Why academic surgery: thoughts for medical students

One of my key areas of interest, and an active area of research for me, is the barriers to careers in academic surgery.  I’m honestly pretty excited about some things I’m looking into and learning on that front, mostly because I want to keep my colleagues, my mentees, and for that matter myself from being part of the attrition statistics.

A few months ago I was asked to write a blog post for the Association for Academic Surgery with the intent of convincing medical students with career intentions in surgery that academics is a great way to go, and that many options for a career in academic surgery are out there.  Since I just returned this evening from the Society for Critical Care Medicine Congress, I’m using this as an opportunity to cross-post my own work.

Sure, you’re a medical student who is interested in a career in surgery.  You hear people talk about  “academic surgery,” but you’re not entirely certain what that means.  More importantly, why should you consider academic surgery as a career?

The historic academic surgeon shows little similarity to the modern academic surgeon.  The conventional definition was that an academic surgeon was to be a triple threat- clinician, educator, and researcher. Part of that definition as a researcher was to be a basic science researcher; clinical research and outcomes, education, global health- none of those things were on the radar screen of possibilities for credible research.  Fortunately, times have changed and the definition of scholarly activity has broadened tremendously.  A simple review of the program for the Academic Surgical Congress demonstrates this increased breadth, with tracks dedicated to basic/ translational research, clinical trials and outcomes research, global health, and education.  In addition, many now consider administration to be a fourth facet to the ideal academic surgeon.  Although that does increase the theoretical demands placed upon academic surgeons, there is also growing recognition that the idea of someone demonstrating excellence in all four domains is less likely; promotion and tenure criteria at many institutions are being adjusted commensurate with that injection of realism into the process, now asking for recognition in perhaps two of the four domains.  This new view of academic surgery opens up many options for academic surgeons, and even within the career of many of the leaders of the Association for Academic Surgery we’ve seen the creation of a bigger tent as young surgeons innovate in their scholarly activity.  My take-home message for a junior resident or medical student contemplating the concept of academic surgery is that it is a career increasingly defined by those who are in it, with expanding acceptance of alternative forms of scholarship.

On to that next question- why academic surgery?  Certainly there are a few prerequisites that you should meet before you commit to a career in academics.  When I review the characteristics of the most outstanding, committed academic surgeons I know, they share a few key qualities.

  • They are innovative.  Regardless of their field of scholarship, they are always pushing the boundaries and looking for new and better ways to do things.  If you are risk-averse, you are unlikely to be happy advancing scholarship in your field, and if you’re not going to advance scholarship in your field, a career in academics is likely a non-ideal fit for you.
  • They are passionate about their chosen career and all facets of it.  Yes, all surgeons are passionate about surgery.  But among the true greats in academic surgery, you find that they are passionate about surgery and scholarship.  You’ll also find that their enthusiasm is infectious!
  • They are committed to academic surgery and they are tenacious in their promotion of the field.  In order to succeed in academic surgery, you need to be both a mentor and a mentee.  The best academic surgeons have never shied from either end of that relationship, and have used both roles as opportunities for growth.
  • They are always teaching.  Think about that person who really influences you in medicine and surgery- they are the person who always has a few moments to teach about clinical care, the state of research, the state of education.  When you engage them on those topics, not only do you get the benefit of their wisdom, but you also get to watch their faces light up when the talk about those things that get them intellectually or technically excited.

While a career in academic surgery might be viable if you don’t meet these criteria, you’re certainly more likely to succeed if you have these qualities.  Don’t be frightened off by them, either- with a good mentor and genuine enthusiasm for what you pursue, they’re not that difficult to develop.

Should you become an academic surgeon?  My answer at this point in my career is a resounding yes!  The field has so much to offer, and the idea of being on the leading edge at all times is irresistible to me.