides a coherently organised written plan for academic advancement, which recognises the aspirations of faculty members as well as the needs of the departments where they work. ADPs help faculty members to define and describe intellectual focus, clarify personal values, and long term career goals, and identify areas where skill development is necessary
An effective ADP outlines a pathway for each professional domain (such as teaching, clinical care, research, or administration) and involves careful consideration of personal aspirations, interests, strengths, values, priorities, sources of fiscal support, current and desired roles, and programme and department priorities. Making choices that are consistent with individual values underpins the entire process. In other studies, values have been recognised as being important   but little work has focused on relating values to actions.  
The ADP can be used either individually, in a group setting, or within a mentoring dyad where trust has been established. Such a dyad could be either a traditional senior/junior partnership, or a co-mentoring relationship between peers. The process is applicable to faculty members at any stage of their career. By completing their own ADP, senior faculty members not only derive personal benefit but also prepare to facilitate the process for junior colleagues.
Outlined below is a description of each of the steps to be taken when formulating an ADP. It is important to keep a written record of each step because writing helps to clarify thinking, and serves as a record and memory aid. The ADP is a long term, evolving process that can be added to over time.
Step one—clarify your governing values
These are the deeply held values and standards that govern all aspects of your life and which act as guiding principles for choices, decisions, and behaviours.   Some examples are truthfulness, enjoyment, responsibility for children, intellectual challenge, social justice, financial wellbeing, kindness, respect for diversity, freedom, and security. Typically, an individual's values are acquired through interaction with family, peers, and social systems.  In our experience of working in medical schools, most faculty members have not taken the opportunity to articulate their own governing values.
Prepare a list of your governing values
This first critical step will build self awareness and an understanding of your values, which is fundamental to starting your ADP.
Write a list of what you value most. This first step may take a few hours. Try to find a period of uninterrupted time in a pleasant, non-work setting to do this. Try to avoid identifying what you think you should value, but concentrate instead on what's important to you. A person's values can be inferred from their behaviour, so if you are having trouble identifying your values, it may be helpful to think back to an important decision you have made and try to elucidate which values motivated you in the choices you made at that time.
Write a clarifying paragraph for each value.
Step two—prioritise your values
These questions may help you:
What do I value the most?
What does my conscience tell me are the highest priorities in life?
Based upon my experience and knowledge, what do I consider to be of greatest worth?
If I could live by only three or four values, what would they be?
From a long term perspective, which will have the highest reward for me—my family, friends, work, and/or profession?
How do I wish to be remembered by my family and by my colleagues?
What would I want others to say about me at my funeral? Write your own obituary.
Step three—identify your strengths
It is important to identify your strengths rather than focusing on skills you do not possess (the latter can deplete enthusiasm for the process). Write down the individual strengths and abilities that have helped you to get where you are now, and identify your special talents.
Step four—consistent with your values, where do you want to be 10 years from now?
What is your dream for yourself?
What type of position are you ultimately seeking?
Which pathway in academic medicine is most exciting for you? Where do you want to place your intellectual focus?
How do you want to focus your career? Do you want to concentrate on research, clinical practice, medical administration, scholarship, teaching, or some combination of these?
Do you want to be a famous researcher, a department chairperson, a dean, a great teacher, a great humanitarian, a compassionate doctor, a devoted parent?
Define the position you want to be in 10 years from now without considering how you will get there. Is this consistent with your governing values? It has to be. You can craft your career to realise your own chosen legacy
Write down your dream for yourself.
Step five—identify your one, three, and five year goals
With your 10 year trajectory defined, it's now helpful to identify logical intermediate goals that will be important in the realisation of your long term aspirations. Clarifying these goals will also help you evaluate and respond to each new request or opportunity. Having carefully thought out goals will help you to differentiate between the opportunities that reflect your values, and complement the choices you have made, and those that are not contributory or are in conflict.
Write them down.
Step six—what skills or tasks do you need to develop to achieve your one year goals?
You now need to go through the process of developing strategies to achieve your goals for the next year. Are there certain tasks you need to do to meet a certain goal? List the skills and tasks you wish to address in this first year of your plan.
Step seven—write a learning contract for each skill or task
You will now make a learning contract  with yourself for each of the skills or tasks you want to develop. Formulating a learning contract will help you plan how you will accomplish your learning and goals. Use a separate learning contract form for each skill or task (learning objective).
Guidelines for completing the learning contract
Learning objective—write down the skill or task you wish to address at the top of the form. Make the statement in terms of the outcome, or end result, rather than the process you will use to get there
Write the date by which time you intend to accomplish the learning
Action steps. List detailed sequential steps for how to achieve this learning objective (for example, five small group teaching sessions, Medline search, enrol in a faculty development workshop on using statistics, find some collaborators)
Target date. Enter a target date for completion of each action step. Note dates in your calendar as reminders
Resources. Think through what you will need for each action step
Evaluation. How will you know that you have accomplished your learning objective?
Verification. What measurable and observable evidence could you show to verify that you have achieved the learning objective (for example, student evaluations of teaching session, peer evaluation, research analysis, calendar showing dinner with the family three times a week for six months)?
Step eight—involve your supervisor
At this stage, it would be wise to make an appointment to meet with the head of your department to discuss your draft plan, and ask how your plans fit in with those of the division and department. This is vital information as you are much more likely to receive help and support for your ADP if your interests match those of the unit. If you find that your plans do not fit in with the unit's priorities you will need to reassess your position. Be prepared to negotiate goals, ways of achieving your learning objectives, and your timeline. Ask your supervisor to help you achieve your goals and try and have these integrated into your annual expectations within the department.
Step nine—repeat steps six and seven for your three and five year goals
As you approach the last quarter of your first year on your ADP, draw up the list of skills and tasks that you need to develop to achieve your goals for the next three and five years. You are now well on the way to achieving a planned career that will be consistent with your values and fulfil your dreams. ■
Competing interests: None declared.
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Linda Pololi senior scientist and resident scholar Brandeis University Women's Studies Research Center, Massachusetts, USA firstname.lastname@example.org