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What Do You Know About Family Medicine?

Posted By Jennifer Ayres, Thursday, October 2, 2014

Jennifer Ayres, PhD is a graduate of the Behavioral Science Family Systems Education Fellowship program. If you are interested in applying, please click here.

“What do you know about family medicine?” 

It was 07:00 PST and I was participating in a phone interview with the program and associate directors of the family medicine residency in Austin.  I had woken up two hours earlier to prepare a brief response to that simple question, so that I sounded simultaneously honest and self-assertive.

“Very little.  However, I know a lot about mood disorders, trauma, substance abuse, personality disorders, and family therapy.  If you’re wanting someone to treat those issues and teach others to do the same, I know how to do that.”  

My first day as a behavioral science educator occurred approximately three months later. The first two years were rough, despite excellent support from the program director and my faculty colleagues.  The credentialing process took six to eight months.  My predecessor was gifted, experienced, and talented in areas that I was (and am) not.  People missed him.  It took almost a year to grasp that teaching psychology graduate students and family medicine residents necessitated a different skill set.  Thus, most of the labor-intensive power point lectures I wrote were ineffective, despite their excellent research reviews and catchy graphics.  Some of the residents were thrilled that I was there, others were suspicious of me and my intentions.  Support group attendance was abysmal.  One of my first resident evaluations included a comment that I had very little to contribute to his/her resident education because I did not understand what being a physician entailed. In the last half of my second year, we had a leadership change after our program director resigned and our associate director assumed leadership. 

The first two years were rough 


Our new program director and I met to discuss if my chosen amount of clinical care (25-30 scheduled patient hours/week) reflected a deeper issue that needed program support. The truth was obvious to both of us. I still thought and functioned as a practicing clinical psychologist because I had not adopted the mindset of a behavioral science educator. We agreed that I would shift to a weekly caseload of 10-15 scheduled patients within six months and that I would seek mentor(s) to help me with this career transition. Several months later, she forwarded me an email about a new fellowship sponsored by the Society of Teachers of Family Medicine (STFM). The primary objective of this yearlong fellowship was to mentor new behavioral science educators.  Four years ago, I was accepted into the inaugural class of STFM’s Behavioral Science/Family Systems Educator Fellowship (BFEF).  

My favorite program evaluation question is “What do you think you will remember from this experience in five years?”  Here is what I remember about the fellowship and the advice I pass along to my colleagues who are new to this field.  It is intended particularly for those who have achieved career success in other areas and are making a professional identity shift from that career to behavioral science education.

(1)    There are resources available that will make your job easier.

(2)    Teaching residents and teaching mental health students require different strategies and techniques.

(3)    There is a wonderful conference every September in Chicago (“The Forum”) and most presentations will be applicable to your work.  Attend, if possible.

(4)    Other people also struggle(d) to integrate behavioral health into programs that are focused on the medicine aspects of teaching family medicine. Support is available.  Reach out.

(5)    Be patient.  It takes at least three years to have a resident cohort that does not remember the program without you. 

(6)    Some residents will need several years of professional practice before they realize that behavioral health is a necessary component of family medicine. Keep the labor-intensive power points handy because someday they may shift from ineffective to a desired resource.

(7)     Apply for the fellowship and join this community.  You will not regret it. 

I was struck by how many people wore gold beads The first night of the Forum involves an event known as the “Gathering In.” This event brings together new and experienced behavioral science educators to discuss an issue in our field. I attended for the first time during my fellowship year. We participated in an activity that involved wearing different color beads to indicate our number of years in family medicine education. I was struck by how many people wore gold beads, which indicated greater than 25 years of experience in our field. That number seemed unimaginable to someone in the first month of her fourth year and I could not envision myself attending the Forum in 2031 when I would reach gold bead eligibility. Now I predict that several of us from my BFEF cohort will be there, wearing our beads proudly and welcoming new members to their first Forum.  



Jennifer L. Ayres, Ph.D. is the director of behavioral health services at the University of Texas Southwestern Austin Family Medicine Residency Program.  She is a clinical psychologist who completed a postdoctoral fellowship in child abuse and trauma.  Prior to her current position, she worked as a trauma psychologist in community mental health centers and was an adjunct professor of psychology. Her interests include trauma in primary care, resident self-reflection and support, supervision of psychology students in integrated behavioral healthcare settings, and palliative care/family medicine collaborations.



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