J. William Eley MD, MPH is Executive Associate Dean of Medical Education in Emory University School of Medicine. In this episode Bill talks about his journey from planning to be a high school chemistry teacher to ultimately pursing medicine and public health degrees. He also speaks about his passions for building community and meaningful relationships with others. Bill's words of wisdom include "do the next right thing in front of you and it will lead you to those places that you feel fulfilled and you are helping others", "if we feel we're in a place where we're able to use our talents to do good work to help other people, what else can we ask for our work life?", and "we have to develop meaningful relationships with our learners. It is essential to everything positive that we do on this earth."

Resources

• The New England Journal of Medicine (NEJM)
• CBCT® | Cognitively-Based Compassion Training - Emory University

Hello listeners, welcome to Educational Landscapes: Lessons from Leaders. On today's episode, we are going to learn from Bill Eley. Welcome to the show, Bill.

I'm privileged to be here.

Thank you. Thank you. So to get us going, what is your educational leadership title or titles?

I am Dean of Medical Education in the School of Medicine here at Emory.

All right, and what do you do in that role?

So I broadly oversee our degree programs, of which there are six, and our graduate medical education programs, of which as you know, there are 114 and climbing. I never can know exactly because it's very dynamic and growing, which is wonderful. But I have a broad oversight. I have leaders in all these programs that are wonderful and I'm trying to inspire us to change in a positive direction and do the best we can to help all these folks become great caregivers.

That is so very important. Thank you. So given, as you said in your role, you are on one level, you've got leaders working in the other levels, what skills do you find that you use a lot in this role?

I think the most important skill for all of us in this life is how we conduct ourselves in our human relationships. And I think I'm old enough now and been through enough of those relationships, in many different ways from family to the practice of medicine to education, to have learned a lot. And I hope that is what I really bring to my management is listening and caring about our people who are on our teams and the people who we're training and educating, and that caring for everyone that we're around is what we do. And I think by modeling that, we model that for the people who come here for school and training.

Indeed, indeed. Thank you for that insight. So recognizing you likely didn't start off as a dean, what was your journey that led to this current role?

You are right. I never even thought I would be a dean of anything. I started out as a researcher in the School of Public Health, in the epidemiology department working on cancer disparities. And since I was a doctor, I continued to practice medicine at Grady while I was doing that work. After five or six years, I started doing some work weekends and nights also clinically at Emory Hospital, and then I started a practice down at what was then Crawford Long Hospital, a medical practice, and I got my master's in public health as part of my training. And I had such a fantastic teacher/mentor, John Boring, in that realm that I took over his class to the medical students, which was a two semester class when I started and really enjoyed teaching. I was invited to be on the admissions committee. And so for 11 years, I did funded research work and taught and saw patients, the three-legged stool of academic medicine. Somehow, somebody recognized that I might be good as a successor to the Dean of Admissions here in the MD program.

And so I literally got a call from the person who had my job at that time, Jack Schulman, and he said, "Bill, how would you feel about coming over and being our Dean of Admissions? We'll do it for a year and see how you like it." And so I had to think about that very hard because I really enjoyed everything I was doing and I knew that if I kept that job, at some point I was going to have to give up things because my plate was already full. But I agreed to do it and I loved the admissions process and seeing all these bright young people who wanted to help other people, and trying to bring them along as their Dean for the first two years of medical school, I got to continue to teach in the medical school and some in the School of Public Health, and that was the way I started. And then by then I was an associate dean, so it was kind of a shock. I got a phone call.

Amazing. So considering now that I think about it, I didn't realize you had started at the admissions dean kind of role. How did it then lead from admissions to the current, which is kind of oversight of such a broad continuum of education?

So I was the admissions dean and then we went through a curriculum reform process starting in about 2003 and '04. And Jack Schulman, at the time, he was ready to retire when we started the new curriculum or when he got us going towards starting the curriculum. So I took his job as interim for a year, and then I took the job full-time when asked to and finished up our curriculum planning for the MD program and have been in this role since, but expanded that role.

I was always the dean of the other degree programs, which we called Allied Health then, but they were very autonomous at the time and did not interact with us very much. So one of the things I've enjoyed the most about my job is bringing us together to do things together. So that has been really fun. And graduate medical education had kind of been out there. They reported directly to the dean and I don't know when it was exactly, but somewhere around 2012 or '13, they said, really education should report up to one person. So I accepted that role. And again, only because we have such fantastic faculty who run these programs.

Indeed, indeed. A wonderful team under you.

Yes.

As you reflect on the various leadership roles that you've had, what do you wish you knew before stepping into leadership?

Gosh, there've been so many lessons learned along the way. This is a hard question.

We have time.

I didn't know how much things in our world would affect our students and our residents. And the outside events in our world are really tragic at times. And I think we get to see those things unfold like we never have before, whether it's famine or war or terrible natural disasters. We live those things pretty vividly now. And I think it's changed the world, and I'm not so sure it's always for the best because it really does bring suffering into what was our TVs, but now our phones. Every minute there's something bad happening that someone has recorded and is sharing. That's a burden in some ways. I'm glad we know, but it really is. And we work with people who really care about others and I think it's really a toll on all of us.

Yeah. So how do you navigate that? Because you're right, I think a lot of people think leadership and they're like, oh, I just have to manage, I have to organize, but there is a lot of navigating people and their emotions and what's happening around them. And so I'm curious how is it... experience? Is there stuff you've learned along the way? Was there training to help you?

Well, I've had great training. And interesting, I've thought about that. The psychiatric training I got in medical school here at Emory was fantastic and it has served me well in my practice of medicine and certainly in being a dean. I think one of those things that has become more and more important as we suffer all these things together is that, and I'll quote, and you've heard this from Joe Le Doux, that we lose things in the speed, and I think we can only go so fast and pay attention to each other in a way that we all need to be together. And that is with all of our mind and our spirit in the same space with each other. I think those things are threatening us that we're not able to carve out that time where we slow down and are with each other. Like we were the other day when you and I shared words about each other, just very simple things that we had to slow down to do.

Indeed. So powerful and so important. As I think about that, and I'm going to prime you, if you don't answer it in this question, I'm going to ask it directly. But what continuing professional development do you do to keep up with the needs of your role and how does CBCT fit in there?

Well, you mentioned it's [CBCT] part of my professional development, but I still read the New England Journal religiously. I still have a passion for medicine, and that is some professional development for me. So everything I learned, my professional development is working at Grady like I did in January for two weeks where I get to go back to the basics of caring for people and relieving their suffering. So to me, it's a lifelong development, learning about human beings, both from the science part of it, but also from the interactive part of it. And I'll say this, I think the things I have learned from taking care of people who have cancer are universal skills. So they fold over to education. The things that are important in our lives are right in the middle of those interactions that I have with patients. And so I think it's taught me what's important from listening to people and really being with them while they're suffering. That's a tangential way of saying it. I think it's probably one of the most important things I've been able to do is translate that to individual students, residents, and I hope faculty when they need me.

CBCT, this cognitive-based compassion training is a manifestation of being present, of being compassionate, which is different than empathy, and that compassion is sharing the feelings, being able to understand how others are suffering, but then thinking about how we can relieve that suffering or prevent that suffering if we see down the road, trying to help someone avoid being ill. So CBCT improves my ability to be present with people. And as we talked about earlier, that may be one of the greatest things we do is slow down, be with each other so that we can positively affect each other's lives.

And CBCT does another very important thing, and that is it allows us to practice our self-compassion. And for caregivers especially, and I tell the students sometimes this a little bit laughingly but I mean it, is that caregivers are very hard on themselves, and when things don't go well, we tend to blame ourselves. And there are times when we make mistakes and we need to make amends or say we're sorry and do all those things, but often it's just the tragedy in which we find ourselves and we take on those burdens without allowing ourself to look inside and say, "I'm doing the very best I can to help other people who are suffering."

And so allowing the gifts that we get from that which are enormous, a patient saying thank you, just that simple thing feeds me if I allow it to, and I'm not caught up in the, oh, what am I going to do wrong? What did I do wrong? But just being able to accept the kindness of others, whether that's a patient or a partner or anybody else in our life, Ulemu. We really need to be better at accepting kindness of others. And CBCT helps with both of those things, and additionally just growing our circle of compassion, which the world needs so much of right now.

Indeed, indeed. As I listen to you, I can hear the passion for patients and caring for patients in your voice. And I'm curious, when you were born, were you like, "Yes, I'm going to be a doctor," from the beginning or at what point did you realize that that's where your calling was?

Absolutely not. I came to college to become a high school chemistry teacher. I worshiped my high school chemistry teacher. She was so kind and so smart. I was actually a TA in high school for the chemistry lab, which I think she made up just because she thought I had so much love for it. Her name was Molly Wisher and she was one of the kindest, best teachers I ever had. So I wanted to be Molly Wisher. So I went to college and I was taking education courses and chemistry. I was going to be a high school chemistry teacher. And then when I went and started student teaching, I came to the realization that high school students did not love chemistry as much as I did, and it was heartbreaking.

And so I made a turn. I was on my way to get a master's in education and a degree in chemistry. And literally my junior year, I turned and looked at medicine. Somebody had maybe asked me if I was going to be a doctor one day, I think in my church early on, I said no. When I came to college, I put two things on my application. I might be a preacher and I might be a forest ranger. I love being outside. And I really had a bend towards spiritual life in my early life. I was fortunate enough to be in a Methodist church that really helped me develop as a young person. But I had no idea I was going to be a doctor, zero. Nobody in medicine in the family. My parents both came from a farm in southwest Georgia. Not the same farm. That would be not good. But they grew up about 30 miles apart in a very, very economically depressed part of our state.

But I had no idea. I knew I loved science. I did really well in chemistry, which was to the chagrin of all my pre-med college mates who just hated it because I did so well in chemistry. And they would say, "What formula did you use to figure that out?" And I said, "I didn't use any formulas. I just figured it out." And they would hate that. They thought I was just not sharing with them. But Molly Wisher had been such a good teacher, I could figure out all those problems. That's a long answer to a short question.

But those are the stories I love to hear because I am always very curious if people ended off on whatever their tracks were because they knew from very early on or it was like, oh, somewhere along the way the path turned a little.

Well, I'll go a little bit further with that. So I ended up applying to medical school. I thought I wanted to do international health. I was really devoted to that. I thought I needed to go to places that needed doctors around the world. And I morphed that into something later I'll tell you about. But when I got to Grady and I started taking care of patients at Grady, I had no idea of the need in our own city. And I looked at myself in the mirror and I said, "Bill, you do not need to go out of this country to provide underserved people care." I hate to say that, but that still exists.

And I've worked at Grady every year of my life since I was a third year medical student, and it's really a special place to work. I got to get my MPH as part of my oncology fellowship because I had a mentor who said, "I know you've wanted a master's in public health." And so I did that, had a fantastic research mentor, Ray Greenberg, and got really involved in cancer disparity work. And that was a whole other love. And it also informed my medical practice because the master's in public health is just such a fantastic degree. And it really opened my mind to both numeracy, which is really a good thing for anybody, but also to addressing problems on a population level instead of at the individual level.

I tell people all the time, I'm the luckiest person in the world. All the opportunity I've had, all the people I get to work with, all the students, and I include students and residents, but all the people in the hospital who are dedicated to care, and then my education family here in the school of medicine and in the university and all the science we have now about all of those things, including now compassion. It's a remarkable life. And I tell people, anybody can be the luckiest person in the world.

That is true. That is true.

It's an attitude.

Yes. I love the kindness, the compassion, the luck, putting it out into the world. As you think about all of that, those experiences you've had, what advice would you give someone interested in doing the same type of leadership roles that you've had?

Well, I'll quote Bill Fahey here. I tell this story to everybody. Bill Fahey was the head of the CDC and really came up with the tactic to eliminate smallpox from the world. And I talked to him when I was trying to figure out what I was going to do when I got out of residency, and he's been a friend ever since. And he gave this brilliant graduation speech for Emory College, and he had 10 pieces of advice. Number five was don't make a life plan because you have no idea what will be afforded you if you keep your options open. We don't know what jobs there are going to be. We don't know what fields are going to emerge. And I think that's great advice.

But his number six is do make a life philosophy. Because if we know internally why we are doing things, what our intentions are, and we let that guide us, then we'll get to the right place. But we don't know where that place is going to be. I tell people all the time, do the next right thing in front of you and it will lead you to those places that you feel fulfilled and you are helping others, which is what we do in medicine. We help others. That's the whole reason we're here. So I encourage people not to plan too far ahead.

I definitely appreciate that because I'm somebody who gets stressed out when people ask about, "What is your two to five year plan?" I'm like, let's just go with what's happening and we'll see.

Number 10 is he wants us to find our home. And to him, he says, "I'm going to give you a new definition of home. Home is where you can do the most good." And I think that's beautiful.

Indeed, indeed.

So I think, Ulemu, if we feel we're in a place where we're able to use our talents to do good work to help other people, what else can we ask for our work life?

Indeed. And I think about that and I feel like it's true in all aspects of our lives.

Yes.

Yeah. Thank you. Thank you. So thinking about those words of wisdom and the roles that you've had, can you share what your views are around succession planning?

Yes. I think succession planning starts with the people you hire. So it should be something that occurs as best as it can organically. If you bring people around you who you think are going to do great jobs in what they do, then I think that's the best thing you can do for succession planning because people will naturally either want a new job or a different job or the job I have, but they will be able to be fulfilled and find that place for themselves. So I'm not going to pick out one person for this and one person for that, but I constantly think of all the people in our sphere what might be their next, what's good for them, and like to talk to them about it. I think just helping each other find what's best for us is my version of succession planning.

Again, it's not mechanistic. I'm not going to make a plan for five years of exactly who's going to be in what job here. I just want us to have an entire group of people who are really, really committed and really kind and really smart who can step into the roles as they're, they may not even be the same roles. We have to spend a life of self-improvement because we love doing it because we're curious and we love to learn and we love to teach and we love to care for people. We love to think of new things in discovery. So if we surround ourselves with people like that, succession will take care of itself.

I like that. I like that. And it gets to the, if everyone's found their homes in all of that, it will organically come up.

Yes.

Lovely. I'm guessing based off of the fact that education is in your title, this question is going to be very relevant. How do you support or expand education in your profession or through your role?

Yeah, so it is in my blood. Even in college, I knew I wanted to teach, Ulemu. And I'll say that those education classes I still use, I still hold some of those things dear to my heart. Some of the very basic things. So I'm thinking about education going forward, and I think having people like you, and we had Hugh here and now we have Joe Le Doux here and people who eat, live, and breathe education for their science and now everything we're bringing to bear to move things forward, that is my real contribution right now. The direction is really helping us in this transformation to education that is centered around what's best for the patient, is inspiring to the learners, and helps them feel part of this amazing profession we call medicine. From any of our programs. And my great desire is that people can leave Emory inspired to care for others, to create new knowledge, to teach others, and find joy in that as they do it.

So I think life's too short to be unhappy. I know we don't always have control of when we're happy and unhappy, and I think we have such opportunity in the place we work and the place we care for people to have a joyful life. And so that's my great hope. The work is hard, but it's also, to me, the most rewarding thing I could have done with my life. I want to share that. I want to spread it. And bumps happen in all of our lives, but when we have great colleagues like we do, they're there for us when that happens.

Indeed, indeed. I must admit, as you were talking, I was like, I see the preacher side coming in. You still managed to do some of that.

Well, I think that the preachers that I grew up with were inspirational figures for me. But I'll tell you something a little secret. I'm an introvert. When we took those scales, way back when in college and stuff, I was 2% away from zero and a hundred percent on the introvert side. And so I don't come by this always joyfully. I doubt myself and I feel much better talking with you than when I will hear people hear this on the radio, I'll just tell you that. I'd rather be with two people or three people or one person than how many.

However, it's part of what I do. And I've gotten more and more comfortable. People have said, even when they hear me speak now, "How do you do that?" I'm speaking from my heart. I'm speaking from my joy and I'm speaking from my commitment to try to help others. And if I do that, it's a lot easier. It really lightens my spirit up and it's not about me, it's about we and what we can do together.

Indeed. And I have a feeling we're going to hear some of that we in response to your next question, which is what contributed to your biggest successes thus far?

It's all about the people. It's all about working at this great university and working with people internationally in cancer research and working with, I can tell you, but I won't go on. The number of people I've gotten to work with internationally and nationally, it's all about the people. And I give a talk about the gifts of medicine. The first gift is knowledge. The second gift is the people you work with. And, of course, the third gift is patients. But I think for what we do in education, it's all about the people we work with, the people that are committed to helping people learn and then keeping it focused on our patients, amidst all this fantastic science that we are privy to to help people. Truly miraculous stuff. But it's all about the people who teach it and then go out there and do it.

And the students learn most of what they learn from their patients and the application. We get them ready for that. It's big in all of our fields, but it's really in the application, the compassionate application of science that we really can be most inspired. So it's about the people. You were right. You probably knew what I was going to say.

I did. I did. Thank you. So recognizing you've talked about your passion for learning and being a lifelong learner. And so with that, I am curious, what would you say your biggest growth opportunities are right now?

I think my biggest growth opportunities now are doubling down on creating community. I think we live in such a fractured world now, we talked about that earlier, but I think it affects all of us. I think COVID affected all of us. I think all of the strife in the world that is so part of our everyday living now. And I think we live in a country that has way too much violence and way too much name-calling and go down the list of isms. I'm not going to call any of them specifically, but the labeling of others is, to me, one of the great, great losses of humanity. So I think growing community has become harder and harder.

And again, it's one of those things that if I allow myself to get sad that people are not happy and don't feel belonging and I want to do whatever I can, that's a growth opportunity. It's really hard. I think it's happening all over our society and all over the world, but it's the biggest challenge. So let's go for it.

And I'll temper that on a very positive note that I think what you and I do in a school of medicine to help people suffer less or prevent suffering or have them achieve joy in their life is such a powerful thing to do with our lives. I think medicine has the chance to overcome a lot of those divisions. I think it gives us the opportunity to be with anyone, and through our compassion, allow them to be heard. And as we allow people to be heard, and I've told the students this and I'll tell anybody, when we really listen to another person's story with all of our mind and our heart, that is social justice. That is taking a person for who they are, trying to throw away all our preconceived notions, and just hear about who they are without judgment, in fact, with acceptance. And I think that's a great gift. We can learn about medicine to do that with everybody.

And I think as you're saying that, not just in medicine, but on the broader, our interactions with other individuals, so much could come out of taking that kind of a stance constantly.

Yeah. So I think we can be a great example. I think we are a great example. We go into people's rooms and we do everything we can. We know we're all biased, we know we have all those things, but we do everything we can to throw all that stuff over our shoulder and deliver the best care we can to people. There are people doing that every second of every day from our institution. And we shouldn't forget that. Are we perfect? Absolutely not. We won't be. We're human beings. But we're striving, we're trying to go there. And I think that makes it a great model so that we try to break through all the isms and all the things we label each other as and work together to help others who we also accept where they are and who they are and do our best to, in the context of their life, to help them.

Indeed. Thank you. We're getting towards the end. Just got three more core questions for you, but I would love you to reflect broadly or even what we've covered so far, and I would love you to share what do you love most about your work and what you do right now?

Well, I just got off two weeks of oncology at Grady being an attending physician. And I had two of our students with me and I had a fellow with me. And we took care of people who had unbelievable suffering in their lives. And I think we did that giving people as best we could, real care during times that they really needed it. And with all the difficulties with seeing people suffering, some young people, some older people, it doesn't really matter, they're all suffering, we all learned an enormous amount. We fostered great relationships with other teams and other people we were working with. We did the right thing for our patients as best we could. And that made us learn a lot about what it is to be human and about medicine and human disease and suffering. And I think all of us grew a little bit.

So I'll just tell you, when I'm working at Grady, which is kind of an extra job, when I come home at seven or eight or nine o'clock, my wife tells me she's never seen me more tired and never seen me more happy. So it's that combination, again, of the science of and learning about cancer and treatment of cancer, the human element and the teaching that we do to each other because we have assignments when we go home, and I just think that's such a positive thing to do with our lives. And all for the good of those human beings that we're serving. Very powerful.

So I think that's a real highlight. I don't know if I can combine that any better in a single day, but it's just such a... As Dr. Hurst, who was that Chair of Medicine here before, described medicine in his last graduation address of the school, he called it a sacred space. And he said, "That's just the only way I know how to describe it." And I think he is right. And I think we enter those spaces that are sacred and do really, really meaningful work at so many levels. The gifts we receive are so wonderful to our own spirit and our own minds and our own being.

Thank you. So moving. As you think about that sacred space that you're in and you reflect on your experiences to date, what would you say your current passions are around education, or what is your current education philosophy?

That's it. Those are hard questions you ask, Ulemu. I'm really excited about the work we're doing with medical education transformation because we're going deep. We are really thinking about the best way for our learners to learn while keeping the reason we are here in the center, and that is our patients and their families. And I think we can do a lot of improvement, and I think, in fact, we can move things forward. I hope that as we create this and taking already the amazing opportunities to learn we have at our university in our school of medicine, we can move this forward, I hope, in a way that is a model for medical education going forward.

And therefore, again, getting back to that people leaving here absolutely passionate about making life better for their patients and also thinking about ways to make care better, to maybe make science better, to maybe advocate for people in our community in a way that is positive and healthy. Like I said, if we can have people leave inspired and joyful, we will have made a huge difference in the lives of the people that all these caregivers will serve and in the lives of the caregivers. And in the teachers, by the way.

I always love to hear about the teachers.

Me too.

Thank you. Thank you. So I know I've spent a lot of time talking to you about your work, your career and all of that, but going to the joy piece, I would like to know, since you are more than what you do, what are some things you do outside of work to help you maintain joy in life and practice?

Well, there are several things. I love being outdoors. I love being in the woods. I love being on a river in my canoe. I love being in my garden and growing food. I just finished making a fiddle. It took me four years with the help of a master luthier because I don't have that much time, but also, I scratched my head more than I did because I was sure I was going to ruin this. But I did it for a friend who had died in 2019. She was a fiddle player and she started a program in Appalachia to serve youth by giving them music lessons and instruments for free. So it's in 45 counties now around Appalachia for underserved kids. And so I built this fiddle in her honor, and I'm going to give it away as soon as I can get back up there to give it to them. And it is been a labor of love.

I've learned so much, like most good things in life. And I've had this relationship with a man, Wayne Henderson, who's a luthier up there. I go up there and he helps me. He can correct any of my mistakes as it turns out. So as I've been through this process, I've found out that there are people who can correct these mistakes I make, and they were plenty. But I think that I've always liked to do woodwork with hand tools. And this has been, it was partly a COVID thing, but I've really enjoyed making that. And I think of the child playing a fiddle and learning how to do that, and it just makes my heart sing.

Oh, that's amazing.

And just to let you know, I have a family that loves me very much. That's the bedrock of everything. And they also know that I've been obsessed with this fiddle and they've been helping.

Oh, love it. Love it. I'm sure they all celebrated when you said it is officially done.

They're my biggest fans.

I love that. Well, Bill, those were my core questions for you. And I just want to say another big thank you for taking your time out to share your lessons learned with me and the listeners who will be hearing this. Before I let you go, any last words of wisdom for aspiring educators or education leaders?

I think the inspiring words for us as educators is we have to develop meaningful relationships with our learners. It is essential to everything positive that we do on this earth. And Emory is known for that, for students being in their small groups in many of our programs, for faculty, taking time with students to teach them. But I think those relationships are the most important thing we do in our lives, and it needs to come across in education as well as everything else we do.

Thank you so much. Very wise words to end on.

Thanks, Ulemu.