The Daily Dose • Wednesday, May 12, 2021

Many Paths Lead to an Academic Career

Allison M. Janda, MD

The opening session for the IARS, AUA, SOCCA and Early-Stage Anesthesiology Scholars (eSAS) Scholars’ Program on May 8 was an excellent way to kick off the day, inspiring and encouraging the group of over 100 early-career scholars in attendance. An illustrious panel of established academic anesthesiologists shared their experiences, perspectives and suggestions for early-career and aspiring academic anesthesiologists in the session, “Finding Your Academic Path – A Discussion of Academic Career Alternatives.”

eSAS meeting committee lead, Dr. Loren Smith, an Assistant Professor of Anesthesiology at Vanderbilt University Medical Center, began the session with a welcome from eSAS and framed what to look forward to in the day ahead. She introduced the first panelist for this discussion of academic career alternatives, Dr. Mark Stafford-Smith, Professor of Anesthesiology, Vice Chair of Education, Director of Fellowship Education, and Director of the Academic Career Enrichment Scholar (ACES) Anesthesia Resident Program at Duke University Medical Center.

In his talk focused on the academic educator path and the emerging education scholar, Dr. Stafford-Smith outlined the three phenotypes of an academic educator career, goals and suggestions for each phase or stage of a career, and discussed the challenges and benefits of an academic education career focus. Once an interest in becoming an academic educator is identified, he spoke about the importance of then identifying a target audience for your education and then cultivating the intrinsic factors such as career vision and self-directed growth and extrinsic factors such as mentors and other opportunities. These factors can then be focused and filtered to produce the three phenotypes that Dr. Stafford-Smith identified within the academic educator path. The phenotypes include leadership/administration, education and research. He emphasized that some educators may become a hybrid of two or three of these phenotypes. All three phenotypes have the challenges of how to quantify and determine excellence for promotion. In education, teaching scores, which are not equivalent to peer-review, are subject to multiple biases including the impact of popularity and the differences in time an educator is in the clinical realm resulting in variable exposure to trainees. Additionally, education is often viewed as a cost center by hospital leadership, but academic educators must make the business argument for education and adapt to changes in the clinical mission.

Dr. Stafford-Smith also discussed the goals and suggestions for various career stages within the academic educator path. Regardless of phenotype, strategies in the early-career phase are the same. He noted that this phase is best accomplished with many irons in the fire by having multiple mentors. He deemphasized the title you achieve within this phase and recommended a goal of two primary publications per year. He drove home the point that this phase requires great personal investment in developing your own skills and efficiencies because, the more you invest in yourself, the more you inspire others to invest in you as past behavior predicts future behavior. Dr. Stafford-Smith concluded that the academic educator path can lead to a viable and highly satisfying academic career with numerous and diverse opportunities. The future includes healthcare expansion and as more patients necessitate more trainees, this requires the educator pathway to continue expanding and creates a need for increased education research.

The next speaker was Dr. Judith Hellman, Professor of Anesthesiology and Perioperative Care and Vice Chair for Research at the University of California, San Francisco. Her engaging talk was titled, “Research Pathways in Anesthesia” and she began by emphasizing the unique situation of anesthesiologists contributing to scientific knowledge and advances in health care in multiple clinical arenas, as well as being leaders and members of interdisciplinary teams. The anesthesiology specialty encompasses many research topics across many settings including clinical labs, dry labs, ICUs, ORs, floors, preoperative and postoperative units and clinics. As well as this wide breadth in research topics and content, researchers can enter research at any stage. Some academic anesthesiologists start and continue research from an early stage, but some take a break from research and return at a later stage, or join later in their careers. To facilitate this, there are multiple types of research-intensive programs and pathways.

For residents, many training programs have research pathways during training, which can help set up a route to scientific independence. After graduation from residency, T32 postdoctoral research fellowships are geared towards providing protected research time for early-stage faculty aiming to develop a research-intensive career. However, these programs can also be utilized earlier on in training depending on the program. There are also alternative research pathways which can include some research throughout residency without participating in a research scholars track and institutional-dependent early-career support as a young faculty member. There are also multiple opportunities for funding for early-stage anesthesia researchers including the NIH T32, FAER and IARS mentored research training grants and K and R grants depending on the experience and training of a researcher. For any of these pathways or funding mechanisms to be successful, you must have a commitment to research, a structured training plan, excellent mentors and a strong research direction and project. Many factors contribute to the commitment to research including the intrinsic interest in a concept or subject, clinical interests or subspecialty, and the balance between research and clinical focus.

Dr. Hellman closed with suggestions for early-stage and aspiring academic anesthesiologists. She encouraged future researchers to pick a research area and topic that excites them and to pick a project that is doable (time-wise and resource-wise). To ensure the selection of the right research areas and mentorship teams for any individual mentee, she suggested exploring different research options, mentors, and projects before committing and carefully choosing your mentor(s). Dr. Hellman emphasized that the importance of your mentor and mentorship team cannot be overstated. Additionally, she prompted early-stage researchers and trainees to think about the ideal balance of clinical work and research work, as the success of many projects depends on how much time is allocated for research. A recommendation for efficiency Dr. Hellman provided is to try to align your research and clinical focuses. She also suggested developing an individualized career plan with advice incorporated from supervisors, advisors, peers, informal and formal mentors and departmental leadership. She closed her excellent talk with the take-home message that there are many viable pathways for a successful academic anesthesia career and that effective research training requires a commitment from the trainee and department to support a training plan and outstanding mentorship.

The final panelist was Dr. Keith (Tony) Jones, Professor of Anesthesiology and Perioperative Medicine, Chief Physician Executive, President of the Health Services Foundation and Senior Associate Dean of Clinical Affairs at the University of Alabama at Birmingham. Dr. Jones gave an excellent talk about his views on leadership and the characteristics of an effective leader. He first discussed how leadership produces change and movement by establishing direction and motivating, inspiring and aligning people. He cited a number of high-yield resources for learning more about leadership and cultivating the skills to be a strong leader. One book he referenced, The New Agreements for Leaders by David Dibble, outlines the science behind leadership and had four main tenets: find your higher purpose, grow and serve your people, lean into the core problems, and pursue mastery. He emphasized that leading and managing change will create stress, setbacks and conflicts, but the tenet of finding your higher purpose is very important, stating, “If you don’t care, you can’t lead.” These core principles he spoke about were coupled with additional resources about how to develop key leadership competencies such as the ability to adapt, be resilient and recover from setbacks.

Another resource Dr. Jones discussed was Jeff Boss’s book, Managing the Mental Game: How to Think More Effectively, Navigate Uncertainty and Build Mental Fortitude. He explained that this book articulates the key to resilience and recovery from setbacks is to control our reactions to the challenge or stress presented. Dr. Jones also mentioned Dr. Oluwaferanmi O. Okanlami, family medicine physician, author and Director of Adaptive Sports in the Michigan Center for Human Athletic Medicine & Performance at the University of Michigan, as another example of adaption and resilience. He emphasized that leadership, adaptation and resilience can be taught but that the first step in dealing with a setback is to avoid learned helplessness. He discussed how he handles conflict management, and focused on his main pillar that “nobody is more important than the mission.” Dr. Jones concluded that a bottom-up systems approach to leadership produces engaged followers and sustained change. He also re-emphasized that resilience and adaption are critically important leadership competencies.

This outstanding group of panelists then participated in an engaging question and answer session. This session was packed full of wisdom and knowledge from experienced academic anesthesiologists and leaders in our field which touched on a variety of routes and pathways within academic anesthesiology.