Nonprofit Board Membership: A Novel Mechanism for Authentic Community Engagement and Leadership Development for Resident Physicians.

Abstract

Many residency programs have increased curriculum emphasis on the social determinants of health in recent years, and genuine longitudinal experiences for community engagement can be rare and challenging to design. The pediatric residency program at the University of Pittsburgh Medical Center Children's Hospital of Pittsburgh has its separate Pediatric Advocacy-Leadership-Service (PALS) program track with 6 total residents across all trainee levels in a given academic year. Since 2011, the PALS program's mission is to train residents to be outstanding primary care pediatricians with the knowledge and skills to provide effective health care, leadership, and advocacy on behalf of children and families in medically underserved communities. This specific training is accomplished through multiple elements in the spirit of the acronym. Authentic leadership training, beyond personality profiles and suggested readings, is exceptionally difficult to provide. The PALS program provides the following unique training opportunity to meet this need.Enabling authentic community engagement while simultaneously offering robust leadership development, the PALS program facilitates each resident to be a member on the board of directors of a local nonprofit organization during residency training. This pairing is done with individual attention to each resident's interests and the community organization's vision and values. First-year PALS residents are asked to critically reflect on personal strengths, goals, and areas of growth. Local community pediatrician and public health leader, Dr Amy Nevin, has years of experience with grassroots community health networks to coordinate “the match” between each nonprofit organization and resident. To enable junior residents to contribute meaningfully as board members, she and the PALS third-year residents provide specific mentorship and are in communication with various local nonprofits gauging specific organization needs. First, an interview is completed, and the nonprofit leadership decides whether the resident physician is their desired board member candidate. If all parties are interested in proceeding, clear expectations are outlined upfront. For example, residents are never expected to make large personal financial donations to the organization. Residents are transparent regarding their rigorous clinical schedules. Nonprofit organizations provide board meeting times to the residents and share reasonable attendance expectations. Residents then provide board meeting times in advance to residency program leadership for accommodations when possible. The timeline varies per each pairing but is finalized by the end of intern year at the latest to provide at least 2 full years of active nonprofit board membership.The resident nonprofit board membership experience has been an empowering community opportunity with mutual benefits for both local nonprofits and residents. Several residents have cited their nonprofit board role as one of their most rewarding experiences of residency. Many residents invited their community partners to visit the hospital for guest lectures during teaching conferences. Community nonprofits have utilized resident perspectives, often the only medical voice on many boards, on numerous occasions including navigating the COVID-19 pandemic. The list of participating nonprofit organizations (Table) has grown even as some partners actively seek a new resident board member as graduating ones complete their residency programs. Most residents had never previously held board responsibilities, and this leadership opportunity intends to serve all graduates as future community health leaders in their careers. Further investigation is needed longitudinally to survey graduates and community partners of this experience to understand its long-term career impact.