EM Mindset – Secrets to an Academic Career

Author: Judd E. Hollander, MD (Senior VP for Healthcare Delivery Innovation, Thomas Jefferson University; Associate Dean for Strategic Health Initiatives, Sidney Kimmel Medical College; Professor, Department of Emergency Medicine) // Edited by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UT Southwestern Medical Center / Parkland Memorial Hospital) and Brit Long, MD (@long_brit)

A little more than a decade ago, I was asked to reflect upon the secrets to a successful academic career. I summed up my thoughts in a talk entitled – Luck, Fate, and Perseverance. Now, I can offer some more concrete advice about how young and midcareer emergency physicians can develop the mindset to impact the future of our specialty.  These are all simple and easy to understand. That does not mean they are not difficult to do.

Find the right job & follow your passion.  It sounds so simple but it is not. You need to figure out what makes you want to go to work each day (besides the paycheck). If you are not passionate about something in education or research, maybe you should not be in an academic shop. Find the thing that gets you jazzed, makes you wake up with the first (or at least the third alarm) and gets you ready to go.

Remember your essay. This is not only important for you, but it is a great request for your most annoying consultants. I am pretty sure that all of us wrote about helping patients. I bet no one wrote about helping patients only during the day or before the admission cap. When you are overwhelmed, pull it out and read it. Be that person. Then you will always place patients and families first. You can actually live your dream, you just need to remember what it was, every once in a while.

Just say “yes.” Too many people tell you to just say “no” to way too many things. Guess what? People ask people who help for help. Once you say “no” a couple times, no one will ask you again. You will be protected, but you won’t be advancing your career. Perhaps Jennifer White sums it up best – just say “happy to help” and everyone notices. It will launch your career.

Be the “go to” person. Your kids may get participation trophies, but the real world does not give them out. If your goal in life is to get on a committee to build your CV, but you don’t plan on attending the meeting or contributing, it won’t take long for people to figure out you are a slug. When you volunteer, make a tangible contribution. You will never need to worry about building your CV. Show up, work hard, and your career and CV will take care of itself.

It’s ok to fail… unless it is from lack of effort. If you know someone that you think has always been successful, you don’t actually know them. Every successful person has failed, usually a lot. Learn from failure. Don’t make the same mistake again. Find a new way to get it done. No one is more creative than emergency physicians. Take that same attitude to the non-clinical aspects of your career, and you will be fine.

It is not about you.  Too many people worry about themselves. If you want to be successful, you should lead. You lead by embracing others, figuring out how to make them better, and then being included in some of the things that they do. Don’t give people participation trophies (unearned authorship) but rather teach them a skill (how to write), and you can both benefit from a long-term relationship.

Partner with people with complimentary skill sets.  Do an honest self-assessment to determine your own strengths and weaknesses. Once you have done that, find people who can make you better. Some of you are starters – great idea people, have started a ton of projects, but have trouble completing them. Others are closers. You may not have the vision but can get in the weeds and tie up loose ends. Starters and closers should pair up. Both should avoid the constipated people – those who just can’t move things along. 

Think like a venture capital firm. There is not enough time in the world to waste much of it. As hard as you may try, you pretty much can only find 24 hours in a day. Therefore, you have to think like a VC firm. Invest wisely in people, projects, and things. If there will not be a work product or ROI, don’t waste your time. This is what the NIH does – they look at the project and the investigative team. This is what you do when you select residents. Do this for all things that will take up time. In fact, even in the clinical setting, don’t order worthless tests or give meds that don’t help (just because they don’t hurt). If you have not watched the TV show Shark Tank, please do. It could just as well be a grant review panel.

Now the two that you might not like, but you need to deal with.

Know if you prioritize effective or nice (if you have to). This is a tricky one. You can always be nice, but you can’t always be effective and nice. Everyone would love to be nice all the time and build consensus around all decisions, but sometimes that either takes too long or simply cannot be achieved. When do you do what needs to be done, even when you will be perceived as not being “nice” or “considerate”? At the end of the day, you need to go home with yourself, and you need to keep your job. Sometimes these two things conflict – they just do. Where do you sit when you have to choose? It is easier if you understand this conflict before you have to deal with it. If you can’t choose one or the other, you probably lean toward the side of being “nice.”

Work life balance is a fallacy.  Frankly I am tired of hearing about work life balance (and I hear many of you booing). For most of you, your family would like you to be home. For all of you, your job hired you to do a job. The more you do one, the less you do another. It won’t be perfect. Deal with it. But… that said, happiness is not a fallacy. Accept the fact that some of you are happier with more work in your life, and some of you are happier outside of work. Find the spot that maximizes your happiness, but realize that one of the two (work or home) will take a hit. The answer for you may be related to how well you did the first thing on this list.

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