Honoring Excellence: Q and A with Julie B. McCausland, MD, MS

This interview is one in a series of interviews with recipients of the 2021 ACGME Awards. The awardees join an outstanding group of previous honorees whose work and contributions to graduate medical education (GME) represent the best in the field. They were honored at the ACGME Annual Educational Conference, which took place virtually February 24-26, 2021.

2021 Parker J. Palmer Courage to Teach Awardee Julie B. McCausland, MD, MS is the program director for the transitional year program at the University of Pittsburgh Medical Center, Medical Education in Pittsburgh, Pennsylvania. She specializes in emergency medicine.

ACGME: How did you become involved in medicine, and in academic medicine specifically?

McCausland: One of my earliest memories in medicine is answering the phone at my father’s office and saying, “My dad will be back when the big hand is on the two.” My father was a solo practicing dermatologist and I worked in his office as a file clerk, appointment scheduler, room cleaner/stocker, and eventually, surgical assistant. He retired just last year after 50 years in medicine. My mother was a music teacher and is a mom of four whose sunny optimism has always encouraged me to be super positive and think outside the box. I credit her with my resilience to this day. Add to these the fact that I am a first-born child, and it was the perfect combination to become a physician.

In residency I became interested in academic teaching and research. I went from New Haven to Pittsburgh for a master’s degree in outcomes research, met a guy, and I have been in Pittsburgh ever since. As a junior faculty member and “recovering chief resident,” Pitt offered me opportunities to teach both clinically at the bedside and in the medical school/residency programs. I started attending GME meetings and took on the role of the transitional year program director followed by a professional development role in GME locally as well as nationally. It brings me joy to “geek out” over academic medicine, and I love my teaching, clinical, and administrative roles.

ACGME: What does this award mean to you?

McCausland: It is surreal, and I am speechless about it, truly. I am reminded that I have arrived at this moment in time due to unique, and collective, personal and professional experiences. I am moved to know I have made a difference to my residents, faculty members, department, and institution over the years.

ACGME: What do you feel is the most important job the program director has?

McCausland: Believing in and advocating for my residents. Encouraging them to be the best they can be so they can take the best possible care of patients while preserving their kindness, compassion, empathy, and resilience. This, to me, is my most important responsibility to them and to the medical profession overall. 

ACGME: What is the most rewarding part of your job?

McCausland: I love working with the PGY-1s. It has been my personal mission to offer a supportive first year where residents can become the best physician and person they can be. Little did I realize that years later they would become my colleagues and friends, work clinically with me in the emergency department and throughout the hospital system, and join me in teaching in the institution a decade later. I am so utterly grateful for this opportunity. Daily, my residents give me such hope for the future of medicine and for my own personal capacity for resilience.

ACGME: What is the most challenging?

McCausland: The stakes are high in graduate medical education as program directors are entrusted to teach, assess, and promote physicians in their developing professional roles. It is most challenging when PGY-1 residents have personal and/or professional challenges. The transitional year is a 12-month experience, hence recognition and remediation occur under a time pressure. It is a disservice to learners and to their future patients if we do not address issues. These have been some of the most challenging and yet overwhelmingly positive experiences I have had as a program director. I have had the pleasure to work closely with my residents who are experiencing different stressors or challenges and that has made me a better program director and person. 

ACGME: What advice do you have to residents or fellows who may be interested in pursuing a career in academic medicine?

McCausland: First and foremost, invest some time to learn who you are and what makes you tick. It is true that “not all who wander are lost” and you may need to wander a little, or even a lot, to see what really brings you joy.

Academics can mean patient safety or other administrative positions in addition to—or in the place of—clinical work. It could mean a primary research career. Follow your gut, do the extra training required and put yourself out there to ask questions and explore.

I believe you “get out of it what you put into it.” Make sure you take the time to be a good mentee, say “Thanks” often and allow yourself to be coached. For so many people’s academic careers, “Life is about the journey, not the destination.” My two cents.

ACGME: Is there anything else you would like to add?

McCausland: I want to give thanks to fellow learners, colleagues, mentors, friends, and patients I have met on my professional journey. Without them I would not be who I am today.

I also want to thank my family. My husband and girls take great care of me so that I can dedicate time and energy to my clinical and medical education roles. I am fortunate beyond words.