The More AMIA Changes, the More It Stays the Same . . .

Right at this very moment, the American Medical Informatics Association (AMIA) 2022 Annual Symposium is underway in Washington, D.C., and we encourage you to visit NLM @ AMIA 2022 for updates on NLM’s products and programs. Now this may sound quite familiar to those of you who have attended AMIA annual symposiums in Washington, D.C., and other major cities over the past 30 years, but this year it is different. And yet, it is the same.

What’s the same? Well, for me and almost 3,000 other attendees, AMIA is our professional home. Through meetings and conversations, journal articles and webinars, and a host of new events and meetings, members build their knowledge about biomedical and health informatics, share that knowledge with colleagues, and advance the health of the public through informatics. We have built friendships, watched babies be born and grow into adults (including my son Conor), and grieved the loss of great leaders in the field. Colleagues have debated the wisdom of electronic health records that may have inadvertently contributed to clinician burnout and expanded the scope of our design and deployment efforts to encompass tools useful to consumers and language reflective of the diversity of society.

AMIA has welcomed young people into informatics and sponsored high school-student participation in national meetings. Special events now include rapid response to public health threats, special interest meetings for women in informatics, and expanded attention to diversity and inclusion. The fall symposium provides an opportunity for formal and informal mentoring, a quick hug with an old friend, and a reunion of those with whom we studied the basics of the field.

And yet, over 30 years, many things have changed! First and foremost, AMIA as an organization has grown, engaged new leadership, and developed new special interest groups. These each change the tenor of the meeting by adding new events to an already rich and attractive suite of offerings and bringing like-minded people together. The ideas shared and the research reported through the annual symposium have morphed throughout the years; now artificial intelligence takes center stage, tempered by thoughts of transparency and equity. A larger number of panels and industry sessions reflect the rapidly changing landscape of informatics. Electronic posters and smartphone apps take the place of what once were paper posters displayed in long corridors of bulletin boards and a three-inch-thick compilation—dare I say phone book size—of all the papers to be presented at the sessions.

And of course, the pandemic changed both everything and nothing. AMIA still hosted an annual symposium and participants still gathered, at least over video chat! Throughout the pandemic, AMIA offered virtual and hybrid conferences—this is the first annual symposium completely in person since 2019 and boy, was I ready for it!

So, rejoice with us—our annual touchstone of gathering for the science of biomedical informatics and the social support of friends and colleagues continued! Please plan to join us in 2023 and see for yourself what it is like!

Want to Improve Informatics? Don’t Forget About First-Generation College Grads

Guest post by Kim Unertl, PhD, Associate Professor in the Department of Biomedical Informatics, Vanderbilt University Medical Center, and Director of Graduate Studies for the Biomedical Informatics MS/PhD Program at Vanderbilt University.

Who Belongs in Informatics?

I often ask colleagues and trainees about how they decided on a career in biomedical informatics. Over the years, this question has elicited a pattern of responses often involving a chance encounter where the person discovers that there’s a field that connects computer science with health. These were topics they were interested in but weren’t sure how to combine.

Looking for a career in informatics? NLM supports research training in biomedical informatics and data science at 18 U.S. educational institutions. For more information, visit our External Programs Division Grants and Funding and Research Education Program (R25) web pages.

Much of my work now focuses on expanding access to training and career pathways in biomedical and health informatics so that more talented young people learn about informatics earlier and in a more purposeful way that helps them understand that there’s a place for them in the field. A major goal is to increase diversity in biomedical informatics so that informatics better reflects the diversity of the U.S. population and can develop more equitable innovative technology solutions to major health challenges.

One large population that could benefit from increased emphasis in recruiting and networking efforts are first-generation college students, especially those from groups under-represented in the field.

Navigating Academia without a Safety Net

The fact that I’m a successful faculty member at an R1 university (an institution that conducts high research activities) is an improbability. Neither of my parents graduated from high school. My dad earned his GED, joined the Marines, and completed a carpentry apprenticeship program thanks to the GI Bill, which provides benefits and programs to veterans. My parents shared an unshakeable belief in the importance of education for their children, but my siblings and I had to figure out how to navigate the unfamiliar world of higher education ourselves.

The whole process was very lonely, confusing and overwhelming. Even today I regularly feel like I’m missing key behind-the-scenes information about how academia and research environments work. In addition, the skills I developed in managing independently and figuring things out, although crucial in helping my educational trajectory, are not well-aligned with the collaborative nature of science.

I’m far from the only person with this experience. A large proportion of K-12 students in the United States have parents who did not complete an undergraduate degree. This affects every aspect of their educational path. Data consistently show that if you have at least one college-educated parent, you have higher odds for finishing a bachelor’s degree and completing an advanced degree, which has multiple long-term financial implications. Around 13% of the U.S. population holds an advanced degree such as a Master’s, Professional, or Doctorate. Recent studies have confirmed that the odds of a tenure-track faculty member having at least one parent with a PhD are 250 times higher than having a parent without a PhD. The gap is further compounded when these faculty members are also part of other under-represented groups in categories such as gender, race, and ethnicity.

Why Does This Matter?

All of us involved in biomedical research and academic training should care about this reality. Every time a career path is closed to someone, we are missing out on what that person could contribute to their field, to patients, to public health, to their communities, and to the world. The systems that serve to lock under-represented and first-generation students out of opportunities keep amazing and talented individuals from achieving their dreams and goals. The next idea that revolutionizes medical care, cures a disease, invents a device, or identifies ways to address health equity issues may never have a chance to blossom because a student might not see an academic or research career as a viable option. We all lose as a result.

You Have a Role to Play

The good news is that we can all help to improve access to the field for diverse, first-generation students and trainees. We can all open doors to higher education opportunities and scientific career paths, starting with building connections with K-12 students. Mentoring high school and undergraduate students through the Vanderbilt Biomedical Informatics Summer Program (VBISP) has been some of the most enjoyable and worthwhile work of my career.

Developing and supporting programs that provide access to research opportunities through internships is another way we can open doors into scientific research for more people. This can take many forms – running an internship program, serving as a mentor for a summer intern, presenting a talk at a seminar, or financially supporting high school students’ participation in informatics summer programs. Every contribution has the potential to make a significant difference.

We also know that opening doors is not enough. Once students begin an undergraduate or graduate STEM degree program, we need to ensure that training environments are equitable and inclusive. First-generation students need support to help navigate higher education and to start out on their research careers. Information that many take for granted about how to navigate academia and research environments can present an isolating mystery for a first-generation student. Many feel as if they do not belong. Making what has been described as the hidden curriculum of higher education more transparent can help students move forward on a pathway towards a successful career and eliminate some of those feelings of isolation. Addressing topics such as coping with imposter syndrome and collaborating with a mentor can provide skills and confidence, as can regularly checking in about mental health and connecting students with peers with shared experiences.

First-generation students have so much that they can contribute to science. Leaving them sitting on the sidelines when science needs everyone on the playing field is a loss for all of us.

Dr. Unertl gratefully acknowledges Ellen de Graffenreid, Mia Garchitorena, and Jessica Ancker for feedback on drafts of this post.

In addition to her work at Vanderbilt University and the Vanderbilt University Medical Center, Dr. Unertl directs the VBISP and is co-director for the American Medical Informatics Association High School Scholars Program. Her research focuses on interactions between people, process, and technology in health care, especially related to clinical workflow, and on development of new pathways into biomedical informatics.

What is the Role of a Mentor?

Guest post by Karmen S. Williams, DrPH, MBA, Assistant Professor at City University of New York Graduate School of Public Health and Health Policy, and Meera G. Subash, MD, Assistant Professor and Division Quality Officer for the Division of Rheumatology at the University of Texas Health Science Center, McGovern Medical School.

“Everyone, at every point in their career, has the potential to be a mentor as well as [to] seek a mentor. It is the combination of being and doing in mentorship that makes it such a rewarding and important part of a professional career.”

Medical informatics pioneer and NLM Director Patricia Flatley Brennan, RN, PhD, recently spoke these words when she joined us for a special podcast hosted by the American Medical Informatics Association (AMIA)—a crossover episode between For Your Informatics, led by the Women in AMIA Initiative, and ACIF Go-Live, directed by the AMIA Clinical Informatics Fellows.

Bryan McConomy, MD, began our inaugural episode with an introduction to medical informatics, highlighting the early work of Dr. G. Octo Barnett and his team’s development of the MUMPS integrated programming language at Massachusetts General Hospital in the 1960s. Being a relatively young field, we can look to the trailblazers who first used computers to augment clinical decision-making and improve health care discovery and delivery. We pay homage to the rich tapestry of innovative leaders and educators, such as Homer Warner, MD, PhD; Reed Gardner, PhD; Clement McDonald, MD; Margo Cook, RN; Lawrence Weed, MD; and Edward Shortliffe, MD, PhD, to name a few.

We started the History of Medical Informatics joint podcast series with those two AMIA podcasts with the understanding that we need to connect our past with the present. This ongoing series catalogs this history through the eyes of pioneers in the field of health informatics. By highlighting how historical events merge with contemporary topics of interest in health informatics, we intend to strengthen the bridge for new and upcoming professionals both in and outside of informatics.

In our episode titled “History of Medical Informatics – Mentorship” with Dr. Brennan, we focus on how mentorship was established in a field that, until recently, was virtually nonexistent. Dr. Brennan was not only our first guest on the joint series, but she was also featured in a March 2020 episode of For Your Informatics titled “Training the Next Generation of Informaticians,” which also offers valuable information on mentorship. She has been a full-circle guest by highlighting the past, present, and future of mentorship in health informatics.

Dr. Brennan will also be our keynote speaker at this week’s 2022 AMIA Clinical Informatics Conference, which will give us an opportunity to reflect on the real meaning of mentorship. What is mentorship? How did health informatics pioneers build mentorship in a new and novel field? What is the role of a mentor?

Dr. Brennan recalls some of the best parts of her mentorship experience, including having the freedom to explore, engage with like-minded individuals, establish trust, push boundaries beyond your starting point, and open new doors. Mentors are there for your failures in life, for the deeply embarrassing moments, and to help pick you up when you hit a bump in your career.

However, not all mentorships are created equal. There are some that are lifelong, while some are short term. Some aren’t always mutually beneficial, while others are mutually uplifting. Some mentors come from other fields, while others may be in the same field. The commitment to mentorship may be formalized or just a passing activity.

The style of mentorship can also vary. Some may bring a mentee into a research group to work side by side with them while some may only have periodic conversations. Either way, the mentor must be ready and willing to go through the process.

We’d like to share some wisdom we’ve received over the years: seek out people for a cup of coffee and find someone with whom you can share your successes and challenges. This is important because not all skills are learned in the classroom. For example, academicians need to know how to interpret faculty governance, engage with management, and position research and teaching. Dr. Brennan points out that “these things are difficult to learn on your own, and that’s where mentors can come in.”

The point is that mentorship must be purposeful and built on the trust needed to guide the direction of mentees’ careers and important life choices. It is a decision that should not be taken lightly. Mentorship in any arena is pertinent to career development, but it is especially valuable in groundbreaking fields like health informatics.

What is the best advice you’ve received from a mentor?

Headshot of Dr. Karmen S. Williams.

Dr. Williams completed a post-doctorate fellowship in public and population health informatics at Indiana University and Regenstrief Institute, where she focused on systemic informatics integration. Dr. Williams serves as the director of AMIA’s For Your Informatics podcast, which features individuals at all career stages to reveal the diverse world of biomedical and health informatics professions. She is a member of the AMIA Diversity, Equity, and Inclusion Committee; Women in AMIA Pathways Subcommittee; and AMIA Dental Informatics Working Group.

Headshot of Dr. Meera G. Subash.

Dr. Subash received her undergraduate degree from Stanford University and her medical degree from Texas Tech University Health Sciences Center School of Medicine. She continued to University of California San Francisco to complete both her Rheumatology and Clinical Informatics Fellowships. She is Epic Physician Builder certified, and her interest area is implementing and evaluating health IT and electronic health record tools to improve patient care in rheumatology and ambulatory care.

%d bloggers like this: