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Bring Your Whole Self to Work

“Pretend you are going to be interviewed by a conservative, old white man in a bowtie”.

This was the advice I was given when I asked what I should wear, how I should do my hair, and how I should present myself when I interviewed for medical school. I remembered those words when I interviewed for every step of my journey in medicine since, including 1 residency, 3 fellowships, and my first “real” job as an attending. I wore conservative-colored suits (I remember my younger brother telling me I looked like a flight attendant before one interview- not the look I was going for, but okay), always straightened my hair (I never wore my natural curls), and I always thought of that advice before every interview- conservative, old, white, man, bowtie.

Fast forward to “attending’hood”, I would never heed that advice. I started wearing my hair curly as a protest to what “professional” hair should look like, presented on stage in pink blazers and dresses, and brought my whole self to work. When I interview prospective internal medicine residents or cardiology fellows, the most important 3 pieces of their application in my opinion are their letters of recommendation, their personal statement, and their extracurricular activities outside of medicine. While the abstracts, presentations, and publications are fantastic, they do not tell me who you are as a human being. From the letters, you get a glimpse of how others see the applicant, from the personal statement you hear a story, and from the extracurricular activities you learn about passions. My favorite part of the interviews is talking to candidates about who they are, what lights that fire within them, and what kind of vibe they bring to medicine. When I read your application, I want to know your story.

I love what I do in medicine- advanced heart failure and transplant cardiology- I love the research I do but I also love my life outside of medicine. And I am always confused when people are surprised that I love college football, I love LeBron James, my favorite radio show is The Breakfast Club, and I listen to trap music. I love going to concerts, throwing outrageous birthday parties, and going on girls’ trips. I care deeply about equity in medicine and politics that affect the most vulnerable among us and will continue to work my butt off to crush inequities in organ allocation. To me, these are not 2 different worlds. This is just my whole world. So yes, I will keep bringing my whole self to work.

To be completely honest, I am not sure how I should advise my mentees, most of whom are women and men of color, on how to dress or style their hair or carry themselves during their interviews. People of color are judged more harshly, and I would not want my advice of bringing your whole self to the interview be the reason they did not get the position. But then again, who wants to be at a place that does not accept all of them.

I still say, bring your whole self. Every part of it. The authentic you.

And to my mentees I say, continue sharing your magic with a world that desperately needs it.

 

“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.”

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Support Starts at Self

Last month I wrote about how trainees and early career professionals should approach the New Year with a focus on mentorship (from multiple sources when possible!) as a priority to advance their careers. The input we can accumulate from individuals that have the ability to “teach us the ropes”, and expose us to some new tool or perspective to enhance our professional growth and advancement, is essential. This input carries value that fuels the propagation and elevation of society upward and forward. Today I want to discuss what I envision to be the “other side of the coin” to mentorship, the way in which an individual can advance by an “output” effort, in complement to the “input” that mentors provide. Namely what I’m referring to is advocacy. Trainees and early career professionals tend to under-appreciate 2 main truths with regards to advocacy efforts:

1- We are prone, primed and sometimes advised to shy away from advocating for our own causes.

2- We underestimate our ability to advocate and support others within our professional communities.

I’ll start with the case for self-advocacy. It can be hard to dissociate the idea of being self-advocating from being self-absorbed, and that is the root cause for why most well-meaning, humble folks avoid the issue altogether. Seeming selfish or self-centered is of course a bad trait, a noxious attitude that most trainees and early career professionals want to avoid at all cost. Selfishness will lead to career derailment and loss of support from other members in the community. But self-advocacy on the other hand, stems from hard work, a desire for just outcomes, as well as confidence and pride in one’s workmanship and abilities. To advocate for yourself, you must first believe and prove that what you’re advocating for is a just and worthwhile cause.

When there is evidence to support the self-promotional effort, individuals can and should be empowered to advocate for themselves. A quick and easy framework to approach self-advocacy could flow like this:

The first step towards justified self-advocacy is identifying and analyzing the reasons why one should or should not pursue the cause. This can sometimes be difficult, we might not be the best judges of our own efforts, sometimes it helps to have “peer-reviewers” to help us assess the need for advocacy or not. Family, friends, partners, colleagues, and specialized professionals (referees, counselors, etc), are all individuals that could supply viewpoints that help us understand and decide on whether self-advocacy is warranted at present, or if there still is some distance to cross before we get to that point.

Once justified, championing your own causes has become in fact necessary in a world where competition is present, and alternatives are available, at every stage in a career, most evidently in the early career segment of professions. This necessity also brings nowadays a level of expectation from decisions makers, who may see and value self-advocacy efforts as positive traits in individuals seeking professional advancement. This is the clearest reason why one should acquire and optimize the skills needed to become a just self-champion. Of major importance in this discussion is to note that the way in which one is doing what’s needed to advance, is doing so in a manner leading to an overall benefit, and no harm to anyone else (being a champion for one self can also equal being a champion “for the greater good”).

The second point mentioned above, specifically referring to advocating and supporting others within the shared professional community, also warrants a closer look. A strong and advancing community can promote growth for everyone within it, creating momentum and a sense of altruistic advocacy that is much easier to root for and accept without any hesitation or fear of negative feedback. When professionals in a shared community see the advancement of peers as a strength and growth for the whole group, a collective effort to support and promote one another is created, and a positive feedback loop is fueled.

This is significantly more important when the community can have individuals that face some deliberate, or blind forces, that work against their growth and advancement (such as minorities, persons with disabilities, sex and gender systematic biases, and other forces that do exist in many ways). Whenever there exists a gatekeeper with unjust (knowing or blind) motivation that hinders the advancements within a professional community, it is strongly desirable (and necessary) for a whole group effort to champion and advocate for the fair advancement of the affected individuals within this community. Everyone would gain at the end. A strong community would be built and a momentum for “paying it forward” will start.

As mentioned initially in this post, early career professionals have the unique space to be very highly invested in optimizing the “input” provided to them (mentorship), and the “output” they require (advocacy, both self and community oriented). As we progress in our personal and professional journeys, we must aim to maximize the ways in which mentorship and advocacy can help us achieve the goals we aim to accomplish, both for our own benefits, and the benefits of the communities that we are a part of.

 

“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.”

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Building an academic portfolio during medical training: Part 1 – research outside the box

As a medical trainee in the US, whether you are pursuing an academic career or applying for a fellowship or advanced fellowship, your academic profile is one of the most important currencies you rely on for this endeavor. Academia as a general term refers to 2 main areas: research and education. Many trainees, like myself, start their residency with no or very minimal research experience. It then becomes essential to create a reasonable research portfolio during medical training, which is often not an easy task, especially in clinically demanding specialties. In this series of blogs, I will try to share some ideas and tips that can help you build a competitive research résumé during residency and fellowship. These ideas also apply to medical students, inside or outside the US, who are trying to match their dream US residency program.

The first idea that I would like to talk about is one that I thought was particularly a game changer for me when it comes to research. I like to call this one “research outside the box”, and by the box here, in addition to the abstract meaning of doing things in unorthodox ways, I’m also referring to the literal box that is the walls of your training institution. Residents and fellows are rarely involved in multicenter clinical trials or prospective studies. In fact, the vast majority of research done during medical training is retrospective observational studies. One of the main reasons trainees rely on retrospective studies is the time factor. Prospective studies often take longer to execute, and it becomes difficult to get a tangible product, a conference abstract, or a published manuscript on time for your next fellowship or job application. Therefore, retrospective studies become the more realistic option, and traditionally, these are carried out using institutional databases (i.e. clinical data from patients treated at your own training hospital), which is and will remain one of the most valuable research resources. Then comes the fundamental question – why should I consider doing research in a non-traditional way, or “outside the box”? – For many reasons:

  • Many training hospitals do not have large clinical databases that can produce impactful research projects.
  • You may not find a good research mentor in your training institution.
  • Even with available databases and good research mentors, some retrospective studies may still take long to come to fruition, sometimes longer than you can afford without a back-up plan.
  • Diversifying the ways you do research by pursuing both traditional and non-traditional means, can lead to a marked increase in productivity.
  • Most importantly, collaborating with motivated medical students, residents, and fellows around the country (and sometimes even around the globe), not only enhances your research output but is in itself a great learning and networking opportunity.

The next logical question would be – as a student or a trainee, what type of research can I do outside my institution?

For the same practical reasons that I previously mentioned, I am still referring to retrospective observational research rather than multicenter trials or prospective studies. In that case, to be able to easily collaborate with researchers across different institutions the data has to be publicly available and not protected by privacy laws. There are different types of publicly available data, some are mostly free, such as already published literature, some can be purchased for a fee, such as national and state administrative databases, and others require a research proposal that goes through a grant-like process, such as societal databases. The latter typically requires a higher degree of research expertise and are restricted by application cycles, so I would not recommend them as the first go-to option if you are still taking your very first steps in medical research. Here are some examples of observational research work that can be done collaboratively using these publicly available data sources, without being limited by institutional boundaries:

  • Published medical literature can be used for meta-analyses and systematic reviews. These types of studies commonly address hot topics in medicine or topics with controversy or equipoise. A common scenario where topics are considered “hot” is immediately after the publication of a large clinical trial, particularly if the results are not in line with prior trials on the topic. Meta-analyses are also ideal for examining uncommon side effects or complications of medications or medical procedures.
  • National administrative databases can be used to perform retrospective observational studies, e.g. the National Inpatient Sample (NIS) and the Nationwide Readmissions Database (NRD), which are commonly used in cardiovascular research. They are particularly helpful in researching rare conditions or special populations where getting a large sample size using single-center data is challenging, or to examine trends in diseases or therapies over time. Most of these databases are available for purchase per calendar year (e.g. 2010, 2011, 2012 etc.), meaning that you can buy one or more year worth of data, depending on your budget and your research question.
  • Societal databases can also be used for original outcomes and quality improvement research, e.g. the American Heart Association (AHA) Get With The Guidelines and the American College of Cardiology (ACC) National Cardiovascular Data Registry (NCDR) Although these do not cost money, yet, they mostly require more work including submission of a proposal during an annual or bi-annual application cycle, which is a very competitive process.

These are just examples of what can be done and some common resources that can be used to start with, but in reality, the possibilities and the available resources are endless. Now that we talked about “why” and “what”, the next question is “how” – how to reach potential collaborators? how to build a successful multi-institutional team of young researchers? And what are the challenges to this approach? This will be the topic of my next monthly AHA Early Career Voice blog. So stay tuned..

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.

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A New Year and A New Perspective on Mentorship!

At every stage of personal growth and development, mentors play a key role in providing advice and support to propel their mentees forward. The act of mentorship is a core element of social interactions and societal advancement. A line like “it takes a village to raise a child” is basically talking about mentorship. Same for the commonly used line in academic and medical circles – “See one. Do one. Teach one.” Graduate and postgraduate students and fellows are required to have assigned mentors to guide them through their final stages of education, and early stages of a professional career.

The level of success a person achieves can be accurately traced to the level of mentorship afforded to them. Mentorship, more so than just academic education, provides a broad spectrum of opportunities for learning and growth. Great mentors are able to provide advancement in what is classically referred to as “soft skills”. These are skills like: communication, leadership, time management, “tricks of the trade”, and other avenues of growth normally left out of school curriculums. This makes finding a highly qualified and experienced mentor an extremely valuable endeavor. Of course these skills are not limited to the medical and academic fields; mentorship is valuable in all aspects of personal and professional growth.

Here is where I introduce the main message I’d like to pass along in this piece. We (correctly) seek and value mentorship from experienced, highly qualified, and revered individuals, to assist us in advancing our knowledge and skills within our chosen fields. However by focusing on finding one type of mentor, we may be setting ourselves up for lost opportunities, learning and advancements of equally beneficial value, from individuals that don’t fit the classic idea of a mentor. By this I mean, when was the last time you looked for a mentor that was junior to you?

We all are kind of aware of how this type of mentorship can be, like how I’m happy to continuously coach my dad on how to advance his usage of smart phone technology, and how my younger relative is mentoring me on how to be a better skater and hockey player! This same kind of mentorship dynamic can also translate in a professional/academic setting. In our present fast-paced advancing world, many novel ideas and tools develop, and typically the earliest adopters are not individuals that have established some previously learned and used idea/tool (i.e. the ones with the lived-in world “experience”). Most of the time, early adopters are typically young, enthusiastic, quick learners!

This group has shown time and again, when it comes to the newest forms of knowledge and skills, they’re ahead of the archetypal mentor. Seeking and accepting younger mentors, in addition to classic mentors, allows the mentee to gain knowledge and skills in a wide range of topics and fields, as opposed to only seeking top-down knowledge. There is great value in learning from experienced individuals, but there is also value gained by seeking the expertise of younger enthusiastic early adopters of novelty, regardless of what field one is pursing mentorship in.

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(Image collage sourced from pixabay.com)

 

Considering this is the time in the calendar where everyone is reflecting on the accomplishments of the past, and making plans and resolutions for the coming year, I thought I would suggest an additional resolution to add to your list this time around. In an effort to maximize personal and professional growth, why not make a resolution centered on mentorship? I’ll even create a fun plot device J What if the resolution could be formulated as follows: This year I will seek (or continue to benefit from) one mentor that is “double” my age/experience AND one mentor that is “half” my age/experience (let’s call it the Double & a Half Mentorship rule!). *All values are approximate.

I’ll use myself for an example: as an early career scientist, a mentor “double” my age is already in place (that’s my boss, Chief Science Officer of the Institute I work in, and Senior Principal Investigator on the research group I’m part of; who truthfully has way more energy than I can achieve, proving that age is not a good measure for vitality!). A mentor “half” my age would be a summer/undergraduate student or temporary employee in our research group (again, the age part of the rule is approximate); someone that will teach me a skill in the lab or on a computer, that will promote my professional goal of learning and conducting high caliber research in cardiovascular disease areas.

This year I aim to continue finding ways to learn and gain skills from both an experienced mentor, and a young enthusiastic mentor, to advance my personal and professional development. I hope you maximize your mentorship opportunities as well. Happy New Year!

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Have You Picked Your Mentor’s Brain Lately?

It’s funny how people meet – some are coordinated efforts at work or meetings while others are random. I met one of my mentors – Dr. Jane Freedman – in the outpatient echo lab. We had never met prior to my fellowship but I recognized her name from the echo reports of my patients. After introducing myself to Jane, I fired all sorts of questions her way – mostly about restaurants in Boston we both enjoy, things we do in our free time, how to get involved in the AHA, and how best to read echocardiograms. This sparked not only a great friendship but an even better mentorship.

Jane has become my work-life-balance mentor, advising me on how to be an effective chief fellow, developing my own leadership style, types of jobs to pursue, and balancing personal life with the intense time commitment of medicine. I soon realized in order for me to be a good mentee, I had to support my mentor when I could. This included, attending her talk at the AHA not out of a feeling of obligation but out of a genuine desire to support my mentor. Over time, our mentor-mentee relationship has taken on more academic facets – largely, honing in the on the type of job I would want in the future. Jane has pushed me to clarify the type of job I want to pursue and more importantly, what are the reasons for wanting it.

mentorOver the course of my training, I realized that not all of my colleagues have mentors to turn to for these critical career conversations. It made wonder how mentors can help fellows in training, and more importantly, what are the key elements to a successful mentor-mentee relationship. To understand what made our mentor-mentee relationship successful, I asked Jane at a recent dinner at one of the many great restaurants we wanted to try.

In her experience, a successful mentor-mentee relationship comes down to be receptive as a mentor and mentee. You have to have the self-awareness of the relationship to provide support for those seeking it.  In addition, the relationship has to be symbiotic. The mentor has to give advice to the mentee based on the level he or she is at. For example, the chair of cardiology may not be a good mentor to a first-year fellow if he or she is not able to give the appropriate support needed for the fellow at that specific stage of training. Conversely, the mentee needs to work hard towards the goals and expectations he or she has set for this to be a successful relationship. This made me think: how do we go about even choosing the ‘right’ mentor??

Jane highlighted that everyone needs more than one mentor. For example, an academic mentor to help me pursue research opportunities, a clinical mentor who helps cultivate knowledge in my area of interest, and even a work-life mentor that I can turn to when this demanding job seems undoable. Every mentor offers something unique to the relationship and more importantly, not one mentor will be able to give you everything you need. Jane stressed that she never stopped at one mentor but sought those that will help her become successful in all aspects of her life and career.

Jane explained that while she was training she reflected on what would improve her work-life balance. There were only so many things she could accomplish in a day and had to recognize where she needed help. For example, with the various apps to help improve efficacy, I could order groceries to be delivered to our home. The time saved at the grocery story can be spent with my significant other or at the gym. Something Jane stressed – which I took to heart – was to never feel guilty for not being able to do it all. People who go into health care are incredibly driven but we all have our limits. It’s important to recognize these limits to prevent burnout, enjoy our work, and continue to work on achieving a balanced life.

A piece of advice Jane gave me is to make sure I pick a career path that will make me happy, not the one I think I should take. With the extensive amount of board certifications in cardiology, fellows feel pressured to take them even if they do not want to. Again, this comes back to a point Jane highlighted earlier – we need self-awareness to be successful.

As dinner started to wind down, I was able to reflect on how I was performing as a mentee and what steps I can take in the future to make our relationship more successful. Checking in with my mentors always brings about new found motivation and energy to continue to strive for success.

 

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Get a Mentor, Be a Mentor

mentorship bubbleEarly in our careers, academics are encouraged to find good mentors. You need an advisor to get a doctorate, and this person is a mentor. You might be working in someone’s lab as a grad student or post-doc, and that person can be a mentor. You might be junior faculty and have a senior mentor to show you the ropes. There are formal mentorship relationships and informal mentoring relationships, and you’ve likely had both in your career. They’re a key part of professional development.

But what about being a mentor? The other day, a colleague came into my office and asked me to mentor her. My first response was to say “no, I can’t, I’m really new, we’re the same age, I don’t know anything you don’t know, you’re smarter than me. . .” But I paused. What made her ask for a mentor? What made her ask me? What can I offer this person to help her thrive professionally, so we don’t lose a much needed person in the field?

On reflection, I considered what mentorship means. Having a senior, accomplished mentor is a gift, especially if that person also works as a sponsor for you. Yet it’s also valuable to have a mentor who’s closer to where you are— someone whose life and struggle more closely resemble yours. A young(-ish) woman in academia can mentor another young woman in academia. Non-hierarchical and team models of mentorship also hold enormous promise. I attended a great session on this at #AHA18 in Chicago — I hadn’t thought of that before. Mentorship as a tool to encourage success is much broader than the classic senior-junior one-way relationship. My mentor-seeking colleague and I could certainly benefit from this kind of arrangement.

It’s also easy to forget that as early career scientists, clinicians, and educators, we are already accomplished. A grad student, an undergraduate student, a high schooler, or a middle schooler who’s interested in your field could benefit from your guidance and experience right now. Also at #AHA2018, AHA president Dr. Ivor Benjamin spoke about mentoring young black doctors. He then dug deeper, urging us to mentor young people earlier, before there’s a leak in the pipeline. This is such a crucial idea— the value of mentoring people from underrepresented groups in your profession is enormous. Science and medicine desperately need diversity, but this diversity cannot grow and flourish without the attention of dedicated mentors. Support is especially crucial for racial and ethnic minorities, LGBTQ people, and women, who remain underrepresented in many areas of STEM, including crucial leadership roles. In addition to perpetuating oppression by limiting access to career paths for individuals and groups, the downstream effects of this underrepresentation undermine equity in our science and clinical care. We can’t ignore the need for diversity and the crucial role for mentorship in building it.

 

So, early career scientists, educators, and clinicians, will you take up the challenge of mentorship?

 

Need a resource or want some further reading?

Check out this discussion of The Mentorship Guide.

 

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5 Things To Consider Before Choosing Your Dissertation Topic

As I am inching towards, what I hope would be my final year of PhD research, I have been thinking and analyzing a lot of my actions in retrospect. I thought of putting together a list of things I learned and things I wish I had considered in my first year.

 

1) Finding the “right” mentor.

We spend a lot of time in deciding the right lab or the best PhD supervisor. A lot has been said and done about finding the right fit. One thing I have learned is that apart from the usual parameters we set in finding the best supervisor for us personally, sometimes we forget to consider if the supervisor is right for the project. Sometimes the project may expand in an area beyond your and your mentor’s expertise. In such cases, it is important to consider whether your mentor will make the right resources available to you. Putting together a good research advisory committee, scientists who would have expertise in that specific topic, will come in handy. Research can be quite daunting and grad students deal with intense pressure and stress on a daily basis. Your time should be spent researching and not trying to find the right instrument in the cheapest core facility and definitely NOT YouTubing the workings of a new technique. Make sure to find someone to train you, attend workshops, shadow a technician and make sure your supervisor makes these available to you when needed. A mark of a good mentor is when they don’t hesitate to seek consultation or advise from an external or senior scientist who is an expert in the field.

 

2) Is this a good career investment?

Turns out most students forget about the crucial thing about spending years in grad school – landing the job! Most of us don’t think about job search or the next move until our final year, which I think is too late. While choosing a topic, you may want to consider things like job market, skill requirement, funding agencies and so on. For example, researching therapeutic drug targets for a disease that has no cure is far better than investing in a project discovering drug targets for a disease with multiple FDA approved drugs. Weigh the pros and cons carefully. Will your project help you acquire technical skills that are translatable to the industry? If you live in a city or country that is in dire need of science policy advisors or climate crisis advocates or good science communicators, will your PhD program give you enough skills to apply to these jobs?

 

3) Is there scope for collaborations?

Collaborations are a unique way to expand into different research topics in your field, whether it’s a collaboration within your group or research with a different research group altogether. This lets you become more versatile, get a flavor of how other researchers approach their science and if nothing else, learn a new scientific topic up-close. A productive collaboration is one which will take your expertise and enhance another project, without taking too much time away from your project. Inter-lab collaborations are a great way to demonstrate your negotiating, team management and interpersonal skills. Oh, and did I mention it’s good for networking? So finding aims in your proposal early on, that are good for teaming up with other groups is a good idea, especially while conferencing.

 

4) Will it help you AND your science grow?

I will start with the science part first. Obviously, we all want to learn and become an expert in the respective field when we started off, so what do I mean by growth here? If your research topic is only going to be a repeat of your previous techniques and scientific concepts, chances are, halfway through the project, you’re going to lose interest. It is great to start off the project with something familiar, but if it isn’t exploring in areas that are uncomfortable and challenging to you, is it really worth a PhD? Test new ideas, push your boundaries and give yourself a deadline to fully delve into answering these questions. But be wary not to spend too much time and get distracted. It is good to spend the first two years (in a five-year program) to be adventurous, but if it gets too challenging it really should not be pursued at the expense of your time.

I stress on personal growth next. PhD project is a LOT of time commitment. Especially to one very specific thing, that more often than not, will consume most, if not all of your time. This means one must consider having room for co-curricular activities that will in turn be an asset for your own research project. For example, I love to read about popular science, wildlife, climate science, conservation, policies and history. My program had a structured graduate minor alongside my PhD major and I decided to study science communication for this minor. Now, I get to write, read or watch other popular forms of science, engage with community, organize local events and dissect science policies as part of my curriculum. I have also gotten opportunities where I talked about my own research to strangers and thus, honed in my craft of communicating science. All of this will ultimately reflect in your resume and you know that apart from spending long hours fine-tuning your experiments, you will leave with heaps of useful skills for future jobs. So, I would recommend finding things that compliment your science early on, this will go a long way!

 

5) Will you need a backup plan?

If you are diving into something extremely challenging, let’s say it will not only require you to learn new, field-specific techniques, but it will mean questioning the dogma – make sure you have another small project to safely rely back on. If your program has at least one first-author paper requirement for dissertation, it is imperative you sit with your supervisor and make sure you will get a paper out in time. No dogma is worth challenging at the cost of your degree!

 

These are some pointers that I thought of, from personal experience. I hope that you will find it useful and informative.

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A Profile in Mentorship: Dr. Thomas Pearson

Every scientist, even those who are particularly good at hiding away in their offices, will have an impact on others. Most of the time, this impact is a byproduct of our everyday work. We don’t give it much thought – it just happens. But what if that impact was not accidental, and instead was a deliberate, strategic path of choices that build up those around us – even those who disagree with us, compete with us, and threaten us? That is the path that has been trodden by Dr. Thomas Pearson who was awarded the 2019 AHA Council on Epidemiology and Prevention Mentoring Award.

Dr. Pearson has an impeccable academic pedigree and an enviable career. After an early start at the University of Wisconsin, he earned his Bachelor of Arts, MD, MPH, and PhD all from the Johns Hopkins University. He has achieved the goal of every early career scientist – over 35 years of continuous NIH support and is a Fellow of the American Heart Association, American College of Cardiology, the American College of Preventive Medicine, and the American College of Physicians. But the degrees, grants, and accolades are a byproduct of a man driven to service for the love of science.

Dr. Pearson’s own mentors reflected his insatiable curiosity. As a student, he drew from a broad mentoring team that left lifelong impressions of the qualities of good mentor. While excellent teaching was important, more so was the “utterly frank” assessment and advice they provided him. He states, “from them I learned that the primary role of a mentor is to provide an honest, encouraging perspective on the mentee’s ideas, plans and experiences. While some mentors may be tempted to acquiesce or tell mentees what they want to hear- that is abrogation of their responsibility of a mentor.” Such frankness can be tough in today’s academic environment, so to help cultivate this skill, Dr. Pearson’s University of Florida developed the Mentorship Academy. Equally important to learning how to deliver a frank assessment of the mentee is helping the mentee learn how to receive and act upon such advice without taking umbrage to it.

Additionally, Dr. Pearson offered this advice on how early stage professionals can intentionally become effective mentors, including:

  • Be a good communicator. Communication is the basis of mentoring. Good communication should include developing shared expectations of the goals, responsibilities, and processes of the mentor-mentee relationship. Many of the problems that occur in the mentoring relationship result from a misalignment of expectations and reality. An honest conversation, with both parties being active listeners, about the mentor and mentee’s strengths, weaknesses and goals early on in the relationship can set both parties up for success.
  • Broaden your network. Every day we hear about new grants, interesting conferences, and visiting professors. Yet because they are just starting their career, mentees may not hear about the same opportunities. Part of being a good mentor, Dr. Pearson suggests, “is to continually be looking out for opportunities for your mentee and actively encouraging them to pursue them”. This includes inviting a mentee to a lecture and offering to introduce her to the speaker. Opening this door can help a mentee broaden her professional network and embolden her to pursue new opportunities.
  1. Focus on the mentee. The mentor must recognize the mentee is not “hers.” Rather the mentor should focus on the mentee’s needs and goals and, if she finds another investigator can provide a better opportunity for the mentee, help to arrange it. Dr. Pearson states, “Mentoring and selfishness are like oil and water- they don’t mix.”
  2. Stay curious. In his acceptance speech, Dr. Pearson talked about how much he learned from each of his mentees. They taught and inspired him as much as he did them. But that can only happen by accepting that mentoring is a partnership in which each person has a lot to offer. Good mentors need to be curious about their mentees and excited about learning from them.

Dr. Pearson has mentored over 60 people during his career. Many have gone to have equally enviable careers where their impact reverberates into every corner of our profession. He told me, “You never really stop mentoring a mentee. People I mentored still call me and talk about their career, their family. At some point, they start being friends.”

Mentors – true mentors – view their work not as a requisite service but as a thread that weaves together the knowledge of the current and past generations to the next. Mentors are the foundation upon which scientific progress is made; and their impact is the greatest when their mentoring is done with humility, enthusiasm, compassion, curiosity, and an infallible sense of optimism. These are the traits Dr. Pearson embodies; and are the ones that all who seek to see further should strive to emulate.

 

 

 

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Fellow Focus: Peer Mentorship Program

During my first year of general cardiology fellowship, our program underwent an exciting transition – our incoming fellowship class increased from 6 fellows the previous year to 10 fellows in my class, nearly doubling the size of the fellowship. This growth was necessitated by the welcome addition of the West LA VA as a rotation site for house staff, which meant spreading our fellowship across 4 different clinical sites. While this gives our fellows the opportunity to train in a wide variety of clinical settings with different patient populations and pathologies, it also creates a very large fellowship program, with 30 fellows altogether. Although there are advantages to having a large program, a program this size poses the risk that fellows ultimately may not get to build the camaraderie that many acknowledge is a pivotal aspect of their medical training. Indeed, much of the education received during clinical training occurs through our peers.

At the beginning of my chief fellowship year, my co-chiefs and I chose to implement a new program within our fellowship to promote peer mentorship among our fellows. Inspired by an outstanding JACC article describing a peer mentorship program that was instituted in Columbia University’s Pediatric Cardiology fellowship,1 we created a similar program in which “Houses” were formed consisting of one fellow from each class. Each House would be led by its senior 3rd year fellow, who would also choose a faculty mentor for the group (Figure 1).

Figure 1: Schematic representation of the House system. Each pillar represents one “House” consistent of 3 fellows and 1 faculty mentor. Adapted from Reference 1.

Each House was advised to meet at least once each quarter, with each meeting organized by the senior fellow. Meetings were suggested to be informal, but discussion items, such as research opportunities, balancing family and fellowship, and exploring career paths, were recommended. Further, senior fellows were encouraged to take ownership of mentoring their respective 1st year fellows, particularly during the first half of the year.

After surveying fellows before and after the implementation of the House program, the results of the program were rather impressive. For instance, prior to the program, only 44% (4/9) first-year fellows said a senior fellow helped them during an early-year overnight call. Post-implementation, this number improved to 100% (10/10 first-year fellows from the next class). Further, first-year fellows were asked to assess their satisfaction with “Peer Mentorship” within the fellowship, and these ratings improved significantly after the House program implementation (Figure 2).

Figure 2: First-year fellow satisfaction for peer mentorship within the fellowship program.

Many more aspects were assessed in these surveys, as well as in surveys given to senior fellows and faculty members. These included measures of feedback frequency given by senior fellows and faculty on conference presentations and measures of academic productivity (abstract submissions to national meetings, peer-reviewed publications). While many other factors besides the House program may have contributed to the improved scores we observed on these surveys (perhaps even a placebo effect), the feedback we received on this program from fellows and faculty were overwhelmingly positive. As the program is far from perfect, we have found that it was easy to implement, sustainable, and effective at improving fellow satisfaction with our training program. As it continues into its second year, we hope that it will continue to improve, and more importantly, that it will further improve the fellowship experience within our program.

This past weekend, I shared our experience with this peer mentorship program with others as a moderated poster abstract at ACC.19 in New Orleans, Louisiana.2 For other large training programs looking for methods to improve peer mentorship, we believe our House system was effective and would be happy to share more details from our experience with those who are interested.

 

References:

  1. Flyer JN and Joong AN. Improving Peer Mentorship: A Novel Fellow “House” Program. J Am Coll Cardiol. 68:2907-10. 2016
  2. Hsu JJ, Flyer JN, Joong A, Small A, Vampola S, Yang EH, Watson KE. House of Cards: Implementation of a Formal Peer Mentorship System in an Adult Cardiology Fellowship Program. American College of Cardiology, Cardiovascular Training Section, New Orleans, LA. March 2019

 

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The Invaluable Importance of Mentorship Throughout Your Career as a Female Cardiologist

Featuring an Interview with Dr. Stacey Rosen recipient of the American Heart Association (AHA) 2018 “Women in Cardiology Mentoring Award”

 

Lack of Females in the Cardiology Field

Over 36% percent of Internal Medicine residents are females. Despite this fact, females account for less than 20% of the Adult Cardiologist workforce in the United States and account of less than 10% of Interventional Cardiologists in the United States1. Recruitment and retention of many talented female cardiologists remain a constant challenge and is due to a variety of reasons. Some of these reasons include the thought that cardiology is a grueling field that does not allow for work life balance and is often inhospitable for females desiring to start a family. There is also difficulty in retaining females in the field due to increased gender discrimination in the field1. In fact the Professional Life Survey conducted by the American College of Cardiology had reported that many female cardiologists in the field report a high level of career satisfaction which has not changed over the last 20 years1. However, there are many challenges that have remained the same for female cardiologists over the last 2 decades, such as gender discrimination, the need to arrange for paid or unpaid childcare, being single and not having any children1. In addition, there has been aging of the workforce and there are increasingly more female cardiologists practicing in an academic and/or hospital employed setting rather than in private practiceand therefore having less autonomy over their work schedule and environment.

 

Need for Effective Mentorship For Female Cardiologists and the American Heart Association Women in Cardiology Mentoring Award

 

There is an ever increasing need to not only recruit more females in the field of Cardiology, but to also retain many talented female cardiologists in the field. Finding a good mentor and fostering good mentorship is invaluable for many females throughout their career in Cardiology. The Women in Cardiology Committee of the American Heart Association (AHA) values the importance of good mentorship and as such bestows the Women in Cardiology Mentor Award that is sponsored by the AHA Council on Clinical Cardiology to Cardiologists who have been recognised as having an outstanding record of effectively mentoring and supporting female cardiologists. Dr. Stacey E. Rosen,  Endowed Chair and Vice President for the Katz Institute for Women’s Health at Northwell Health, Partners Council Professor of Women’s Health at Hofstra North Shore-LIJ School of Medicine at Hofstra University and Professor of Cardiology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell is the recipient of the 2018 AHA Women in Cardiology Mentoring Award. She has mentored and supported numerous female cardiologists, and in the following interview, I had the honor of discussing the following questions with Dr. Rosen.

Courtney could we add a hyperlink to the AHA WIC mentor award nomination site?

 

What attracted you to the field of Cardiology?

Dr. Rosen: “I am the first member of my family to become a doctor. I am the daughter of educators and while in high school , I volunteered at Memorial Sloan Kettering in the pediatric child-life center. I thought that the medical field would allow me to pursue various professional options including clinical care, education, advocacy and research. I felt one could never be bored in medicine! As a student in the 6-year medical program at Boston University, we dissected a bovine heart and I was so amazed by the “simplicity” of the structure. Nothing else seemed intriguing after that – my only important decision was between pediatric cardiology and adult cardiology.”

Who were the inspirational persons that influenced this decision?

Dr. Rosen: “The Division of Cardiology at Boston University School of Medicine in the 1980’s – and ever since – was extraordinary. The faculty at Boston City Hospital (BCH) demonstrated commitment and passion for those in the underserved neighborhoods near BCH and the faculty at University Hospital were national respected clinicians , investigators and educators.”

Who were your mentors in Cardiology and how did they contribute to the advancement of your career?

Dr. Rosen: I completed Internal Medicine residency and a chief resident year at Montefiore Medical Center in the Bronx, and was privileged to work with an impressive Division of Cardiology. Hildrud S. Mueller, MD and James Scheuer , MD taught me the importance of rigor and attention to detail in both clinical work and research. I presented my first oral presentation with John Fisher, MD – the recently retired division chief – and learned to perform a complete and thorough cardiac exam with Mark Menegus, MD.

As a fellow at Cornell – New York Hospital, Mary Roman, MD, Peter Okin, MD, Paul Kligfiled, MD, and Richard Devereux, MD fostered my fascination with imaging and non-invasive cardiology. Doppler physics was replacing hemodynamic assessment in the cardiac catheterization lab and I was hooked!

Finally, my first faculty position was at Mount Sinai Medical Center. Working in the echo lab with Martin Goldman, MD was an extraordinary opportunity. He inspired me to view echocardiography as a critical tool to enhance optimal patient care and helped me to develop the skills to become a lab director in my next position.

You have mentored many colleagues in the Cardiology field and have been valued by many as a great mentor, which led to your selection for the 2018 AHA Women in Cardiology Mentorship Award. What are the factors that mentees should consider when selecting a mentor?

Dr. Rosen:Mentees should consider several critical factors:

  • Compatibility – Choose someone with whom you are compatible but not someone who is a “mini me“ of yourself. You do want a mentor who will challenge you, be comfortable providing feedback, and teach you to internalize and utilize feedback to advance your goals.
  • Trust – You want a mentor whom you can trust – you will likely be sharing important and perhaps confidential conversations. It is also critical to know that you must earn a sense of trust from your mentor.
  • Expertise – Your mentor does not have to have the most senior titles or positions, but should have the requisite expertise to help you advance your career and help navigate challenges.
  • Willingness – A great mentor is one who is devoted to helping you develop a vision and is delighted to share knowledge and wisdom. It should be someone who is a good listener and has sufficient time to commit to the relationship.

 

Would you recommend having more than one mentor?

Dr. Rosen:  “Absolutely! But do remember that the mentee needs to commit sufficient time to each relationship in order to optimize the value of the partnership

 

How can mentees truly harness the power of strong mentorship?

Dr. Rosen:First – choose your mentor wisely and respect the relationship. Meet with individuals who you think may be good mentors and ask questions that will help you make a decision and get advice from friends and colleagues. Networking is often the key to identifying good choices.

Second – do the work and always respect the relationship! Discuss the goals and expectations of the partnership, as well as the process for communication, meetings and feedback. Be respectful of your mentor’s time and build trust immediately.

 

What are the differences between mentorship and sponsorship?

Dr. Rosen: Simply put – mentors advise you, while sponsors advance your career. A mentor is someone who can offer support, guidance and feedback, and allow you to develop your personal vision. A sponsor is earned – not chosen. A sponsor connects us to opportunities and advocates for our career advancement. It has been said that women are over-mentored and under-sponsored.

 

 

How has the experience of being a great mentor for so many colleagues contributed to your own career and personal growth?

Dr. Rosen: My late father was a middle school principal and my mother is a retired school teacher who taught in an underserved community in Brooklyn, NY. I learned from them the deep satisfaction one gets from teaching and advancing someone’s skills and abilities. I am also so grateful to MY mentors and get great satisfaction from “paying it forward.”  I am certain that I have learned as much from my mentors as they have learned from me!

What have been the 3 most rewarding experiences you have had throughout your career?

Dr. Rosen: As the director of the fellowship program at Northwell, I have had the privilege to work with dozens of trainees. I have helped impact their professional success and hopefully, the joy they find from practicing cardiology.

As chief of cardiology at Long Island Jewish Medical Center, I was able to rebuild a division that had weathered a hospital merger. Together with my colleagues, we completely revamped the division.

As a lifelong advocate for women’s heart health, I get enormous pride seeing the impact we have had on women’s health through improved clinical care, advances in gender-specific investigation and through advocacy and changes in policy. I know that our work is not done and that we still need to continue to advance women’s heart health agenda.

How has the field of Cardiology evolved over the duration of your career with regards to gender diversity and inclusivity of women in Cardiology?

Dr. Rosen: Unfortunately, our field has not advanced sufficiently when it comes to gender diversity and inclusion in Cardiology. Currently, fewer than 25% of cardiology fellows are female and fewer than 15% of board-certified cardiologists are women. Now that women are 50% of medical school graduates, the importance of developing a strategic approach to this lack of diversity is critical, or we will see a true talent drain in the near future. The good news is that both the American Heart Association and the American College of Cardiology have focused on lessening this disparity by better understanding the barriers facing female cardiologists and by making changes that will encourage young women to choose Cardiology.

What advice would you give to females considering a career in Cardiology?

Dr. Rosen: I can honestly think of no better choice! As clinicians, we can develop long-term longitudinal relationships and have an enormous impact on health and longevity. I believe that cardiology combines the best features of primary care and subspecialty medicine. As investigators, we can have a lasting impact on individuals and communities. Cardiology is also a field that is perfect for those who enjoy advocacy and advancing health policy improvements. I urge women NOT to eliminate Cardiology as a possibility because of concern about the challenges. Find the area of the field that you love, without fear or compromise, and then make decisions that will allow you to fulfill your vision of work – life integration.

References:

  1. Lewis SJ, Mehta LS, Douglas PS, et al. Changes in the Professional Lives of
    Cardiologists Over 2 Decades on behalf of the American College of Cardiology Women in Cardiology Leadership Council. J Am Coll Cardiol 2017