Career In Academic Medicine Research Articles

Transforming a U.S. scholarly concentrations program internationally: lessons learned

BackgroundScholarly Concentrations programs in U.S. medical schools aim to instill passion for critical thinking and promote careers in academic medicine. The rise of these programs has seen variable goals, structure, and outcomes. Transformation of these programs internationally is in its infancy.MethodsWe describe implementation of the Johns Hopkins School of Medicine Scholarly Concentrations program, offering Basic Science, Clinical Science, Medical Ethics/Healing Arts, History of Medicine, and Public Health/Community Service, at Bezmiâlem Vakif University in Istanbul, Turkey. Over six modules in the preclinical years, students develop a faculty-mentored experience which encourages the acquisition of attitudes and skills for self-directed, lifelong learning and scholarship. This culminates in abstract and project presentation. We report program characteristics (context and logistics) and outcomes (student engagement and experiences).ResultsThe Scholarly Concentrations program at Bezmiâlem began in 2014, with nearly two completed cohorts of students. In comparison to Johns Hopkins, students at Bezmiâlem begin at an earlier age (thus do not have as much prior research experience) and are subsequently evaluated for residency in terms of test scores rather than scholarship and publications, but have a similar level of intellectual curiosity and desire to take ownership of their project. Eighty-two percent of Bezmiâlem students stated the project they pursued was either their own idea or was an idea they formed after meeting with their mentor. Students at Bezmialem were more likely to choose Clinical Science projects (p = 0.009). Only 5% of Bezmiâlem students in end-of-course survey felt dissatisfied with the level of ownership they experienced with their project, a frequency similar to that seen by Johns Hopkins students (2%).ConclusionsScholarly Concentrations programs play an important role in U.S. medical schools, and these programs can be successfully implemented internationally. The Scholarly Concentrations program at Johns Hopkins has been transformed to a program at Bezmiâlem in Istanbul, the first program outside North America or the European Union. When designing these programs, one must consider the context, logistics, student engagement, and outcomes. While long-term outcomes are needed, this can serve as a model for implementation elsewhere.

Promoting Leadership by Women in Gastroenterology—Lessons Learned and Future Directions

Promoting Leadership by Women in Gastroenterology—Lessons Learned and Future Directions

Women and academic careers in obstetrics and gynaecology: aspirations and obstacles among postgraduate trainees - a mixed-methods study.

To examine the relationship between gender and a career in academic medicine. Mixed-methods study. Obstetrics-gynaecology postgraduate training programme in Paris, France. Postgraduate trainees in obstetrics-gynaecology (n=204). Statistical analysis of quantitative survey data, thematic analysis of qualitative interview data and integrative analysis. Women's aspirations and obstacles related to their decision about a career in academic medicine. A career in academic medicine was envisaged by 13% of the women residents and 27% of the men (P=0.01). Women reported receiving advice from a mentor less often than men (38.8% versus 52.9%, P=0.002). Overall, 40.6% of women and 2.9% of men reported experiencing gender discrimination (P<0.001). In response to the question 'Do you have doubts about your ability to pursue or succeed at an academic career?', 62.4% of the women and only 17.7% of the men answered yes (P<0.001). The global analysis identified the following obstacles: persistent gender stereotypes that produce everyday sexism, lack of identification with male role models, lack of mentors, perceived discrimination, an ideal of professional excellence that is difficult to attain, constraining professional organisational norms, inequality between men and women in the domestic and family spheres, and finally self-censorship and important doubts about their ability to combine a demanding career and a fulfilling personal life. Women reported the desire to follow a career in academic medicine half as often as men. Improving the presence and visibility of role models for residents and combating workplace discrimination will address some of the barriers to women choosing a career in academic medicine. Women obstetric trainees in France are only half as likely as men to envisage following an academic path.

Emerging Subspecialties in Neurology: Pain medicine

Pain medicine is a multidisciplinary field specializing in the diagnosis and treatment of chronic pain anywhere in the body. Neurologists have a long history of contributions to the field of pain medicine, and in our experience, today's generation of aspiring pain neurologists are finding ample opportunities for pain medicine fellowship positions as well as academic and nonacademic pain medicine career opportunities upon graduation. Pain medicine is a rapidly evolving subspecialty that challenges practitioners' cognitive, procedural, psychomotor, and interpersonal skills and offers a desirable work–life balance. Herein the authors provide a general overview of pain medicine as a neurologic subspecialty.

The foundation for a successful career in academic medicine

After being exposed to all facets of medicine, I have found Obstetrics and Gynecology to be the most challenging, artistic and amazing field in medicine. The University of Iowa Obstetrics and Gynecology Residency Program shaped my personality to become a successful academic obstetrician and gynecologist. With the confidence built at the University of Iowa, Department of Obstetrics and Gynecology I saw Fetal Surgery/ Maternal Fetal Medicine as an opportunity to combine these two passions and I did it, thanks to my residency program at Iowa.

Neurology Residents as Comprehensive Educators (Neuro RACE).

Residents are expected to be educators often without any formal schooling, and many continue a career in academic medicine where they play a pivotal role in education. However, few resident curricula have been published to include instruction in teaching, particularly in the field of Neurology. To guide Neurology residents as they take on their role as a clinician-educator, we developed a 1-year curriculum (Neurology Residents as Comprehensive Educators "Neuro RACE") with monthly sessions divided into didactics, small group discussions, and interactive kinetic learning. A postcurriculum survey was used to evaluate the residents' response to this curriculum. Residents reported an overall improvement in their comfort and confidence in their teaching abilities. As an integral part of academic training, residents-as-teachers curricula should take a prominent role in Neurology training programs.

Two-Week Resident-As-Teacher Program May Improve Peer Feedback and Online Evaluation Completion

Many training programs have implemented Resident-as-Teacher curricula. Previous evaluations of such programs have largely focused on direct, often self-assessed benefits to the learner in the curriculum, without evaluating higher-level educational outcomes such as behavioral changes that benefit other trainees and the program as a whole. We developed a 2-week Resident-as-Teacher (RaT) rotation, during which senior medicine residents lecture, lead morning report, teach exam maneuvers, and rehearse feedback skills, under direct faculty observation. We surveyed participating RaT residents, interns who worked with RaT residents, and interns who did not work with RaT residents, and we examined rates of program evaluation completion. All 42 Post Graduate Year 3 residents completed the rotation during the 2015–16 academic year, 26 (62%) during the study period. Of these 26 residents, 21 (81%) responded to the pre-rotation survey and 24 (92%) to the immediate post-rotation and 6-month follow-up surveys. RaT residents reported increased confidence in all teaching formats. Interns who worked with these residents were more satisfied with the feedback they received than their co-interns who did not (92 vs. 63%). Residents who completed the RaT rotation were more likely to fill out online evaluations (mean completion rate 82 vs. 69%). Our 2-week intensive curriculum on teaching and feedback improved self-reported comfort with teaching and preparedness for careers in academic medicine. Moreover, our analysis suggests the intervention changed resident behaviors, improving the experience of other trainees and rates of online evaluation completion.

Moving Career Development Upstream: Evaluation of a Course for Internal Medicine Trainees Contemplating Career Pathways in Academic Medicine.

Despite training in academic medical centers, many residents and fellows lack an understanding of the different career paths in academic medicine. Without this fundamental knowledge, choosing an academic career pathway and transitioning to junior faculty is challenging. We started the Pathways in Academic Medicine course ("Pathways") to introduce residents and fellows to the wide array of academic career pathways and to expose them to the concepts and resources needed to transition successfully from trainee to junior faculty. Sixty-nine medicine residents and fellows participated in Pathways programming. Surveys and focus groups revealed high satisfaction with the course sessions. Trainees indicated that Pathways helped them to envision an academic career, clarified the steps needed to pursue an academic career, and normalized common challenges. Pathways is an important educational innovation that gives participants experiences to jumpstart successful careers in academic medicine. We hope that our program will serve as an example for other institutions interested in improving the trainee-to-faculty transition.

Abstract 5286: Meharry Medical College medical student summer program in integrative science and cancer research

Abstract The American Cancer Society estimates that 1,688,780 new cases of cancer will be diagnosed in 2017 and that 600,920 people will die from their disease. The burden of cancer is disproportionately borne by the poor and underserved. Underrepresented minority physician scientists and clinician researchers are uniquely qualified to address these disparities as they have frequently experienced them in their own families and communities. As some portion of health disparities is rooted in socioeconomic status and lesser education, economically deprived and first generation college students of all races and ethnicities also experience these disparities. Unfortunately, the number of physicians who do research has been declining so the need for programs that educate students in the art and science of research is increasing. The Meharry Medical College Summer Program in Integrative Science and Cancer Research (MMC-SPiISCR) has provided Meharry medical students with the opportunity to participate in short-term cancer research experiences for eleven years. The program is unique in combining weekly half-day workshops at MMC, an historically black college or university, with a research experience supported by faculty mentors at the Vanderbilt University School of Medicine (VUSM),an institution that includes the Vanderbilt Ingram Cancer Center, one of only 69 NCI-Designated Cancer Centers in the United States and District of Columbia. The workshops include topics emphasizing bioethics and responsible conduct of research as well as presentations by Meharry faculty on their cancer research, cancer disparities, cancer and big data and more. The overarching goal of this program is to inspire Meharry medical students to aspire to medical careers in academic medicine and/or careers that will ultimately include cancer research. To date, 73 MMC students have started and completed the program and 94% are from underrepresented minority groups. The male to female ratio reflects the male to female ratio of the class. Over half of the participants presented their work at meetings outside of the program including AACR National Meeting, AACR Science of Cancer Disparities, Society of Black Academic Surgeons, Student National Medical Association, American Medical Association Research Symposium, American Society for Clinical Oncology, KBRIN Bioinformatics Summit and the Meharry-Vanderbilt-TSU Cancer Partnership Annual Retreat. The students are authors on 27 manuscripts and these numbers are still growing as is the interest of program participants in doing a year of research. Surveys of both mentors and program participant mentees overwhelmingly support the strength of this program and participation in the future. This comprehensive program will go far towards fueling the physician-scientist pipeline with researchers whose life experiences mirror those of minority and underserved patients. Citation Format: Dana R. Marshall, Carol Freund-Taylor, Philip Lammers, Leon Dent, Samuel Adunyah, Billy Ballard. Meharry Medical College medical student summer program in integrative science and cancer research [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5286.

Scholarship in Emergency Medicine: A Primer for Junior Academics: Part II: Promoting Your Career and Achieving Your Goals.

Scholarship is an important component of success for academic emergency physicians. Scholarship can take many forms, but all require careful planning. In this article, we provide expert consensus recommendations for improving junior faculty’s scholarship in emergency medicine (EM). Specific focus is given to promoting your research career, obtaining additional training opportunities, networking in EM, and other strategies for strategically directing a long-term career in academic medicine.

Reflections on a career in academic medicine

Reflections on a career in academic medicine

Interest and perceived barriers toward careers in academic medicine among medical students at Alfaisal University – College of Medicine: A Saudi Arabian perspective

Aims: [1] Identify the percentage of undergraduate students who are interested in academic medicine (AM) careers, [2] Explore the relationship between students’ characteristics, previous experiences and interest in AM careers and [3] Determine students’ perceived barriers toward AM careers at Alfaisal University – College of Medicine.Methods: An online, anonymous, random, self-rating survey was administered during spring 2013–2014 to second-year and third-year students (n = 302). Chi-square test was used to correlate between interest in AM careers and students’ characteristics. Mann–Whitney U-test was used to compare the mean 5-point Likert scale responses between male and female students.Results: A total of 231 students participated in the survey (response rate: 76.5%). A total of 32 students (13.9%) expressed interest in AM careers, and this percentage significantly differed by gender, academic year, interest in teaching and research and previous research experiences (p < 0.05). The top three barriers were “lower income” (77.5%), “competing pressures to fulfill clinical-teaching-research duties” (73.6%) and “lack of career advising” (69.7%). As opposed to males, females achieved higher statistically significant differences of means regarding: “competing pressures to fulfill clinical-teaching-research duties” (p < 0.001) and “lack of same-gender role models in AM careers” (p < 0.000).Conclusions: AM careers were unpopular by students. Curricular, extracurricular and institutional measures should be implemented to rectify this dilemma.

MP21: Global emergency medicine fellowship: establishing a global EM training program at Queen’s University

Introduction: Global Emergency Medicine (Global EM) is growing rapidly as an academic niche in Canada. An increasing number of Canadian emergency physicians work internationally as part of their practice, and trainees consistently seek out international projects and electives. For the most part however, residents have had to create their own training opportunities as formal Global EM fellowship training has been lacking in Canada. To address this identified need, Queens University established a Global EM fellowship, the first of its kind in the country. Methods: The fellowship is designed to provide the skills necessary for an academic career in Global Emergency Medicine. Curriculum and objectives are modeled on similar well-established fellowships in the United States. Areas of expertise include emergency medicine systems development, humanitarian medicine, disaster response, public health, tropical medicine, research, administration and education. Fellows have the opportunity to tailor their training according to their specific interests within these domains. Importantly, the fellowship provides direct mentorship from academic global EM and public health physicians, and networking opportunities within the global health sphere. Results: The two-year fellowship curriculum is divided between: 1) coursework to complete a Master of Public Health (MPH) Degree 2) fieldwork 3) relevant international emergency medicine training courses and 4) clinical work in the emergency departments at the Kingston Health Sciences Center. The Queens Global EM fellowship admitted its first fellow in August 2017. To date, the inaugural fellow has completed the MissionCraft Leadership in Disaster Relief course as well as a Humanitarian U Disaster and Response course, in addition to submitting a research grant as a co-principal investigator, starting coursework for an MPH degree and giving several invited lectures on humanitarian medicine. The fellow also travelled to Lebanon to support research in collaboration with aid organizations responding to the Syrian crisis. Upcoming fieldwork involves teaching at a newly established emergency medicine residency program in Haiti as well as a humanitarian crisis deployment. Conclusion: In response to a lack of formal international emergency medicine training opportunities in Canada, Queens University has established a Global Emergency Medicine fellowship. The fellowship aims to provide protected time, access to field opportunities and dedicated mentorship to develop the skills necessary to succeed as an academic Global EM physician. We believe it provides a unique opportunity to significantly expand fellows experiences in global health fieldwork, education and research while continuing to practice in a Canadian tertiary emergency department.

Personal values influencing career path in academic medicine: Perspectives of selected Canadian trainees

To pursue research, education, and health policy in one’s career, broadly defined as academic medicine, is one of the most important decisions of a trainee doctor’s career. Despite this, there is scant literature on which factors influence trainees’ choices towards clinical work or academic research. As the MD/PhD is a relatively young training path compared to the traditional PhD (Doctor of Philosophy) and MD (Doctor of Medicine) programs, it prompts the question: at the crossroads of a career, what sways the individual to select an MD, PhD, or MD/PhD program? This is a valuable question to be answered for trainees who are considering multiple career paths, for educators who want to guide undifferentiated students, and for policy makers who develop and coordinate research programs. “Intellectual stimulation” is the most consistently identified personal value which draws trainees to academic medicine. Mentorship is linked strongly to success in the field. Conversely, long training periods, a lack of autonomy, and financial considerations are deterrents from a career in academic medicine. Insight into the decision-making process is provided by recent Canadian trainees in these respective fields, in a series of short interviews.

Residents' Perspectives on Careers in Academic Medicine: Obstacles and Opportunities.

Worsening faculty shortages in medical schools and residency programs are threatening the US medical education infrastructure. Little is known about the factors that influence the decision of family medicine residents to choose or not choose academic careers. Our study objective was to answer the following question among family medicine residents: "What is your greatest concern or fear about pursuing a career in academic family medicine?" Participants were family medicine residents who attended the Faculty for Tomorrow Workshop at the Society of Teachers of Family Medicine Annual Spring Conference in 2016 and 2017. Free responses to the aforementioned prompt were analyzed using a constant comparative method and grounded theory approach. A total of 156 participants registered for the workshops and 95 (61%) answered the free response question. Eight distinct themes emerged from the analysis. The most frequently recurring theme was "lack of readiness or mentorship," which accounted for nearly one-third (31%) of the codes. Other themes included work-life balance and burnout (17%), job availability and logistics (15%), lack of autonomy or flexibility (11%), competing pressures/roles (10%), lower financial rewards (4%), politics and bureaucracy (4%), and research (3%). To our knowledge, this is the first study to identify barriers and disincentives to pursuing a career in academic medicine from the perspective of family medicine residents. There may be at least eight major obstacles, for which we summarize and consider potential interventions. More research is needed to understand why residents choose, or don't choose, academic careers.

Preparing for an Academic Career: The Significance of Mentoring.

Mentorship is essential for students considering a future in academic medicine. Mentoring is recognized as one of the most important factors in determining career success through enhancing trainees' goals and productivity. An effective mentoring relationship can drive trainees' goals to fruition by providing support so that opportunistic risk can be taken and failures can be reevaluated into learning experiences. Mentorship has such importance that it was deemed mandatory in education by the Liaison Committee on Medical Education and the Accreditation Council for Graduate Medical Education. Moreover, mentoring can play a significant role in helping to diversify the academic medicine workforce. This 60-minute workshop utilizes a didactic PowerPoint presentation and small-group role-play exercise to introduce participants to the importance of mentoring in the development of academic medicine careers and to provide instruction on establishing effective meetings with prospective mentors. Faculty facilitated the workshop at nine regional academic medicine conferences held across the country. Eighty-seven diverse participants completed an evaluation form. In comparing pre- and postworkshop responses, there was a statistically significant increase in confidence to "Find a mentor for a career in academic medicine" (2.29 vs. 3.26, p < .001) and "Have a successful relationship with an academic medicine mentor" (2.52 vs. 3.38, p < .001). Moreover, more than 85% agreed or strongly agreed that the workshop's learning objectives were met. Trainees from diverse backgrounds gained crucial insight into the importance of mentorship and techniques on how to establish and maintain mentors while pursuing an academic medicine career.

Improving female physician's careers in academic medicine: Chances and challenges.

University hospitals are involved in the care of critically ill patients, pregraduate and postgraduate education, and medical research with an increasing demand on physicians due to a higher burden of disease. The number of female physicians is increasing; however, young female physicians are less willing to work at university hospitals under the given conditions. They often do not find appropriate working conditions in mostly hierarchically structured university hospitals. Institutional structures involuntarily erect barriers against the recruitment, retention, and career progression of women. Gendered working conditions remain firmly fixed, and this is even more challenging - overt discrimination has been replaced by less visible mostly implicit stereotypes and prejudices against women. Having children is an additional "career stopper" for female physicians: those with children are less likely to be promoted and have a lower income. Regulatory measures should act in several directions: cultural gender equality policies, family support policies, and active work policies.

Systematic review of interventions to encourage careers in academic medicine

Aims: Academic medicine is a career route that historically struggles to recruit and retain suitable doctors. The aim of this paper is to review the evidence for interventions to encourage careers in academic medicine by way of a descriptive systematic review.Methods: Key databases were searched in February 2017. Studies that evaluated interventions to encourage careers in academic medicine and that used a pre–post analysis or included a comparison group were included. Interventions reporting only learner satisfaction were excluded. The review was specific to medical students and graduates.Results: Twenty-four studies were identified for inclusion within the review. The included studies identified interventions across five domains: postgraduate funding, postgraduate training, mentoring, undergraduate interventions, and institutional change. The papers varied in terms of strength of conclusion and method of analysis with broad, structured, well-funded programs having the most palpable results.Conclusions: The five domains identified offer a framework that can be used by institutions who wish to develop similar programs. It also offers a body of research on which an evidence base can be built.

Diversity and Inclusion in the Academic Medicine Workforce: Encouraging Medical Students and Residents to Consider Academic Careers.

The expansion of medical schools and increased faculty attrition call for heightened efforts to encourage medical students and residents to consider academic careers. As diversity serves as a driver of institutional excellence, special attention to the ongoing underrepresentation of certain groups in academia, such as racial and ethnic minorities, women, and lesbian, gay, bisexual, and transgender individuals, is warranted. We developed a 90-minute workshop to raise medical student and resident awareness of academic medicine careers, and the benefits and challenges of having a diverse faculty. The workshop consists of a didactic PowerPoint presentation and a reflection exercise, shared in small- and large-group format, discussing facilitators and barriers to pursuing academia. The workshop was implemented at nine regional conferences. There were 165 diverse participants. In comparing pre- and postworkshop responses of learners using the sample t test, there was a statistically significant increase in confidence to succeed in academic medicine given learners' gender (2.69 vs. 3.34, p < .001), race and ethnicity (2.53 vs. 3.24, p < .001), or sexual orientation (3.04 vs. 3.42, p < .001). Approximately 95% of learners felt that each of the workshop's learning objectives had been achieved. Participants considered the workshop to be enlightening, motivational, realistic, and validating. This workshop was effective in providing an interactive format for medical students and residents to gain awareness of the state, benefits, and challenges of diversity and inclusion in academic medicine, and can affect their perception of being a future faculty member.

An Introduction to Research Work, Scholarship, and Paving a Way to a Career in Academic Medicine.

Despite high faculty attrition and challenges to expanding the number of clinician-researchers, career development to heighten trainees' pursuit of an academic research career remains a relatively understudied topic. Completing peer-reviewed publications during medical school increases a trainee's likelihood of becoming a future faculty member. There is a lack of educational content to guide trainees in selecting research activities, publishing, and gaining self-efficacy to pave a path towards a clinician-researcher track. The Kern model was applied to create a multimodal workshop that would heighten trainee awareness of various research opportunities, skills for conducting research, best practices in publishing, and also help them develop a personal plan to pursue research. The workshop included a presentation, reflection exercises, and a case scenario. The workshop was implemented among trainees attending professional development conferences at nine medical schools. A questionnaire assessed participants' change in self-efficacy in completing research scholarship and pursuing an academic research career. Sixty medical students and seven residents participated in the workshops. Paired-sample t tests indicated a statistically significant increase in participants' perception that academic medicine would allow them to engage in research work, and in their self-efficacy to publish and succeed along a clinician-researcher track. The workshop not only exposed participants to a variety of research activities but also provided a sense that all research types are valid, aiding some participants to identify new research opportunities. In addition, participants gained clarity on how to publish and develop a research path, which may help maintain interest in a clinician-researcher track.