Building a research career in general internal medicine: a perspective from young investigators

Developing a Physician-Led Model for Research Mentorship in Academic Urology

PURPOSE OF REVIEW

Quality mentorship is difficult to attain amidst the conflicting demands of academic medicine. In this review, we sought to characterize mentor-mentee relationships and discuss their optimization towards productivity in the research team setting.

RECENT FINDINGS

A high-value mentor, defined by exceptional commitment to both research productivity and mentoring, naturally attracts prospective mentees, who can demonstrate their interest by shadowing and completing delegated tasks. Once fully initiated, the mentee establishes expectations with the mentor, identifies their roles within the research team, and, over time, takes ownership of the mentor-mentee relationship and collaborates with near-peers. Mentorship is a dynamic, reciprocal relationship that enhances career development of both participants. In the research team setting, episodic virtual research meetings and prudent delegation orient the entire team, while the mentor-mentee relationship is upheld by embracing a culture of responsiveness, feedback, and collaboration.

Mentoring up: Twelve tips for successfully employing a mentee-driven approach to mentoring relationships

Effective mentorship is critical for achieving professional success, influencing outcomes such as career selection and advancement, self-confidence and performance, and sense of community and fulfillment. Despite the established importance of mentorship, however, mentoring relationships can be challenging to develop and sustain. 'Mentoring up' is a concept adapted from the business concept of 'managing up' that encourages mentees to actively drive their mentoring relationships to ensure desired results. In this article, we hope to empower mentees with twelve strategies and practical steps to cultivate and maintain quality mentoring relationships, and successfully drive their mentoring relationships in a direction that serves their needs and achieves desired outcomes.

Surviving and Thriving as Physicians in General Internal Medicine Fellowship in the Twenty-First Century

General internal medicine (GIM) fellowships play an important role in the development of physician scientists and clinical educators, as well as leaders in academic medicine. Nevertheless, the challenges of developing another novel aspect to one's career, along with balancing coursework, research productivity, clinical duties, and personal life during fellowship, can be overwhelming. Similarly, successfully securing a job at the end of fellowship can be a daunting process. In this article, we discuss the foundational tenets and themes of the GIM fellowship. These themes include (1) finding your purpose and passion, with a focus on selecting research coursework and developing an area of study; (2) the role and importance of mentorship, including the various kinds of mentorship that fellows require (traditional and peer mentorship, sponsors, and coaches), as well as how to be an effective mentee; (3) securing research funding; (4) landing a job; (5) and protecting time to meet personal goals. There is an increased need for a vibrant, diverse, and successful generation of general internal medicine researchers to advance our understanding of complex issues in clinical medicine and healthcare delivery and to inform health policy. It is our hope that this piece helps to support that mission.

How to survive and thrive as a new breast imager: what they don't teach in fellowship

PURPOSE

To provide practical tips to assist new breast imagers succeed in their first job after fellowship training.

METHODS

Transitioning from fellowship to a practicing breast radiologist is daunting for the new radiologist. There is a void in the literature addressing this transition. Practical tips are described based on various roles a new breast radiologist must navigate and highlights skills that can help ensure a successful transition and career.

RESULTS

Proficiency in clinical acumen may be assisted by becoming familiar with sentinel works and feedback based on the medical outcome audit. Noninterpretive skills that can assist the transition include communication skills, delegation of tasks, and implementing hanging protocols. Depending on the practice, skills in research, education, administration, teamwork, and community engagement may also assist the successful transition.

CONCLUSION

Practical strategies can assist the new breast radiologist to become proficient at essential skills that will assist the radiologist to survive and thrive in clinical practice.

Addressing the "Global Health Tax" and "Wild Cards": Practical Challenges to Building Academic Careers in Global Health

Among many possible benefits, global health efforts can expand the skills and experience of U.S. clinicians, improve health for communities in need, and generate innovations in care delivery with relevance everywhere. Yet, despite high rates of interest among students and medical trainees to include global health opportunities in their training, there is still no clear understanding of how this interest will translate into viable and sustained global health careers after graduation. Building on a growing conversation about how to support careers in academic global health, this Perspective describes the practical challenges faced by physicians pursuing these careers after they complete training. Writing from their perspective as junior faculty at one U.S. academic health center with a dedicated focus on global health training, the authors describe a number of practical issues they have found to be critical both for their own career development and for the advice they provide their mentees. With a particular emphasis on the financial, personal, professional, and logistical challenges that young "expat" global health physicians in academic institutions face, they underscore the importance of finding ways to support these career paths, and propose possible solutions. Such investments would not only respond to the rational and moral imperatives of global health work and advance the mission of improving human health but also help to fully leverage the potential of what is already an unprecedented movement within academic medicine.

Cultivating Medical Education Research Mentorship as a Pathway Towards High Quality Medical Education Research

The lack of effective and consistent research mentorship and research mentor training in both undergraduate medical education (UME) and graduate medical education (GME) is a critical constraint on the development of innovative and high quality medical education research. Clinical research mentors are often not familiar with the nuances and context of conducting education research. Clinician-educators, meanwhile, often lack the skills in developing and conducting rigorous research. Mentors who are not prepared to articulate potential scholarship pathways for their mentees risk limiting the mentee's progress in early stages of their career. In fact, the relative paucity of experienced medical education research mentors arguably contributes to the perpetuation of a cycle leading to fewer well-trained researchers in medical education, a lack of high quality medical education research, and relative stagnation in medical education innovation. There is a path forward, however. Integration of doctoral-level educators, structured inter-departmental efforts, and external mentorship provide opportunities for faculty to gain traction in their medical education research efforts. An investment in medical education research mentors will ensure rigorous research for high quality innovation in medical education and patient care.

The role of gender and distance mentoring in the surgical education research fellowship

OBJECTIVE

The nature of the mentor-mentee relationship is important in the pursuit of successful research projects. The purpose of this study is to evaluate the mentor-mentee relationships in the Surgical Education Research Fellowship (SERF) based on gender and geographical distances regarding program completion. We hypothesize that there are no differences for SERF program completion rates based on gender pairs and distances between pairs.

METHODS

This was a retrospective study from 2006 to 2011. Mentor-mentee rosters were retrospectively reviewed for program completion, demographics, and PubMeD indexing. Time zone differences and geographic distances between pairs were found with online applications. Chi-square tests were used for categorical variables and nonparametric statistics were carried out using α = 0.05.

RESULTS

Of the 82 individuals accepted into the SERF program, 43 (52%) completed the SERF program during the study period. There were no differences in program completion rates based on fellow gender and gender pairing (all p > 0.05). Different-gender pairs that completed the program (n = 17) were indexed more frequently on PubMed than same-gender pairs that completed the program (n = 24) (41% vs 12%, p = 0.04). There were no differences in program completion based on time zone differences (p = 0.20). The median distance between pairs completing the program (n = 35) was greater than that for pairs not completing the program (n = 36) (1741 km [IQR: 895-3117 km] vs 991 km [IQR: 676-2601 km]; p = 0.03).

CONCLUSION

Completion of the SERF program was independent of mentor-mentee gender pairs and time zone differences. There was greater geographical distance separating mentor-mentee pairs that completed the SERF program compared with pairs that did not complete the program. Distance mentoring is a successful and crucial element of the SERF program.

Making the most of mentors: a guide for mentees

Effective mentorship is likely one of the most important determinants of success in academic medicine and research. Many papers focus on mentoring from the mentor's perspective, but few give guidance to mentees forging these critically important relationships. The authors apply "managing up," a corporate concept, to academic medical settings both to promote effective, successful mentoring and to make a mentor's job easier. Managing up requires the mentee to take responsibility for his or her part in the collaborative alliance and to be the leader of the relationship by guiding and facilitating the mentor's efforts to create a satisfying and productive relationship for both parties. The authors review the initiation and cultivation of a mentoring relationship from the perspective of a mentee at any stage (student through junior faculty), and they propose specific strategies for mentee success.

Mentoring the mentors: Aligning mentor and mentee expectations

The Radiology Alliance for Health Services Research sponsored a symposium at the 2005 Annual Meeting of the Association of University Radiologists, which focused on the issue of aligning mentor and mentee expectations to foster successful mentoring relationships. This article presents a summary of the informal discussion of the panelists' individual experiences, common themes, and insights gained from the panel participants.

Mentorship in academic general internal medicine. Results of a survey of mentors

BACKGROUND

Effective mentorship is crucial to career development. Strategies to improve the availability of mentors include mentoring multiple mentees at once, compensating mentors, comentoring, and long-distance mentoring.

OBJECTIVE

To describe current trends in mentorship in general Internal Medicine (GIM).

METHODS

We conducted a national cross-sectional web-based survey of GIM mentors, GIM fellowship directors, and GIM National Institutes of Health K24 grant awardees to capture their experiences with mentoring, including compensation for mentorship, multiple mentees, comentorship, and long-distance mentorship. We compared experiences by mentorship funding status, faculty type, academic rank, and sex.

RESULTS

We collected data from 111 mentors (77% male, 54% full professors, and 68% clinician-investigators). Fifty-two (47%) received funding for mentorship. Mentors supervised a median (25th percentile, 75th percentile) of 5 (3, 8) mentees each, and would be willing to supervise a maximum of 6 (4, 10) mentees at once. Compared with mentors without funding, mentors with funding had more current mentees (mean of 8.3 vs 5.1, respectively; P<.001). Full professors had more current mentees than associate or assistant professors (8.0 vs 5.9 vs 2.4, respectively; P=.005). Ninety-four (85%) mentors had experience comentoring, and two-thirds of mentors had experience mentoring from a distance. Although most mentors found long-distance mentoring to be less demanding, most also said it is less effective for the mentee and is personally less fulfilling.

CONCLUSIONS

Mentors in GIM appear to be close to their mentorship capacity, and the majority lack funding for mentorship. Comentoring and long-distance mentoring are common.

Getting funded. Career development awards for aspiring clinical investigators

For aspiring clinical investigators, career development awards provide a primary mechanism for "getting funded." The objective of this article is to provide information that will facilitate a successful application for a research career development award. Specifically, we discuss important issues that cut across the diverse array of awards, and we highlight the most common sources of funding, including the unique opportunities that are available for underrepresented minorities. The target audience includes junior faculty and fellows who are pursuing or considering a research career in academic medicine, as well as their mentors and program directors.

Physician leadership: enhancing the career development of academic physician administrators and leaders

As the health care environment grows more complex, there is greater opportunity for physician administrative and management leadership. Although physicians in general, and academic physicians in particular, view management as outside their purview, the increased importance of physician administrative leadership represents an opportunity for academic physicians interested in working at the interface of clinical medicine, health care, finance, and management. These physicians are called academic physician administrators and leaders (APALs). APALs are clinician-administrators whose academic contributions include both scholarly work related to their administrative duties and administrative leadership of academically important programs. However, existing academic career development infrastructure, such as academic promotions, is oriented toward traditional clinician-educator and clinician-researcher faculty. The APAL career path differs from traditional academic pathways because APALs require unique skills, different mentors, and a more expansive definition of academic productivity. This article describes how academic medical institutions could enhance the career development of academic physicians in administrative and leadership positions.

Program directors' perspectives on federally funded fellowship training in primary care research

PURPOSE

To describe the organization, models of training, and institutional impact of National Research Service Award fellowship programs in primary care research.

METHOD

Survey of 25 directors of currently-funded and former training sites.

RESULTS

Twenty-four program directors (96%) completed the survey. Programs allocated 39% of fellows' time to course work leading to an advanced degree or other didactic instruction, and 40% of time to the conduct of research. Collaborations with other training programs within the institution occurred at 83% of sites. Programs commonly (54%) or exclusively (42%) relied on a research model of "early research independence" in which the fellow defined an area of research interest, rather than an "apprenticeship" model in which the fellow worked in a senior investigator's research area. These programs enriched the local academic environment, but required extensive financial subsidies. The high costs of training often had adverse impacts on recruitment and other components of the training process.

CONCLUSION

Research training programs in primary care often substitute acquisition of advanced degrees for early immersion in research. The "early independence" model of research differs from fellowships in the medical specialties, and requires further study to assess its effectiveness. The need to subsidize training costs poses substantial problems for the institutions that host these fellowship programs.