I’m a Junior Faculty Member at an Academic Medical Center…Now What?

Background

I was originally going to entitle this paper “Read before making every junior faculty mistake I did,” but that sounded too dramatic. Also, it’s entirely possible that you won’t make the same mistakes I did even though the transition from a post-graduate trainee to a junior faculty member is an uncertain, stressful time. Three years ago, I was elated to have completed the drudgery of post-graduate medical training and to flex my muscles of autonomy. I was ready to shed the cloak of constant unwanted advice and to do things my way. I cannot count the number of times I thought to myself “I can do this better” than the attending physician under which I was working. I repeatedly harshly judged the decisions of my mentors, especially those who traded in their research careers for clinical medicine as their grant funding dried up. After all, I had completed a T32 research fellowship, winning several awards as a promising young investigator along the way. I assumed a productive research career with sustained external funding would shortly follow.

Within this mental framework, I started my assistant professorship three days after finishing my advanced fellowship in transplant hepatology. I chose this in order to pursue a mentored KL2 grant program that occurred once every three years. This opportunity offered the promise of both research funding and more importantly, additional time protected from clinical obligations. With the grant application due in two months, I burst onto the academic scene with inexhaustible energy but a lack of direction. I worked tirelessly to draft a strong grant proposal in parallel with my expanding clinical duties which in themselves featured their own unique challenges. I was also saying “yes” to almost every request for additional demands on my time while balancing being a father to two young toddlers and supporting my wife in her career aspirations. Needless to say, my KL2 grant was rushed and ultimately not funded. I was devastated. Now I was the one standing in the same shoes as my mentors whom I had judged during my fellowship. How was this possible?

If this sounds familiar, you may very well make the same decisions and mistakes that I made. I cannot stress enough the importance of avoiding the toxic combination of needing to be self-sufficient, accepting every opportunity, expecting limitless energy, assuming resources will materialize without asking, and deciding everyone has your best interests at heart. This is a recipe for almost certain academic failure. Fortunately, many academic medical centers now offer junior faculty development programs as a way to combat this. I found participating in our institution’s Junior Faculty Development Program to be invaluable over the past two years. This eye-opening experience allowed me to hear the perspectives of my colleagues and to arrive at the conclusion that many junior faculty experience the same challenges that I faced. This program also allowed me to identify what are, in my opinion, the top five myths about how to be successful as a junior faculty member. It is my hope that in writing this article and sharing my experience, that future and current junior faculty may be able to develop their careers with fewer self-imposed road blocks.

Myth #1: I need to be completely self-sufficient

As a junior faculty member, there is often the self-imposed expectation of self-sufficiency. Whether that is completing every screening colonoscopy without assistance from one of your more experienced colleagues to giving the best lecture the gastroenterology fellows have ever had because you were just in their shoes, the desire to be self-sufficient is there. As John Donne said “no man is an island entire of itself¹,” and oftentimes through the lens of self-sufficiency, we as junior faculty can overlook the importance of mentoring and guidance in our fledgling state. While many academic centers have formal mentoring programs,[1][2] the onus is still on the junior faculty member to recognize the need and the opportunity for receiving mentoring. While the mentor-mentee relationship is a topic to which an entire additional piece could be dedicated, several important components of this relationship are worth noting in that mentees are largely interested in the success of the mentor in producing scientific work and having a clear path for academic development leading to independence.[3] A mentor who is experienced, successful and has a plan will enable junior faculty to meet their needs in better understanding benchmarks for promotion and tenure, academic curriculum vitae development, research collaboration, obtaining grants, building a national reputation, work-life balance and establishing a clinical practice.[2] It was only through my failures in choosing self-sufficiency that I learned the true value of mentorship. I was fortunate that my mentors afforded me the opportunity to pick myself up after the KL2 failure and to continue to collaborate and develop research proposals that would ultimately achieve funding.

Myth #2: I need to accept every opportunity given to me

Over the past three years, I have repeatedly thought to myself “if I don’t say yes to this opportunity, there may not be another one.” With this in mind, I initially acquiesced to almost every request for my time under the pretense that each would help me advance professionally. Despite my concern that opportunities would dry up, another opportunity seemed to rear its head shortly after I accepted the previous one. I soon became known as the “yes guy.” It wasn’t until I became completely overburdened and missed an important professional deadline that I understood the fallacy of this belief. Logically, I knew that I couldn’t accept every academic opportunity, but emotionally I still wanted to. Although I was honored to be nominated to an important committee and to serve my institution, I soon learned that most committees require many additional hours than the time spent in the actual meeting.[4] Too many service obligations, especially committees, impinged on other important academic tasks. I heard stories from my colleagues that they felt their extensive service obligations delayed their promotion and tenure. In fact, junior faculty members who allocate only a small portion of their time to service are most likely to be promoted,[4] likely due to freeing time to pursue the core activities of teaching, research, and patient care.[4] For these reasons, I now carefully listen to my mentors and heed their warnings about how to be selective in the opportunities to which I agree. And while I am not always successful in selecting the right opportunity or refusing without consequence, having a choice now allows me to maintain more of my focus on what drives me professionally, which is clinical research.

Myth #3: I have limitless energy

I did not follow the advice of my mentors in part because I thought energy and enthusiasm would be enough to take on all of the opportunities afforded by academic medicine. I regarded faculty members with heads of grey hair operating at slower paces as outdated and unmotivated, content with ‘resting on their laurels’. I couldn’t have been more wrong. Despite my best attempts to access limitless energy, my lack of focus and direction won time and time again leaving me exhausted, questioning my career choices, and with little tangible gain. This took its toll on my personal life as well. I found my relationships with my family starting to strain and I didn’t like the person that I was becoming. Through our Junior Faculty Development Program and the sessions on time management and systems thinking, I was able to gain a new perspective. I was able to see the forest through the trees and for the first time, I found direction. This was achieved by recognizing that energy is a limited resource. Combining this new perspective with outstanding mentoring and accepting selected opportunities, my professional life began to slowly come back into balance and the whirlwind experience of early academia slowed down to a more manageable pace.

Myth #4: I will be given the resources I need without asking for them

Junior faculty members rarely understand the expectations of their division chiefs and department chairs in terms of teaching, research, scholarship and patient care.[4] Without clear understanding of expectations, how can one prioritize their actions to meet said expectations? A Junior Faculty Development Program can also provide a more in-depth understanding of the inner workings of academic medicine. Through our program, I soon learned that the annual performance review which I blew off in the year prior was the optimal time for getting clear expectations from my division chief. Furthermore, I realized that this meeting also offers an opportunity to negotiate for what resources I needed to be a successful junior faculty member. I completed a needs assessment and found several resources I was lacking to ensure my continued momentum. For me, negotiation with my boss was a daunting task. Every time I played the scenario out in my head, I ended up feeling I didn’t have the clout to ask for more. Fortunately, I developed confidence from the Junior Faculty Development Program session on negotiation and performance review. After this session, I decided that I would ask for three additional resources for the upcoming academic year: more administrative time to continue to serve as our Liver Center’s Research Director, a Fibroscan device to non-invasively stage fibrosis in my chronic liver disease patients, and more clarity on the bonus structure. I was pleasantly surprised at the reception of these requests by my division chief; though not all of them have been put into action, the conversation has at least been started. Through this experience, I felt validated and realized that my divisional and departmental leadership truly desire their faculty to succeed.

Myth #5: Everyone has my best interests at heart

In our society, looking out for #1 often comes with a negative judgment. We are taught from a very young age that people are inherently good and that everyone has your best interests at heart. Unfortunately, this is not always the case. Academic medicine is no exception. Even though many faculty take pride in helping their junior colleagues, junior faculty remain readily exploited, often in ways that go unnoticed.[4] I can think of several experiences of my junior faculty colleagues where they were invited to collaborate with a more senior faculty member on a research project only to find that they were burdened with all of the “grunt” work, wasting valuable time that could have been spent on more fruitful endeavors. While this is not surprising given the historical hierarchy of academic medicine, deciding which collaborative opportunities with other faculty members with which I agree remains one of the areas in which I struggle the most. With additional responsibility there is always an additional cost. Now if I hear “this will be a great career opportunity for you,” I look critically at the ask of me both through my lens and also the lens of the faculty member pitching the idea. I’ve found that clear delineation of roles and expectations including authorship before a project starts to be key in avoiding exploitation. Grigsby takes this one step further and recommends drafting a very specific memorandum of understanding to define roles, commitments and expectations to be signed by both parties.[4] If this is not agreeable, then a clear understanding of what the relationship will look like moving forward will present itself. For this reason, if someone is unwilling to enter into a memorandum of understanding, I simply say “no thanks,” confident that my decision was correct.

In conclusion, being a junior faculty member is one of the most exciting times of one’s career but also one of the most difficult to navigate. Through collaboration and mentoring, careful selection of opportunities as they present themselves, recognizing my limits, asking for needed resources, and advocating for myself in order to avoid exploitation by my colleagues, I have found that as junior faculty, I can grow and blossom in the environment where I am currently planted.