Organizational Savvy: Critical to Career Development in Academic Medicine.

Organizational savvy is critical to career development, but is rarely discussed as a learnable skill. Drawing on >45 years of working closely with Academic Health Center professionals, the author offers an introduction to navigating organizational dynamics that will be especially valuable to women, as they tend to be less effectively mentored than men; mentors may also find this guide of use in coaching these skills. Common misconceptions that interfere with acquiring organizational savvy include assuming that academic medicine is a meritocracy, that hard work will assure success, and that disagreements are personal.

Not Too Late to Reinvigorate: How Midcareer Faculty Can Continue Growing.

The continuing engagement of midcareer faculty is critical to the functioning of academic health systems (AHSs). However, despite their strong desire for ongoing meaningful work, many midcareer faculty are at a standstill, with further promotion unlikely. Drawing on more than 40 years of working closely with AHS faculty, the author describes growth-promoting strategies that midcareer faculty can tailor to individual needs, including questions for personal reflection.

Through a Gender Lens: A View of Gender and Leadership Positions in a Department of Medicine.

Background: Despite increasing numbers in academic medicine, women remain underrepresented in top leadership positions. The objectives of this study were to characterize leadership positions held by department of medicine (DOM) faculty at all ranks at one Academic Health Center and to compare leadership positions held by male and female faculty.

Methods: This was a cross-sectional survey to collect information on all leadership positions from 16 divisions in the DOM at the Johns Hopkins University School of Medicine in early 2012, including type of position, method used to fill the position, and financial compensation.

Discussing the undiscussable with the powerful: why and how faculty must learn to counteract organizational silence.

Dialogue is essential for transforming institutions into learning organizations, yet many well-known characteristics of academic health centers (AHCs) interfere with open discussion. Rigid hierarchies, intense competition for resources, and the power of peer review in advancement processes all hamper difficult conversations, thereby contributing to organizational silence, and at great cost to the institution. Information necessary for critical decisions is not shared, individuals and the organization do not learn from mistakes, and diverse perspectives from those with less power are not entertained, or worse, are suppressed.

How men can excel as mentors of women.

Most male professionals have more experience mentoring men than they do mentoring women, and their male mentees progress further than their female mentees. Yet, in academic medicine, men have few forums in which to discuss the gender-related issues that they encounter. To address the gender-related questions that commonly arise, the author of this commentary offers perspectives and recommendations, consolidated from over 25 years of experience leading career and talent development programs, to assist men in successfully mentoring women.

Difficult issues in mentoring: recommendations on making the "undiscussable" discussable.

Many mentoring relationships do not reach fruition because the individuals fail to bridge a critical difference. When a difference prevents a learning partnership from achieving its potential, the loss is multidimensional for the individuals and the institution--wasting opportunities for the fostering of current and future talent. Insights into when such impasses are likely to arise may help both mentors and mentees address what feels "undiscussable.

Career development as a long-distance hike.

Traditional images of achievement do not capture today's more complex career development realities. Approaching career development as a long-distance expedition can help professionals in addressing the strenuous challenges they face, in seeing that a career can be built in many ways, and in taking a long-term view of their journeys. Skills are like muscles, self-efficacy is like sturdy boots, advancement "how-to's" are like maps, and mentors are like trail guides.

The work that remains at the intersection of gender and career development.

Building on the study by Wagner et al, this commentary opens with a discussion of the persistence of gender disparities in career development and the challenge of interpreting those disparities. Given the multifaceted challenges facing rehabilitation medicine, facilitation of the career and leadership development of women physiatrists is critical. I suggest 3 areas of targeted action to facilitate the realization of women physiatrists' intellectual capital: (1) updated approaches to faculty and leadership development and mentoring, (2) more flexible faculty structures, and (3) chair support and accountability.

Experiences of belittlement and harassment and their correlates among medical students in the United States: longitudinal survey.

Objective: To determine medical students' perceptions of having been harassed or belittled and their correlates, for the purposes of reducing such abuses.

Design: Longitudinal survey.

Setting: 16 nationally representative US medical schools.

Generation X: implications for faculty recruitment and development in academic health centers.

Differences and tensions between the Baby Boom generation (born 1945-1962) and Generation X (born 1963-1981) have profound implications for the future of academic medicine. By and large, department heads and senior faculty are Boomers; today's residents and junior faculty are Generation X'ers. Looking at these issues in terms of the generations involved offers insights into a number of faculty development challenges, including inadequate and inexpert mentoring, work-life conflicts, and low faculty morale.