1. A Guide to Productive Scholarly
Work and Mentorship in Residency
Brian Locke, MD and Andy Hahn, MD
University of Utah
Updated Dec 2019
2. Objectives
• Understand the Scholarly Activity Requirement of the residency program
• Know the mentorship structure in the residency, and how to maximize the chance
of a productive mentorship relationship
• Gain insight into the type of projects residents should seek to perform
• Perform a self-assessment on your career goals for peer career-coach matching
• Minimize barriers to contributing to a scholarly project: Complete CITI and GCP
trainings today.
3. Road Map
Scholarly Activity Requirement and Timeline (10 minutes)
Mentorship (15 minutes)
Choosing a project (15 minutes)
Resources for research and dissemination (5 minutes)
Career Goals Activity (10 minutes)
CITI-GCP training (remaining)
4. What counts as scholarly activity?
• Requirement from ACGME during your residency
• 4 components to scholarship
• Discovery = publishing papers or abstracts
• Integration = case reports or patient education projects
• Application = participation in professional societies, policy, QI
• Teaching = Content creation, curriculum development
• Presented at Senior Scholarship Day (Spring PGY3)
PMID: 24294446
Medhub->Residency Policies
5. Why do scholarly work?
1. To achieve your career goals:
1. Career as investigator
2. Fellowship (Required?)
3. Gain useful and marketable skills (QI, Policy, Humanities)
2. Gain insight into the methodology of medical science and implementation
NOT
• Force you to pursue activities you have no passion about
6. What do I want to do?
• Fellowship? Decide by
End-of PGY1
• Sooner is better, but it’s
never too late
• Applications in at end of
PGY2
From UCDenver Fellowship Guide
7. Timeline for doing research (PGY-1)
Fall
• Career options
• Seminar and CITI/GCP training
Winter
• PGY-3 peer mentor
• Start identifying potential research mentors
Spring
• Meet with potential mentors
• Start initial steps of research project prior to beginning PGY-2
8. Timeline for research (PGY-2)
Brainstorm (and IRB approval if needed) before elective
(0-2 weeks of work + 1-2 months IRB processing)
Strategic use of elective time (4-6 weeks)
Winter: submit manuscript or abstracts
9. Road Map
Scholarly Activity Requirement and Timeline (10 minutes)
Mentorship (15 minutes)
Choosing a project (15 minutes)
Resources for research and dissemination (5 minutes)
Career Goals Activity (10 minutes)
CITI-GCP training (remaining)
10. Mentorship: An umbrella term
1. Teacher - teaches you the skills required in your field
2. Sponsor - leverage their own power / reputation capital (LOR, reach out
to program directors / employers)
3. Advisor - reality check
4. Agent – removes obstacles
5. Role Model - someone to emulate
6. Coach – tactics, motivates to achieve, moves them out of inaction
7. Confidante - provide emotional support.
• No one person will do all the above roles
12. How to find the right mentor
• Use the resources available to you:
• Resident research database on MedHub -> Research Resources
• Peer Fellowship coach (more later)
• Faculty Academic Mentor = PD/APD
• Send emails to potential mentors as early as possible
• Mentors are often busy: send multiple follow-up emails until a response
• “Will you be my mentor?”
14. Understand your mentor
A quick detour into the “guide to promotion” from Mike Rubin MD, PhD, MS. DoIM Vice Chair for Faculty Affairs
15. Career-line Faculty Formal Review (SOM)
Clinical, Research, and Lecturer Tracks
Annual Review & Reappointment – June 30
Instructor
Associate Professor
Professor
Assistant Professor
Associate Professor
Professor
Promotion at request (5 years max)Hire
Hire
Hire
Hire
4th year formal reappointment
Eligible for promotion at 5th year
4th year formal reappointment
Eligible for promotion at 5th year
Formal review every 5 years
Eligible for promotion at 5th year
4th year formal reappointment
Formal review every 5 years
16. Tenure-line Faculty Formal Review (SOM)
Clinician and Non-Clinician
Annual Faculty Review
Instructor
Associate Professor
Professor
Assistant Professor
Associate Professor
Professor
Promotion at request (3 years max)Hire
Hire
Hire
Hire
4th year retention review
Tenure review at 7th year
3rd year retention review
Tenure review at 5th year
(Promotion eligible but optional)
Formal review every 5 years
Eligible for promotion at 5th year
3rd year retention review
Tenure review at 5th year
Formal review every 5 years
17. How to Get Promoted: Criteria
• Areas of Demonstrated Value
• Investigation
• Clinical Practice Advancement
• Education
• Administration/Service
• Excellence (national, global influence) vs.
Effectiveness (local influence)
• Career-Line
• Research Track (same as Tenure-line):
• Excellence in Investigation
• Effectiveness in other areas optional
• Lecturer Track:
• Excellence in Education
• Effectiveness in other areas optional
• Clinical Track:
• Excellence in any two areas
• Effectiveness in the other two areas required
18. Mentor Up
• Mentee takes responsibility, ownership, and
directs the relationship to their needs.
Why do mentors mentor?
Pros Cons
• Gratifying
• Duty
• Professional benefits
• Co-investigators
• Promotional Capital
• Time investment
• Competing demands
• Other mentees
• New skillset
• Uncertain rewards
19. Mentor Up
• Be pro-active: Develop an
agenda for each meeting
• Be engaged: set and meet
deadlines, provide updates
• Confidence ⇒ Investment
• Be appreciative: ask
feedback, “Thank you”
20. Road Map
Scholarly Activity Requirement and Timeline (10 minutes)
Mentorship (15 minutes)
Choosing a project (15 minutes)
Resources for research and dissemination (5 minutes)
Career Goals Activity (10 minutes)
CITI-GCP training (remaining)
21. What project is
right for you?
Research QI Education Synthesis
• Case Report
• Abstract
• Manuscript
• Review
• Project
• Poster
• Publication
• Content Creation
• Curriculum
• Assessment
• Policy
• Advocacy
• Narrative
Medicine
22. Synthesis
• Examples:
• ACP Health Policy Internship Program
• @MattMulliganMD (2019)
• Amy Cowan: Perspectives in Medicine
23. Education
• Content:
• Joel Money; COREIM
• Elena Gibson: The Curbsiders
• Curriculum:
• Stein Ingebretsen (2019) Wilderness
Medicine in the Alps
• Curricular Assessment
• Megan Puckett (2019) “Goals of Care
Communication Skills Training: A Qualitative
Analysis of an Innovative Program”
24. Quality
Improvement
• Hospital Medicine track requirement
• Intern QI Projects, continued
• Very common scholarly project
• Dissemination and Venues: Posters,
Abstracts, Manuscripts
• Local: University of Utah
Evidence-Based Poster Fair
(Spring), UT ACP (Spring+Fall),
• Regional: SGIM West (Fall)
• National: SHM (Spring), ACP
(Spring), SGIM (Spring)
26. Case Reports
• Why?
• Easiest way to a conference (networking, shows interest, they are fun)
• Smallest workload
• Why not?
• Limited utility for medical community or your long-term career
• Difficult to publish in Pub-Med indexed journal
• Tips: clarify with your mentor beforehand: conference funding?
27. $ for meetings
• ½ paid by residency, ½ by mentor or mentor’s
division (policy varies by division)
• Submit a travel request form prior to the
meeting.
• Keep and submit all receipts for reimbursement
when you return.
Behind the scenes picture of the
Internal Medicine Office
28. Retrospective, clinical research
• Why?
• Entry point for research: learn skills + demonstrate commitment to field
• Abstracts (⇒ poster or oral presentation) have lower bar, earlier payoff
• Manuscript (⇒ PubMed-indexed publication) is what your mentor and your future self really
want
• Why not?
• Need IRB approval (=time and work)
• More work, payoff is not guaranteed
• Many pitfalls
29. Retrospective, clinical research (pt 2)
• Tips:
• have a clear objective when you start the project
• Does your mentor have a track-record with housestaff?
• Chart-review is a lot of work (sometimes an unavoidable evil)
• Ideal = data(base) is ready to be analyzed.
• Scope your project as small as possible – then try to make it even smaller.
• Get your IRB submitted months in advance of your elective
• Discuss authorship expectations at outset
30. Subject Reviews
• Why?
• If invited (mentor), guaranteed to publish
• Favorable for both fellowship application and early career.
• No IRB
• Why not?
• Lots of background reading (80-100 citations) is time consuming
• If not invited, much more challenging to publish (generally not abstract/poster-
able)
• Tips: ensure it’s invited and clarify authorship before you begin writing
31. Editorials
• Invited by editor:
uncommonly available to
residents.
• Value: good for trainees
and attendings, guaranteed
publication (invted)
• Tips: these are usually short
pieces, high visibility, and
Always accept if offered.
Systematic review
and meta-analysis
• High impact, easily publishable once
completed, contributes to field
• Entails months of background research,
statistician needed for formal meta-
analysis, then writing. Scale is too large
for residency
Clinical trials
• The holy grail of academics
• Not amenable to the usual
timeframe of residency.
• Unless someone offers to
be involved writing up their
clinical trial that is already
resulted, AVOID these.
32. Editorials
• Invited by editor:
uncommonly available to
residents.
• Value: good for trainees
and attendings, guaranteed
publication (invted)
• Tips: these are usually short
pieces, high visibility, and
Always accept if offered.
Systematic review
and meta-analysis
• High impact, easily publishable once
completed, contributes to field
• Entails months of background research,
statistician needed for formal meta-
analysis, then writing. Scale is too large
for residency
Clinical trials
• The holy grail of academics
• Not amenable to the usual
timeframe of residency.
• Unless someone offers to
be involved writing up their
clinical trial that is already
resulted, AVOID these.
(Andy <1y after
writing the above)
33. Elective during residency
• 8 (up to 10 weeks, with proposal to Dr. Milne) elective during residency.
• not counting the 1 week per year of vacation embedded in elective block
• IRB, if required, approved prior to elective block
• allocate 2+ months for processing
• Ensure access to required data prior to elective
34. Road Map
Scholarly Activity Requirement and Timeline (10 minutes)
Mentorship (15 minutes)
Choosing a project (15 minutes)
Resources for research and dissemination (5 minutes)
Career Goals Activity (10 minutes)
CITI-GCP training (remaining)
35. How-to documents
• All documents are housed on MedHub and residency website
• Categorical training -> Research in Residency -> bottom of page
• How-to perform CITI training (must complete after talk)
• How-to perform background research and writing
• Manuscript preparation checklist
• Prepare an IRB
• Better Poster: https://osf.io/ef53g/
36. Reference tools for writing
• Always use a citation manager when writing papers.
• Mendeley is free (https://www.mendeley.com/)
• EndNote Basic is free from the UofU
• You can download EndNote X9 from the UofU for $22
37. Brief overview of EndNote
• How to download citations:
• Go to library.med.utah.edu PubMed
• Find article and open the abstract
• In upper right hand corner, click “send to” then
“citation manager”
• Open downloaded file in EndNote
38. Cite while you write
• Most valuable feature of EndNote.
• To insert a citation: click citation in EndNote tool
enter author name click insert
39. Cite while you write
• To remove a citation: highlight the citation in the text click “citations”
“edit and manage citations” “remove citation”
40. Cite while you write
• To change the order of citations: highlight the citation in the text click
“citations” “edit and manage citations” use up and down arrows on
left side to move citations
41. Statistical/Design Support
• Center for Clinical and Translational Science (CCTS) Study Design and
Biostatistics Center (SDBC)
• Collaborate via Mentor, Resources Compendium
42. Venues to present your research
• General medicine cases and QI:
• Utah ACP meeting (Fall, Spring), University of Utah Evidence-Based Poster Fair (Spring)
• SGIM west regional meeting (Fall)
• National ACP and SGIM meetings (Spring)
• For subspecialties: there are many more options, discuss with your mentor when
you begin your project.
• Apply for local and national awards within your fields! Discuss with mentor and
more senior colleagues.
43. Academic twitter
• Resource for staying up-to-date on your research interest, medical education,
or advocacy.
• Develop a network of peers and mentors that will help you for fellowship
and career.
• Don’t mix your personal and academic twitters (can split with lists). Follow
leaders in your field
44. Road Map
Scholarly Activity Requirement and Timeline (10 minutes)
Mentorship (15 minutes)
Choosing a project (15 minutes)
Resources for research and dissemination (5 minutes)
Career Goals Activity (10 minutes)
CITI-GCP training (remaining)
45. Career Coach Matchmaking
• Please Fill out the Survey through the QR code (5-10 mins)
• PGY3 / CMR / Fellow mentors matches will be made after
each cohort has had this seminar
• or when career choices solidify. Email me as interest change
• To help find a faculty scholarly mentor
• Supplement to your APD – likely to have a better sense of who is the
most productive with residents their personalities for your chosen
specialty.
46. Save the date!
• Senior Scholarship Day
• Opportunity to see how
productive PGY-3s and
their mentors were in
residency.
• Date: Thursday April 23,
2019 from 3:30-6:30 PM
in HSEB 2120
47. Road Map
Scholarly Activity Requirement and Timeline (10 minutes)
Mentorship (15 minutes)
Choosing a project (15 minutes)
Resources for research and dissemination (5 minutes)
Career Goals Activity (10 minutes)
CITI-GCP training (remaining)
48. Evaluation and Citi-Training
1. Fill out seminar evaluation form please!
2. Perform CITI training (link via QR code)
3. Email certificates of completion to brian.locke@hsc.utah.edu
• Due by next Monday, or I will email
Thanks! Questions?
Hinweis der Redaktion
y’all are probably feeling like career goals are the last thing you want to discuss, in the throws of a grueling year where just getting through it is a worthy goal.
However, you all are going to be facing career transitions before you know it, and helpless-ness yet knowing it’s expected you’ll do this is, in my opinion, worse than not having a road map. Thus, my goal here is to give you agency in how to navigate this.
Program policy:
Resident Scholarly Activity Definition for Annual ACGME Report
At the culmination of the PGY3 year, the program is required to report each resident’s scholarly activity throughout the three year training program. This information will be collected from each resident before he or she may check out of the program. The ACGME categories are:
Publication of original research in peer-reviewed journals
Abstracts, posters, or presentations given at international, national, or regional meetings
Publication of chapters or textbooks
Participation in funded or non-funded basic science or clinical outcomes research
Lecture or presentation (such as grand rounds or case presentations) of at least 30 minutes duration within the sponsoring institution or program
ACGME Policy (Updated 2019) - https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/140_InternalMedicine_2019.pdf?ver=2019-06-25-100749-597
IV.D.3. Resident Scholarly Activity
IV.D.3.a) Residents must participate in scholarship. (Core)
IV.D.3.a).(1) While in the program, at least 50 percent of a program’s residents must have demonstrated dissemination engaged in more than one of the following scholarly activities: participation in grand rounds, posters, workshops, quality improvement presentations, podium presentations, grant leadership, non-peer-reviewed print/electronic resources, articles or publications, book chapters, textbooks, webinars, service on professional committees, or serving as a journal reviewer, journal editorial board member, or editor. (Outcome)
Medhub -> Residency Policites: official policy
As of Nov 7 2019:
UNIVERSITY OF UTAH DEPARTMENT OF MEDICINE Medicine Residency Program – University Health Care
SCHOLARLY WORK, RESEARCH, AND SENIOR TALK POLICY REVISED: September 2014
The Internal Medicine Residency Program recognizes the need for establishing and maintaining an environment of inquiry and scholarly activity towards improving professional education. Resident projects supported by sound educational principles are encouraged. Is it this program’s intent that each resident participates in scholarly activity, as defined by the ACGME.
Residents should discuss their research interests with their assigned Associate Program Director at semiannual reviews. The Program Director is also available to meet with residents to discuss scholarly pursuits. The program leadership will help connect residents with faculty in the area of interest.
The program has also set aside funds to assist residents with travel expenses associated with presenting at conferences, see the Travel Policy for more information.
Resident Scholarly Activity Definition for Annual ACGME Report:
At the culmination of the PGY3 year, the program is required to report each resident’s scholarly activity throughout the three year training program. This information will be collected from each resident before he or she may check out of the program.
The ACGME categories are:
Publication of original research in peer-reviewed journals
Abstracts, posters, or presentations given at international, national, or regional meetings
Publication of chapters or textbooks
Participation in funded or non-funded basic science or clinical outcomes research
Lecture or presentation (such as grand rounds or case presentations) of at least 30 minutes duration within the sponsoring institution or program
Senior Talk Presentations
1. PGY 3 residents who have not completed substantial scholarly work during their residency training will be required to give a Senior Talk.
2. Substantial scholarly work includes (but is not limited to): basic bench or clinical research, published or submitted journal articles, poster presentations or an oral presentation to the American College of Physicians or other medical society, or a quality improvement project.
a. The clinic QI projects organized by attending physicians and morning report presentations will not count toward this requirement.
3. At the beginning of the PGY3 year, the Program Director or designee will review each senior resident’s scholarly work to determine if is it is sufficient, or if a Senior Talk is required.
4. Senior Talks will be presented once at noon conference, likely between January and April of the PGY3 year.
Faculty Expectations 1. In accordance with the ACGME requirements, the faculty must establish and maintain an environment of inquiry and scholarship with an active research component.
2. Faculty are expected to encourage and support residents in scholarly activities.
You will not have difficulty achieving the criteria of the residency.
ACGME requirement is not really the reason. We all rely on the cumulative scholarly activity that constitutes medicine’s knowledge base => this is why it is an ACGME requirement.
True goal => be flexible in what you choose, so as to make it useful to you.
This is the terrifying part
HAVE A PLAN FOR THE ELECTIVE!
Zelda, duh
“Mentor (senior, informal but w/ agenda, use their influence) vs collaborator (peer, shared interests, needs a record of finishing projects)”
Peer Buddy has already been assigned
Already heard about GME Wellness Opt-out
PD/APD meetings are coming
I will assign Fellowship coaches
Faculty scholarly mentor = the goal. Sooner rather than later for those pursuing competitive fellowships.
mentors may be internal, external, junior (probably not at this stage), peer, or senior
Avoid “Will you be my mentor” = overly forward first date. Meet and see you if they’re interested, compatible, etc.
Two hire lines: Career lline and Tenure line.
Career line, Research track is very similar in requirements to tenure line, but less of an “all-or-nothing” commitment for the faculty member. 80% research – 20% clinical types.
Most faculty we work with are career line… mostly clinical track… except for those like ^.
Lecturer track is newer. Very few hired on to it currently.
Same as career line.
Mentoring is going to be local = effectiveness.
Faculty are MUCH more concerned about ways to have influence outside the institution, as far as promotions are concerned.
Almost all faculty we interact with are either Research/Tenure-line or Clinical track. VERY few lecturer track hires)
(Comes from “Manage Up”, in corporate culture. Why does this work? Because we are initiating the relationship.)
Especially at first, but probably always, you will be more invested in the relationship
It’s on us to engage.
Why do mentors mentor? (Keep this in mind for framing your relationship - most people think it is in their interest or they get “paid” back somehow - generally not the case, at least directly)
•Gratifying experience- personally enriching. ***this is not, usually in itself, enough of a motivation. We’re already overburdened***
•Personal and career growth
•“Giving back to profession”
•Developmental life stage- seeing others thrive
•Satisfaction in sharing knowledge and experience
•Professional benefits
- Co-investigator
- Acknowledgement
- Promotional capital
However
•Takes time
•Numerous competing demands
•May already have multiple mentees
•Limited skills in the area that mentee needs/desires
Ideal mentee: self-assessment, receptivity, initiative ,responsibility, honesty, appreciation.
“Provide and review timelines and deadlines often. Offer interim updates between scheduled meetings. “
The literature describes mentee’s behaviors that increase the likelihood of receiving effective mentoring and enhancing the productivity of a mentoring relationship: 7, 10
1. Pro-actively takes responsibility for the relationship
• Take responsibility for driving the relationship
• Set up meetings
• Be prepared for meetings with agendas
• Reliable (in establishing expectations and following through)
• follow through with action items, and be timely
• Pay attention to time lines
2. Engages in self-assessment & -monitoring
• Goal setting, following through, timelines
3. Respect mentor’s time
• Respectful of the mentor’s time
• Punctual
• Show up with agenda (prepare for meetings)
• Have a list of topics to discuss
• Have action items to do in follow-up
• Have time lines for projects
• Realize they probably mentors others and have their own projects - and you are not the only one
• Send manuscripts or documents for editing in plenty of advance
4. Comfortable asking for assistance
5. Receptive & Appreciates the mentor’s advice
• Open to hearing new ideas and perspectives
• Active listeners
• Respectful of mentors input
• Don’t just ignore the advice, you don’t have to follow every bit, but discuss it with mentor
• Open to feedback (& courageous to effect change based on the feedback)
6. Acts with integrity (honest and trustworthy)
7. Passion to succeed
Long term: “Tell your mentor how much the relationship has helped you or how much you appreciate the advice that has been given. Regularly update your mentor on your successes and explain how your mentor’s work contributed. “
Case Report < Abstract < Manuscript (Paper)
Original research (manuscript, letter to editor)
Reviews
Editorials
Meta-analysis
Clinical trials
Case reports
Quality improvement
Basic science
Very useful to any type of career.
Craft your project with an eye toward dissemination +/- publication
SGIM west regional meeting (Fall)
National ACP and SGIM meetings (Spring)
REQUIRED for cards, GI, heme/onc. +/- for Pulm. Required for any specialty if seeking a competitive location.
Remember the promotions criteria – these are the way they are because research (aka NIH dollars) drive an institutions national stature.
Also, division chiefs are most (exclusively) interested in hiring faculty who can secure external funding. Your research can help your mentor in this.
What does it entail: find a good case, write it up
If anyone is at the point in their career where their considering meanginful participation in a trial… I am probably wasting your time by making you sit through this
But seriously, don’t get involved in a trial.
This is just to emphasize that the distance between intro to research and meaningful impact is surmountable.
8 / 10 weeks do not count the 1 week of vacation that goes in to each year’s elective block
Skipped rapidly through these except to mention that the feature exists and that this is why you might get one of these programs… probably better for people to learn as they do
The Center for Clinical and Translational Science (CCTS) Study Design and Biostatistics Center (SDBC) is set up to assist clinical researchers in design, statistics, etc. Two links that are probably most helpful to our level of training are:
https://medicine.utah.edu/ccts/sdbc/get_started.php
and
https://medicine.utah.edu/ccts/sdbc/resources/
For those who are interested in formerly requesting collaboration with a statistician, they do request that your project mentor be involved (main reasons: the collaboration is time consuming and collaboration with faculty is part of how the SDBC CCTS proves to their grant funders that they are providing a useful service). This is probably advisable regardless of their policy 😝
IRB (we force y’all to do it now so that when a mentor tries to add you onto a project, it doesn’t delay things a month when this inevitably happens on U-Wards).
If you did this in med school, it counts and is valid for 3 years (you should be able to access from the same login and just fwd me the certificates)
