An Integrated Career Coaching and Time-Banking System Promoting Flexibility, Wellness, and Success: A Pilot Program at Stanford University School of Medicine

Abstract

Faculty in academic medicine experience multiple demands on their time at work and home, which can become a source of stress and dissatisfaction, compromising success. A taskforce convened to diagnose the state of work-life flexibility at Stanford University School of Medicine uncovered two major sources of conflict: work-life conflict, caused by juggling demands of career and home; and work-work conflict, caused by competing priorities of the research, teaching, and clinical missions combined with service and administrative tasks. Using human-centered design research principles, the 2013-2014 Academic Biomedical Career Customization (ABCC) pilot program incorporated two elements to mitigate work-life and work-work conflict: integrated career-life planning, coaching to create a customized plan to meet both career and life goals; and a time-banking system, recognizing behaviors that promote team success with benefits that mitigate work-life and work-work conflicts. A matched-sample pre-post evaluation survey found the two-part program increased perceptions of a culture of flexibility (P = .020), wellness (P = .013), understanding of professional development opportunities (P = .036), and institutional satisfaction (P = .020) among participants. In addition, analysis of research productivity indicated that over the two-year program, ABCC participants received 1.3 more awards, on average, compared with a matched set of nonparticipants, a funding difference of approximately $1.1 million per person. These results suggest it is possible to mitigate the effects of extreme time pressure on academic medicine faculty, even within existing institutional structures.

Figure 1

Banking system framework, for 60 participants in the Academic Biomedical Career Customization (ABCC) Program, Stanford University School of Medicine, 2013–2014. Using this framework, credits are awarded for activities that support the success of the team or institution but are not sufficiently recognized or rewarded, and/or enhance flexibility for colleagues (i.e., stepping up to fill a clinical shift at the last minute). Since research leads directly to career advancement, it is not awarded credits. Credits can be used to purchase work or home support services, which then free up time to spend on either work or home activities that support the faculty member’s work-life goals. Source: Stanford Medicine Office of Faculty Development and Diversity. Copyright © Stanford University School of Medicine. Used with permission.

Figure 2

Credit accrual, for basic and clinical faculty, for 60 participants in the Academic Biomedical Career Customization (ABCC) Program, Stanford University School of Medicine, 2013–2014. Values for individual categories of activities and overall total represent average monthly credits banked per person throughout the pilot program. Mentoring includes time spent advising trainees and junior faculty. Service includes service to the institution (e.g., serving on committees, administrative roles) and service to the discipline (e.g., National Institutes of Health study section, developing symposia). Teaching includes preparation time and contact hours. Shift coverage includes last minute clinical coverage for a colleague. Raw credit numbers differ between basic science and clinical faculty because of the different activities that each team chose to recognize with credit accrual. Raw credit values were then adjusted to make purchasing power comparable across basic science and clinical teams.

Figure 3

Credit redemption, for basic science and clinical teams, for 60 participants in the Academic Biomedical Career Customization (ABCC) Program, Stanford University School of Medicine, 2013–2014. Data reflect average monthly percentages of credits redeemed for home support (e.g., meal delivery, housecleaning) and work support (e.g., grantwriting and manuscript writing support, website services).