Teaching is an integral part of medicine and an essential clinical doctor responsibility, teaching physicians are vital to the graduate medical education. Teaching medical students and residents are key components of a doctor’s role. Obviously, it is important that there are clear metrics for teaching excellence attributable to individual academic teaching performance. However, there remained to be explored that how teachers are formally prepared for their teaching role: Who are the ideal teachers? What are the teacher’s day-to-day duties? What will be the major focus?
Graduate medical education (GME) defined typical teaching physician’ work including 3 main duties: delivering high quality, safe, and efficient patient care; providing comprehensive physicians-in-training education; and contributing to scholarship. Each of these duties has regulatory aspects with which the teaching physician must comply (1). Teaching physicians involves following these standards, they spend a great deal of time reviewing each patient’s medical care accompanied by a resident who observes their activities (4). The residents even achieve competence through the efforts of teaching physicians, who are mentors, advisors, role models, instructors, evaluators, and safety officers (1).
Thus, with today’s focus on the translation of basic science discoveries into clinical practice, the demand for teaching physicians is growing. Teaching physicians play a central role in advancing residents initiatives and promoting a culture of education among new physicians. An educational teacher pathway is regarded as an independent area of specialization in teaching, which is an option for those who has the potential for teaching effort. In our investigation, 91.43% of the interviewers are from the teaching hospital, among them 40% are teaching physicians. 88.57% confirmed there are teaching physicians in their hospital, 71.43% felt it is necessary to set the type of teaching physician.
Frequently, as one considered to develop as medical educators, he established his priority and mission to be able to navigate his career. Especially for those who desire education as a major component of their careers should combine educational theory, operating, and simulation research. For example, we recommend the first step for any developing surgeon educator is to master one's abilities as a surgeon, followed closely or simultaneously by mastering one's abilities as a teacher. Without the former though, the latter is of no use(5). Thus, surgeon educator should encompass and excellence in clinical surgery, and well integrate the science knowledge and skill acquisition into surgical training and administration since they are not only responsible for developing clinical skills, but also required to become adept at teaching. Additionally, some teaching physicians have specific teaching responsibilities within their sub-disciplines. As to the obstetrics and gynecology department, the surgical skills requires hand to hand teach, the professional goals of teaching physicians are to advise the best clinical and operative skills to residents in graduate medical education. Therefore, educational doctor should be equipped with experiences, perspectives, and skills that make them appealing in medical education nationally. In our investigation, we assessed career development among doctors’ opinion towards teaching physicians, 85.71% of the interviewers believed doctors can’t teach if they are not equipped with clinical knowledge or surgical skills, thus demonstrated that good teaching was generally conducted along with experienced clinical technology.
However, the challenge all physician investigators face is the increasing burdens of clinical activities, particularly with the advent of writing medical records (3).Thus it is recommended to reduce the clinical workload of teaching physicians. Yet, teaching physician even face a number of unique challenges to juggle the demands of clinical care with the time required to perform scientific research or teaching grant funding/awards/publications for their career development. Only 11.43% of the interviewers thought 80% teaching physician reach the standard, while 71.43% indicated the percentage is 20%; Another 31.43% believed 20–40% of the teaching physicians do not meet the requirements, their purpose of being an educational doctor is to require career promotion, even more 17.14% regarded the proportion was up to 80%.
Ultimately, an appointments, promotion system is not responsive to the needs of faculty working across clinical care and research, particularly when it comes to evaluating team may have trouble being promoted (3). The teaching physician is a part-time faculty member, they would even competition for funding from full-time PhD investigators (3). When investigators split their time between clinical activities and research, they are not likely to fully meet the target metrics of either full-time researchers or full-time clinicians. We analyzed interviewers’ responses to these questions, even 68.57% of the respondents from programs thought the appropriate science research proportion of teaching physician should be 20%, which is corresponded with the evaluation for teaching physician’s promotion in our hospital. 77.14% regarded the teaching physician should also be equipped with the scientific research ability in order to teach students. While another 2.86% reported although scientific research is important, the reason why they choose to be a teaching physician is to safe effort on scientific research.
On the other hand, the hospital also recommended teaching grant funding/awards/publications as the specific promotion requirements for teaching physician. Since it seems the recipients of grant funding were more successful in career promoting than those individuals without grant funding on most career achievement measures, in recent years, there existed the phenomenon that doctors only focus on teaching grant funding/awards/publications, but don’t actually do teaching work. As more awards are made, the teaching physician faculty candidates increase career promotion and gain training, observation, or education in order to be fully successful. Most of us regarded the use of grants as promotion criteria is cruelly unfair, although 80% of respondents regarded that they should put emphasize on the actual teaching problems rather than take the level of grant funding/awards/publications as the only evaluation, 8.57% indicated 80% teaching physicians only focus on grant funding/awards/publications, while do not actually engage in teaching work. Thus 28.57% agreed the purpose to be educational doctor is for career promotion, so they regarded grant funding/reward/publication is the most important. The reason might be that 71.42% indicated they are happy to teach, however time is limited, they need to gain grant funding/awards/publications for career promotion instead of daily teaching work. 48.57% reported there is no other evaluation way, grant funding/awards/publications are fair in evaluation, only 22.86% believed it is very reasonable.
These above severe situation need to be changed, Mark Hayter believed that only focusing on publishing an internationally excellent paper or wining a large competitive research grant or even successfully supervise PhD students, ignore actual teaching, might be a dark art worthy of inclusion in education curriculum (6). In theory, it would be ideal for all surgical residency applicants to have high technical aptitude—among other nontechnical skills essential for the professional development of an effective surgeon (7). Development of skills to become a successful medical professional, including professional behavior, goal setting, establishing and maintaining self-esteem, time management and teamwork (8). We referenced that perceived professional competence among clinical research coordinators recommended three career constructs including career engagement (CE), career planning (CP), and career satisfaction (CS) were selected to represent career orientation (9). Career engagement (CE) represented the degree of proactively exhibiting different career behaviors to enhance career development, is of theoretical, organizational, and personal importance(10). Career planning (CP) represents a facet of career self-management that includes setting clear career-related goals and developing specific strategies needed to achieve those goals(11). Career satisfaction (CS) refers to an internally defined indicator of career outcomes. Thus career goals would be relatively accepted within the current institutional culture on the medical curriculum committee if professional development opportunity was offered to teaching physicians. The distant goals focus on technology, educational theory, curriculum development, accreditation, assessment, feedback, quality improvement. Strategic career planning has recently entered the academic curriculum as part of faculty development educational programs.
Efforts to promote career satisfaction, reduce burnout, and facilitate retention need to be expanded beyond early career interventions and may need to be tailored by career stage. Previous literature has shown that dissatisfied physicians are also at higher risk for professional burnout, which is a potential barrier to successful health care reform(12). Therefore, we should also provide a way for teaching physicians to report their satisfaction when educating. Compared with those who chose other specialties, the largest influences on those who chose teaching physician were enthusiasm or commitment: what I really want to do, fits my domestic circumstances, wanting a career with working conditions. The most recent cohorts have become much more definite about their choice of educational doctor as a career than older cohorts. In our introduction, we showed 25.71% very much willing to work in as teaching physician.
Actually, teaching physicians require regular clinical generation, supervision and evaluation of training. Frequently, there are many different pathways in medical education. Surgeons assume that training translates them into being an excellent educator, for example, surgical Education Leadership lesion is intended to serve as preparation for a career in surgical education. More local opportunities like personal and professional progress can be made in various aspects of educational development. Substantially committee participation and on-line options for specializations could also be important avenues of medical professions education. Teacher faulty can participate in the network, resources, and conferences through educational development opportunities such as lectures, seminars, workshops, communities and organizations. A workshop should be conducted for educators which had two objectives: (1) demonstrating educational methods that have been successfully used for teaching in the arena of career development and practice management and (2) developing a professional network to facilitate communication and collaboration toward effective teaching and learning.
Fellowships provide the opportunity to obtain and participate in formal training combined with research and teaching. We assessed quality of teaching predominantly using evaluations, 57.14% recommended training as well as updating the teaching concept and methods. Next we conducted investigation about training in teaching, 68.57% detected that we should develop frequently training combined with new teaching concept and methods. 51.43% believed regular frequency lectures are very important, they take seriously to prepare clinical teaching and courses. Yet, current challenges in surgical education include limitations on time for training due to work-hour overload and scientific demands, as well as the increasing diversity and complexity of surgical procedures (13). Likewise, 54.29% considered that whether they can participate in training course depends on time, since they are occupied with clinical work. Another part of interviewers recommended although they think it is very important, however due to the clinical and scientific research cost time, they can’t ensure the quality (14.29%) or follow the frequency (8.57%);
It is through the development of clear, objectively measurable teaching related outputs and quality evidence that we can be unequivocal when we answer the question; ‘who is the best teacher in your school’. Students’ feedback and qualitative evaluations of their tutorial should also be available to judge teaching effectiveness and quality in individual promotion and career progression cases(6). In our investigation, regarding attitude towards integration through teaching, 34.29% greatly promoted, 57.14% have a positive effect. 48.57% believed the most important quality of an educational doctor were: devote to the teaching work, good at getting along with students, benefit students from clinical knowledge, while no one thought good at speeches and teaching competitions are the most important quality of an educational doctor. 34.29% agreed with the statement “Educational physician is important to guide the educational team”. Furthermore, 74.29% indicated teaching physicians should update the teaching concept regularly to bring students new and meaningful teaching experience. As a sensitivity analysis, 40% observed teaching is related to the teacher's appearance, teaching state and speaking tone can be trained; 20% considered theoretical and clinical knowledge is more important. Then what is the difference between a teaching physician and general teacher? 74.29% felt teaching physician is both a teacher and doctor, who should be equipped with good theoretical and clinical knowledge. 17.14% indicated teaching physician is much more busier than no-medical teacher, who should ensure patients’ safety during teaching.