Choosing and Maintaining an Academic Career Lawrence R. Schiller, MD, FACG Digestive 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 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 solicitations sent to membership About 500 responses received – 11.2% women, 88.8% men – Age distribution: – Mean yrs since fellowship: % yrs

Current Role in GI Training, Education & Research % N=282N=225

Academic Clinician Characteristics Years on current faculty: Years on other faculties: Role in division/section: – Chief14.3% – Program director13.2% – Clinical service director15.8% – Clinician61.5% – Researcher25.7% – Educator37.7% – Volunteer/part-time24.2%

Academic Clinician Characteristics Total work hours per week: Percent of time devoted to: %

Academic Clinician Characteristics Type of research: – Basic science 2.6% – Clinical68.6% – None28.8% Have you ever received research funding? – Yes47.1%* – No52.9% *44.9% currently doing grant-supported research

Academic Clinician Characteristics Which of the following groups do you train? – Medical students77.5% – Residents85.0% – Fellows67.8% – Others (nurses, PAs, etc.)35.2% Number of inpatient wks per year: Half-days per week in clinic:

Academic Clinician Characteristics Why did you choose a career as an academic clinician? – Interest in teaching2.1 – Colleagues/mentors3.0 – Interest in research3.3 – Patient care in academic institution3.3 – Work conditions4.2 – Financial rewards5.5 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 satisfied17.2% – Satisfied47.3% – Neither satisfied nor dissatisfied22.0% – Dissatisfied11.4% – Extremely dissatisfied 1.9%

Academic Clinician Characteristics What are the greatest challenges to your career in academic gastroenterology? – Time/compensation for teaching3.5 – Pressure for more clinical duties3.5 – Noncompetitive salary3.6 – Time/compensation for administration4.2 – Difficulty securing research funding4.5 – Balancing work/family responsibilities4.6 – Poor quality of personal life 2 o work5.6 – Difficulty achieving promotion5.7 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 unlikely24.4% – Unlikely34.7% – Neither likely nor unlikely21.9% – Likely10.7% – Extremely likely 8.1%

Academic Clinician Characteristics What factors might prompt your departure from academic gastroenterology? – Job satisfaction3.0 – Financial concerns3.0 – Family concerns3.9 – Lack of recognition for teaching3.9 – Lack of recognition for admin. duties4.6 – Lack of research funding4.9 – Lack of promotion5.0 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