So we're going to start off talking about mentorship and specifically the title is not just for early career. So let's make sure we're all talking the same language. There are various definitions of mentorship. The one that's going to be apropos for our conversation today is the mentorship can be defined as a long-term relationship with a responsibility to provide the support, knowledge, and impetus that can facilitate professional success of the mentee. That's the goal, basically professional development and growth of the mentee. And this is the definition used by Dr. Selwyn and colleagues that's permeated throughout the literature. So what constitutes an ideal mentor? First of all, the correct experience and temperament to be able to guide mentees, being able to listen non-judgmentally to the mentee for input, being able to provide support, resources, knowledge, and guidance. But over and above all that there are personal and professional characteristics that come through in literature about ideal mentors. On the personal side, the dominant features altruism, orientation towards the greater good, honesty, and compassion. And on the professional side, being collaborative, intellectual, and skilled. Almost everybody can remember some mentor that was important in their life whether it was getting into high school, college, or university, or medical school for many of us, or radiology. And we don't forget these individuals. They're our balcony people who help us move on in our lives. Ideal mentees, in contrast, are listeners. They are open to feedback. They are responsible. Two things that keep coming through the literature as well as they are constantly respectful of mentors time. So the mentor-mentee relationships that are successful usually have an agenda brought by the mentee with a fixed agenda to make value of the time. And they are engaged, engaged, engaged. The literature showed, you know, significant outcomes for mentees. And mind you, most of this is from academic studies. But there are better career opportunities shown longitudinally, higher clinical productivity. They often will publish more papers and research grants in successful mentorship mentee programs, higher promotion rates in the academic world, greater career satisfaction, and in this day and age, very importantly, increased retention. For the mentor, there are outcomes as well. It is personally and professionally rewarding and stimulating to be engaged with the conversations and the actual questions posed by mentees. The altruism aspect of mentorship is fulfilling and actually resonates with the core of most mentors. And there's often the opportunity to engage in reverse mentorship where the mentee can also mutually provide mentorship for the mentor. What are the barriers to successful mentor-mentee relationship? Repeatedly in literature, the most significant barrier is that of time. It is hard to find time as both in academics and in private practice, but it really is the crux of a successful program. There's lack of formal recognition for mentors. Nowadays there's things like stipends, CME credit, and awards being offered by institutions to recognize these individuals. The mentor may be ineffective and not be the correct pairing for the mentee. And so if the mentor-mentee relationship is strained, that also can lead to an outcome that's not necessarily favorable. What is then the ideal mentor-mentee relationship? What are the dynamics that we actually want to see? First of all, there needs to be commitment on both parties. There needs to be mutual confidentiality and respect in all conversations. Expectations need to be set forth at the very beginning that's understood by both sides. Often there's a written contract for engagement in terms of frequency of meeting and what things are expected to be prepared for the next meeting. There's a voluntary component to the participation. Nobody should feel like they're committed to this long term. It's okay for a mentor to see a mentee move on to other mentors, for example, and nobody should feel bad. That's part of the process. Ideally there should be protected time, regular time often, that's allocated to make sure that the relationship builds and there's a symphony as time moves on of the actual exchange of ideas. And the culture needs to be appropriate, whether that's funding, CME recognition, or just the leadership buying into the idea of mentorship being important. Now, non-academic radiology also requires mentorship. Speaking from somebody from private practice, I am still to this day grateful to individuals who mentored me while I was in private practice. Rachel Perry, who actually trained under Dr. Cannon and works with me at MD Anderson, was first author on this article, and I want to call out Rachel for her collaboration and her energy in producing several papers in this space. But in private practice, two of the key metrics that are looked at repeatedly are volumes and performance benchmarks. When you eat what you kill, you have to be careful every day what's at the table. And so three components that are historically looked at in private practice are for successful private practice radiologists to be affable, to be able, and to be available. Affable meaning that they're actually somebody who can actually interface with the referring providers very well and with patients. So one way mentors can help mentees is to hold meet-and-greets and introduce them to the clinicians in the community. They also need to be able, and when you start out, remember, it's a little bit challenging and tricky to see the volume in complex cases when your nickel goes down on reports. So being able to have that relationship with mentors and senior colleagues in the practice who to bounce difficult cases off for second opinions really matters. And availability means that the radiologist ideally should be available on a regular basis for consultation. To do that effectively, we need to have enough staffing and therefore the mentorship mentee program, which can enable retention, can also contribute to that as well in private practice. Now there's a lot of confusion about the terms coaching and mentorship and I want to make sure we distinguish them from the get-go and this will be our guide for the rest of the session. In a mentorship relationship, personal experiences are used to motivate and guide the mentee as opposed to coaching where you're always striving and pushing for improved performance for the mentee. That's the core. The approaches are different. The mentorship relationship is that of discussion. The focus is on one individual typically. There are no limitations. I've had certain relationships with mentees that have gone on for years, stopped, and then rekindled later on in life when different questions and goals came up. Technique can be that of advice and guidance and a mentee-mentor relationship may or may not use goals whereas a sine qua non of coaching is a goal-setting process for the mentee. In simple terms, and this has been discussed in various articles, a coach will talk to you, a mentor will speak with you, but a sponsor will talk about you and I'm excited to hear the upcoming forthcoming sessions on sponsorship and coaching. So let's make sure though that this session was really geared more and intended to be for the mid-career and the late-career individuals. And why is that? Well first of all, before we get into that, let's talk about what do we actually mean by the mid-career. In this article which is put out by the ACR Commission on Human Resources, now adopted by the ACR, it's very specific what we're talking about when we talk about early, mid, and late career. So most radiologists will have a training portion of their career, then they'll start out their actual professional practice, and then there's the three sections, the early, the mid-career, and late, and ultimately into retirement. What we define in the Commission is that the first five years after starting of training would constitute early career, and the last five years before planned, not necessarily intentional, but planned retirement is what we talk about when we refer to a late career. Now there is increasing literature right now and bodies of evidence referring to the rut of mid-career. Physicians are regularly at that stage of career where they're constantly battling in terms of figuring out their purpose. Self-discovery, self-inquiry become more of an issue at this stage. There's a growth mindset but sometimes a challenge in terms of being able to take it to the next step and move to the next phase of life. And sometimes this can frankly be beyond clinical medicine. So part of the purpose of this session is to actually address how do we go about doing that using these tools that we're going to hear about today. In late career there are different challenges that we're seeing more and more. As was brought up last year by the RS&A Professionalism Committee here at one of their sessions, sidelining is being increasingly seen in late career professionals. This refers to the term where organizations value junior faculty or junior radiologists in organizations giving them promotional opportunities or advancement opportunities within their organizations and basically letting the senior faculty or senior radiologists kind of erode into the woodwork and blend there and get forgotten. Leadership opportunities, it is not unusual. We had a survey for example our institution at MD Anderson where one of the things that we saw repeatedly is the senior faculty are very interested in engaging in leadership opportunities but they're often bypassed where it's the junior faculty or at least their perception is. Philanthropy is another opportunity that senior faculty and senior late career physicians want to get involved with. Or an encore career where you rotate your career into something that's more for the greater good, more for society and you start to shift your mindset in terms of what your priorities are. Again how do you do that? Well I think one of the things that's available both at mid career and at late career that should not be forgetting, should not be forgotten, is the opportunity to get involved with mentorship in a perhaps in a different way. Many of the individuals of this stage of career are used to being the mentor but you can also be the mentee in various methods. Bouncing ideas off of colleagues in the same age category or age group, peer mentoring is a fantastic way to be able to achieve growth. Another opportunity is using distant mentoring. What does that mean? That means actually finding mentor-mentee relationships and pairings outside of the base institution usually beyond walls, sometimes beyond states, beyond countries even. And those boundaries are not necessarily applicable in this world of video conferencing anymore. Reverse mentoring refers to how sometimes some of the mentees you've known for years can sometimes be your mentor if you have that relationship and they understand the dynamic. For example a mentor may have helped a mentee advance in the academic world in terms of promotion but the mentee may be more familiar with things like the electronic medical record and be able to teach the mentor shortcuts to be able to cope with those skills. And so there's an opportunity for both the middle and late career to be able to strategize mentoring targeted using these three approaches, peer, distant and reverse, to be able to still fulfill their selves and their careers and move on with their lives. Networking is the key, right? How do you do this? Well radiological societies, medical societies, community events, social media all can help. The important thing is not to be stuck at the last minute with an emergency and you want to build the flowerbed while you're early to middle in your mid-career so that when you get to your late mid-career or late early I'm sorry late career in general that you'll always have already have these resources available to leverage. So the take-home points, first of all we define mentoring and distinguish that between coaching and sponsorship. There are different types of mentoring that are available and for mid and late career you know using peer mentoring, distant mentoring, or specifically maybe a benefit and reverse mentoring. And cast your network early so that you're prepared for that stage of life should you need it. Thank you for your attention. So to transition a little bit from Dr. Parikh's talk about mentorship to talking about sponsorship, I want to kind of review again that the difference between a mentor and a sponsor. So as Dr. Parikh mentioned, a mentor is someone who has knowledge and will share it with you, will talk with you. A sponsor is a person who has power and will use it for you. So again that mentor someone who's going to sit, they're going to talk with you, they're going to spend time to have those difficult conversations, and a sponsor is going to talk about you to other people. And so that might be through recommendation letters, it might be through putting your name forward for a committee, putting your name forward for a leadership position, but they're going to talk about you to other people. And so mentorship is critical kind of in all career phases. We tend to think about it a little bit more in early career and focusing on career development, but really at all phases. Sponsorship's important at the beginning of a career, but can really become more critical later in the career as you're seeking out more leadership positions and more opportunities. So mentorship and sponsorship, it kind of exists on a spectrum. So there's sort of these private conversations with a mentor to the more public aspects of advocacy and sponsorship. The sponsor is the person who's going to put you forward for those more public roles. The mentor is going to provide you with advice and support. Then moves on to the role of a strategizer, someone who's going to share their insider knowledge with you about how to advance in an organization. Strategize with mentees about how to get ahead, how to fill any developmental gaps that might block her progress. A connector is someone who's going to help make connections and introductions to influential people in their network. And so a mentor and a sponsor might serve in this connector role. But then it starts to move more towards the sponsorship, an opportunity giver, maybe an executive giving their protege a high visibility project or a promotion to the more discreet acts of sponsorship, which are a little bit more transactional one-offs than those long conversations with a mentor. So this definition of a sponsor is one who advocates for the advancement of another and encourages them that they are ready. They may encourage them to step out of their comfort zone a little bit to go for a new leadership position or a new committee position. A sponsor is a person who has some type of power and currency influence and will use it for you. So it's important to remember our duties as sponsors and protégés or as mentors and mentees that we really reflect on each other in these relationships. So if you're in a mentorship relationship, you expect certain things of your mentor and the mentor expects certain things of the mentee. It's very similar in a sponsorship relationship. Your sponsor may put your name forward for you and if you don't really kind of deliver, they may not sponsor you for other activities again. So it's important to remember what your roles are and to try to follow up with them and to remember that really the world of medicine is kind of a small place. I actually had a recent story. There was an AAMC meeting in Nashville and one of my mentors is outside of radiology. She's in internal medicine. I've worked with her for years and she went to this AAMC meeting. So people from all different specialties sitting there and she happened to sit down next to a few radiologists and she texted me. She said, oh I'm sitting next to the radiologists at this meeting and I was like, oh I might know them. I don't know. And so she turned and she said to them, you know one of my mentees is a radiologist. Her name is Lucy Spaluto and they said, oh we know Lucy. They said she actually stood up at a meeting once and said how important it is to have mentors who are outside of radiology. And my mentor said, oh well that's me. I'm that person. So your actions and the way that you present yourself in the greater world of radiology or the greater world of medicine reflect on your mentors or your mentees. So just remember that as you're building these relationships. So what else about sponsorship? So we talked about how mentorship is really takes time to grow a mentorship relationship. You have really sort of deep conversations about moving career forward. Sponsorship on the other hand is more episodic and focused. It may be sort of a one-off. Putting someone's name forward, introducing them to someone. Effective sponsors are career established and well-connected talent scouts. So to be able to be a sponsor you have to have some sort of currency to exchange. You have to be able to introduce someone to people that want to be introduced to. You have to know people within an organization who are running a committee that you could put someone's name forward for or be in a position where you may be able to nominate someone for a leadership position. The effective protege's of sponsors rise to the task and remain loyal. So again if someone's going to put your name forward for something you need to rise to that task, perform well, remain loyal if you want to continue to be in that sponsoring relationship. So trust, respect, and weighing risks are key to successful sponsorship relationships. And sponsorship is really critical to career advancement. As I said, all stages of career advancement but really especially later in your career as you're rising to new leadership positions. So mentorship and sponsorship exist within this Venn diagram. So as I showed in the slide earlier, the spectrum, there are some elements that are within both mentorship and sponsorship. Things like developing that key professional relationship that both participants really need to benefit from the relationship. And a mentor may serve as a sponsor. You may have someone who helps with your career development who acts in both a mentorship role and in a sponsorship role. And in both of the mentorship and sponsorship relationships you really need to develop that trust, respect, and loyalty. And while this talk is not focused on diversity within radiology, I think it's really important to remind ourselves of this. So a recent publication in the Harvard Business Review found that a lack of sponsorship is keeping women from advancing into leadership. And this is beyond medicine. This is in all types of industry. And I think you can actually insert any other underrepresented group where women are listed. So a lack of sponsorship is keeping those who are from underrepresented groups from advancing into leadership. And it's actually data has shown that women are actually over mentored and under sponsored. And I heard a talk earlier today where I think Dr. Amy Kotson summed this up the best. She said, we give women a lot of advice but we don't give them a lot of opportunity. And so I think that's something that we should all think about as we grow and have opportunities to serve as mentors and sponsors. Really be intentional about your time and your efforts and who you mentor and sponsor and make sure that really everyone is getting the opportunities that are needed. So I'm often asked, can I ask to be sponsored? Is that like a weird thing to do? Can you go up to someone and say, would you mind putting my name forward for something? So to answer that question, can I ask to be sponsored? Yes, absolutely. We do it all the time. We ask for letters of recommendation. We ask for introductions. You know, if you're walking out down the hallway and I see Dr. Cannon talking to someone who I really want to meet, I'll say, you know, Sherry, would you mind introducing me to so-and-so next time you see them? So if in a situation like that, I think it's totally appropriate to ask for that sponsorship moment. You can make people aware that you want your name put forward for different opportunities. So, you know, I'd really like to go to the RS&A meeting next year. You know, do you know of anyone? I have expertise in this area. If you know of anyone who's putting together a talk for that, would you consider putting my name forward? And so sponsorship is critical at many levels. So if we think about in training, what are things that trainees might be able to ask for in the sponsorship setting? A letter, a letter of recommendation for residency or for fellowship. When you ask for this sponsorship, do your due diligence. Provide your sponsor with really good, clear, succinct information so they can write that letter because remember, part of the currency that they're operating on is time. It's one of the biggest constraints we all have in our careers, right? So I'd love to write you a great letter, but make sure that you've provided me a really good CV or a list of points you want me to cover because I want the letter to be as good as it can be, but I don't have days and days to write the letter. You can ask for introductions at national meetings. And other ways a sponsor may be helpful to trainees are things like contacting the people you know at different programs. If you identify a program you really maybe want to do your fellowship at, ask a sponsor if they can make that connection with someone they know there. How might sponsorship be applicable for research? Things like introductions to be on study sections for review committees, introductions to potential industry sponsors for grant funding, suggestions for speakers on research topics at meetings. So sponsorship is applicable across multiple ranges of academic and non-academic careers. When we think about career advancement and leadership, again, things you might ask for, letter writing for promotion. Again, provide all of the really good information so that that best letter can be written as efficiently as possible. Committee recommendations, whether this is within your organization or for a national society. That's a really key sponsorship moment to set, or even if you are in a sponsoring position where someone has asked you if you can be on a committee, if you don't have the time for it, put forward the name of someone else. Be a sponsor in that way. Nominating people for career development programs, nominating people for leadership positions or awards. These are all acts of sponsorship. So as academia has become more complex, there's been these ideas of mentoring networks, and I think sponsorship really builds into this. So this is an example of a mentoring network developed by the David Geffen School of Medicine at UCLA, showing all of the different types of mentors that a trainee might need. That horizontal line across the middle differentiates peer mentors across the top from faculty mentors across the bottom. So things like resident buddies or a chief resident buddy. You might have faculty mentors, a scholarship champion, your program director. So there's this idea of all the different types of mentors you might need. But really, to advance our careers, I think we need mentors and sponsors, and then we're gonna hear a little bit more about how we also need coaches as well. But all of these different parts play into how our careers advance. Academic leadership, national society leadership, clinical effort, and you can have mentors and sponsors in this space. The mentor, again, is the person who's gonna really talk to you, build that longer term relationship, help you think about all the different ways to advance your career. But the sponsor is the person who's going to identify those key critical moments and put your name forward for different leadership opportunities and career advancement opportunities. And so as you build your network, think about the different areas where you may need mentorship or you may need sponsorship. And this is a very personal network for each individual. We all need different types of mentoring, we all need different types of sponsorship. And again, all are applicable through all career stages. So early career, again, introductions, application support, letter writing, networking with potential places where you might wanna do residency or fellowship. Mid-career, research career development, award nominations, committee recommendations. Later in the career, national leadership role recommendations or promotion recommendations, award nominations become really critical to later career, looking at our ACR gold medalist over here. So sponsoring is also really very much a pay-it-forward scenario. I have been very fortunate over my career to have a series of wonderful sponsors. And so I've looked at creating this talk as a way to remind myself that it's time to pay it forward and continue to sponsor others. RSNA events are a great way to do this. A lot of times we end up getting invited to different events for RSNA and a lot of them have that plus one on them. So I encourage everyone to use that plus one opportunity as a time to invite a trainee or maybe an early career faculty member or other radiologists to an event that they may not have been to before so that they can meet other people, network with other people. It's a really great sort of low time commitment way to sponsor an individual. So sponsorship and radiology, who needs it? I think the answer is everyone. Thank you all so much for your time and joining us. I look forward to your questions at the end of the session. I'm Dr. Cameron from Atrius Health and I'll be talking about coaching and radiology. I'll be drawing upon my experience coming from a few different private practices as well as my current employed practice. There will be some overlap between coaching and mentorship and advising. So don't get too hung up on the terminology but we'll get into that. And I think this talk is especially gonna be useful for those in the crowd who may be struggling with how to implement this if they're in a private practice environment or, excuse me, employed environment but the tips will be applicable to all different types of environments as well as all different types of career stages. So if you've ever heard people say, oh, I have so many mentors and coaches and how do you do that? I hope we'll get into that today. So my disclosures, I'm a stockholder and consultant for several medical companies, none of which should introduce any bias for today's talk. And I wanna thank the Arsenae Program Committee and Drs. Cannon, Spoluto, and Parekh for having me join them. So coaching, we're gonna talk about what it is as a concept. We'll talk about the rationale for why you might want that in your life. We'll talk about implementation strategies, how to actually do the nuts and bolts of putting that in practice. And as I mentioned before, the contrast of different practice environments, different challenges you might see in those and what to do if you don't have a robust coaching or mentoring infrastructure in place at your institution. So coaching, there's no universally agreed upon definition. I'm going to conceive of it as closing a skills or a needs gap. One definition in the literature was this quote here, which is support of a developmental process to create goals, identify strategies to manage existing and potential challenges, improve academic performance, and further professional identity development towards reaching the learner's highest potential. So it's all about optimizing something in your life, whether it's a skill, whether it's a new role, whether it's yourself holistically as a person. Some fundamentals of coaching are listed below. So one point is that it's about aims and outcomes, not necessarily the processes. Coaching involves direct instruction and real-time feedback between the coach and the individual being coached. It facilitates new behaviors and can also facilitate the acquisition of new skills, concrete skills. Importantly, the coach will have that expertise and experience to get you to where you need to go. This can be done in an individual setting or in a group setting, as opposed to mentorship that Dr. Parekh mentioned is just done individually in general. Group setting can have an advantage of being a little less intimidating for some, if they see that others are around and are also receiving instruction, or it can have the opposite effect and be a little bit awkward if somebody doesn't want to share things that they're struggling with in a group setting. So it can cut both ways. Why seek coaching? So one is if you feel like you're in a rut. You know, you feel like you're stuck, you need some career advancement or some professional growth and you just feel that there's a little bit of stagnation and you need some coaching to get you forward. If you want to optimize a facet of your work or your life, it doesn't have to be something that's work-related. It could be something personal, weight loss or some sort of non-clinical skill. That can also be an opportunity for coaching. If you're learning skills for a new role that you're stepping into, great opportunity for coaching. And also to increase confidence in a particular area. For example, a new imaging modality that you're picking up or some new skillset in the workplace. Another big reason is burnout. Everybody's heard of this, of course. Some say it's the number one risk to a long and fulfilling career, especially for those that are early to mid-career. I would agree with that statement. And I think this is an area of big potential gain for a lot of people to combat burnout. And again, especially important for those in early and mid-career. And burnout has been conceptualized as a syndrome that results from chronic workplace stress that hasn't been successfully managed. It has three different dimensions. One is a feeling of energy depletion or exhaustion. You're just wiped out. Another is increased mental distance from your job or feelings of negatism or cynicism related to your job. And lastly, a sense of ineffectiveness or a lack of accomplishment. You're just not going anywhere. Important to know that burnout specifically refers to phenomenon in the occupational context and should not be applied to other domains. For example, depression has a different neural pathway. And as we all know, this is very prevalent. Statistically, 50% of the audience is suffering from this to some degree. There are a number of studies in the literature looking at how coaching can impact well-being and burnout. This is one article in JAMA where they implemented external professional coaches over six different coaching sessions. There was a big dollar tag attached to that. And they saw that in the intervention cohort, there was a decrease in burnout by about 17%. In the control cohort, there was actually an increase in burnout close to 5%. So a bit of a difference there. This is a nice article from Dr. Fishman and Reddy in JACR about coaching, a primer for the radiologist. And this article really focuses on health and wellness coaching and talks about how coaching can enhance self-motivation, identify strengths, and implement a framework for change. It involves mindfulness, positive mindset, resilience, and self-awareness. And they're using three fundamental skills that are hit on in this article. One is mindful listening, one is open-ended inquiry, and one is perceptive reflections. So really, there's a world of possibilities for where you can go with coaching in both personal and professional domain. So where to begin? So first, identify what's your goal, what's your gap, what is the skill that you're trying to pick up or the problem that you're trying to solve? And then do an audit. First one would be an internal audit. So introspect and say, what are the things I recognize about myself that need improvement? What are those areas that I'd like to spend time on and improve? Then the second would be an external audit. So basically, getting feedback from others that you trust, whether that's your colleagues, whether it's your spouse, whether it's others that you know through your professional circles, and see if they can provide some honest feedback into areas that you could improve in your life. Then look at your role models. Say, who are the people that you look up to and you want to be like? And what are the different characteristics and skills that they have that you'd like to possess? And how could you reverse engineer that and get to where they are and work on that? And then lastly, you can think about applying a business model to the problem. So think about yourself as a business. What core business functions would need improvement? And in the same way that you might spend money on improving a core business function that's lacking, you can think about spending money or time, which is the equivalent of money, on yourself in improving that core business function. So below, I've listed some opportunities for coaching depending on your career phase. These are not mutually exclusive. In the early phase of your career, you might be looking for tips on workplace adjustment, coaching on how to adapt to the workflow, diagnostic and procedural skills improvement. In mid-career, you might be looking at writing and speaking refinement, advancing those same skills that you've been working on all along in your career, and navigating challenges of complexity versus challenges of sophistication. And briefly, what I mean by that is challenge of complexity is when you're being asked to do something at a greater scale than you've done before. So example is you are a section chief, you're managing five different people, now you're being asked to be a department chair and you're managing many more people. And a challenge of sophistication is when you're being asked to do something you've never done before. So you're currently a department chair and now you're being asked to implement an innovation hub in collaboration with another healthcare institution. Late career, you could be looking at things related to management and leadership refinement, fine-tuning those skills, navigating any career changes or pivots that are happening late career, and lastly, new technology adoption. Any new modalities you're learning, artificial intelligence, solutions that are being layered into your workplace that you might need coaching with. Think about holistic approach to coaching. So I like to say that everything is related in life, and I've heard, as I'm sure many of you have, that your home life is a reflection of your work life and vice versa. These things are all related. You can't really fully carve out one from the other. And studies have looked at how if you get holistic coaching or coaching in other domains of life, in the non-professional sphere, how that can impact and improve your overall wellbeing and personal and professional success. So I've listed a few here on the screen. The radiology ones we've talked about, diagnosis, workflow efficiency. In the personal domain, we're talking about work-life balance, parenting issues, relationship issues, and ways to improve. In the non-clinical skills domain, things like public speaking, negotiating skills, those are all coachable skills. And then lastly, non-clinical roles, such as forays into industry, startups, and writing, those are all things you can be coached on. So how do you source coaches? Let's talk about the nuts and bolts. So one is internal to your department and organization, just right where you are. Look in your backyard and see what exists and what you can create. Some institutions have trained some senior physicians in appropriate techniques and have made them their internal coaching body. Others will undergo external certification. The Physician Coaching Institute is one of them. There are many. You can also have informal coaching versus formal coaching. It can be something where you just sort of curbside someone and get a bit of coaching here and there, or it can be something formalized where you have a set meeting interval and time. Executive coaches are also an option if you have the financial resources at your institution. They have various certifications. Some are healthcare-specific and some are not. There are a lot that are out there, if you look. Some strategies also include thinking about not just live coaches, but also virtual coaches. So talking about things like someone that you tap into through a Zoom meeting. Also, you could think about even recorded videos or pre-recorded lectures, podcasts, books. They're not the same as an actual bona fide coach that's giving you real-time feedback, but at least it's something and it can get you in the right direction. Looking in your health system is important as opposed to just limiting yourself to your department. Think about others in your healthcare ecosystem. Organized radiology is also a great place to start if you're involved in your state, local, or national branches. You could start there. And affinity groups, such as the AAWR. There are many others. Those can also be great sources for mentors or coaches. And keep in mind that private practice and employed may have to lean more heavily on these virtual coaches and mentors, as may smaller groups that have less people in them. Other strategies are conferences and meetings, as has been mentioned. Informal networking sessions, in addition to formalized sessions, such as speed networking and those sorts of things. Social media, availing yourself of what people are talking about, what resonates with you, and who's sort of emphasizing things that are important in your life that you might wanna get coaching on. And learning from your peers. Talk to others, see what they've struggled with, what they've improved on, and how they did it. Some potential barriers that cut across all practice types are the following. One is knowledge, where basically you haven't done that audit, and you don't know what you don't know. No one has told you, or you haven't really looked yourself. The other is you don't know how to get there. You're kind of stuck. You know what the problem is, but you don't know who can help you and how to do it. Another big one is time. Definitely agree with Dr. Parikh when he mentioned that was a huge one. I think that's all about finding opportunities and seeing how you can create them. Find small moments in the day. Take advantage of micro-requests that don't take that much time. Test the waters for after-hour engagements with other peers or faculty. And also think about noontime conferences for group coaching sessions, for example, to start that ball rolling. Ultimately, a lot of this will be local. And culture is also a big one. There can be basically a culture of mentorship and coaching vacuum at your institution. That's a big struggle. You're gonna have to be the initiator there. Inertia, just people being stuck in their workflow, not wanting to get out of that. There's a gravity to that. And stigma, not wanting to admit that there's something wrong or you need help with something. A few different strategies that you can use to combat some of those barriers. One is just taking more initiative on your part. Another is making it informal. Smaller asks can also be helpful to build on small successes and transform that into larger, bigger asks and successes. Entail the help of leadership to help promote long-term sustainability and bake it into the culture. And departments may want to think about instituting coaching check-ins a few times over the year, across several years, and at identified career inflection points, such as promotion, lateral transfer, fellowship, prior to departure. Lastly, the future of coaching. We're gonna see a greater prevalence of this in our lives. There's gonna be a greater need for it. It's gonna become more commonplace. And there should be some institutional infrastructure, especially as groups get larger and consolidate more to build in that infrastructure, initiatives, and feedback loops. So in conclusion, the take-home points. One big one is you have to be the driver. You have to be the one that's really taking the initiative here with the coaching and speak up and try to set that up. Coaching can promote physician wellness, optimize your personal and your professional spheres, and further skills acquisition. It includes resilience, reflection, and goal-setting. And always think about growing and learning and improving yourself throughout the career lifecycle, not just early career, but mid and late as well. Thank you very much.

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