Transcript No Slide Title

Self Management: What Do You Need to
Provide to the Mix to Ensure Success
John Chae, M.D.
Association of Academic Physiatrist
Daytona, FL, March, 2006
What is Success?
• How is “Success” defined?
• Personal versus professional
• Definition of “Success” should always be
PERSONAL
What is Success?
Personal
Nonprofessional
Professional
•How many of us in our death bed would be saying “I wish I spent more time in
the lab, had more publications, had more grants….?”
•You might be saying “I wish I spent more time with my wife, my children or
grandchildren. I wish I invested more in people…”
•We don’t want to climb the ladder of success to find out at the end that it’s
leaning against the wrong wall.
Relational vs Terminal Thinking
• Relational thinking: Making daily choices in light
of long-range objectives.
• Terminal thinking: Viewing each activity as an
end in itself.
Why Set Objectives?
• “If you aim at nothing, you hit it all the time.”
• You are a limited resource
• Not every “good” activity is valuable. Beware of
“opportunities” that come your way
• Well defined objectives become the filter through
which you assess your activities
• Relational thinking: All activities have short and
long-term consequences
Objectives
Faculty
Med School
Residency
K12
K23
R01
“Independent
Investigator”
Tenure
Independent Investigator
• Scientifically independent
-A new/unique line of scientific inquiry
-No longer dependent on a mentor for scientific
input
• Financially independent
-Has own grant to fund salary, staff and lab
-R01/Merit Review/NSF
Timeline for Independence
Faculty yr
•Select mentor
•K12 research
•Write K23
•K23 research
•Publish
•Write R01/Merit
Review
• R01/Merit
Review
1
2
3
4
5
6
7
8
9
10
Criteria for Tenure
• Research: Grants and publications
• Teaching: Medical students, residents, community
• Service: Committees, board examiner, study
section
• National Reputation
Timeline for Establishing National Reputation
Year:
•Professional Activity
•Journal Articles
•Join national organizations
•Local & regional meeting
presentations
•National meeting presentations
•Committee in national
organizations
•Review articles
•Book chapters
•Text books
•Positions at other institutions
0
1
2
3
4
5
6
7
Case Study #1
Michael is a PGY-III resident who is participating in the RMSTP. He
is enthusiastic about his project on a novel technique for motor
relearning in hemiplegia. Upon returning from the annual AAP
meeting, a faculty member in his program approaches him to join
him as a coauthor on a chapter entitled “Physical Modalities” for
the latest textbook in PM&R edited by DeLisa, Gans, Braddom
and Frontera. Michael was incredibly intrigued by the offer. He
has a great deal of respect for this faculty member and the new
textbook by DeLisa, Gans, Braddom and Frontera was the talk of
the meeting.
Case Study #1
• Why was Michael so intrigued by the offer?
• What should he do and why?
• Why shouldn’t he take the offer?
-Book chapter takes an incredible amount of time
-He will probably do most of the work
-Future grant success is dependent on peer reviewed
articles
-Topic is not even related to his present project
Case Study #2
Chris has just started as an assistant professor. Chris’ mentor is the
department chair, who is constantly providing opportunities for
Chris. These include heavier teaching load than anyone in the
department, several committees that are very time consuming, and
administrative responsibility within the department. When Chris
discusses these observations with the department chair, he is told
that all these activities are important for promotion and tenure and
that he should not worry
Case Study #2
• What’s wrong with this picture?
• What will likely happen when he comes up for
promotion and tenure?
• What should he do now?
Chris speaks to a senior professor in another department. This professor describes
the fate of Chris’s predecessors, each of whom has been denied promotion and
tenure due to lack of research/creative productivity. Chris and the senior
professor meet with his department chair. The 3 of them develop a plan to
decrease Chris’ teaching, committee and administrative responsibilities so that
that Chris can devote more effort to research/creative activities.
Case Study #3
John Chae’s 6th pre-tenure year review, June 6, 2001
Research
Dr. Chae began his work under the mentorship of Hunter Peckham
but has been developing his own areas of expertise in stroke motor
impairment and disabilities and upper limb neuroprosthesis in
hemiplegia. He is currently PI on a FIRST award.. and an NIH
R01 award.
Dr. Chae’s publication record had been going well but recently has hit
a snag. After publishing 3 first authored articles in 1998, he lists 5
articles as in-press with the Am J Phys Med Rehabil which, Dr.
Murray informed the committee, were accepted 15 months ago.
Dr. Chae has published only one other research article, as a middle
author, in the past three years. The Committee took note of Dr.
Chae’s 3 review articles published in 2000, but until the 5 in press
articles appear, it must consider Dr. Chae’s publication record
problematic. The committee encouraged Dr. Murray to discuss with
Dr. Chae consideration of placing research articles in journals with
broader audience, suggesting the journals Stroke and Neurology.
A national and international reputation is indicated by membership
since 1998 on the NIH SBIR/STRR, Rehabilitation Study Section,
on a Dutch Grant Review Council, service as an American Board of
PM&R oral examiner, membership on the K12 Advisory Board, and
by 2 international presentations made during 2000.
Teaching
Dr. Chae is an active and much valued teacher. He runs the stroke
rehabilitation curriculum for the residents. Between 1995 and May
2000, he was an active participant in the Core Physician Development
Program, teaching between 40 and 100 hrs annually. He accepts a
large number of trainees in his laboratory and has hosted a visiting
Ph.D. scholar as well.
He has offered a Type A elective seminar each year since 1995, often
more than once each year and has maintained a steady medical student
enrollment. He has served on a biomedical engineering and FES
committe, and made other teaching contributions. The Committee is
pleased to see that Dr. Chae has maintained the range of his teaching
contributions in the three years since his third pretenure year review.
Service
Dr. Chae makes an important service contribution at the department
level by serving actively on its graduate medical education
committee. His local service is highlighted by serving on the
Board of Trustees of the NE Ohio chapter of the National Stroke
Association and the Program and Education Committee of the NE
Ohio affiliate of the American Heart Association. He makes no
University service contribution or national service contribution on
professional societies, an important omission from his record.
Summary
Dr. Chae’s teaching contributions have been quite good. The committee notes
that he has cut back on some contributions and, given his past teaching
strengths, continued contributions, and the need to focus on research
publication, the Committee believes this is the correct course. Dr. Chae’s
funding support record is also on track, but the key to his promotion and
tenure candidacies appears to be his publication record. The committee hopes
that Dr. Chae’s in-press articles appear and that he is able to publish as first or
senior author in a greater variety of journals of wider appeal. Such
publications could enhance the likelihood of future R01 awards, another
important aspect of promotion and tenure. Publication of the already
submitted articles and additional articles in journals with a broader readership
will also increase the likelihood of a favorable decision concerning promotion
and tenure. The Committee recognizes that Dr. Chae is a very valuable
member of the department, but the clinical and teaching demands on his time
may make it difficult for his research program to reach the required fruition
within the pre-tenure period permitted.
Case Study #3
• What was JC’s typical day during 3 yrs since his
3rd pre-tenure yr review?
-Into work by 7am and home by 7-8pm.
-Full inpatient service (12-16 patients), 6 mo/yr
-Half day of clinic per week
-Director of Stroke Rehabilitation
-Medical student teaching: 2hrs/wk + coordinator for an elective
-Resident teaching
-R29 for 50% effort; an R01 at 25% effort
Case Study #3
• What’s wrong with this picture?
• What should JC do?
-Discussed the review with his mentor
-He leveraged the discouraging pre-tenure review to:
-Reduces inpatient load to ½ inpatient service 3x/yr
-Reduce clinics to 1 half day per month
-Eliminate medical student teaching
-Relinquish administrative role
-Cranked out papers
-Joined the AAP research committee
-Chaired the AAP Council of Researchers
Important Principles and Questions
• Become an excellent doctor!
• Do not get deceived by flattery. Beware of
“opportunities”
• Constantly ask “How does the activity contribute
to the overall goal?”
• Learn to say “no”
• When in doubt consult your mentor
Success & RMSTP
• How do we measure success in the RMSTP program?
-Successfully become an independent investigator
• How do we ensure that you become an independent
investigator?
-Work with your mentor
-Learn the science
-Do the research
-Publish results
-Say “no” to all other activities that distract you from this
goal