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CHICAGO—Throughout medical training, you have guideposts and guardrails all around you: academic advisors, professors in the classroom, preceptors in the clinic during residency. But once you get a job as a medical faculty member, you’re basically on your own.
“No one really trains you or teaches you about how you’re supposed to negotiate and navigate this really difficult channel,” said Christopher Ritchlin, MD, MPH, director of clinical immunology research at the University of Rochester, N.Y., during a session at the 2018 ACR/ARHP Annual Meeting.
“You have to take responsibility,” said Michelle Kahlenberg, MD, PhD, associate professor of internal medicine at the University of Michigan, Ann Arbor. “No one is going to hold your hand to bring you along.”
But Drs. Ritchlin and Kahlenberg offered suggestions that can help you achieve your career goals and keep you happy in the process.
The First 2 Years
For the first and second years in your first faculty position, Dr. Ritchlin said the first step is to develop a plan centered around what motivates you and how you can best contribute, how you want to spend your time in the world of medicine and outside it, your financial needs and your family plans. This will help the people in higher positions understand what you need to help you obtain your goals.
“When I have people come into my office who have this already done, it simplifies my job because I’ve got a great idea of what they want,” he said.
He suggested designing your fantasy job—whether it’s clinical, educational or research—and deciding where you want to be in three years, brainstorming it with friends, colleagues and family.
It’s important not to forget basic, but often overlooked, questions: Is this the right place? Are there people who will support me in what I want to do? Do I have commitments from division chiefs and department chairs? Does this place have solid financial standing?
Without addressing these factors at the outset, “It’s very challenging, once you start, to make it happen,” Dr. Ritchlin said. Also, get commitments of resources in writing, mainly in case the person who made the commitment leaves their position.
Practice communicating, he said: “[Communication is] so important to your success and for you to get your ideas across.” When writing, he said, use outlines, leave time afterward for the editing process and write every day if possible. When making presentations, remember your audience, keep slides simple and emphasize no more than four main points.
Leaving time and energy for life outside of medicine, and taking time to reflect on your path, will help keep a sense of balance, Dr. Ritchlin said.
‘People look at your number of publications & count them.’ —Dr. Kahlenberg
Years 3–7
Dr. Kahlenberg noted that for years three through seven of that first job, there are benchmarks to keep in mind for seeking promotions. On the instructional track, for example, a promotion to associate professor generally requires 30–40 publications, an ability to obtain independent external funding for research, quality teaching based on learner evaluations, good organizational citizenship and a national reputation with a unique contribution to the field. A professor position generally requires 50–70 publications, with continued teaching quality and a national and international reputation.
You’ll need to get to work putting together a promotion packet, she said. It’s not a short list: a cover letter from the department chair, a summary
of your work and experience, a very detailed curriculum vitae (CV), an educator’s portfolio, teaching evaluations, bibliographic notes, a scholarly clinical portfolio, a research portfolio and other items.
“Organization is key to making promotion easy,” Dr. Kahlenberg said. She suggests keeping your CV updated regularly—she reserves time to update hers every Monday. It involves keeping a list of mentees, all publications, internal and invited talks, patients, awards, grants, consulting work and teaching work. She said you shouldn’t be afraid to ask your administrative assistant for help with this.
Good mentors are essential, she said. But remember, it’s a mutual relationship.
Take on assignments when asked, but not too many, keeping in mind what you need to do to achieve your goals, Dr. Kahlenberg advised.
“In years three through seven, you really have to get your nose to the grindstone and focus. So learning to say ‘no’—nicely—is an important skill. If you’re organized, smart people are going to ask you to do all kinds of stuff.”
Obtaining a coveted National Institutes of Health R01 grant should be a goal. Her advice: Think about applying for one in the third year of your career development award, which—if rejected, as most are—allows you to re-assess and apply again later. This means thinking about your aims early in the second year, and identifying preliminary data you’ll need and assessing your resources.
For building your publication numbers, make sure you collaborate, Dr. Kahlenberg said, and don’t be afraid to publish interesting cases, which count toward your total.
“This is really how you are judged,” Dr. Kahlenberg said. “People look at your number of publications and count them.”
Don’t forget, she said, to “toot your own horn,” by emailing your division chief about accomplishments and even letting your public relations department know about upcoming papers to give them time to publicize them.
“Your successes are not automatically registered by anybody else but you,” she said. “Don’t be shy about letting people know you’re doing good things.”
Thomas R. Collins is a freelance writer living in South Florida.
