Staving Off Mediocrity in Academic Medicine: Academic Experts Share Their Advice on How to Thrive (and Not Thrive)

Jordan Francke, MD, MPH

What attributes allow one to fly under the radar in an academic environment and stagnate? In one of the final sessions of the 2026 Annual Meeting, presented by IARS and SOCCA, and entitled “How to Have an Average (Mediocre) Career in Academic Anesthesiology,” Vidya T. Raman, MD, MBA, FASA, FAAP, director of adult anesthesia services, division of anesthesia, and professor, UC Department of Anesthesia, at Cincinnati Children’s, and Patrick Olomu, MD, FRCA, FMCA, professor of anesthesiology at Virginia Commonwealth University and chief of pediatric anesthesia at the Children’s Hospital of Richmond, moderated a panel to explore the best and worst advice in academic medicine.

The first panelist Olubukola Nafiu, MD, MSc, professor of anesthesiology and vice chair of research at Montefiore Einstein College of Medicine, began with a graphic showing two roads parting at a fork, just as one is exiting medical training. He suggested that the road to the left is viewing anesthesia as a “job,” one that pays the bills and requires bare minimum effort. The road veering to the right views anesthesia as a “career,” a long-term journey marked by skill development, advancement, and impact. Many who are unsuccessful in academic medicine take the path to the left. He has had conversations with individuals who have signed contracts at teaching hospitals who, for example, do not even know at what academic level they have been hired (nor the steps to academic promotion). If one wants to continue not thriving, they should avoid mentorship (“who needs people snooping in on your business?”), avoid research (“that’s just for nerds anyway!”), and isolate from all advancement opportunities (“do your cases and go home”). These mindsets will virtually guarantee academic stagnation. If one wants to avoid this destination, he recommended audience members start today by looking toward the future, surrounding oneself with passionate mentors and sponsors, and learning from others’ mistakes.

The other panelist was Sujatha Ramachandran, MD, MACM, professor of anesthesiology and former residency program director and now vice chair of education at the Montefiore Medical Center and Albert Einstein College of Medicine. Dr. Ramachandran focused her talk on residency, and how some consistently avoid a growth mindset that hinders development. To her, successful residents have several things in common: (1) clinical excellence, (2) strong work ethic, (3) effective teamwork, (4) emotional resilience, and (5) continuous learning. These are individuals who seek out opportunity and strive to improve their skills.

For example, there’s a patient with a difficult airway in the ICU who requires intubation, even though the shift ended 5 minutes ago. The successful resident thinks, “this is an opportunity for me to contribute to my team, help a patient in need, and continue refining my skills! I will go!” An unsuccessful resident says, “someone else will take care of that. My learning is over for the day and I want to go.” Successful residents don’t wait for feedback to be given but actively seek it out. They prepare for every big case, not just with taking discrete questions in a question bank, but by going back to the textbook and looking up primary articles related to the management of these cases. They find pieces of information buried in patients charts that even the attending anesthesiologist missed, especially ones that might change management. So, how does a resident guarantee stagnation? Dr. Ramachandran’s advice was simple: (1) avoid preparation, (2) do the bare minimum, (3) frame disengagement as “balance,” such as protecting your time too aggressively or avoiding any extra effort, (4) skip didactics, and (5) avoid feedback.

To close, Dr. Ramachandran left future and current residents with this piece of advice: the difference between a terrific residency and a poor one is usually not the program, but rather how the resident chooses to show up (or not show up) each day when they come to the hospital.