A Window into Professional Trajectories: How to Do A Lot But Not Everything

Cameron Bosinski, MD, MS

Scholars from all over the world came together to attend the annual Scholars’ Day, hosted by Early-Stage Anesthesiology Scholars (eSAS) on Saturday, May 2 at the 2026 Annual Meeting, presented by IARS and SOCCA. This session, “The Resilience Playbook: Turning Adversity into Academic Momentum,” was moderated by Ryan Eshard from University of North Carolina, and featured three distinguished leaders: Max Kelz, MD, PhD, IARS board member, Lee A. Fleisher professor of anesthesiology and critical care, and vice chair of research in the Department of Anesthesiology & Critical Care, University of Pennsylvania; president and chief scientific officer, Foundation for Anesthesia Education and Research (FAER), Julie Freed, MD, PhD, IARS board member,  senior associate dean and director of the Clinical & Translational Research Institute (CTSI) of Southeast Wisconsin, executive vice chair and associate professor in the Department of Anesthesiology at the Medical College of Wisconsin, and Miles Berger, MD, PhD, professor of anesthesiology, neuro-anesthesiologist and translational human neuroscientist at Stanford University. The panelists provided candid accounts of their professional trajectories, highlighting challenges such as rejected manuscripts, unsuccessful grant applications, and the demands of balancing clinical practice, research, and personal responsibilities. While the panelists strongly believe that the attendees can do anything, it is equally important to recognize that it is impossible to do everything.

Dr. Kelz spoke about the unanticipated directions that his career has taken and how he has been able to reframe ambiguity as insight. Although originally interested in neurology and psychiatry, Dr. Kelz found that it was much easier to determine whether a mouse was unconscious than if it was happy or sad and decided to adapt his career direction. After taking care of a narcoleptic patient who did not emerge from anesthesia for more than 6 hours, Dr. Kelz first wondered what he had done wrong, and then second, wanted to understand why this had happened. This led him to explore mutations in the orexin/hypocretin system, which to his dismay did not have any effect on anesthetic induction. However, he decided to ask a question that no one had asked before: Is anesthetic emergence a distinct process from anesthetic induction? Although the groundbreaking article exploring this topic was rejected by multiple journals, it was published by a journal willing to entertain studies that questioned the prevailing dogma. Throughout his career, Dr. Kelz has been lucky enough to have a supportive spouse, Rachel Kelz, MD, who is also a physician-scientist. At times, he has encouraged her to keep going after encountering setbacks and at other times he has reminded her that she has a higher h-index. Dr. Kelz is a shining example of the ideal physician-scientist: intellectually rigorous, resilient, and always humble.

Dr. Freed addressed the frequent challenge of overcommitment, asserting that while one may achieve any individual objective, simultaneous pursuit of all opportunities is unsustainable. She presented several illustrative scenarios where several “quick phone calls” became opportunities to take the next step in her career. Although already busy with her current workload, she strategically took on certain opportunities that aligned with her goals. In addition, Dr. Freed mentioned that although she is still just as busy as ever, she is able to be more productive with her time and accomplish more than she could before. Deciding what to take on comes from both considering how much time it will take as well as learning how to perform the job more efficiently with less effort. This, combined with other roles such as parent, spouse and clinician allows anesthesiologists to purposely and dynamically change the amount of effort put into a given category at any time. But when making these decisions, it is important to seek out the advice of others. Dr. Freed often asks her husband, who is not in medicine, for advice and a different perspective, including the tradeoffs that come with it. In addition, Dr. Freed has maintained a strong relationship with a mentor, who is a retired cardiologist. By being at the end of his career, he is able to give insight on what has been important to him and help Dr. Freed determine whether she would find the same satisfaction. Although Dr. Freed has tried to say yes to every opportunity that she was interested in, she also recognized her limits and has had to cancel meetings, take on a new role by leaving a previous role or consciously make time for family. Time management is less about managing your time and is more about training your mind to switch gears from one context to the next.

Dr. Berger shared a similar change in direction as Dr. Kelz in that he intended to study the neurologic impact of abnormal serotonin in a mouse model, but ended up studying pancreatic islet cells instead. This shift in research focus taught him to be nimble and follow the science even if it leads in an unanticipated direction. Once Dr. Berger transitioned into clinical rotations as a medical student, he was again thrown into the deep end and had to learn how to adapt. Although he had always viewed himself as primarily a researcher, his wife noticed that he was actually happier when he came home from the long hours on his trauma rotation than he had been during his PhD. Dr. Berger found satisfaction in both the long-term goal of answering scientific questions, but also in the short-term wins that accompany daily clinical practice. He sought to find balance in a career that neither lacked depth nor had seemingly endless delayed gratification.

Dr. Berger then shared an analogy he heard from a colleague about academic medicine. Academic medicine is like a pie-eating contest. At the beginning the pie tastes great and you can’t stop eating it. Then at a certain point, you are forcing yourself to take another bite and it no longer tastes good. For this reason, it is important to maintain broad interests rather than purely focus on a singular topic. While in graduate school, Dr. Berger participated in bike rides with hundreds of participants to clear his mind. During one of these rides, he received sage advice from a fellow rider. The man reminded Dr. Berger that when he rides his bike, he is continually relearning each element and mechanisms of the process. Dr. Berger has taken this perspective to heart and applied it to his scientific career. Even though he was only an expert in CSF biomarkers, he applied a growth mindset and successfully transitioned to fMRI, then omics and machine-learning. With all of the professional success that Dr. Berger has had, he made a point to mention the importance of the personal relationships that he has cultivated along the way. He credited his sister and uncle as two of these important personal relationships that he has dedicated time and who have made a significant impact on him. When his sister had a medical event, he flew to another city to be with her in the hospital. He advised that there are only two things in life that matter, work and love. If you love your work and work on your love, it doesn’t get any better than that.