AGA Editorial Fellowship-Three Lasting Lessons.

Abstract

As a first-year gastroenterology fellow, banding my first patient with a variceal bleed was an exciting, but also stress-provoking event. What if I banded incorrectly and caused more bleeding? With a successful band, a patient’s hemorrhagic shock is now controlled, hemodynamics improved, and euphoria takes over. Now, in my third year of gastroenterology fellowship but first year of the American Gastroenterological Association (AGA) Editorial Fellowship, preparing for my first manuscript that I handled and was to present to the Board of Editors at our weekly meeting has now induced the same excitement and need for the same level of dedication. Have I researched the foundational literature that this current manuscript was built on? What is the trajectory of this research and will this project be interesting to our readers and lead to breakthroughs in the field? Gastroenterology is the premier flagship journal of the AGA and in this Editorial Fellowship, I was selected to spend a fully immersive 1-year experience to work in all aspects of this journal. In its second year of inception, I echo Dr Eric Shah’s insight into the transformative and immersive nature of this Fellowship.1Shah E.D. Skills acquired during my 1-Year AGA editorial fellowship.Gastroenterology. 2018; 154: 1563Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar In this role, I have made three developments and each one has left me with a valuable lesson. My first development was as a direct mentee under the leadership of Editors-in-Chief, Drs Peek and Corley and Associate Editor, Dr John Inadomi. In this role, I reviewed submitted manuscripts regarding outcome data of oncological studies in the fields of colon, esophageal, and gastric cancer. I served as a reviewer for submitted manuscripts and discussed the impact, novelty, and decision for publication with the Board of Editors. In our weekly meetings, the Associate Editors discussed manuscripts that needed further review prior to acceptance, revision, or rejection. A few themes underpinned the discussion of these manuscripts:•Is this science reproducible and is there scientific rigor for study design, validity, and analysis?•How does this manuscript add to the current state of the literature?•What is the trajectory of this research field?•How will this manuscript lead to breakthroughs in this field?•Are the advancements in this manuscript likely to lead to paradigm shifts in the field in its approach, design, or findings? I was also fortunate to meet leaders in the field, including working daily in person with multiple members of the Board of Editors at Vanderbilt University Medical Center, but also visiting professors, including Drs Corley, Rabeneck, and Liang who not only spoke on their scientific inquiries but also their transitional path from a gastroenterology fellow to a pioneer in their respective fields. From this lesson, I have learned the scientific rigor of manuscript review for Gastroenterology and also how to approach modern challenges in our field to directly improve patient care. The Editorial Fellowship allowed me to expand a traditional 3rd year gastroenterology fellowship to dive deeply into the intense path to get a manuscript published in Gastroenterology. Where one year prior I found dilating a complete esophageal stricture difficult, I now found myself learning to master clinical trial design, applying modern techniques of artificial intelligence, understanding organoid development, and navigating the impact of the microbiome. I was fortunate to be selected for Vanderbilt’s Master’s in Science in Clinical Investigation which allowed me to apply my education not only to my own research, but also to synergistically understand and deconstruct new submission ranging from modern statistics with Bayesian modeling to analysis of large genetic data. All of this was built in a supportive framework of my mentoring committee. As a fellow, I am inspired to see the multi-center, international collaboration to answer important questions in our field. Leveraging large databases and the expertise of multiple investigators, breakthroughs were made due to the collaborative nature of the science. This was also felt in the review process, where experts in the field generously reviewed multiple manuscripts to help improve the submitted manuscripts to advance the science. Reading hundreds of these reviews this year has allowed me to refocus my current research studies and also improve the way I write my current reviews. In the spirit of reproducible science and challenging the precision of study design, I was impressed by the time, effort, and dedication reviewers from our field spent to help improve the literature. The Editors-in-Chief, Drs Peek and Corley, committed their time in discussing my innovations and critiques and showed their level of vested interest in the opinions of early career investigators and fostering the next generation of scientists and practitioners. In this lesson, I was invigorated by the depth of AGA opportunities for fellow and junior faculty in education, research, and involvement. Having the honor and privilege to review manuscripts upon submission also increased my critical view of my current practices. I now question the level of evidence for which current patient care practices are based on which allows me to better understand the research areas that need increased attention to improve our quality of guidelines and evidence. For motivated fellows interested in a path of academic medicine, I would strongly advise applying for this prestigious fellowship. In no other training process, could I have learned such a breadth of scientific skills and directly apply them to my patient care, my research, and my role as an educator. Furthermore, I was able to contribute towards the reviewing and editing process, which allowed me to directly contribute to the field at an early stage of my career. In this final lesson, I exit this impactful Editorial fellowship in reflection. I leave this Fellowship humbled -- by you the reader who continues to learn to improve your patient care, the scientist as she works tirelessly to answer questions and contribute to the literature, the gastroenterology community for their willingness to teach and mentor fellows and early career investigators and practitioners, and the patient who reminds us that we all have a shared mission to advance scientific knowledge to improve patient care.