academia – The Early Career Voice

What Are Your Thoughts on Work-Life Balance/Imbalance in Science and Medicine?

January 2, 2020January 2, 2020 Sasha Prisco, MD, PhD

My blog post this month is meant to be a starting point for discussion. There are a plethora of articles and blog posts on work-life balance/imbalance in medicine and science (and many other professions). Some articles and blog posts even discuss that it is not possible to have work-life balance in medicine/science/academia^1-3. As the winter holiday season comes to an end and a new year and decade starts, I find myself reassessing my personal and professional goals and resolutions for this upcoming year and decade. On my list is “continuing to work on work-life balance.” My blog is meant to stimulate discussion and solicit advice from those of you in science and medicine on potential tips to improve work-life balance. Figuring out how to balance the personal and professional aspects of our lives throughout a long and arduous career can be a formidable process.

Some people have voiced concerns about the recommendations often told to trainees and early career physicians/scientists to maintain work-life balance and wellness in order to prevent burnout: get adequate sleep, eat well, exercise, meditate, pet dogs, wake up earlier to plan your day, travel, read nonmedical/nonscience books, continue your hobbies, find good mentors, and spend time with family and friends all while providing good clinical care and/or doing good research. How are there enough hours in a day to do all of this?

An article in The Atlantic published last year entitled “Give Up on Work-Life Balance”⁴ discusses a recommendation from Brad Stulberg, author of The Passion Paradox, of not thinking of work-life balance as dividing hours within a day for personal and work activities. Alternatively, consider balance in terms of “seasons.” For example, one “season” could be a few years where the majority of the time is focused on one’s training/career and another “season”, possibly during a time when one has young children, where focus is on spending time with family. One of my mentors who has young children says that when he goes home, he prioritizes spending time with family and tries not to do any work until he and his wife go to bed. Some people have noted that they dislike the term work-life balance since it implies that there is a scale where one side is competing against the other. Instead, “integrating” work and personal lives is encouraged. Unfortunately, careers in science and/or medicine do not always allow for easy integration of work and personal lives, but system changes can occur to allow for better integration of work and personal life. For example, I applaud the efforts of one of my co-AHA early career bloggers, Dr. Nosheen Reza (@noshreza), in assisting with establishing a culture and creating tangible changes to support breastfeeding cardiology fellows⁵. Another AHA early career blogger, Dr. Renee Bullock-Palmer (@RBP0612) wrote a blog post last year discussing tips for integrating motherhood and a career as a female cardiologist (https://earlycareervoice.professional.heart.org/balancing-versus-integration-of-motherhood-and-your-career-as-a-female-cardiologist/).

Many established researchers and clinicians have recently told me that they regret not spending more time with their families. This same sentiment has been echoed by many clinicians/researchers on Twitter over the holiday season. While it is not always possible to spend every holiday with loved ones, especially while in training, allotting some protected time to spend with loved ones is important for maintaining wellness.

Establishing work-life balance is a constant evolving process dependent on the stage of our careers and personal lives and is a very individualized process. As mentioned before, I hope that we can have a further discussion on work-life balance and that you will share some tips on ways to improve work-life balance. I wish all of you a happy, healthy, and productive new year!

Lazzari, Elisa. To be a top performer you need to be happy – something academics tend to forget. Naturejobs Blog. 13 Jun 2016. http://blogs.nature.com/naturejobs/2016/06/13/can-scientists-really-have-worklife-balance/.
Powell, K. Young, talented and fed-up: scientists tell their stories. Nature538, 446–449 (2016).
Is Work-Life Balance for Physicians a Unicorn? com. 3 Jan 2018. https://www.kevinmd.com/blog/2018/01/work-life-balance-physicians-unicorn.html
Khazan, Olga. Give Up on Work-Life Balance. The Atlantic. Atlantic Media Company. 30 May 2019. https://www.theatlantic.com/health/archive/2019/05/work-life-balance/590662/.
Kay J, Reza N and Silvestry FE. Establishing and Expecting a Culture of Support for Breastfeeding Cardiology Fellows. JACC: Case Reports. 2019;1:680-683.

The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.

The Joys of Teaching

July 9, 2019July 9, 2019 Jacqueline Leachman

This June I had the pleasure of working with high school students participating in the 4-H Teen Conference held at the University of Kentucky. Underneath their health major, another student and myself proposed a nutrition course titled #HealthGoals. Together, the objective of our course was to inform students of basic nutrition facts, guidelines, and consequences of overnutrition, as well as to introduce the students to fruits that are traditionally less eaten, and healthier snack options. While my colleague and I prepared intensively for the class, what we were not ready for was how much joy our group of students were going to bring us. We packed each day with interactive nutrition activities and games and on the last day played, what turned out to be, a very competitive game of jeopardy. However, what made each class spectacular was how engaged each student deemed to be. We received all types of questions ranging from why do we need water to what we thought about the ketogenic diet. With this being a group of high school students, one thing that was important to us was ensuring that each day be filled with engaging activities that would best promote learning and retention. Each student came equipped with varying educational backgrounds. However, whatever the case may be, we wanted, possibly their first, nutrition educational experience to be an impactful one.

For the course the bulk of the class consisted of a powerpoint prepared with basic nutrition facts such as how many servings of fruits and vegetables are required for their age group, for example. However, we made sure to break up the powerpoint with fun Kazoot.it quizzes. Other activities that the students did to break up the lecture included:

Create an individualized meal plan utilizing Choose MyPlate
Make a healthy “no bake” snack
1-minute presentations on their favorite fruit/vegetable that included the season it is grown in, calories per serving, ways to prepare it, and key nutrients
“Non-traditional” fruit tasting that included students peeling and cutting the fruit
Jeopardy
Long and short term health goals and how to reach them

Maybe this is how it always feels to teach, or maybe we just got lucky with an amazing group of students. Whatever the case may be, this is a memory that I will cherish forever.

Can you think back to your first teaching experience? Is there anything that you would change or knowledge you would pass on to help future educators?

Industry vs. Academia: Which Road To Take?

March 28, 2019March 28, 2019 Keerat Kaur, PhD

If you are an early career researcher, this question might have crossed your mind at some point: “What’s the best career choice after finishing my PhD – ‘industry’ or ‘academia?'”

While you will still be called a researcher, the context of work changes when you pick one or the other option. Like myself, who is still contemplating between the options, it is really important to understand the differences between both career choices. It is also very critical to make your decision on basis of your interests, skills, qualifications and personality. I personally make my decisions with a critical eye listing all the pros and cons, which I will be sharing with you.

Work Independence:

Your work responsibilities in an industry are based mostly on supply and demand. Whatever product is in demand, most likely your project will be focused on that specific product development. This can also mean that there will be clear direction of work without you wasting time on things which might be uncertain to work. This can be a best case scenario if your personal project interests align with the company’s. However, in most instances, your work (or broadly speaking, your career) will be controlled by higher authorities.

Whereas in academia, you have a freedom of exploring different horizons. It’s up to you to design and pursue your own project with or without limited direction from senior authority. Your job will be more intellectually adventurous as you will be constantly thinking, reading and exploring new ways to solve a problem.

Money:

To some of us, finance plays a big role in deciding our career… but for others, the decision is purely based on what you enjoy doing. Generally speaking, the salaries in industry are 1.5 to 2 times higher compared to academia. While the world is brighter on industry side, you don’t even want to know about how much graduate students and postdocs earn.

Late 20’s and early 30’s is typically the time when you want to buy a house or start a family, but these things just seem far-fetched in your early academic career years. On the positive side, if the promotion or bonuses sound unreal in academics, maintaining employee satisfaction is bit accessible. This can be a hard earned task in industry given the cost of bringing on a new hire is so high.

Work responsibilities:

Most research jobs in the industry are standardized and structured to align with the company’s management. You may have more time to contribute to multiple projects, but the ideas/instructions may be coming from a different team directing which goals are best for company’s progress (and not your personal research interests).

Whereas in academia, as a PI for instance, the scope of your responsibilities would be much wider and entrepreneurial. It surely depends on your size of your institution, but more or less you will find yourself applying for grants, mentoring your students, publishing your research, looking over your finances, and at some places you will be responsible for teaching students, as well. If you obtain tenure, you are pretty much guaranteed a job, which can be a struggle in industry if you unable to reach the goals set for that particular year. Academia also gives you the liberty of finding your own boss, whereas industry doesn’t.

Flexibility:

If you are a family person or likes to work at your pace, then academia is the way to go. In most cases, you don’t have to stick to work hours. You are able to make your own work schedule and hence work environment in your lab. You may have grant and manuscript revision deadlines, but they can’t be compared with rigorous quarterly deadlines or monthly reports in an industry.

The pace at which these 2 sectors works is also very contrasting. Where academia is free of short term deadlines and focuses on long-term education and learning goals, industry is fast paced where most of work is done on quick timeline driven by product development goals.

So, if you are asking yourself this big question about which career path to choose, first understand what kind of personality you have and what your life priorities are. It is really important to know your strengths and which place they can be more effectively applied. Also, it is of great importance to be open minded and keep your options open – especially now when industry is collaborating with academia to conduct research, it has become little smoother to transition between the sectors. I hope some of my thoughts would help you choose the right direction.

The Clinician-Scientist-Educator: Why The “Jack of All Trades” is Viable and Valuable

February 11, 2019March 28, 2019 Elizabeth Knight, PhD, DNP

I am a nurse practitioner, nurse scientist, and nurse educator. That means I’m typically teaching nurse practitioner students two days a week, seeing patients in family practice two days a week, and working on a clinical research project one day a week. (At least, this is the “official” breakdown. Sometimes, in the real world, these things bleed into each other, and into the rest of my life!). I am frequently asked, with some measure of incredulity, why I completed both a DNP (clinical doctorate) and PhD (research doctorate). Was I trying to delay graduation as long as possible? Am I just indecisive? There may be some truth buried in those quips, but I think there are compelling reasons to marry clinical practice, research, and teaching.

The physician-scientist is the most well-established professional role that marries science and practice (see recent popular press mentions here and here). Other clinical fields including nursing, psychology, dentistry, and physical therapy also have dual practice/research roles. Often, teaching is additionally part of an academic position, making the role even more diverse. So what’s behind the role of clinician-scientist? Why do we need these jacks-of-all trades?

I asked clinician-scientist colleagues on Twitter what the rewards are for them. Several described feelings including seeing patients is a reminder of the ultimate reason for clinical research, and seeing the ways that research findings impact patients is motivation for further discovery. One mentioned that participating in research combats the tendency to feel like a “cog in the machine” of medicine. Another noted that it keeps the day-to-day exciting to be in practice, as lab work can sometimes be lonely. And then, there’s the exposure to new ideas and methods that comes from following multiple paths.

(Thanks to @andyYchang and @AnberithaT for the feedback!)

Elizabeth teaches health professions students at the Mobile Health Program’s clinic on wheels, where she practices as a family nurse practitioner

I agree, colleagues! In addition to these personal reasons, there are philosophical reasons to take this path. One reason that speaks to me is the nature of the relationship between science and practice. The gulf between research findings and practice change is wide — some is because the research community doesn’t always do a good job disseminating findings, some is appropriate caution on the part of clinicians, and some is inertia. But part of the problem is upstream — a lot of clinical research was not designed with translation in mind, so the findings don’t seem readily applicable or there are logistical barriers to implementation. Clinician-scientists can address these problems by designing clinically relevant studies and publishing papers that speak directly to clinician’s concerns. They may also enhance research translation by serving as hubs of disseminated learning in the clinical context. (see evidence on clinician-scientists as knowledge hubs here). This brings us to the role of educator: people with research and practice expertise are excellent educators, both in clinical and academic contexts. The deep understanding that comes with immersion in both clinical and research contexts is a powerful tool for teaching. Encouraging current students to appreciate the tools of both disciplines will pay dividends in the shared future of science and healthcare.

My colleagues and I identified many reasons to pursue the clinician-scientist-educator role. Why then isn’t this the default position with everyone following this path? There are challenges. Training as a researcher and clinician takes time, and it may require intense focus in areas that are not always well aligned. The “publish or perish” mantra of academic careers is taxing to those who may dedicate a significant amount of time to clinical practice and teaching. The expected pace of productivity for a tenure-track job can seem unattainable. Likewise, the time and focus required to prepare for and lead a large research project may be out of reach for someone with an active clinical practice. While some may find it energizing to switch contexts frequently, it can be taxing for others. It can be an uphill battle, depending on your work environment, to meet the expectations of multiple roles.

On a personal note, I have faced many of these challenges myself, but I’ve found great support in places like the AHA Early Career community. While my path isn’t typical of those in my profession, I’ve been able to seek out the resources I need to succeed. While taking an unusual path isn’t always easy, it’s also deeply rewarding to be one of the only ones who does what you do.

Would you consider a career as a clinician-scientist-educator? If you’re one or the other, do you collaborate with people who have different roles and expertise?

Elizabeth with a team of early-career clinicians and scientists and mentor David Goff at the AHA 10-day seminar on the Epidemiology and Prevention of Cardiovascular Disease in Tahoe City, CA.