National Conference Q&A: Past Chairs Reflect on Growth, Evolution
June 26, 2024, David Mitchell — With the 50th anniversary approaching for the National Conference of Family Medicine Residents and Medical Students, held this year Aug. 1-3 in Kansas City, Mo., AAFP News gathered six past student and resident chairs whose leadership experiences span the event’s half-century.
In this four-part series, these family medicine leaders share their thoughts on the beginnings, evolution and growth of conference; the event’s vital role in helping students choose the specialty, find residency programs, connect with mentors and become future leaders of the specialty; and the future of the specialty itself.
Family medicine was recognized as a specialty in 1969. Five years later, the AAFP was looking for a way to give residents a voice. This is where the story of National Conference begins.
What were the origins of National Conference? What problem was it intended to solve?
Alan David, M.D., resident chair 1974-75: I was a family practice resident from ‘73 to ‘75 at the University of Missouri in Columbia. A call went out to program directors in 1974. The AAFP wanted resident input and they were going to have a meeting in Kansas City. I volunteered. It was only 120 miles away.
We went to Kansas City and met Tom Stern, who had been the medical advisor for Marcus Welby, M. D., in California where he was in Santa Monica as a program director. He was in charge of the AAFP’s Division of Education. Bob Graham was his assistant division director.
University of Missouri family medicine resident Alan David, M.D., speaks at the 1975 National Conference of Family Practice Residents. David was the first resident chair of the event, serving in 1974 and 1975.
They outlined how the Academy worked; there were two delegates from each chapter. The question was, should there be a resident chapter? How should residents become involved, and how would their voice be recognized and in what fashion and in what forums?
We selected two delegates and one chair. I was the first chair. Did I know what I was doing? No, not really. It was a brand new organization.
Then we were invited to the Congress of Delegates in Los Angeles. The two resident delegates were Ross Black from Ohio (former Ohio AFP president and AAFP Board member) and Bruce Bagley from New York (AAFP president 1999-2000). We went to all the hospitality rooms in those days, and they got recruited heavily and lobbied about voting for different candidates. We really got a sense of how the Academy and the Congress of Delegates operates. We were welcomed with open arms. We had two votes, like every other chapter, even though we represented a small number of people. There were probably less than 100 programs at that time.
A decision was made to then have another meeting, and students were invited. Out of that came a Committee on Resident and Student Affairs and the idea to have an annual national meeting.
The Expo Hall draws hundreds of exhibitors, including residency programs from across the country. How did students find residency programs, and vice versa, before the conference existed?
David: You usually talked to the program director. It was basically word of mouth. The Internet had not been developed, so you couldn’t Google or go to some other website and look up family medicine residency programs. I interviewed at the University of Rochester, the University of Vermont, University of Iowa and decided to stay at the University of Missouri.
Marla Tobin, M.D., FAAFP, student chair 1980, resident chair 1982 and 1983: Lots of young people were going into medicine at that time, and specialties were dominating. It was a time when we were worried we’d have a glut of doctors, but there weren’t enough in primary care because family practice was still pretty new.
When you looked for a residency, you searched on paper. You called, you met people in person, you networked with people across the country. You traveled. I went literally from the West Coast to the East Coast in my travels and spent about 30 days doing interviews. In some states and some medical schools, there really weren’t any connections to family medicine. It was not a specialty that was well established, so even knowing that there was a specialty to look at was hard for some medical students.
Douglas Henley, M.D., FAAFP, resident chair 1980: I was in Chapel Hill, N.C., so I could connect not only with students at Chapel Hill, but students at Duke who I saw at other events because of close proximity. You connected with faculty at the Department of Family Medicine and got recommendations from them about good programs. I concentrated on the southeastern part of the country from Virginia down to Georgia. I was on the road for probably two and a half weeks visiting 12 programs.
What role did National Conference play in helping you find your residency?
Tobin: Even if we didn’t have a residency fair, we still had a lot of people involved in early Academy leadership who were program directors, program faculty, people that represented programs. I met program directors. The Board of Directors had people on it who were program directors who we got to work with. The big thing as students was that we got to talk to residents. I was following people like Doug around asking, “What do you know? What’s next? What am I going to do next?” A lot of my superheroes in family medicine have come from that group of people who I learned from and followed there.
I was able to interview at some top programs because of the connections the Academy gave me and the ability to go to Cluster (commission) meetings and to go around the country meeting family practice leaders.
Beulette Hooks, M.D., FAAFP, student chair 1993, resident chair 1996: We had started the residency fair by the time I was a student. I interviewed with programs I met at National Conference, but it just so happens I’m a hometown girl, a home state girl, so I stayed in Georgia.
What is a key memory from your first National Conference? What stands out as far as speakers, workshops or connections?
David: Well, in those days, it was a fairly insular world. You really didn’t understand what else was going on outside of your own medical school, department or residency program. I didn’t have friends at other programs. You just kind of knew people where you were. Going to the Academy meeting and meeting people like Tom Stern, who everybody was like, “Oh, he’s the advisor for Marcus Welby, M.D.” And Bob Graham, who you could clearly see was the intellectual thought leader of what might happen, what could happen and maybe what should happen. Then you met residents from other parts of the country, and you thought, “Wow! There’s something going on here.”
Meet the Panel
Alan David, M.D.
Then: Resident chair from the University of Missouri Family Medicine Residency in 1974 and 1975
Now: Retired chair of the Department of Family Medicine and an associate dean at the Medical College of Wisconsin; Granville, Ohio
Other notable roles: Former president of STFM (1991); Also served on the boards of the Association of Departments of Family Medicine and the ABFM
Douglas Henley, M.D., FAAFP
Then: Resident chair from the University of North Carolina Family Medicine Residency in 1980
Now: President, Henley Health Care Consulting; Loch Lloyd, Mo.
Other notable roles: North Carolina AFP president (1987-1989); AAFP president (1995-96); AAFP Board chair (1994-95, 1996-97); AAFP executive vice president/CEO (2000-2020); chair of the Patient Centered Primary Care Collaborative (2015-17)
Marla Tobin, M.D., FAAFP
Then: Student chair from University of Missouri in 1980; resident chair from Duke University Family Medicine Residency in 1982 and 1983
Now: Retired Aetna Inc. regional senior medical director, who previously practiced full-scope family medicine in rural Missouri, Warrensburg, Mo.
Other notable roles: Inaugural convener of the National Conference of Women, Minority, and New Physicians (now the National Conference of Constituency Leaders) in 1990; Missouri AFP president (1993-94)
Beulette Hooks, M.D., FAAFP
Then: Student chair from the Mercer University School of Medicine in 1993; resident chair from Atrium Health Navicent /Mercer University School of Medicine Family Medicine Residency in 1996
Now: Medical director for the Family Medicine Clinic at Martin Army Community Hospital, Fort Moore, Ga.
Other notable roles: President of the Georgia AFP (2011-2012); convener of the National Conference of Special Constituencies (now the National Conference of Constituency Leaders) in 2006
Daniel Lewis, M.D., FAAFP
Then: Resident chair from Self Regional Health Care Family Medicine Residency in 2006
Now: VP and CMO of Southern Market for Ballad Health/Wellmont Health Systems, Greeneville Tenn.
Other notable roles: Member of the Commission on Education and chair of the National Conference Planning Subcommittee; president of the Tennessee AFP (2020-21); resident member of the AAFP Board of Directors (2007-08)
Julia Wang, M.D.
Then: Student chair from Keck School of Medicine in 2020
Now: Reproductive Health and Advocacy Fellow, Tufts Cambridge Health Alliance; Family medicine attending, Cambridge Health Alliance Primary Care, Malden, Mass.
Other notable roles: Student delegate to the AAFP Congress of Delegates; student member of the AAFP Commission on Education
Tobin: One of the early memories I have is the DOC presentations with Alan Blum, M.D., (co-founder and former director of Doctors Ought to Care program), Rick Richards (DOC co-founder) and Tom Houston (former Ohio AFP president). It wasn’t my first meeting, but one of the first couple. Those guys were at every conference in the early days, and they really pushed tobacco education.
It was a small group in Kansas City, like one ballroom for the residents and the students — 100 people or less. One of the people I remember at my first meeting was Mickey Bush. She was a couple of years older than me and from Texas. She stood up and said, “You need to get yourself a good lawyer and a good accountant and preferably a good woman lawyer, and a good woman accountant to really help you do well.”
Another thing I remember from the early days of growing the membership of the residents and the students, Steve Brunton (AAFP Director of Education from 1981-85) and Kathy Englund (former AFMRD executive director and AAFP resident/student affairs manager) were an excellent team from staff that did a great job, really promoting and helping us.
Henley: My first conference was in 1976 in between my third and fourth years in medical school. That was the second student meeting, the third resident meeting, at the old Muehlebach Hotel downtown. Remember the specialty was only seven years old, so it was still very much counter-cultural in terms of its ethic and its spirit. It was amazing. We only had 30 or 40 students at most. And since it was the third resident meeting, they probably had maybe close to 100, so the total was probably 150 or less. But it was so refreshing to be in a group of like-minded individuals with that counter-cultural bent to it, which is exactly what the DOC movement was all about, a counter-cultural way to approach tobacco abuse and things like that.
Julia Wang, M.D., student chair 2020: I would have loved to be in these rooms like a fly on the wall. Thanks for sharing your stories. It speaks volumes, hearing all of your stories about what things have been like because the idea that being against tobacco is counter-cultural is wild to me because it’s not where we are anymore.
If you have been back to National Conference since you were a student or resident, what have you noticed about how the event has changed as the specialty has grown?
David: It absolutely flabbergasted me how many people attended. When you think about starting with 35 people and then you have the number of programs we’ve added in the last 10 or 15 years, particularly. Then you look at all the presentations that are going on in the wide spectrum of people from all over the country. I don’t think there’s another national organization of a specialty group in the United States that could say they do the same thing for students and residents.
I’ve always said to students and residents, this is a unique phenomenon. You are welcomed into the discipline and into the practice milieu of family medicine, more so than any other discipline in medicine. Students have come back and said, “This tells me that although I am in a small group of people in this medical school interested in family medicine, there’s a lot of people like me out there, and I feel good about that choice.”
Daniel Lewis, M.D., FAAFP, resident chair 2006; current chair of the National Conference Planning Subcommittee: I remember as a resident chair, we were hoping to break 1,400 registrants between students and residents, so 700 for each. We had 1,319 total attendees that year. Last year we had 1,320 residents, so we had more residents than we had total attendees in 2006. And we had more than 4,800 total attendees last year. We had about 1,400 each for students and residents and then 2,000 exhibitors. The scale of the meeting has gone up about 300% in the 17 years from the time I was chair to now chairing the planning subcommittee.
Marla shared a paper that reviewed the congresses from her era, and in one of those early years the student and resident congresses adopted six resolutions that they sent on to COD.
Tobin: There’s one that had three resolutions and one had six. Having a resolution was a big deal. When I use a word to describe what changed, I use the word “exploded.” It seems like that when you go from 100 or so people in one hotel ballroom or two to filling Bartle Hall in Kansas City. There are a lot more breakout sessions. There are a lot more connections. There’s a lot more showcasing of residencies. They’re highlighting family medicine research, which really excites me. It’s become a major convention. I never would have dreamed, I don’t think Doug would have, either, before we started all this, that it would be this big, but the specialty has grown proportionately, too. It’s a reflection of that.
Henley: The year that I was chair, some of the senior staff of the Academy were worried that they may need to put a cap on attendance because it was getting too big, or bigger than what whatever their vision was.
Tobin: Or their budget.
Henley: Of course, the residents and students said, “Forget that.” Bill Coleman, when he was president (1993-94, two years before Henley), set the goal of trying to get 1,000 students there for a single conference. We almost made it.
I’ve had the good fortune to attend 35 of the 50 conferences, and Marla is right. “Exploded” is a great word, not only for the attendance, but just the energy of having that many people there, sharing that same passion for a single discipline. Particularly for students, it’s interesting to connect in the hallways with some of the students who are there for the first time and are thinking, “OK, I’ve heard about family medicine,” but they come there and meet their peers, get mentored by residents, see the exhibit hall, etc. It’s like the lightbulb went on, and they are hooked, and it’s just incredible.
Hooks: The year I was student chair was the first year it was in both the Westin and the Hyatt, and we thought, “Oh, my gosh.” And then, by the time I was the resident chair, we were at Bartle Hall. That’s only a five-year period, so it did explode.
We are still getting the students who want to do family medicine. I always heard, “You’re too good to go into family medicine,” but it’s the opposite. If we’re not good and can only concentrate on one thing, we couldn’t do this. What I love about family medicine is the fact that I have three exam rooms where I’m working now, and whatever room I go in, it’s never the same. I may have a child. I may have a newborn. I may have an older person. Your mind has to keep going. You’re always thinking. I love being a family physician. I can’t imagine doing anything else.
I think we did explode, and I think with the explosion we got a lot of good people.
Tobin: Maybe the fuse was lit somewhere in your era then? Because it exploded right then.