Against the Odds? Lessons from Establishing a Clinician Educator Career Track in a Non-Academic Medical Centre.

Teaching and learning are often positioned as secondary to patient care, research, and leadership. In non-academic medical centres (NAMCs), this can make it difficult to justify investments in faculty development, as educational activities may be perceived as peripheral, even disruptive, to patient care. Although academic medical centres face similar challenges, far less is known about how they manifest in non-academic contexts. In 2020, East Tallinn Central Hospital, a secondary care NAMC in Estonia, took deliberate steps to rethink teaching and learning as central to quality patient care. A key innovation was the clinician educator (CE) career track, designed to provide healthcare professionals with the resources, skills, and support needed to fulfil their educational roles. We designed and implemented the CE career track using the social practice theory to translate and adapt contemporary academic faculty development practices to a non-academic setting. In this traveling concept, we first describe the CE career track as the contextualized application of faculty development practices using the social practice theory, illustrating its applicability for translating and adapting faculty development to non-academic contexts. Second, we reflect on the CE career track's implementation to derive five key lessons from "importing" faculty development to non-academic settings: (1) time allocated to teaching needs to be collaborative and visible; (2) teaching skills are transferable across patient care; (3) developing specific, shared educational expertise early is a priority; (4) reflection is key to meaningful and purposeful collaborations; and (5) teaching and learning are inherent to patient care. Together, these insights suggest the social practices approach to faculty development can help reposition teaching and learning within NAMCs as integral to patient care.