“An expert is one who knows more and more about less and less until he knows absolutely everything about nothing.”

Tips for Success As an Academic Clinical Investigator

Stephanie J. Lee, From the Fred Hutchinson Cancer Research Center, Seattle, WA.

When confronted with a new and challenging task, the first thing I have always done is to see how others have succeeded before me. Hearing and reading others’ reflections on their tips, tricks, and pearls has often given me helpful strategies, whether the topic is parenting, traveling, or having a successful career. In hearing the reflections of those who went before, I can benefit from their experiences without any commitment to follow their paths. The advice is free, and I can take what I want and leave the rest behind.
So it is in this spirit that I decided to share what I tell aspiring young investigators if they seek my advice about how to achieve success as an academic clinical investigator. After writing down my initial thoughts, I shared the list with my colleagues, who provided many helpful additions and edits. I then circulated it to junior investigators, and the list continued to evolve. Clearly the generalizability of the strategies varies, and the list reflects the lens of my experience. I have been told by some young investigators that the list looks scary, but I wanted to be concrete about how discipline and hard work can enhance your chances for success in academic medicine. My hope is that people reading the list might find some new tactics that resonate with them or, at least, that it will provide a nidus for more discussion about what success as an academic clinical investigator means and how best to achieve it.
This article is not about what someone else can do for you—that is mentorship.This article is about what you can do for yourself—the behaviors and skills that you can cultivate to increase your likelihood of success in academic medicine. Although everyone has a unique path that reflects his or her interests, skills, talents, and environment, effective habits can help you achieve your goals and be more successful in whatever career you choose. For fellows and junior faculty who spend less time engaged in research, protected time may be more limited, making focus and efficiency consequently even more critical.
A number of benchmarks have been used to quantify success in academic medicine, including number of publications, grants, lectures, research collaborations, and leadership positions. These closely mirror the physician-scientist criteria for promotion, the academic track with which I am most familiar. For the purposes of this article, academic success is defined as a personal sense of accomplishment and external recognition by others in the areas noted. It does not cover many other sources of job satisfaction, including the physician-patient relationship.
Clinician-scholars are also judged on their clinical productivity, clinical reputation, and teaching skills. I have not seen any tips for success published for this academic track but hope to see this gap in the literature filled by someone else.
The following tips are organized according to the major challenges for academic clinical investigators:

Choosing and Completing Projects

1. Choose important and feasible research projects.

Consider all aspects of a project in addition to its intrinsic scientific quality. Will you gain new skills or work with someone established and successful? If you have a negative study, is it still interesting and publishable? Choosing good projects takes time, thought, and discussion with many people. It is a research project in itself.

2. Seek out a niche rather than a crowded area.

The project should not be easily scooped or done better or quicker by someone else.

3. Make sure you are passionate about your research topic.

It is hard to sustain the necessary enthusiasm unless you are vitally interested in your research question.

4. Stagger your projects.

Try to have at least one short-, medium-, and long-term project going simultaneously so that the time crunches for each are spread out, and the payoffs are layered.

5. It is more efficient if your projects intersect.

A simple test is whether you can adapt some of the previously written background material for use in your new project.

6. Take personal responsibility for your success.

Attack problems and barriers with creativity and vigor. Do menial tasks yourself to move a project forward. The surest way to get something done is almost always to do it yourself.

7. Have productivity goals and timelines.

A general benchmark of productivity for a young investigator is three projects in planning, two projects in process, and one manuscript under review or in press at any one time. Approximately double this target is appropriate for a midcareer investigator. Set research goals for the month, and make sure you achieve them.

Interacting With People

8. Surround yourself with people of high standards, skills, work habits, and compatibility.

Ensure your efforts are enhanced rather than sabotaged.

9. Avoid chronophages who ask you to perform extraneous tasks that eat your time without reward.

Ask yourself: “Where could this new responsibility be listed on my CV?” If you cannot find an appropriate heading to put it under, you should strongly consider saying no.

10. Fully commit to whatever you agree to do.

If you are part of a committee, then strive to be part of the 30% of members who actually contribute to the functioning of the group. Prepare for meetings, and speak up.

11. If you cannot commit, be able to say no.

If you have a hard time saying no to requests, then a strategy of “yes, no, yes” can be helpful. Starting with a positive statement such as “thank you so much for thinking of me” is an easy first sentence. Then deliver the no clearly: “But I’m sorry I won’t be able to write a chapter… join that committee… write a review… I am unable to meet your deadline.” Then end on a positive note: “Please think of me in the future” or just simply end with a thank you. You can offer to suggest someone else who will do a good job (if it is actually a good opportunity).

12. Understand and participate in others’ work, and include them in yours.

Give insightful comments on others’ papers, protocols, and grants. Be a sought-after collaborator who can deliver what is promised.

13. Help your colleagues, and celebrate the success of others.

Give credit where credit is due. Academic medicine is a small world.

Giving Talks

14. Know your audience.

Aim your content at them, and prepare meticulously.

15. Be clear in your slides, logic, and speech.

Practice until you are completely comfortable with your talk. If you are a beginner, memorize your abstract presentations.

16. Make sure you stay within your allotted time, and allow adequate time for questions.

Practice answering questions about your work. Know the work of others.

Writing Papers

17. Write often and well.

Understand that if nothing is published, then nothing is gained on your CV. During the promotion process, you will be asked to provide your three to five most important papers.

18. Take pride in what you write.

Make sure grammar, spelling, and formatting are correct. People are getting an impression of you through your writing, even the drafts and e-mails. Read your writing out loud to see how it sounds and flows. Start early enough that you can put it aside for a while to get some perspective.

19. If you have writer’s block, break the paper apart on your to-do list.

Methods, results, conclusion, and introduction are not as daunting as “write paper.”

20. If all else fails, just start typing some text.

Worry about editing in the next phase. It is usually easier to edit than write.

Securing Funding

21. If research grants will be your primary source of support, then it is critical that you become adept at writing grants.

These should convince others that your research question is important, and you and your team are capable of successfully answering the question. Read about how to write grants and look at other people’s successful grants. Ask more experienced grant writers for help, and give them enough time to help you.

22. Pace yourself with interim deadlines.

Ensure you have adequate time to submit the best grant you can.

23. Do not waste your time writing a grant for a funding source that is not appropriate for you.

Invest the time to talk to your colleagues and granting agency officials to find this out.

Clinical Work

26. Set priorities.

It is helpful to consider the profile of the various tasks in your day. Is a task important or trivial, difficult or easy? The basic idea is to do the hard and important tasks first, then fill in the remaining time with the easier and less important stuff (Fig 1).
An example of prioritizing research tasks based on balancing importance, ease of completion, and reliance on others. Set aside focused time for tasks in the upper right. Complete tasks in the lower left during downtime or at the end of the day.

27. Meet deadlines.

Reliability is noticed, and reliable people are usually given more responsibilities, which can lead to great opportunities. Make it a priority to meet all external deadlines, such as paper reviews and return of comments to coinvestigators. Set your own deadlines for your research tasks, and make sure you achieve them.

28. Work many hours.

The number of hours needed to work during the week is controversial and personal, but many academic physician-scientists I know log at least 60 hours, often gaining extra and precious hours of deep focus on the weekends, early mornings, late nights, or during travel.

29. Work efficiently.

Make whatever hours are devoted to work count. Aim to work smarter, not harder. Know when you work most effectively during the day and week. Protect your research time from small distractions.

30. Do not confuse being busy with being productive.

They are not the same thing.

31. Keep a realistic and prioritized to-do list.

Find the format that works best for you.


32. Think deeply and clearly.

Force yourself to ask why and how, and be able to communicate this information to others. Aim to be authoritative.

33. Try to see yourself through others’ eyes.

Critically evaluate yourself after completing something. Did I do a good job? Why or why not? Know your own strengths and weaknesses.

34. Study others you admire.

Dissect which specific qualities you want to emulate.

35. Get feedback from different people.

Self-reflect, reprioritize, and learn from these comments.

36. Understand why you want to be an academic clinical investigator.

Keep sight of the noble goals of your work while you are down in the trenches.

Keep Evolving

37. Be a continuous learner.

Embrace challenges. Learn new skills, and take some chances to keep things fresh.

38. Practice leadership when you get a chance.

Notice the skills and behaviors required to be a good leader.

39. It is helpful to interact with others from different disciplines and different institutions whenever you get a chance.

This exposure helps encourage creativity and makes sure you are known outside your institution. Your local, national, and even international reputation will be evaluated in the promotion process.

Final Bits of Advice

40. For those with significant others or children, do not underestimate the challenge of work-life balance.

Choosing a supportive significant other and, if applicable, reliable child care about which you feel good is absolutely essential to a productive career. If you are worried about your relationship or your children, it is impossible to focus on anything else. Make time for your partner and your children.

41. Consider getting involved in professional societies.

Let organizations know you want to be involved. If invited to participate, make sure you do an outstanding job.

42. Keep your CV updated.

Include dates of invited talks and committee participation. Know what format is required by your institution. Include a summary of your research program.

43. Have fun.

Not always, not only. But academic medicine can be grueling, and you need to enjoy the many hours spent at your job.
The personal sacrifices of achieving success in academic clinical investigation can be burdensome, in terms of the long work hours, job insecurity, lower salary, and delayed gratification. If after reading this, you find yourself saying, “I don’t want to do this, be like this, work like this,” then ask yourself whether this is the best career for you. There are many other definitions of a successful career. Academic clinical investigation is only one approach to improving the care of people with cancer.


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