The Daily Dose • Saturday, April 28

Education, Research, and Administration: Three Paths to Success in Medicine

By Dr. Michael D. McDonald, from the IARS 2018 Annual Meeting*

This panel aimed to share the experiences of three successful anesthesiologist and the paths they took to achieve success. Panelists were asked to address three points: the biggest challenges they faced and how they overcame them, how funding opportunities and departmental needs shaped their careers, and advice for young anesthesiology scholars. Dr. Paloma Toledo, MD MPH, shared her path to educational leadership, Dr. Peter Nagele, MD MSc, shared his path to academic leadership, and Dr. Laureen Hill, MD MBA, shared her path to executive leadership.

Dr. Toledo started the panel off by discussing skills that carried her to success in educational leadership. Educational leadership is harder to quantify progress and success when compared to academic leadership. Dr. Toledo discussed how to quantify such progress to advocate for promotion. With an interest in becoming a clinical educator, intraoperative teaching is not enough. Other teaching opportunities include medical school teaching, CME work, mentorship, visiting professorships, and speaking opportunities. Compiling experience and building an educational portfolio is essential to advocate for promotion.

In order to receive funding as a clinical educator, Dr. Toledo argued the importance of framing educational projects as research. She utilized an example of her work in postpartum hemorrhage via teaching how to accurately estimate blood loss. Instead of simply teaching how to estimate blood loss through didactic training, she designed a study to quantitate the efficacy of didactic teaching in estimating blood loss, publishing all her data. The importance of publication goes beyond measurement for promotion, but allows for dissemination of training protocols for education beyond a single institution.

Although there is limited NIH funding for clinician educators, there are many additional funding opportunities available. Dr. Toledo described how creativity can go a long way in obtaining funding by adaption of clinical questions to fit the specifications of different private or other non-profit grant opportunities.

Next, Dr. Nagele shifted gears to discuss his path to academic leadership. Dr. Nagele began by outlining the fundamental truths about achieving academic success. To become a name in the field, a physician scientist must find a niche they are passionate about, focusing to become an expert in the niche. To parallel, sometimes saying no is as important to career development as saying yes.

Getting started as a young physician scientist requires multiple mentors for different perspectives in identifying personal strengths and weaknesses. Having a mentor that can give honest feedback to build on weaknesses is necessary for growth and maturity. A mentor should also help to nurture and be supportive with rejection. Rejection is inevitable in academic medicine and should be expected. Persistence is essential to learn from these failures.

Dr. Nagele described research, publication, and grants to be the three most important activities as a junior researcher. Time management and avoiding distractions are skills that will allow for career progression.

Dr. Nagele finished with a brief overview on progression from residency to R grant funding through the K grant. K-awards are 3-5 year awards with salary support but limited research time. To be successful in selection for such an award, the application must contain an individualized training and research plan, addressing an educational path to address personal weaknesses and achieve research goals. Common flaws include being overly ambitious and not creating an individualized plan.

The final panelist, Dr. Hill, described her path to organizational leadership. Being organized and team leadership are very often strengths of anesthesiologists and critical care physicians that allow anesthesiologists to succeed as physician executives.

However, there are numerous unique skills required for success as a physician executive that most clinicians do not have exposure to. For instance, an understanding of finance and accounting are important skills to have. A young anesthesia scholar must be willing to invest in additional training and education to become marketable for a position as a physician executive.

Dr. Hill did not get to her position as EVP and COO by using her prior roles as stepping stones, but instead focused on being excellent in every role she led. From there, opportunities came to her. Dr. Hill emphasized the importance of not being afraid to fail, explaining how learning from failure can build a career as much as individual successes.

Common themes that carried across all three career paths included the importance of finding and pursuing a specific passion, identifying and building relationships with strong mentors, and time management. Each panelist emphasized the importance of communication with their mentors and the skill of learning what opportunities to decline, selectively pursuing opportunities that aligned with their personal career goals.

*Coverage of Scholar-03: Shine Like a Rockstar: Different Paths to Success

Encourage, stimulate, and fund ongoing anesthesia-related research projects that will enhance and advance the specialty, and to disseminate current, state-of-the-art, basic and clinical research data in all areas of clinical anesthesia, including perioperative medicine, critical care, and pain management. The IARS is focused solely on the advancement and support of education and scientific research related to anesthesiology.

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