AFMRD Leader Is Eager to Serve Her Peers

Cole and Hoekzema were attending the AAFP’s Residency Leadership Summit when he gave her the news in somewhat unconventional fashion.

“He said, ‘There’s a talk on how to do succession planning, transitioning from one program director to the next. You and I need to go to that, sit next to each other and think about how we are going to make this transition,’” Cole said. “That was how he announced to me that he was moving up to department chair and he wanted me to take over as program director.”

Not that she’s complaining. Cole, who has been program director since 2016, said the well-planned process gave her an “18-month on-ramp” to the role.

“I recognize that not every program can do that,” she said, “but if program directors find themselves in that position, where they feel like the program is in a stable place and they have time to make that thoughtful transition, that was incredibly helpful. We had a whole academic year when he could show me, as he was doing them, the things that needed to be done for the ACGME, ABFM or our institution. We sat side by side and did that work together. When it was my turn in the program director role, I felt incredibly comfortable with what I was doing because I had essentially done it the year before in partnership with him.”

Cole, a Mercy graduate, has been an assistant clinical professor in the Department of Family and Community Medicine at the St. Louis University School of Medicine since 2006. She said she had been “chomping at the bit” for the program director’s role and joked that Hoekzema likely grew weary of her frequent, unsolicited advice.

But Hoekzema, who served as Mercy’s associate program director and program director for more than 20 years, said he knew it was time for him to step aside and that he would have been “foolish” to let Cole seek a director’s role elsewhere.

“I had really big shoes to fill,” said Cole, who was a resident, junior faculty and associate program director at Mercy during Hoekzema’s time as program director. “I learned from the best. I’m lucky that he is still here, so I still have that resource down the hall if I need him.”

Hoekzema played a central role in last year’s Residency Leadership Summit, speaking as chair of the Accreditation Council for Graduate Medical Education’s Review Committee for Family Medicine a few months before new program requirements were implemented.

This time around, Cole will be the one in the spotlight during RLS, which is scheduled for March 25-27 in Kansas City, Mo. Cole, president-elect of the Association of Family Medicine Directors, will assume the role of president during the association’s annual meeting, which coincides with RLS. She accepted her first committee assignment with AFMRD in 2018 and has served on its board since 2021.

“I had an amazing resource in Grant, but I really appreciated hearing how other programs and other program directors were thinking about things,” she said, “so the AFMRD listserv, RLS, serving on the Bylaws Committee and just networking with other people helped me learn so much. My knowledge and understanding as a program director was broadened by this community, so it was important for me to give back to my fellow program directors.”

Cole, who is a past president of the Missouri AFP, said her time on the AFMRD Board has been a valuable learning experience.

“What I have learned, among other things, is grace, humility and the importance of soliciting other’s opinions, not just listening to what they are saying but asking reflective questions to really get to a deeper understanding of how we’re doing in family medicine,” she said. “We’re at a crossroads where there are some possible changes to how we are going to be structuring the content and duration of family medicine training down the road, so hearing the voice of every stakeholder that’s involved in that process is incredibly important.”

Cole will lead a session at RLS on building a sustainable structure for scholarly activity in residencies with AFMRD president Kristina Diaz, M.D., FAAFP, (who will be transitioning to the role of immediate past president) and immediate past president Kimberly Stutzman, M.D., FAAFP, (who will be rotating off the AFMRD Board). Cole also will present a poster related to Mercy’s implementation of a four-year training track that is offered to one resident per class.

RLS had record attendance last year due, in part, to interest in the new program requirements. Cole said she thinks that topic will remain a big draw, and the programming will reflect that continued interest.

“We’re all in this first year with the new program requirements, so we’re figuring out what’s working and what’s not and we’re ready to come together and share best practices,” she said. “Last year there were a lot of theoretical questions. This year, I think people will have a lot of practical questions and practical advice for each other.”

Cole’s teaching background stretches back to her teens. She worked as a camp counselor, teacher’s aide and, eventually, substitute teacher at the St. Louis elementary school for children with learning disabilities where her father taught.

“The stories around our dinner table centered around health care and education, so both areas really resonated with me,” said Cole, whose mother was a nurse. “I debated between teaching and medical school before ultimately deciding on medical school. During residency, it was Grant who said, ‘You’re pretty good at teaching medical students. Have you thought about going into academic medicine?’ I realized I had this path that could blend these two things I grew up with.”