- Neha Shah
1. As a member of the Pediatric Hospital Medicine (PHM) Certification Leadership Group and appointee of the first Sub-board for PHM, you have been very involved with developing guidelines for the PHM subspecialty certification. We now have board certified pediatric hospitalists! Where do you see the field of PHM going in the next 5-10 years?
I'm honored to be actively involved in the certification process, it's been an incredible journey! It's been a long road to get to the point where we can be recognized for the expertise we bring in areas like high value care, QI, DEI, advocacy, medical education and more. Over the next several years, I think we will see growing contributions to the scientific literature in all of these realms, further defining and refining what the best care for hospitalized children should be. I also see growing presence of hospitalists in leadership positions, acting as the content expert for all topics related to in-hospital care. My hope for the future is that the work that we always do, that we have been doing all along, receives the support and recognition needed to make lasting change happen.
2. You have your MPH in Epidemiology and Biostatistics from The George Washington University School of Public Health and Health Services. How does this degree help you in your daily work?
Earning an MPH broadened my perspective on how health metrics and initiatives impact populations and it also gave me an incredible foundation in critical appraisal of and conduct of clinical research. Though my happy place is in medical education scholarship, I mentor many fellows and junior faculty who do a variety of scholarly projects and I can say with certainty that my ability to be a good mentor to them comes from the knowledge gained from my MPH classes. On occasion, I have been part of clinical or health services research studies and it has really helped to have an inherent understanding of epidemiology and biostatistics.
3. As the program director for the PHM fellowship at Children’s National and co-author of “Development of a Curricular Framework for Pediatric Hospital Medicine Fellowships” in Pediatrics 2017, what do you think is the benefit of a fellowship for PHM? If a resident is deciding between a PHM fellowship and looking for a job as a community pediatric hospitalist, what advice would you give them?
It's a personal choice, to be honest. Each individual has their own career goals, so the decision to do a fellowship or to not do a fellowship isn't one that I think can have a blanket response. The thing is, individuals who set out to achieve specific career goals, usually get there if they put in the time, effort and dedication. The paths are many and varied, just ask any hospitalist you know! All of us took a slightly different path and we are all great hospitalists regardless of whether we did a fellowship or not.
Of course, these days, if you desire to be certified by the ABP in PHM, then you only have the option of doing a fellowship. I see tremendous benefits in fellowship training, especially if you are a learner that does best with dedicated time, support and mentorship for development of expertise in a particular area. When I speak to graduates of our program, they resoundingly say that the best aspect of their training was the mentorship, structure and support that fellowship gave them to launch their careers. PHM fellowship directors as a group are so invested in the training experience for fellows--we recognize that two extra years of training has many implications, including economic/financial. We were staunch in our desire to retain the ability to individualize training, allowing for each program to retain its unique aspects/expertise, which the ACMGE has supported with 1/3 of the training dedicated to an individualized curriculum. I encourage any trainee who is contemplating fellowship to talk to PHM fellowship graduates, examine the existing literature and discuss the pros/cons with their own mentors.
4. Having published and spoken extensively about children with medical complexity and how to teach residents about their care, what is the best approach for teaching others about the care of children with medical complexity? What is the role of simulation?
In my humble opinion the best approach for teaching others about the care of children with medical complexity (CMC) is to actually just do it. Make it part of curricular requirements and focus. Regardless of patient volume (of CMC), the educational curriculum can and should contain basic foundational knowledge on common diagnoses, problems and devices found in CMC. In addition, the overall ability to provide high quality, effective care to CMC depends on cultivating skills in care coordination, shared decision making and interdisciplinary teamwork. Simulation can be beneficial as an adjunct methodology to deliver skills-based components of an educational curriculum. We do the same for common pediatric procedures and rare events, why not for things like a dislodged tracheostomy tube? A program director may say, with limited time and resources, where to start or focus? A recent paper by Huth et. al. (Academic Pediatrics 2020) describes a national modified Delphi study to elicit curricular priorities for care of children with medical complexity. In that paper, the authors identified 11 topic areas that national experts across the country agreed were top priority for training. I have partnered with Dr. Huth and others to take the next step in more clearly defining the knowledge, skills and attitudes deemed necessary for competent practice in the care of CMC.
5. You co-led a workshop, “Hacks for Women in Academic Medicine,” at PAS in 2018, and you are a member of the Women at Children’s (WATCH) Steering Committee at Children’s National Medical Center. Tell us more about this work and what is changing for women in medicine. Any hacks to offer?
I am very passionate about the unique challenges that face women in academic medicine and it's clear that I am not alone since this workshop was presented at PAS numerous years in a row! I became part of the steering committee here at Children's National several years ago, and through our advocacy and programming, we have helped to change policies and procedures at our institution to be more equitable and supportive. A few of us thought of the idea to present some of our programming to a national audience and that was the impetus for the workshop. We focus on practical tips for things like time management, negotiation, academic productivity and how to navigate curveballs/juggle responsibilities. Over the years, we have added managing microagressions and imposter syndrome to the list of topics. My content expertise is in time management and for anyone that knows me, they know that I'm a huge proponent of using time blocking and other techniques that are well-described in the literature. Perhaps the thing that keeps me sane and happy is to always plan my upcoming week by first blocking out the time that I will spend on personal things (son's birthday party or the gym) and then putting in the time to be spent on other tasks. It helps me to do that in terms of honoring my own wellness/happiness and setting an intention and atmosphere of respecting personal/professional boundaries--which have become increasingly blurred in the current environment. If you ever want to learn more about time blocking, I am happy to discuss!
6. Jack Percelay often ends his list-serve commentary with the phrase “that’s just my 2 pennies.” What are your two cents?
My whole professional life, I was taught to grasp every opportunity that comes because you don't know if it will ever come again...more recently, I was told by a trusted colleague that you may not get the same opportunity twice, but opportunities come along all the time, so there will be another one around the corner. If it doesn't align with your values and your passions, then think twice.
What I took from that is that rather than saying yes to anything all the time, it's okay to be strategic about what you say yes to as you navigate your career. I started my career by saying yes to everything all the time and that quickly led to me being overburdened, stressed out and at times unhappy/unfulfilled. Allowing it to be okay for me to be choosy about what I say yes and no to puts me in control of my own destiny and has really helped me to combat burnout and maintain resilience and vitality.
I'm honored to be actively involved in the certification process, it's been an incredible journey! It's been a long road to get to the point where we can be recognized for the expertise we bring in areas like high value care, QI, DEI, advocacy, medical education and more. Over the next several years, I think we will see growing contributions to the scientific literature in all of these realms, further defining and refining what the best care for hospitalized children should be. I also see growing presence of hospitalists in leadership positions, acting as the content expert for all topics related to in-hospital care. My hope for the future is that the work that we always do, that we have been doing all along, receives the support and recognition needed to make lasting change happen.
2. You have your MPH in Epidemiology and Biostatistics from The George Washington University School of Public Health and Health Services. How does this degree help you in your daily work?
Earning an MPH broadened my perspective on how health metrics and initiatives impact populations and it also gave me an incredible foundation in critical appraisal of and conduct of clinical research. Though my happy place is in medical education scholarship, I mentor many fellows and junior faculty who do a variety of scholarly projects and I can say with certainty that my ability to be a good mentor to them comes from the knowledge gained from my MPH classes. On occasion, I have been part of clinical or health services research studies and it has really helped to have an inherent understanding of epidemiology and biostatistics.
3. As the program director for the PHM fellowship at Children’s National and co-author of “Development of a Curricular Framework for Pediatric Hospital Medicine Fellowships” in Pediatrics 2017, what do you think is the benefit of a fellowship for PHM? If a resident is deciding between a PHM fellowship and looking for a job as a community pediatric hospitalist, what advice would you give them?
It's a personal choice, to be honest. Each individual has their own career goals, so the decision to do a fellowship or to not do a fellowship isn't one that I think can have a blanket response. The thing is, individuals who set out to achieve specific career goals, usually get there if they put in the time, effort and dedication. The paths are many and varied, just ask any hospitalist you know! All of us took a slightly different path and we are all great hospitalists regardless of whether we did a fellowship or not.
Of course, these days, if you desire to be certified by the ABP in PHM, then you only have the option of doing a fellowship. I see tremendous benefits in fellowship training, especially if you are a learner that does best with dedicated time, support and mentorship for development of expertise in a particular area. When I speak to graduates of our program, they resoundingly say that the best aspect of their training was the mentorship, structure and support that fellowship gave them to launch their careers. PHM fellowship directors as a group are so invested in the training experience for fellows--we recognize that two extra years of training has many implications, including economic/financial. We were staunch in our desire to retain the ability to individualize training, allowing for each program to retain its unique aspects/expertise, which the ACMGE has supported with 1/3 of the training dedicated to an individualized curriculum. I encourage any trainee who is contemplating fellowship to talk to PHM fellowship graduates, examine the existing literature and discuss the pros/cons with their own mentors.
4. Having published and spoken extensively about children with medical complexity and how to teach residents about their care, what is the best approach for teaching others about the care of children with medical complexity? What is the role of simulation?
In my humble opinion the best approach for teaching others about the care of children with medical complexity (CMC) is to actually just do it. Make it part of curricular requirements and focus. Regardless of patient volume (of CMC), the educational curriculum can and should contain basic foundational knowledge on common diagnoses, problems and devices found in CMC. In addition, the overall ability to provide high quality, effective care to CMC depends on cultivating skills in care coordination, shared decision making and interdisciplinary teamwork. Simulation can be beneficial as an adjunct methodology to deliver skills-based components of an educational curriculum. We do the same for common pediatric procedures and rare events, why not for things like a dislodged tracheostomy tube? A program director may say, with limited time and resources, where to start or focus? A recent paper by Huth et. al. (Academic Pediatrics 2020) describes a national modified Delphi study to elicit curricular priorities for care of children with medical complexity. In that paper, the authors identified 11 topic areas that national experts across the country agreed were top priority for training. I have partnered with Dr. Huth and others to take the next step in more clearly defining the knowledge, skills and attitudes deemed necessary for competent practice in the care of CMC.
5. You co-led a workshop, “Hacks for Women in Academic Medicine,” at PAS in 2018, and you are a member of the Women at Children’s (WATCH) Steering Committee at Children’s National Medical Center. Tell us more about this work and what is changing for women in medicine. Any hacks to offer?
I am very passionate about the unique challenges that face women in academic medicine and it's clear that I am not alone since this workshop was presented at PAS numerous years in a row! I became part of the steering committee here at Children's National several years ago, and through our advocacy and programming, we have helped to change policies and procedures at our institution to be more equitable and supportive. A few of us thought of the idea to present some of our programming to a national audience and that was the impetus for the workshop. We focus on practical tips for things like time management, negotiation, academic productivity and how to navigate curveballs/juggle responsibilities. Over the years, we have added managing microagressions and imposter syndrome to the list of topics. My content expertise is in time management and for anyone that knows me, they know that I'm a huge proponent of using time blocking and other techniques that are well-described in the literature. Perhaps the thing that keeps me sane and happy is to always plan my upcoming week by first blocking out the time that I will spend on personal things (son's birthday party or the gym) and then putting in the time to be spent on other tasks. It helps me to do that in terms of honoring my own wellness/happiness and setting an intention and atmosphere of respecting personal/professional boundaries--which have become increasingly blurred in the current environment. If you ever want to learn more about time blocking, I am happy to discuss!
6. Jack Percelay often ends his list-serve commentary with the phrase “that’s just my 2 pennies.” What are your two cents?
My whole professional life, I was taught to grasp every opportunity that comes because you don't know if it will ever come again...more recently, I was told by a trusted colleague that you may not get the same opportunity twice, but opportunities come along all the time, so there will be another one around the corner. If it doesn't align with your values and your passions, then think twice.
What I took from that is that rather than saying yes to anything all the time, it's okay to be strategic about what you say yes to as you navigate your career. I started my career by saying yes to everything all the time and that quickly led to me being overburdened, stressed out and at times unhappy/unfulfilled. Allowing it to be okay for me to be choosy about what I say yes and no to puts me in control of my own destiny and has really helped me to combat burnout and maintain resilience and vitality.