March 6, 2025, David Mitchell — In 1990, the AAFP held its first meeting of the National Conference of Women, Minority and New Physicians to give members of those groups direct input into Academy policy discussions. In its 35 years, the event, now the National Conference of Constituency Leaders, has expanded to provide representation and leadership opportunities for members who are international medical graduates, and LGBTQ+ physicians and allies.
Elections held during NCCL determine which members fill several leadership roles:
Three current members of the Academy’s Board of Directors who previously served as NCCL conveners recently spoke with AAFP News about how the event shaped their leadership journey and why they encourage others to attend the April 24-26 event in Kansas City, Missouri.
Kisha Davis, M.D., M.P.H., FAAFP; Jay Lee, M.D., M.P.H., FAAFP; and Sarah Nosal, M.D., FAAFP, got leadership experience as National Conference of Constituency Leaders conveners.
AAFP Director Kisha Davis, M.D., M.P.H., FAAFP, chief health officer for Montgomery County, Maryland.: I attended my first NCCL as a minority constituent delegate from Maryland. I didn’t know what I was getting into. I thought it was a regular CME conference the chapter was sending me to for free. When I got there, I was little overwhelmed.
I was excited about the opportunity for leadership but had not planned to run. My constituency co-convener, who happened to be Jay Lee, encouraged me to run for the AMA-YPS position because nobody else was running. I said “Sure, I’m happy to run for a position with no competition.” I showed up the next morning, and there were five people running for the position because others also had been encouraged to run. But I won, and it was a great taste of leadership. Running on the spur of the moment wasn’t something I would normally do, but I appreciated the nudge to step out of my comfort zone in a supportive environment.
AAFP Director Jay Lee, M.D., M.P.H., FAAFP, medical director of Integrated Health Partners of Southern California: There’s something about the vibe and the energy you get from being at that conference with like-minded people who are trying to articulate what’s in their heart, have it jibe with what’s in their head and writing it down in a resolution or coming to the microphone to offer testimony. We all learned to do that because we have a shared love of family medicine. I had never experienced that before, even in residency. I loved my residency program, but at that stage you’re busy learning clinical things, not about advocacy or the future of the specialty. Equipping you to be an advocate is one of the things NCCL does extremely well.
AAFP President-elect Sarah Nosal, M.D., FAAFP, vice president for innovation and optimization and chief medical information officer at The Institute for Family Health, New York: I went to NCCL the first year after I graduated residency. I had been the resident delegate to the New York State Academy’s Congress of Delegates, and we were passing resolutions that influenced state policy changes. We were having an impact. At that time, we didn’t have gay marriage in New York, and I had a female partner. Family doctors had not yet endorsed gay marriage. But there was a community of people at NCCL who cared about it, and I felt like we could actually do something. If family doctors stood up for it, we could actually change what was happening in my own life. That was incredibly powerful. I wanted to come back, and I wanted to be in charge.
Nosal: The reality is that there are people who have not been given the same opportunities to be in the room where leadership is taught — the secret language, how you approach things and how you negotiate. Traditionally the people in those rooms were white men. This is a place where everyone else, including younger white men who haven’t been in those rooms either, is going to learn how to be effective. It’s a leadership stomping ground to learn how to do it in a way that allows you to step forward as a leader in NCCL, in your state and on the national level.
Lee: One of the best ways to be innovative and evolve is to embrace diverse ideas. It provides strength to a leadership group to have diverse voices around the table. It’s about the leadership journey and the process of learning not just to speak from the heart but to speak in a way that can meet the high standards of the Academy and its membership. In some cases, you’re putting up a test balloon to get feedback about how to make policy better. So, sometimes ideas get shot down, but they come back stronger the next year because we’ve had opportunities to talk about it.
I’ve been in front of a microphone at NCCL with my heart pounding and my palms sweating, so now when I go into a board room, or when I need to talk with business leaders who aren’t physicians, I have the courage and know how to approach them and frame the conversation in a way that makes business sense but still meets the needs from a clinical, equity and justice perspective.
Register for Leadership Events
Registration is open for the National Conference of Constituency Leaders, which is a leadership development event for these underrepresented member constituencies: women; new physicians; international medical graduates; members who are Black, indigenous and people of color; and LGBTQ+ physicians and allies. The April 24-26 event in Kansas City, Missouri, coincides with the Annual Chapter Leader Forum, which is a developmental program for chapter-elected leaders and chapter staff.
Davis: NCCL helped me find my voice as a Black woman in medicine when I wasn’t seeing others around me. It gave me a supportive environment, but it also taught me to listen to other diverse voices, and that’s really the strength of the event.
People are coming from all different walks of life and experiences. To hear what’s troubling them, and to hear them advocate on an issue they are passionate about that I might not have even thought about made me a better listener and leader so I can support them in their advocacy efforts. That opened my world to experiences other people have had. That has pushed us as an Academy when we think about things like gay marriage, so the Academy has been ahead on many issues because NCCL has allowed us to hear from folks on the ground who have experienced something.
Lee: There are cutting-edge ideas that come through the resolution process that I might not have been aware of from reading just the standard literature. A good example for me is buprenorphine. I didn’t know what it was until it was in an NCCL resolution. Years later, I was in a position as a CMO and had just started a community health center. There was a small but mighty group of physician leaders in that practice who were beginning to do work in terms of ambulatory induction of patients with buprenorphine. I had a baseline understanding because I had heard about it at NCCL. That allowed me to think about, “How can we be innovative about this?” We were able to deploy a program at the clinic to serve patient needs in a way that was ahead of its time. Plugging into some of that innovation helped me to not be afraid to lead change and better care for patients.
Davis: In that role you are leading a diverse group of people from across the country who have different interests and are there for different reasons. You have to work with them and bring them together to produce a final product. It’s an exciting opportunity to move that work forward. It gives you confidence to feel like you can do more. You’re on stage engaging with folks and trying to ignite the fire you felt in the people there. It teaches you the skills needed to be successful on the Board.
Lee: It was my first chance in a very public forum to try on what I would call “executive presence” and think about how vulnerable or authentic I wanted to be. How can I bring my own personality to the script? A big part of leadership is learning how to roll with the punches, understand the assignment and get the work done in the time allotted.
You also learn how to pull others along, encourage them to see qualities they might not see in themselves and pushing them to get outside their comfort zone. You also learn how to navigate a process that has rules and the pitfalls, which you learn how to manage on the fly. That contributed to my ability to do this at the state level and now at the AAFP Board level.
Nosal: For me the strongest place of learning is the work we do in the advisory group that plans the conference. I had attended many types of conferences and participated in events with my state as a student and resident, but in that advisory group you go through every piece of how you’re going to make the conference run. The AAFP staff really is hands-on collaborating with you, but as convener you are managing this group of people who are running different segments of the conference. Sometimes they are having problems or have something happening in their life that prevents them from doing what they were supposed to do. You’re negotiating those relationships for a successful, bigger purpose. For me, it was at a time in my career that I hadn’t done that level of management.
The AAFP staff recognizes and knows they are developing leaders and give us an opportunity, particularly in that advisory group, to learn skills that are recognized when we go back to our states. It’s not a surprise because those individuals were chosen and ended up where they were because they had some of those skills. But when you bring back what you learned in the advisory group to your state, it’s inevitable that you’re going to step forward and lead because you are inspired to do so. And now you have this new skillset you can apply right away, often at a younger age when you’re energized and believe in the work and that change is possible.
Nosal: At NCCL, there is such a camaraderie and willingness to support people in vulnerability. I’m an introvert. I don’t like public speaking, but everyone is like, “Come on, you can do it. Step forward. We’re right there with you.” The best friendships of my life, people who get me more than anyone in the world, are people I met at NCCL. It’s a community that is ready to help you be vulnerable, take a risk and support you if that doesn’t succeed. And not succeeding is still a success because you put yourself out there. There’s so much support that it makes it possible to take a risk.
Lee: It’s a safe place to try on leadership. It is high stakes but lower stakes than the Congress of Delegates. The event is working as designed. It was intended to encourage people from diverse backgrounds to consider leadership. If you go to a medical society meeting, you talk about networking. But when it comes to NCCL, it’s community-building. You’re finding your family within family medicine. We’ve grown up together. We don’t have a secret handshake. We don’t give each other a sign, but when you go to Congress or state meetings and you meet somebody who has been through the NCCL training, it’s something you bond over. It doesn’t matter what year it was. There’s a recognition that you went through that, and there’s value in it. In hard times and good times, the first people I reach out to are people who have been through NCCL.
Davis: It’s such a supportive environment. You feel it when you walk in the first time. This is a group where you could fall on your face, and they would pick you up. It makes taking leadership roles, both within the Academy and outside of it, feel more accessible. You feel like you can try it on at NCCL. “I could run for co-convener. I could do that.” A bunch of people are going to run, and only two of them are going to win but it feels accessible. And you say, “That wasn’t so bad. Maybe I can do something else.”
The training is so good. You see people who haven’t had the training, and you might think, “Oh. I could do better than that. Well, I can do that.” It gives you the confidence because you know you can do it. That’s what drives me and others because you have that environment that is trying to build you up and see how much further you can go rather than when people are being competitive and trying to beat you down.
Nosal: This is the leadership stomping ground that’s going to teach you the skills for wherever you want to step up to next, whether that’s your organization, your business, your community or your state academy. You will step out of there ready to do it. There’s no place better I could send you to prepare.
Lee: Now that you’ve begun the pathway to becoming the physician you wrote about in your personal statement, now is the time to become the physician leader your community and specialty need you to be. And, oh, by the way, do you like barbecue?
Davis: This is where you will find your family medicine tribe and the opportunity to try on leadership and grow in ways you didn’t even know were possible.
Nosal: You find your people in family medicine, but this is the next level of people who are really committed to social justice. It’s different stuff. It’s not the same things we’re all working on in our communities. It’s deeply personal and passionate. It’s a different way to get to know humans, love them and be glad they exist and are doing the work in communities that need them. You can support them and vote for their resolutions. Everyone who writes a resolution, everyone who works with a team to get a resolution adopted, is leading. When you are talking about things that matter in your community and the patients you are serving, that’s leadership. We were conveners, but it’s an extensive web of people that makes change possible in our communities and our country.
Lee: Embrace the fact that vulnerability is strength. Each of us has different strengths we can bring to the table. Every convener I’ve experienced has had a different style and personality, and yet we still get the work done.
Nosal: We’re going to be in a time when opportunities to make sure we are inclusive and comprehensively providing opportunities are going to be limited. This event is so critical when you look at the leaders who have been developed and the work that has been done. The value is so phenomenal. We can’t miss how important it is.
Lee: At a time when we are going to experience headwinds in the health care system, leadership is the key to get us through it. Embracing the values and principles of who we are as family docs and learning to communicate and espouse that in a way that is engaging across the spectrum is important. I can’t think of a better group to lead us into the future than the people who have grown up in this event.
Davis: The Academy is better and has better leaders because of NCCL. That’s why you see so many people from NCCL on the Board and other places in leadership, because of the emphasis on training. Bringing diverse folks to the table pushes us as an Academy, and that’s a good thing. It keeps us at leading edge of conversations, and that diversity of voice and opinions, learning how to hear and learn from each other, puts the Academy ahead. As much as it’s helped our personal development and made us better leaders, it’s also helped make the Academy a better organization.