Correspondence:
Editor‐in‐Chief, Brain Pathology
Arie Perry, MD University of California, San Francisco (UCSF) Department of Pathology, Division of Neuropathology 505 ParnassusAvenue, #M551, Box# 0102 San Francisco, CA 94143 Ph: 415‐476‐5236 or 415‐476‐4961 Fax: 415‐476‐7963 E‐mail: Arie.Perry@ucsf.edu
President
Prof Herbert Budka Institute of Neurology Medical University Vienna AKH, Waehringer Guertel 18‐20 A‐1090 Vienna Austria Fax: +43‐1‐40400 5511 E‐mail: herbert.budka@meduniwien.ac.at
Secretary General
Dr David Hilton Department of Cellular and Anatomical Pathology Derriford Hospital Plymouth PL6 8DH United Kingdom Fax: +44‐175‐2763590 E‐mail: david.hilton@phnt.swest.nhs.uk
Treasurer
Prof Markus Tolnay Institute of Pathology, Division of Neuropathology Schoenbeinstrasse 40 CH‐4003 Basel Switzerland Fax: +41‐61‐265‐3194 E‐mail: mtolnay@uhbs.ch
Project Secretary
Dr Homa Adle‐Biassette Inserm U676, Université Paris Diderot Hôpital Robert Debré 48 Bd Sérurier 75019 Paris France Fax: +33‐1‐40031995 E‐mail: homa.adle@inserm.fr
From time to time, trainees and junior faculty have asked: what is the formula for success in medicine? Keeping in mind that there is no single answer and that free advice is worth just what you pay for it, I will attempt to address this as best I can, based on my own opinions and personal experience.
When I consider the most successful people in neuropathology today, a few essential attributes come to mind. Of interest, despite the remarkable cumulative intelligence within our field, it has become abundantly clear to me that genius, while clearly an advantage is absolutely not required for success. Naturally, this is extremely good news for the rest of us mere mortals comprising the majority! Many years ago, when I posed this burning question to one of my first mentors, Dr. Chuck White, he wisely informed me of the three A's of success: ability, availability, and amiability, which don't necessarily rank in that order of importance. Ability certainly makes intuitive sense and brings diagnostic acumen to mind first and foremost. Diagnostic competence and a “good eye” are obviously of critical importance and should be fostered through frequent clinical experience, diverse case material, and ample reading; nonetheless, diagnostic acumen is insufficient by itself to launch a successful career. Additionally, excellence in teaching, research abilities, people skills, administrative talents, and many other valuable traits also fall under the category of ability. Availability and amiability are closely linked to reliability and mostly relate to peer interactions. Are you considered a supportive colleague and valuable team player or do you only look out for Numero Uno? In other words, one's personal interactions within the work environment are often valued at least as much as ability, if not more so.
In addition to the three A's, I would add the four C's to our formula: communication, communication, communication, and collaboration. I list communication skills three times not only because I consider it the single most important ingredient for success, but also because there are at least three forms of communication that can be cultivated: verbal, written, and visual. Verbal communication is utilized in daily interactions with colleagues and during oral presentations. Some naturally emit an infectious enthusiasm verbally, while others have to work at it. Written communication represents one of the most important forms, since it is utilized in job applications, promotions, papers, grants, and even e‐mail correspondence. In looking back at my own education, the most valuable course I ever took in college had nothing to do with any required pre‐med curriculum. Instead, an elective entitled technical writing provided me with a solid foundation for scientific prose. Similarly, when I review applications, I often read the personal statement first to determine if the candidate communicates clearly and effectively. Visual communication is particularly important to pathologists since it includes not only body language (which often communicates more than words), but also images incorporated into PowerPoint presentations, manuscripts, books, and grant applications. Since a picture is worth a thousand words and all pathologists are visual thinkers, a small effort to become proficient with microphotography and image processing (e.g., Photoshop) pays great dividends towards successful career development. In fact, medical training often focuses too little on teaching communication skills, leaving many to fend for themselves. While courses are occasionally helpful, sharpening one's skills typically involves emulating those that we admire most as effective communicators and frequently asking our mentors for advice, feedback and constructive criticism on presentations and writing activities.
The fourth C, collaboration is also key to career development since medicine has become incredibly complex and the most interesting study questions are often impossible to address with any single person's skill sets alone. As such, it is critical to promote collaborations with clinical colleagues and basic scientists, both at one's own institution and externally. In terms of the latter, participation at meetings is extremely valuable not just for exchanging information, but also for networking with colleagues. Lastly, I would add one F to complete the formula: flexibility. In my own career, the most valuable opportunities were almost never planned ahead of time, but presented unexpectedly and commonly included an element of risk. With this in mind, a degree of flexibility can yield unexpected rewards and further opportunities, while being too rigid or overly cautious tends to limit one's career significantly. For instance, trainees occasionally state that they could only be happy working in one very limited geographical location. However, finding the position that best matches one's career goals is nearly impossible with such self imposed restrictions.
In summary, my own personal formula for career development is: success = 3A + 4C + F. I have no doubt that other neuropathologists would place greater or lesser emphasis on these qualities and might list many others. For instance, one should never underestimate the power of serendipity and simply being at the right place at the right time, although these are mostly beyond our control. Fortunately, the qualities listed above are all present to greater or lesser extents in each of us and can be further cultivated. That being said, when I meet the individual that excels in all of them simultaneously, I'll be sure to let you know.
Arie Perry, MD