Welcome, everyone. Thank you for joining us for this discussion on ageism. I'd like to give a little background on how we came up with this topic. As we continue on this journey of inclusion within our academy and getting to know our members and being able to better serve our members, we came across the idea of, as you progress and transition throughout different stages of your career, how you engage with the academy, and is there a commonality as to when we don't engage as it relates to where we are in our career, and if there is a time in which we engage more. So we felt it necessary to discuss progression throughout the career as it relates to age, given that within medicine, we all know that there has been historically a hierarchy within medicine, whereas you start out, you probably enter the room not saying much. And as you become more comfortable and confident and gain more years within your career, you become the forefront and the person that speaks that enters the room. However, we have come to learn that maybe we should challenge this idea, and that maybe some of our early career physicians could remain engaged if they felt they had a voice, and if we, as an academy, were including their voice as valuable. So that's how we came across this topic, and we'd love to hear from you all regarding this, and we look forward to a productive discussion. Having said that, I'd like for us to visit our principles of inclusion and engagement, in that we do have the pillars that we utilize with any time that we gather as an academy, valuing diverse group composition, where we recognize that a diverse group is more representative of the overall member composition, results in enhanced outcomes. Mutual respect, given that we demonstrate respect for different opinions and viewpoints, that this can create a space for cultivating new ideas. We also value talent and skill-based selection for leadership opportunities to ensure that there is a broad base of diversity within our leadership and remove any barriers to involve further support and equitable environment for all future leaders, which is important in the topic we're discussing this evening. And then finally, comprehensive collaboration, building community between various member constituents, which we find essential as a physiatric member association, and that bringing different perspectives together will enhance innovative thinking and achievement. With that, I would like to introduce our board president, Dr. Deborah Vennessy. We welcome her. And Dr. Vennessy, I would like to pose the first question to you. How does the Academy support inclusion and engagement of our members across the age spectrum? All righty. Thank you, Dr. Watson. But before I answer your question, since I have the mic, I want to say personally thank you, Carla, and the Diversity and Inclusion Committee for organizing tonight's conversation. I am honored to be able to participate. And I am most grateful for all of our listeners. It's super hard to do in the middle of the week. It's 8 o'clock my time. I'm Eastern. And after a long day at work, so I just wanted to give my personal thanks to you, the committee, and for those of us, those people that are listening. So back to your question, how does our Academy support inclusion and engagement of members across the age spectrum? I think that our Academy and all leaders in our Academy are very committed to supporting and celebrating members of all ages. I'm going to say we, as an Academy, value inclusivity and belonging. And I can tell you that we really need all voices from all age groups and all generations to be heard. And really, I think that the Academy offers lots of opportunities to get involved. And there's those opportunities just like the world in which we live in is always evolving. I can share just a couple of examples. And one, I'm not sure who's listening or who knows what we have at the Academy, but there's a group called the Physiatrist in Training or FIT. And we have the president, who's actually Dr. Heidi Shen, who is with us tonight. She's a member of our AAPMNR Board of Governors. And she will play a very vital role in our AAPMNR Board of Governors. Each one that I've gotten to know over the years has been extraordinarily vocal and provided great insight. And they are, as I said, very vital in our role from a strategic process. In addition to FIT, there are lots of other volunteer opportunities for anybody in training, meaning residency and fellowship throughout early career, mid-career, later career, retirement. I feel like we're selling something. But we really have a lot of opportunities for anybody that wants to do it. It's a great self-job. It's an easy thing. It's a wonderful way to participate and get engaged in our specialty society. And so we really, there's lots of different educational opportunities. They can be tailored to different career stages. And as I said, it's really to make sure that we encourage engagement. We want to hear all voices and throughout all stages of our career. Anyways, that's my spiel. I'm thrilled that everyone's joining. And I really hope that by the end of this, you'll be excited and go, yes, I need to volunteer. So hopefully that kind of answered it for you, Carla. But I'm going to turn it over. And it is my great pleasure to introduce everyone to tonight's moderator, Dr. Christy Kirshner, who comes from the University of Illinois, Chicago College of Medicine. Oh, no, I'm sorry. University of Illinois College of Medicine. Sorry about that. Yeah. Hi. Another word. It's a pleasure to be here. Thank you, Dr. Watson and Dr. Fennessy. Thank you, Ms. Sanford, for all of your support with this. Ageism is something that doesn't get nearly as much attention as race and ethnicity and gender and sexual orientation. So it's really very interesting for us to be creating this space and time to think about ageism and how it might be operating in terms of our academy. Can I advance the slides, or do I need to say next slide? There we go. OK, so ageism is a lens that we use. We have biases and stereotypes, oftentimes from our lived experience, that inform the way we think about and learn about different groups of people or people with different characteristics. And ageism really has three interconnected components. So the term goes back to 1969 with Robert Nell Butler, who described discrimination against seniors, patterned on sexism and racism. But discrimination on the basis of age can occur at any age, including young people. So we're going to talk about that a little bit. The Age Discrimination Employment Act forbids age discrimination against people who are 40 and older. So there are some protections for people above 40, but it doesn't protect workers under the age of 40. And there are some states that actually have laws that do protect them from discrimination. So when you think about ageism and the problems that it can create, well, because it's a lens or it's oftentimes based upon preconceived ideas, projections, stereotypes can become fairly well-ingrained. Our beliefs, our expectations about individuals in different age groups. And that's a problem because we may not look openly and curiously at age groups if we come in with our biases and our lenses already colored. Prejudice can be both positive and negative about certain groups of people. But ultimately, the biggest problem is the way this affects our behavior, the way we treat people, the opportunities we afford them, the way we might ask them to engage and be included in the work that we do. Next slide, please. So let's talk a bit about what we know about the employment of older physicians. So if you look at the data from the American Medical Association, actually a good number of physicians are still employed after the age of 55, about 43%. And that's more than the general population, where it's about 30%. The primary care doctors are a little bit less than the specialist. But this is a significant number that many of us, as we age, are staying engaged professionally. And we could talk about why that is. We can also talk about why some people might choose to leave before 55. When we think about how prevalent age discrimination is, older adults tell us it's pretty common. In fact, if you look at AARP data and you look at ages 45 and older, about 60% have seen or themselves experienced age discrimination. That's a lot. And of the older adults or workers who've seen age discrimination, they kind of date it to about 50 and above. So we are talking about the older adults that feel they're more prone or susceptible to age discrimination. Younger adults, though, also feel that there may be some effect in how they're seen and viewed by others. So we're going to talk about that in a bit. When you think about ageism with the younger adults, oftentimes it has to do with whether you're viewed as being experienced enough or having enough life experiences to really inform your work. It may have to do with the recognition of the scope of your cognitive abilities. So these social situations, the way it plays out, the way you're viewed in terms of your stage of life and whether you're starting a family or where you are in terms of work-life balance, younger adults feel that and experience that as well. Next slide. So what we want to do today is to talk to three different leaders in PM&R about their stories and how they see age affecting their work. We also want you to begin to think about your stories and your questions. So you can begin to formulate those. Stanford, should we have people put them in chat or should we just have people raise their hand? At this point, do we have a preference in terms of how we begin to collect those? Dr. Kirshner, since we have a small group, I think we should have people speak if they want. And they can use the chat if they're not comfortable speaking. That sounds great. So let's hear from our three PM&R leaders who are experiencing different stages of life. So we're going to start with one of our most distinguished members, Dr. John Melvin. I've heard about him my entire life. I've been so pleased to work with him and meet him through this panel. But he's now an emeritus professor in the Department of Rehab Medicine at Thomas Jefferson University. He's also been a past president of AAPM&R. So he clearly has a lot of wisdom to share with us. So Dr. Melvin, if I were to pose to you the question, how has age been a factor in your professional life? And also think particularly now in these more recent years. Well, actually, when I was trying to answer the question, how has age affected my professional career, I actually focused mostly on the very early part of it. Because as coming out as a resident, I was actually very interested in being involved in organizations. We were proselytizers in those days, we called ourselves, for physical medicine and rehabilitation because so little of it was known about. And so I've started to look at the situation and found that for an organization to pick somebody to be in a leadership role or a role, it first required that they knew that person existed. And the second is that they needed to have confidence that person could do whatever it was that they were going to be asked to do. And the third was there had to be positions available for them to fill. Now, all three of those affect people just coming out of residency because they're not known. And of course, the positions might not be the very highest positions at that point for sure. So residents, when they get out of the residency, really only know the people that they came into contact during the residency. So as it turned out during our residency, we traveled around Ohio and Michigan a lot. And actually, there were a number of really national leaders there that as residents, we got to know. And then we had meetings of state societies and sometimes joint meetings. And we got to know those people that way. But as it turned out, when I came out of the residency, none of them were really in a position to help me get into a position at a national level. And so what I had to do was to think more in terms of starting at the state level. And so we did have a state organization of physical medicine and rehabilitation. And then the state medical society had a section. And so actually, these organizations were eager to have people that would do heavy work, like be the secretary. In those days, it wasn't like the present day where there's a staff person that might be around to help you. There were no staff people around. All of the secretary work, treasurer work, planning the meetings, organizing was done by the members. And usually, it was the secretary or the secretary treasurer. So actually, I was successful the first year out of my residency of becoming the secretary treasurer of the section in the state medical society and also the secretary of the Ohio Society of Physical Medicine Rehabilitation. But that was because I was known to the people that were involved because of having, as a resident, attended those meetings. And I guess you'd have to say I kind of socialized around with people, talked to them, and networked. But I think the important thing there was that I had been doing what it took to get to be known. And then I had, of course, the recommendations of my chair, Ernie Johnson, that I would do a decent job when I got the job. And actually, they were having trouble finding people to do the secretary jobs because they took so much time and were so burdensome. So that was the reason that I moved forward into those roles. And so I outlined what happens in the organization and how a young person needs to try to strategize that. It's different than now because, actually, the academy has a volunteer portal. So it's getting attention of an organization at the national level isn't as difficult as it used to be. And then that's organized in a way to put people into positions that they can succeed in and gradually get known as being successful. But I think there's certain characteristics to overcome actually being too young or being too old or at any time. And that is, first, you have to demonstrate an enthusiastic interest in wanting to lead. Secondly, you have to be willing to take on the necessary workload. And actually, the more you volunteer little extras, the more likely you are to be successful. You need to be known and network. And then you need recommendations from people who know you, especially if you have a mentor that's a senior one that's in the organizations, to recommend you. And so these are the general factors that actually apply to getting leadership roles of all ages, but I think especially at younger ages. Sounds like we owe a great debt of gratitude for the work you did at setting up the infrastructure that we all benefit from through AAPMNR, because the idea of mentorship and networking are clearly some of the beauties of what AAPMNR has offered me in my life. And I wonder if we talk about that role of mentor. Do you want to say anything? You've been a mentor to many people. I know you've been a mentor to Dr. Vannessy. But do you have anything to tell people in terms of what you look for to find a good mentor, particularly if you want to have more leadership opportunities? Yes, well, first, I make the point that you probably need more than one mentor sometimes. But what we're talking about more as a senior, more a person that is more connected and involved in the areas that you want to move towards. And so I think you want someone who, in terms of experience, knows where you're moving. But also, the mentor needs to be a person who is collaborating with the person to move forward into where they want to go. The mentor shouldn't be a person that tells them how to go. Or I saw a discussion, shouldn't be a coach that outlines the game plan, but rather works with the person to assist them in achieving the game plan. So personality of the mentor is very important in addition to their positioning. Yeah, a generosity of spirit is what I'm hearing you say. That you want somebody who's going to listen, be very attentive to what your goals are, and have a generosity of spirit in terms of being willing to engage and support the next generation coming along. So really, really wonderful words. Dr. Melvin, we may come back to you. We'll see what questions come our way. But I'm going to turn now to Dr. Chen. So Heidi Chen is also in a leadership role in the Academy. But she comes from the other end of the spectrum because she's still in training. So she isn't even a full-fledged AAPMNR physician yet. But she's already been demonstrating interest and capacity for leadership roles. So she's been the board president, AAPMNR Physiatrist and Training Program. She's a PGY-4 at New York Presbyterian Columbia Cornell. So Heidi, we're going to have you address the question. As you near the end of your formal training and you look to continue taking on leadership roles, what factors about your age do you think will play a role in your willingness to take on new leadership roles as you go forward? How do you think about that? Sure. When I think about my journey to a leadership role within the Academy, I think there is a self-imposed barrier based on actually my medical training age and maybe not so much my numerical age. But I think in some ways, that comes in hand in hand. And so it's easy to equate that level of training with the amount of knowledge that I have. And so for me, initially, I feel like that led to a lot of imposter syndrome. Because here I am, I'm just starting my training. How could I possibly know anything that's meaningful? Or how can I contribute in looking at the big picture? And so in a way, I compare my taking on this role as someone to jumping off a cliff into a pool, where it's really nerve-wracking when you're looking over the cliff edge. And you're just like, should I do it? Should I not do it? I don't know if I can do it. But then once you take that step off, it's just not as scary as it really seems. Despite how my young age in training, I have this life full of different experiences or even different perspectives of shared experiences that we all have that's still valuable and different. So now when I look at taking new roles, it's less scary than before, really. Because I jumped, and I landed. I'm still swimming. And kind of like what Dr. Melvin was saying, it's just once you take that leap, there are just opportunities that keep coming your way. And it's like a natural flow. And so I think regardless of what I thought, what I felt about my age or my perceived lack of experience, I think my life experiences prior to all of this has already prepared me for my current role. And so looking forward, I don't know if my age will stop me in any way, to be honest. It sounds like your imposter syndrome is slowly dissipating. Is that right? I would, yeah, I would say so. And do you feel like you're also already beginning to mentor some younger residents who are coming through the pipeline? Yeah, absolutely. And actually, funny enough, before all of this started, I was just saying I was part of an alumni panel yesterday for my medical school and had been talking to I think like a third of the school, actually, and converted some people to PM&R. They're like, I have no idea what this is. And so it's kind of exciting. It's fun. So I think what's really interesting here is we've got Dr. Melvin, who was there in more of the early days of PM&R when we were still kind of this baby profession, even fewer people, Heidi. There was a time when there were even fewer people knew who we were. And there were very few numbers of us. But we're much more established than we were. And I think that we're thousands now as opposed to hundreds. So this idea that your unique perspective coming through the pipeline at this moment in time really is important is, I think, unquestioned because the world of medicine is changing. The place of rehab in the world is changing. So it's also part of what we can reflect on as we're thinking about the diversity of voices and perspectives that we are sharing with each other across the age spectrum. So Heidi, I will leave you for a moment. And we'll see if we've got some questions to come back to you with as well. So third, we have Dr. Malani. And Dr. Malani, as you can see, has both an MBA and an MD, AAPMNR delegate to the AMA. So he's also chosen to take on different professional roles and a wider role within a very large organization, which I think, again, is important for us to think about in terms of how our professional organizations interface with others outside of our field. He's a RPRC committee member and advisor to the AMA Relative Value Update Committee. So he's at Weill Cornell Medical School, Medical College. So Dr. Malani, the question I'm going to pose to you, can you share a time when your age has positively impacted your decision to get involved and lead in any position or whatever position you'd like to share? Sure. I just want to take the opportunity again to thank the Academy for putting this on, because I know when I was in training, there really wasn't anything like this. So if I wanted to find out about how to get involved in leadership or anything like that, it really kind of came through word of mouth. I tried to peruse the Academy website, but at the time, it was a little bit difficult to find. So times when, or a time when I thought that my age positively impacted my decision to get involved in LEAD, I think, you know, this is probably going to be a theme, but Dr. Melvin, you know, gave great examples and a great sort of tour through his journey. Dr. Chen is, you know, in her residency and she's working through the FIT Council. That's really sort of where I got started too. I think for me, I, you know, I think I'm an optimist by nature. And so I come to, I came to residency thinking, okay, well, I've probably got, you know, residency is busy, but I've probably got more time and a little more energy than some people who are out in practice. And so where can, how can I get involved and, you know, bring that to leadership? And so at the time, what is now the FIT Council was then the RPC, the Resident Physician Council. And so there were positions that were open. And I actually, I was fortunate to know somebody in my own residency program who was involved in it already. And so I was talking to that person and talking to them about my interests. And lo and behold, there's a position on there that seemed like it would, you know, fit my interests really well. And that was being a delegate to the AMA and the resident and fellow section of the AMA. But it also afforded me an opportunity to participate in our academy's delegation to the American Medical Association. So there was sort of two ways to get involved in the AMA through AAPMNR, and it was a chance to represent AAPMNR to the AMA. And for those who don't know, the AMA is, they do a lot of things. But one thing they do is sort of, they can lobby, they can help sort of promote policy for physicians, surgeons, and patients. And so one way they do that is by using the policy that they create internally through their house of delegates. And so this is where I was able to kind of get involved and start to have influence. And so for me, you know, I guess I tend to be one of those people who, you know, I feel like if I'm not actively part of the solution, then I'm just kind of a bystander and, you know, I have no place to really be critical. And so if I want, you know, if I want to see change, I really kind of have to live it. And so I think a lot of people feel that way, and I think a lot of people on this call feel that way. And I think just Dr. Melvin put it so, so succinctly and so well, you know, there needs to be some requirements here, there needs to be the desire, right? You need to start with the desire, then you need to be enthusiastic, you need to do the work, and there needs to be positions. And so thankfully, for me, one position kind of led to another and as you know, if you show up, a lot of life is showing up in a lot of ways, and especially when it comes to, you know, leading and volunteering and doing work. Part of it is just showing up, doing the work and if you if you do that, and you do a relatively okay job, people tend to keep asking you to help. So so if you're enthusiastic, and you want to, you know, you want to lead, really just sort of showing up, asking what needs to be done. And sometimes you just start with, you know, the secretary position, because that's what needs to be done. And then you work your way and you work your inroads into the things that really interest you. And before you know it, you're doing stuff that you find, you know, really meaningful. Hopefully, it was that way from the beginning, but you can kind of navigate to the things that are most meaningful for you and, and, and sort of help rejuvenate you. So I think that's, you know, that's a lot of why I do these things that I do, because it sort of puts everything else in perspective that I do patient care and everything else. And so I, from the beginning, saw my, at the time, younger age, as a positive thing. And that was sort of my, that's how it positively impacted my decision to get involved. And how did you feel, Dr. Malani, that you were received when you got involved with this large organization of the AMA? Did you feel that your age was a factor in terms of how people perceived you? Or did you feel like it was fine? That's a good question. So in a place like the AMA, there's, there, there is a hierarchy in terms of people who've put time in, you know, the people, the, the, the older generations typically are in levels of senior leadership, either on delegations or in positions within the AMA sort of administrative structure. But over the years with, especially with the AMA, you know, so I think it's sort of a model for other organizations. They're really, I mean, there's been such an effort to include participants from the full range, the full range of medical training. So medical students actually have a huge delegation and a huge voice in the AMA now. It's been that way for decades, but, but when you get into, you know, the, the AMA structure, you feel the sort of the breadth of experience and expertise that's there just from years in and knowledge, because it's the things that they do there are kind of, you know, it takes a while to understand the system. But at the same time, there's been, you know, there's, there's so much support for those in their early years of training in medical school, in residency, in fellowship. And so the structure that they've created to really produce sort of a well-rounded democratic voice for everybody has been really impressive. So it's kind of both ends of the spectrum. At the same time, you know, there's, there are issues that the AMA continues to work on in terms of making sure that everybody feels included. They built into their system, the ability for everybody's voice to be heard in a really powerful way with regards to the way that their, their voting structures and everything else work and the amount of delegates that are allowed and that sort of thing. So, so yeah, I definitely felt it, it was intimidating at first, but knowing that there was a system on my side that I could rely on, went a long way towards just sort of supporting my confidence in the process. Yeah. Plus we have an amazing delegation. There's four people on the AAPMNR delegation. I think Dr. Hubbell, Sue Hubbell is on this call even, and she really did a great job making me feel comfortable from the beginning. She's now the delegation chair, but before that it was Dr. Leon Reinstein and he was excellent as well. I always felt welcome. And so, you know, I think from the highest levels of AAPMNR, I think that the goal has been there for, for a while, for a long time, ever since I've been involved to make sure that we all feel included in that our voices are heard and valued. Well, I'm going to just reflect back that when I hear our speakers describe their experiences, I'm not hearing a lot of barriers. I'm not hearing a lot of experience with bias or stigma or discrimination. Is that a fair statement? Do we feel like actually we've been welcomed in most of the spaces where we've come? That the barriers may be, I mean, Heidi, when I hear you talk, the barriers were almost more internal, your confidence, your imposter syndrome, but nobody was telling you that you couldn't do it, right? So I think that this is kind of interesting to think about, you know, are we actually fortunate as a field that we don't have a lot of age discrimination and barriers? What do you think? Could I speak? Sure. We'd love to have you speak, Dr. Leon. Because I've observed, you know, selecting leaders for a long time. Actually, I would agree with you that I think the academy has always been more at the forefront and actually looking for people who are in different categories and different, I don't know that we looked at age. We usually were not against anybody because of age, but we did used to look at experience. And so that one, being convinced of the competency was the important thing. But I remember many meetings where we would say, oh, this young person is coming along very bright, doing very well. We should put them in a position to get them moving up. And so while I'm sure we all have somewhere our unconscious biases and so forth, I think among most organizations, the academy has been very strong in being inclusive. Now, I think we're also talking about not just our experience in the academy, but in our life in private practice or if we're an employee of an organization. So I am going to open it up to our audience and invite you to share personal stories or questions or things where you might want to probe, you know, experiences that you've had. We've got some comments here in the chat. I do invite you to unmute and just speak. Dr. Gershkoff, how about you? You've got a comment here about mentorship. I think that I, well, first of all, I want to thank Dr. Melvin for hiring me for to be clinical director of stroke rehabilitation at Moss Rehab Hospital, which was an area that was very important to me. And the position was a tremendous opportunity for me to develop leadership skills and to work with a team. And I tried to create an environment where basically everybody respected each other and also encouraged as part of the Einstein and Moss system to encourage people under me, as well as resident physicians who rotated, you know, if they had ideas to develop them. And, you know, for instance, encouraging residents to take on a topic for Grand Rounds, for instance. And also to, you know, when the residents in their clinical work, you know, showed excellence to really make sure that they, you know, that they received feedback about that. And when it was not excellent to try to interact with them in a way that helped them understand difficulties, and at the same time also supported them as they grew further. But in the comments I made, I remember one area was trying to encourage residents to participate in AAPMNR National Meeting presentations. In those days, we had slide projectors and other, you know, other complexities to giving presentations and the residents could just serve as an assistant moderator to help make sure the presentations went smoothly. But also got them involved in thinking about presentations that they ultimately might make themselves. That was something small, but I think it helped some of the resident physicians break the ice and see potential involvement in the National Meeting. I agree. I mean, I remember as a resident being encouraged to do a presentation. Talking about this old slide, Carol, so give me a little bit of PTSD, I have to tell you, because I remember dumping mine. Put them back together again in a meeting. But I think you're right, and what we're also describing here is how influenced we are by our role models. So we're learning. This is hidden curriculum. We're learning by watching, we're learning by the experiences we have, and we're passing it on, you know, to others that we work with, and that's pretty powerful. Thank you, Dr. Gershkoff. I just want to say one other thing, and that is that I think ageist comments and ageist behavior I think often was from our patients. Either we were too old or sometimes too young to understand their difficulties. So tell us, if you experienced a comment from a patient along those lines, how would you handle that? Well, you know, I try to be very, what can I say, diplomatic to a patient. Sometimes I might have to justify it by saying, you know, I've had this experience, I've been doing this for so many years, and try to reassure the person. Oftentimes that might be a way that they deflect the conversation away from their own suffering and their own anxieties. So I always try to, you might say, think of what was causing them to be in conflict and to express themselves negatively or negatively towards me, and, you know, try to get, try to deal with the issue that seemed to be behind that. Yeah, I love that. I love that. And I think that's really important to not brush it off, but to pause and try to understand what's behind it. Dr. Sharma, I see your question, but I also see I have a hand here from Dr. Vennessy. Dr. Vennessy, does this follow up in our current conversation? Just one light antidote when you, I can think of when I was first out of residency with Ernie Johnson, since there are so many people that know him, where I was seeing one of his patients for him, and it didn't seem like that person believed what I was telling them, and he said, oh, Deb, don't worry, you just need to have a little gray hair. So I still don't have gray hair, so, but it was just, it made me think of it just to, since Ernie, and it seems like there's a lot of people that know Ernie Johnson, and we all, it's nice to see everybody that's there and supporting the panelists. Yeah. And we also don't know about issues of intersectionality in terms of what might be also provoking some of this. So some of this may be gender related, some of this may be, you know, perceptions of race, ethnicity, other issues, but we'll stick with age today. So Dr. Sharma, this is a really great question. Do you want to unmute and talk a little bit more, or do you want me to read it out loud? Hi, can you see me? I can't see you. Yes, we can. Thank you. Yeah. I mean, I'm happy to read it, but I guess instead of just reading out loud, I'll just articulate it. Yeah. The concept is, you know, people sort of in my age group who are, you know, in the 10 to 15 year range out from residency, I feel like there is some stronger support within the academy and elsewhere for residents and sort of for new grads, but you can sort of get to a point and it's just, you're here, right? And it's an easy spot to get stuck in. It's an easy spot to not feel a lot of career growth or opportunity to excel or learn new skills. So I think there may be a role for some mentorship at this level too. There's always people who know more and have been through it. And then it also comes into the whole family balance for a lot of people in this age group kind of hit where they might have younger children, they might have elderly parents, you know, they still want to excel at work, but there's other responsibilities and just sort of some guidance. I mean, honestly, I feel like anyone could benefit from mentorship regardless of age, really. So I just, maybe the panelists thoughts on that. I love that. And I love the fact you brought in the personal, you know, as we go through different developmental stages and you're right, by the time you've 10 or 15 years out, you probably got, you know, some other responsibilities with our sandwich generation. So I think that's a really important point. I'm going to ask Dr. Vanessie, maybe if she will help us address it. It's if Dr. Sharma posted through the portal, you put the portal here, right? For volunteer opportunities, what would happen? What would happen? What would she say? Say she just said, I would like to get involved and I would like to participate. What would happen? So, so I know that Dr. Sharma is actually very involved in our academy. So and, and is very active, but I would agree with, so let's pretend that she's really not involved in, she's just trying to, has a few minutes and see something on the portal. So this is actually, it's answered by Margaret Keating, who's our, one of our executive folks at the academy. And so there are lots of, I haven't been on it recently, but I know that there are a lot of different opportunities where you can look and say, these are the things that I'm interested in doing. I know that Dr. Sharma is involved with pain and some orthopedics as well as some different types of alternative pain management, but it could be that, you know, maybe she's trying to find, like she said, something that, that we all are trying to balance in regards to work life, our kids, our dog, the phone, parents and everything else. And you just need a little bit, like you only want to do maybe just one meeting a year or two meetings a year. And that's all you could do. I think that there's an opportunity to do that. Margaret is fantastic. All of the staff are, and they can certainly help, you know, find the right fit for you. In regards to, I think Sharma's question about mentorship, we do have a mentorship program. I'm not sure honestly how much it's used. Tom and I and the rest of our whole group have been, all of our leaders have been thinking about how can we make it a little bit better. We have been kind of toying with, you know, teaching the mentors and training mentors and having it more than just a virtual space. But I think you're right, Saloni, we all need people to help and there's, and it's really just like, gosh, I really like what you're doing and I don't know how you do it. And just talking to a variety of people, but you're right. It's not just for young people out of residency, but it's for all of us. And yeah, happy to help in any way. So, you know, we're just really scratching the surface and of course now it's going to be time to wrap up and I'm going to have to hand it back to Dr. Watson. But I do want to acknowledge Dr. Anaswamy, what you're saying here about a bio sample, because I think I tend to agree that we've got people who have been successful in finding their way and haven't experienced a lot of barriers. You know, I think that this is an issue and I bet Dr. Watson would remain very open to hearing from people who are experiencing barriers and thinking of ways for us to explore in more depth, you know, what these experiences are like and how we as an academy can help address it. So, Dr. Watson, back to you. Thank you, Dr. Kirshner. Yes, that does bring up a good point, because anytime we host a conversation or a Grand Rounds, unfortunately, sometimes that engages the people who are already engaged to a certain degree. And so it doesn't necessarily reach everyone that we're hoping to reach. However, I do think that this discussion was very valuable to everyone here, but also just to the academy in terms of getting feedback. We might not have been able to address people who have barriers, as we didn't necessarily discover many. But certainly just hearing people's personal stories, I think helps. You know, I tend to see that we see the world from where we are. And when we hear other people's stories, it allows us to broaden seeing the world better. So I do appreciate everyone sharing. I did kind of want to touch on how we can sort of avoid the stereotypes of ageism. You know, with this event and future opportunities, we want to continue the discussion on age, certainly as a part of our academy's diversity inclusion efforts. We also want to lead by example and continue to acknowledge our biases, continue to use a lens that is not just representative of you personally, but representative of other people, certainly from some of the stories that we've heard. Another thing we can do is avoid using labels. It's hard because sometimes the labels such as Generation X and Gen Z and Millennials roll off of our lips fairly easily. But we want to sort of address people without the label and sort of putting them in boxes based on when they were born. We also want to actively create and measure the results of age equitable teams. Because we have an example right here, certainly with Dr. Chen's leadership of what we can accomplish with someone who's still in training. And we want to continue to lead from where we are. You know, we don't necessarily need a title. We don't necessarily need to belong to a committee to continue to lead within our practices and certainly within the academy if we do choose to volunteer. And with that, I encourage if you aren't currently volunteering, although I think our pool pretty much includes people who do volunteer, but if there's anyone on this call who does not, we certainly encourage you to apply at the Volunteer Center. So with that, I want to thank everyone. Dr. Vennessy, as our president, we value your time and input. So we certainly appreciate you joining us. Dr. Kirshner, as a mentor of mine, I always enjoy seeing you, so I truly appreciate you moderating the event. Dr. Chen, I am so very happy that you took the leap and recognized that it wasn't so scary and you did a wonderful job. So thank you. Dr. Melvin, I'm sure everyone on here is so appreciative to see you, all the mentorship that you've provided throughout the years. We certainly appreciate you agreeing to join us tonight. Dr. Malani, we know your plate is always full. And as you said, you know, the more you do, the more people ask you to do, so we definitely appreciate you saying yes and offering your expertise and thoughts with our conversation. Sean Sanford, can't thank you enough as our staff for putting everything together and keeping us on task and creating this event. Thank you very much. And I ultimately thank all of you that have volunteered. It's great to see your faces and thank you for participating in such a productive conversation.

ageism

medical field

leaders

PM&R

experience

networking

imposter syndrome

mentorship

inclusivity