Career In Academic Medicine Research Articles

Perspective: PhD Scientists Completing Medical School in Two Years: Looking at the Miami PhD-to-MD Program Alumni Twenty Years Later

Producing and retaining physician-scientists remains a major challenge in advancing innovation, knowledge, and patient care across all medical disciplines. Various programs during medical school, including MD-PhD programs, have been instituted to address the need for continued production of physician-scientists. From 1971 through 1989, 508 students with a prior PhD in the sciences, mathematics, or engineering graduated in two years from an accelerated MD program at the University of Miami School of Medicine. The program, designed to address potential clinical physician shortages rather than physician-scientist shortages, quickly attracted many top-notch scientists to medicine. Many program graduates went to top-tier residencies, pursued research careers in academic medicine, and became academic leaders in their respective fields. A retrospective examination of graduates conducted in 2008-2009 demonstrated that approximately 59% took positions in academic university medical departments, 3% worked for governmental agencies, 5% entered industry as researchers or executives, and 33% opted for private practice. Graduates' positions included 85 full professors, 11 university directors or division heads, 14 academic chairs, 2 medical school deans, and 1 astronaut. Overall, 30% of graduates had obtained National Institutes of Health funding after completing the program. These results suggest that accelerated medical training for accomplished scientists can produce a large number of successful physician-scientists and other leaders in medicine. Furthermore, these results suggest that shortening the medical portion of combined MD-PhD programs might also be considered.

Engaging Students in Dedicated Research and Scholarship During Medical School: The Long-Term Experiences at Duke and Stanford

For more than 40 years, the faculties of Duke University School of Medicine (SOM) and Stanford University SOM have encouraged or required students to engage in scholarship as a way to broaden their education and attract them to careers in academic medicine. A dedicated period of research was first integrated into the Duke curriculum in 1959 to provide an opportunity for students to develop into physician leaders through a rigorous scholarly experience in biomedically related research. Originally designed to foster experience in laboratory-based basic research, the third-year program has evolved in response to the changing landscape of medicine and shifting needs and career interests of the medical student population. Stanford University SOM also has a long-standing commitment to biomedical research and currently requires each student to complete an in-depth, mentored "scholarly concentration." In contrast to Duke, where most of the scholarly research experiences take place in an immersive third year, the Stanford program encourages a longitudinal, multiyear exposure over all four (or five) years of medical school. Although the enduring effects of embedding a rigorous research program are not yet fully known, preliminary data suggest that these experiences instill an appreciation for research, impart research rigor and methodologies, and may motivate students to pursue careers in academic medicine. The authors discuss the histories, evolution, logistics, and ongoing challenges of the research programs at Duke University SOM and Stanford University SOM.

Anthony Trevor Seaton

As a student, Anthony Trevor Seaton (“Trevor”) was enthusiastic and dedicated and excelled academically. However, he initially rejected a career in academic medicine in favour of general practice like his...

John Anthony Calvert

As a student, John Anthony Calvert was senior president of the Royal Medical Society. He rejected a career in academic medicine in favour of general practice, and gained early experience...

Of mentors, mentoring, and extracellular matrix #

D. Montgomery Bissell briefly describes the way he came to a career in academic medicine, how he found mentors, initial projects, and finally a focus on matrix biology and hepatic fibrosis. He draws some lessons from the experience, which should have relevance for physician-scientist trainees, those considering that path, anyone with responsibility for training the next generation, institutional leaders, and the National Institutes of Health.

Commentary: Missing the Elephant in My Office: Recommendations for Part-Time Careers in Academic Medicine

Several recent articles in this journal, including the article by Linzer and colleagues in this issue, discuss and promote the concept of part-time careers in academic medicine as a solution to the need to achieve a work-life balance and to address the changing demographics of academic medicine. The article by Linzer and colleagues presents the consensus of a task force that attempted to address practical considerations for part-time work in academic internal medicine. Missing from these discussions, however, are a consensus on the definition of part-time work, consideration of how such strategies would be available to single parents, how time or resources will be allocated to part-time faculty to participate in professional associations, develop professional networks, and maintain currency in their field, and how part-time work can allow for the development of expertise in research and scholarly activity. Most important, the discussions about the part-time solution do not address the root cause of dissatisfaction and attrition: the ever-increasing and unsustainable workload of full-time faculty. The realization that an academic full-time career requires a commitment of 80 hours per week begs the question of whether part-time faculty would agree to work 40 hours a week for part-time pay. The historical underpinnings of the current situation, the implications of part-time solutions for the academy, and the consequences of choosing part-time work as the primary solution are discussed. Alternative strategies for addressing some of the problems facing full-time faculty are proposed.

Part-Time Careers in Academic Internal Medicine: A Report From the Association of Specialty Professors Part-Time Careers Task Force on Behalf of the Alliance for Academic Internal Medicine

To establish guidelines for more effectively incorporating part-time faculty into departments of internal medicine, a task force was convened in early 2007 by the Association of Specialty Professors. The task force used informal surveys, current literature, and consensus building among members of the Alliance for Academic Internal Medicine to produce a consensus statement and a series of recommendations. The task force agreed that part-time faculty could enrich a department of medicine, enhance workforce flexibility, and provide high-quality research, patient care, and education in a cost-effective manner. The task force provided a series of detailed steps for operationalizing part-time practice; to do so, key issues were addressed, such as fixed costs, malpractice insurance, space, cross-coverage, mentoring, career development, productivity targets, and flexible scheduling. Recommendations included (1) increasing respect for work-family balance, (2) allowing flexible time as well as part-time employment, (3) directly addressing negative perceptions about part-time faculty, (4) developing policies to allow flexibility in academic advancement, (5) considering part-time faculty as candidates for leadership positions, (6) encouraging granting agencies, including the National Institutes of Health and Veterans Administration, to consider part-time faculty as eligible for research career development awards, and (7) supporting future research in "best practices" for incorporating part-time faculty into academic departments of medicine.

Swiss national MD-PhD-program: an outcome analysis.

This study aims at a first evaluation of the outcome of the Swiss national MD-PhD program during the last 16 years. One hundred and twenty six former and current students in the Swiss national MD-PhD program were surveyed via a Web-based questionnaire in September 2007. Twenty-four questions assessed information regarding participant demographics, information on the PhD thesis and publication activity, current positions and research activity, as well as participant's opinions, attitudes and career goals. Eighty questionnaires were received from 126 MD-PhD students and graduates (63.5% response rate). The responders consisted of present students (36%), former graduates (56%), and dropouts (8%). The percentage of women in the program was 23%, and the average duration of the program was 4.2 +/- 1.4 years. Research interests were predominantly in the fields of neuroscience, immunology, molecular biology and cancer research. A considerable portion of the MD-PhD graduates had an excellent publication record stemming from their PhD research work, and 89% were planning to continue a research-orientated career. Over 50% of those MD-PhD graduates completing their thesis before 2002 had already reached an assistant or full professor position at the time of the survey. Nearly all participants considered the MD-PhD training helpful to their career and high quality standards were assigned to the acquired practical and intellectual skills. However, criticism was expressed concerning the general mentoring and the career related mentoring. Moreover, general mentoring and career related mentoring were significantly less well perceived in research groups employing more than seven PhD students at the same time. The MD-PhD students and graduates surveyed were satisfied with their education and most of them continued a research-orientated career. Regarding the overall positive evaluation, this study supports the view that MD-PhD graduates are well qualified for a successful career in academic medicine.

Swiss national MD-PhD-program: an outcome analysis.

This study aims at a first evaluation of the outcome of the Swiss national MD-PhD program during the last 16 years. One hundred and twenty six former and current students in the Swiss national MD-PhD program were surveyed via a Web-based questionnaire in September 2007. Twenty-four questions assessed information regarding participant demographics, information on the PhD thesis and publication activity, current positions and research activity, as well as participant's opinions, attitudes and career goals. Eighty questionnaires were received from 126 MD-PhD students and graduates (63.5% response rate). The responders consisted of present students (36%), former graduates (56%), and dropouts (8%). The percentage of women in the program was 23%, and the average duration of the program was 4.2 +/- 1.4 years. Research interests were predominantly in the fields of neuroscience, immunology, molecular biology and cancer research. A considerable portion of the MD-PhD graduates had an excellent publication record stemming from their PhD research work, and 89% were planning to continue a research-orientated career. Over 50% of those MD-PhD graduates completing their thesis before 2002 had already reached an assistant or full professor position at the time of the survey. Nearly all participants considered the MD-PhD training helpful to their career and high quality standards were assigned to the acquired practical and intellectual skills. However, criticism was expressed concerning the general mentoring and the career related mentoring. Moreover, general mentoring and career related mentoring were significantly less well perceived in research groups employing more than seven PhD students at the same time. The MD-PhD students and graduates surveyed were satisfied with their education and most of them continued a research-orientated career. Regarding the overall positive evaluation, this study supports the view that MD-PhD graduates are well qualified for a successful career in academic medicine.

Thomas E. Andreoli, MD 1935–2009

Thomas E. Andreoli, M.D., passed away on April 14, 2009. Dr. Andreoli’s meteoric career in academic medicine is outlined in detail in published obituaries (see New York Times April 19, 2009). He was the recipient of awards and honors too numerous to mention, but his legacy is far greater than the many awards and honors that he received. Dr. Andreoli was a long-time member of the Southern Society for Clinical Investigation. It was following his suggestion that I become a member of the Southern Society for Clinical Investigation, that he nominated me for membership in the Southern Society.

Fellowship Training in Rhinology

To define the educational goals and determine the success of formal fellowship programs in rhinology. An anonymous, Internet-based survey of current rhinology fellows and those from the past 5 years. A 5-point ordinal Likert scale was used, with higher scores being more favorable. Complete responses were collected from 46 of 70 eligible participants (66%), representing 19 fellowship programs. High overall satisfaction with the fellowship experience was reported (mean score, 4.7). Pooled scores for comfort levels with the management of medical issues (mean, 4.8) and surgical procedures (mean, 4.5) were also positive. Following completion of training, lesser levels of comfort were associated with craniofacial procedures (P <.001), frontal sinus obliteration (P <.001), and dacryocystorhinostomy (P = .002) compared with all surveyed procedures. Respondents reported a greater interest in (mean score, 4.3 vs 2.4; P <.001) and preparation for (4.3 vs 3.5; P <.001) a career in academic medicine compared with private practice. The rhinology fellowship experience appears to be generally favorable in terms of meeting stated training goals and helping fellows achieve subjective comfort with medical and surgical management of rhinological disorders. Continued discussion of the goals of rhinology fellowship training is necessary.

An intercalated BSc degree is associated with higher marks in subsequent medical school examinations

BackgroundTo compare medical students on a modern MBChB programme who did an optional intercalated degree with their peers who did not intercalate; in particular, to monitor performance in subsequent undergraduate degree exams.MethodsThis was a retrospective, observational study of anonymised databases of medical student assessment outcomes. Data were accessed for graduates, University of Aberdeen Medical School, Scotland, UK, from the years 2003 to 2007 (n = 861). The main outcome measure was marks for summative degree assessments taken after intercalating.ResultsOf 861 medical students, 154 (17.9%) students did an intercalated degree. After adjustment for cohort, maturity, gender and baseline (3rd year) performance in matching exam type, having done an IC degree was significantly associated with attaining high (18–20) common assessment scale (CAS) marks in three of the six degree assessments occurring after the IC students rejoined the course: the 4th year written exam (p < 0.001), 4th year OSCE (p = 0.001) and the 5th year Elective project (p = 0.010).ConclusionIntercalating was associated with improved performance in Years 4 and 5 of the MBChB. This improved performance will further contribute to higher academic ranking for Foundation Year posts. Long-term follow-up is required to identify if doing an optional intercalated degree as part of a modern medical degree is associated with following a career in academic medicine.

Medical teachers' attitudes towards science and motivational orientation for medical research

Research is an important motivating factor for pursuing a career in academic medicine, but the relation between motivation and other factors involved in scientific research are not clear. To explore the motivational orientation for doing research and its relation with attitudes towards science and publication practice among members of faculty at a medical school. We used a Science Attitude Survey and the Work Preference Inventory (intrinsic and extrinsic motivational orientation using 4 Likert-type scales of motivation, possible range 1-5) to survey two groups of teachers at the Zagreb University School of Medicine (n = 327, 66% response rate): professors, elected to tenure-track positions (n = 150), and instructor/research fellows working on or just completing their thesis (n = 177). Overall, teachers scored highest on the Enjoyment subscale of intrinsic motivational orientation (mean score +/- standard deviation 4.3 +/- 0.42 for professors vs 4.1 +/- 0.42 for instructors/research fellows, P = 0.001, t-test). Professors also scored higher than instructors/research fellows on the Challenge subscale of intrinsic motivational orientation (3.8 +/- 0.55 vs. 3.5 +/- 0.64, P < 0.001, t-test), whereas instructors/research fellows scored higher on the Compensation subscale of extrinsic motivational orientation (3.5 +/- 0.74 vs. 3.1 +/- 0.71, P < 0.001, t-test). Multiple linear regression analysis showed that the number of publications was positively associated with scores on the Science Attitude Survey and the Challenge subscale of intrinsic motivation, and negatively associated with scores on the Compensation subscale of extrinsic motivation. Members of the medical faculty differ in motivational orientation for research depending on their academic status, and their motivation is associated more with requirements for academic advancement than with research. These findings have important implications for developing strategies for enhancing academic research production.

Academic career in medicine: requirements and conditions for successful advancement in Switzerland.

BackgroundWithin the framework of a prospective cohort study of Swiss medical school graduates a sample of young physicians aspiring to an academic career were surveyed on their career support and barriers experienced up to their sixth year of postgraduate training.MethodsThirty-one junior academics took part in semi-structured telephone interviews in 2007. The interview guideline focused on career paths to date, career support and barriers experienced, and recommendations for junior and senior academics. The qualitatively assessed data were evaluated according to Mayring's content analysis. Furthermore, quantitatively gained data from the total cohort sample on person- and career-related characteristics were analyzed in regard to differences between the junior academics and cohort doctors who aspire to another career in medicine.ResultsJunior academics differ in terms of instrumentality as a person-related factor, and in terms of intrinsic career motivation and mentoring as career-related factors from cohort doctors who follow other career paths in medicine; they also show higher scores in the Career-Success Scale. Four types of career path could be identified in junior academics: (1) focus on basic sciences, (2) strong focus on research (PhD programs) followed by clinical training, (3) one to two years in research followed by clinical training, (4) clinical training and research in parallel. The interview material revealed the following categories of career-supporting experience: making oneself out as a proactive junior physician, research resources provided by superior staff, and social network; statements concerning career barriers encompassed interference between clinical training and research activities, insufficient research coaching, and personality related barriers. Recommendations for junior academics focused on mentoring and professional networking, for senior academics on interest in human resource development and being role models.ConclusionThe conditions for an academic career in medicine in Switzerland appear to be difficult especially for those physicians combining research with clinical work. For a successful academic career it seems crucial to start with research activities right after graduation, and take up clinical training later in the career. Furthermore, special mentoring programs for junior academics should be implemented at all medical schools to give trainees more goal-oriented guidance in their career.

Becoming an academic doctor: perceptions of scholarly careers

Despite a recognised need to prepare future faculty members, little research has been conducted on how best to accomplish this task, especially among learners and faculty members within research-intensive medical schools. We interviewed 40 medical students, residents and faculty members from a single institution in the USA and asked questions about which careers the school does and should prepare individuals for, and the strengths of the institution for doing so. Interviews were conducted in person at a location chosen by the participant. All interviews were transcribed and coded using qualitative methods and software. The coding and themes were reviewed and discussed among members of the research team and verified by external reviewers. We identified five themes related to becoming an academic doctor: early exposure to research; role models and mentoring; career pathways; interplay of personal and social factors, and career support for junior faculty members. Results suggest that opportunities should be structured within undergraduate and graduate medical education to stimulate interest in careers as academic doctors and to aid junior faculty members to act as role models who can encourage learners to pursue careers in academic medicine.

Academic Careers in Cardiovascular Medicine

With aging of the US population and continued success in prolonging survival of patients with cardiovascular disease, the prevalence of cardiovascular disease will increase exponentially in the next several decades.1 The anticipated supply of cardiovascular specialists will be insufficient to meet the demands of this increasing disease burden. A shortage already exists of cardiologists as a whole, and this shortage has translated to an even greater undersupply of academic cardiovascular specialists as fewer and fewer physicians who enter the field pursue academic positions. Prolonged training periods, expanding debt burdens, increasing discrepancies between salaries in academic and private practice positions, and a perceived lack of funding for research continue to push cardiologists into the private sector. The cardiovascular clinician-scientist is an endangered species. So the question arises: How do we combat these real and perceived threats and increase the number of young cardiologists choosing careers in academic cardiovascular medicine? The purpose of this series of articles in Circulation is to provide trainees and new faculty with a practical guide to launching a successful research career in cardiovascular medicine across the spectrum of cardiovascular specialties and across the strata of scientific investigation. The primer will provide advice for choosing a mentor; selecting a research project; identifying funding opportunities; selecting a research career pathway among the many opportunities in basic, clinical, epidemiologic, outcomes, and translational research; writing a grant; publishing a paper; finding a job; and making the transition from fellow to faculty. In addition, issues on ethics in cardiovascular research and specific considerations for international trainees are included. Our aim is to provide new investigators with many of the tools they will need to make informed choices about entering academic cardiovascular medicine and to make the initial career stages as successful as possible. Cardiovascular medicine is a specialty defined by research …

Keeping clinicians in clinical research: the Clinical Research/Reproductive Scientist Training Program

In recent years the need for translational and clinical research has increased, whereas the number of physicians involved in clinical research has diminished. There is clearly a need for formalized academic training in the quantitative and methodologic principles of clinical research in reproductive medicine. The Clinical Research/Reproductive Scientist Training Program (CREST), a program supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the Clinical Research Training Program (CRTP) at Duke University, and the American Society for Reproductive Medicine (ASRM), meets this existing need. In addition, this program is specifically designed for physicians in private or academic clinical practice in reproductive medicine. Innovative programs such as CREST encourage the practicing physician to engage in clinical research while maintaining an active role in clinical practice. Participants in the program receive didactic on-line training from the CRTP and attend intensive weekend seminars at the National Institutes of Health (NIH) as well as CREST seminars at the annual meeting of the ASRM. Successful participants in the program receive a Certificate in Clinical Research from the CRTP. The program's goal is to provide practicing physicians with the tools and research credentials that will facilitate collaborations with investigators involved in large clinical trials.

Editorial Comment

No AccessJournal of UrologyAdult Urology1 Feb 2009Editorial Comment John B. Forrest John B. ForrestJohn B. Forrest More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2008.10.112AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Editorial Comment." The Journal of Urology, 181(2), pp. 765–766 References 1 Forrest JB: Are we preparing urology residents for careers in private practice and/or academic medicine? Society of University Urologists. Presented at annual meeting of American Urological Association, Anaheim, California, May 19-24, 2007 Google Scholar Urologic Specialists of Oklahoma, Inc., University of Oklahoma Health Sciences Center-Tulsa, Tulsa, Oklahoma© 2009 by American Urological AssociationFiguresReferencesRelatedDetails Volume 181Issue 2February 2009Page: 765-766 Advertisement Copyright & Permissions© 2009 by American Urological AssociationMetricsAuthor Information John B. Forrest More articles by this author Expand All Advertisement PDF downloadLoading ...

Practice management education during surgical residency

Background Surgical education has undergone radical changes in the past decade. The introductions of laparoscopic surgery and endovascular techniques have required program directors to alter surgical training. The 6 competencies are now in place. One issue that still needs to be addressed is the business aspect of surgical practice. Often residents complete their training with minimal or no knowledge on coding of charges or basic aspects on how to set up a practice. We present our program, which has been in place over the past 2 years and is designed to teach the residents practice management. Methods The program begins with a series of 10 lectures given monthly beginning in August. Topics include an introduction to types of practices available, negotiating a contract, managed care, and marketing the practice. Both medical and surgical residents attend these conferences. In addition, the surgical residents meet monthly with the business office to discuss billing and coding issues. These are didactic sessions combined with in-house chart reviews of surgical coding. The third phase of the practice management plan has the coding team along with the program director attend the outpatient clinic to review in real time the evaluation and management coding of clinic visits. Results Resident evaluations were completed for each of the practice management lectures. The responses were recorded on a Likert scale. The scores ranged from 4.1 to 4.8 (average, 4.3). Highest scores were given to lectures concerning negotiating employee agreements, recruiting contracts, malpractice insurance, and risk management. The medical education department has tracked resident coding compliance over the past 2 years. Surgical coding compliance increased from 36% to 88% over a 12-month period. The program director who participated in the educational process increased his accuracy from 50% to 90% over the same time period. Conclusions When residents finish their surgical training they need to be ready to enter the world of business. These needs will be present whether pursuing a career in academic medicine or the private sector. A program that focuses on the business aspect of surgery enables the residents to better navigate the future while helping to fulfill the systems-based practice competency.

Chronicles of a cardiologist in Canada's North

Doctor to the North: Thirty Years Treating Heart Disease among the Inuit John H. Burgess MD; McGill-Queen's University Press, 2008; 168 pp $34.95 ISBN 978-0-7735-3431-5 During medical training, aspiring physicians at some point decide whether to pursue a career in academic or community medicine.