Choosing and Maintaining an Academic Career

Lawrence R. Schiller, MD, FACGDigestive Health Associates of Texas

Baylor University Medical Center, Dallas

Questions to Consider

• Why do physicians go into academic medicine?

• What jobs do they do in academic medicine?• How satisfied are academic physicians?• How can you maintain happiness in academic

medicine?• How can you avoid “burnout”?

Survey Background

• Dr. Eamonn Quigley, President ACG, proposed initiative “Fostering Research in Small Training Programs” in 2008

• ACG Institute held meeting in Bethesda, MD in February 2009 to discuss and further define this initiative

• Focus extended to support of “Academic Clinicians”

• Internet-based survey of membership conducted

Survey Plan

• Invite entire membership to respond by e-mail• Link to SurveyMonkey website• Respondents self-identified as “academic

clinicians” would be directed to questions about their careers, satisfaction, needs

• Other respondents would be directed to series of questions about College activities and CME needs

Survey Demographics

• Two e-mail solicitations sent to membership• About 500 responses received– 11.2% women, 88.8% men– Age distribution:– Mean yrs since fellowship:

18.6 + 12.2

25 - 35 36 - 45 46 - 55 56 - 65 66 - 75 76 - 850

5

10

15

20

25

30

35

%

yrs

Current Role in GI Training, Education & Research

Academic Non-Academic0

10

20

30

40

50

60

OtherNo academicsClinical appt.Less than full-timeFull-time

%

N=282 N=225

Academic Clinician Characteristics

• Years on current faculty: 14.1 + 12.2• Years on other faculties: 4.9 + 8.0• Role in division/section:– Chief 14.3%– Program director 13.2%– Clinical service director 15.8%– Clinician 61.5%– Researcher 25.7%– Educator 37.7%– Volunteer/part-time 24.2%

Academic Clinician Characteristics

• Total work hours per week: 51.5 + 20.1• Percent of time devoted to:

Activity0

10

20

30

40

50

60

70

80

Patient CareEducationResearchAdministration

%

Academic Clinician Characteristics

• Type of research:– Basic science 2.6%– Clinical 68.6%– None 28.8%

• Have you ever received research funding?– Yes 47.1%*– No 52.9%

*44.9% currently doing grant-supported research

Academic Clinician Characteristics

• Which of the following groups do you train?– Medical students 77.5%– Residents 85.0%– Fellows 67.8%– Others (nurses, PAs, etc.) 35.2%

• Number of inpatient wks per year: 19.9 + 21.3• Half-days per week in clinic: 4.1 + 2.9

Academic Clinician Characteristics

• Why did you choose a career as an academic clinician?– Interest in teaching 2.1– Colleagues/mentors 3.0– Interest in research 3.3– Patient care in academic institution 3.3– Work conditions 4.2– Financial rewards 5.5

AVG. RANK*

*Above answers & “other” ranked from 1—7, SDs ranged from 1.4—1.9

Academic Clinician Characteristics

• Current level of satisfaction with role as an academic clinician:– Extremely satisfied 17.2%– Satisfied 47.3%– Neither satisfied nor dissatisfied 22.0%– Dissatisfied 11.4%– Extremely dissatisfied 1.9%

Academic Clinician Characteristics

• What are the greatest challenges to your career in academic gastroenterology?– Time/compensation for teaching 3.5– Pressure for more clinical duties 3.5– Noncompetitive salary 3.6– Time/compensation for administration 4.2– Difficulty securing research funding 4.5– Balancing work/family responsibilities 4.6– Poor quality of personal life 2o work 5.6– Difficulty achieving promotion 5.7

AVG. RANK*

*Above answers & “other” ranked from 1—9, SDs ranged from 2.0—2.6

Academic Clinician Characteristics

• Is it likely that you will leave academic gastroenterology within the next 3 years?– Extremely unlikely 24.4%– Unlikely 34.7%– Neither likely nor unlikely 21.9%– Likely 10.7%– Extremely likely 8.1%

Academic Clinician Characteristics

• What factors might prompt your departure from academic gastroenterology?– Job satisfaction 3.0– Financial concerns 3.0– Family concerns 3.9– Lack of recognition for teaching 3.9– Lack of recognition for admin. duties 4.6– Lack of research funding 4.9– Lack of promotion 5.0

AVG. RANK*

*Above answers & “other” ranked from 1—8, SDs ranged from 2.1—2.5

Survey Conclusions

• Although most academic clinicians chose that career path because of interest in teaching, most of their time is spent on patient care

• Research—mainly clinical research—is conducted by many academic clinicians, but consumes only a small percentage of effort

• Academic clinicians train a variety of students and many are interested in improving teaching skills

Survey Conclusions

• Most academic clinicians are satisfied with (or at least neutral about) their career choice– Only 13.3% were dissatisfied or extremely

dissatisfied– Only 19.8% are likely or extremely likely to leave

academics in the near future

Finding Your Bliss in Academic Medicine

Success is the best antidote to burnout.

What is success?

• It depends….– Helping to train a new generation of doctors– Discovering new information– Sharing your insights in publications– Healing the sick– Maintaining health

What is success?

• …but also includes– Strong relationships with family and friends– Enjoyable extramural activities– Rewarding service to others– Spirituality– Comfortable income

Positive Environment

• The family is the basic unit of human society. Your workgroup should be an extended family, caring about each other’s success/happiness.

• Servant leadership: a model to emulate– Consistency– Persistence– Trustworthiness– Honesty– Being supportive

Positive Environment

• Effective mentoring– Interest in individual being mentored– Selflessness– Willingness to share time and resources– Regular meetings– Successful track record

• Celebrating success and recognizing accomplishment

Personal Efforts

• Decide on realistic goals• Prioritize your tasks• Stay on task• Limit outside commitments• Develop professional relationships• Lead a full life outside the office• Enjoy the journey

“If at some point you don’t ask yourself, ‘What have I gotten myself into?’ then you’re not doing it right.”

— Roland Gau