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#AcademicLifeHacks: A Podcast About Tips and Tricks to Thrive in Academic Medicine

 



Today’s podcast is on academic life hacks, those tips and tricks we have seen and developed over the years to succeed in academic medicine in fields that are somewhat generalist in nature. While the podcast is meant for fellows and junior faculty, we hope some of it applies to the work that all of our listeners do, even in non-academic settings. 

Why are we doing a podcast on #academiclifehacks?   You will notice that at the start of the podcast, we spent a couple minutes to recognize my co-host, Alex Smith, for a particularly important award he received at the 2021 AGS meeting – the  Thomas and Catherine Yoshikawa Award for Outstanding Scientific Achievement in Clinical Investigation.  As part of this award he presented a talk titled "Confessions of an Unfocused Researcher."  We (and when I say we, everyone on this podcast except for Alex who we kept in the dark) thought it would be a good idea both to celebrate Alex’s award and talk about some of the topics he brought up in his talk, as well as other tips and tricks.

So we asked Lynn Flint and Ken Covinsky from UCSF, and Christopher Langston from Archstone foundation to join Alex and me to talk about our shared tips and tricks to succeed in academic medicine.  In particular we focused on several key issues that new faculty need to address as they start their careers including:

  • Academic focus and goals 

  • Mentorship (and mentoring up)

  • Academic scholarship & writing

  • Collaboration & Networking

  • Work / Life Balance

We would also love to see your own academic life hacks by sharing them on twitter and adding the hashtag #academiclifehacks to the tweet.


  


You can also find us on Youtube!

 

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TRANSCRIPT

Eric: Welcome to the GeriPal Podcast. This Eric Widera.

Alex: This is Alex Smith.

Eric: Today we have a very special episode. We're going to be talking about Academic Life Hacks specifically for fellows and junior faculty, but really for anyone. We're going to be asking our guests and hopefully have a conversation online on Twitter using the #AcademicLifeHacks to talk about our own tips and tricks in succeeding the academic medicine. So Alex, who do we have with us on our podcast today?

Alex: Today, we are delighted to welcome from Archstone Foundation, Chris Langston, who is president and CEO of Archstone. We should note of course, as we did in our intro that we are funded by Archstone. Welcome to the GeriPal Podcast, Chris.

Chris: Thank you very much. It's a pleasure to be here.

Alex: And we are delighted to welcome back to the GeriPal Podcast Lynn Flint, who is in the Division of geriatrics as a palliative medicine physician and runs the GeriPal Fellowship and the UCSF Division of Geriatrics. Welcome back to The GeriPal Podcast, Lynn.

Lynn: Thank you.

Alex: And we're delighted to welcome back Ken Covinsky, who is a longtime commenter, occasional host, and guest on the GeriPal Podcast is a geriatrician researcher at UCSF in the Division of Geriatrics. Welcome back, Ken.

Ken: Thank you, Alex. And I'll just say I'm a little relieved because I misunderstood the topic today. I thought the topic was academic hacks and I was feeling a little ego threatened that I was a guest for that topic. [laughter]

Ken: Now that I understand this better, I'm feeling a lot better about myself.

Eric: Welcome, Ken. How about I actually explain how we decided to do this show? Because it's going to be a little bit of a surprise, maybe even for Alex. So just to let our listeners know that Alex got a particularly important award in 2021 at the AGS meeting, which was the Thomas and Kathryn New Chicago Award for outstanding scientific achievement in Clinical Investigation. As part of this award, he talked about confessions of an unfocused researcher. So we're going to be talking a little bit about his talk. But we also got an email from Jolene Fassbinder from Archstone Foundation, who said, "You know what? Maybe we can just take a couple moments on the show, just to recognize Alex for his award and talk about again some of these academic tips and tricks and some of the things that he talked about."

Eric: So in preparation for this, just to give people a little bit of ins of how this podcast works, we've had both Lynn Flint and Ken Covinsky give Alex a bunch of songs to try to make him sing. Lynn, which song did you request for Alex?

Lynn: Toxic by Britney Spears.

Eric: Ken had a string of songs.

Ken: I tortured Alex with a whole string of Chicago based songs. [laughter]

Eric: But given that we do want to recognize Alex, we have actually asked his kids, Renn and Kai, to play his favorite song. So Alex, I know we asked you to sing a song. We're not going to do this today, because we have your two boys playing today. Alex, maybe you can describe this song once I finish. I'm just going to play just a little clip for now, then we'll play the whole song at the end of the podcast. (music).

Alex: I had no idea this was happening. What? Here I am ready to play Sweet Home Chicago for the third time. Wow, thank you. I didn't know the kids did that either, it's a total surprise.

Eric: Alex, can you just describe why is that your favorite song?

Alex: Well played kids. That's the Beauty of Mauna Kea, and it's a song that's written by Keola Beamer. We've seen them a few times in concert. For those of you don't know, Mauna Kea is the largest volcano on the island of Hawaii, the big island where I was born and it's a beautiful mountain and a beautiful song. So thank you so much for that kids and for you for surprising me with that. Wow. Thank you.

Eric: Well, Alex, I think we're going to go into Academic Life Hacks, I just want to take like a couple minutes just to say, it's really been an honor working with you and being part of kind of the solar system that surrounds you. We've asked a couple other people to join us, Krista Harrison unfortunately had to be at a whip. Krista was one of Alex's mentees too. I just want to say, she actually showed me one of the letters of recommendations that she wrote for you for I think, a review committee. And she said, "Good mentors have a ways of becoming a voice in the back of your head, helping you make that work stronger." For Alex, that voice says, but Krista, why does this matter? What problem are you addressing in the world? I really love that statement because it really does describe a lot of the things that we're going to be talking about today too. I'm going to turn it over to our guests. Ken, any other thoughts?

Ken: Yeah, I was going to say like Alex, I mean, I think your recruitment has kind of proved over time to be one of the kind of pivotal and sentinel moments of my career just both because of what you taught me and everything you've done for us.

Alex: The beginning of the downward trajectory. [laughter]

Ken: But you and Eric together have taught me that I'm... Actually am a geriatrics and palliative medicine research, or I used to think it was geriatrics researcher. And I think, of course, like all you've done in mentoring, that's been so pivotable in developing the work we do, so I'm much appreciative.

Alex: Thank you, Ken.

Eric: Lynn?

Lynn: Well, Alex and I go way back. And I think that's a really fun thing that we don't talk about too much. So Alex and I did residency together. I was an intern when he was a third year resident, and then he was a palliative care fellow when I was a second year resident. And I've told him before, I have distinct memories of calling him on the weekend with really tricky questions. And he was a role model of calm and working through things and saying, "I don't know." And so I'm just, it was just such a delight to be able to come over here and join the division and actually get to well sit in real life and virtually next door to Alex and actually get to benefit from some of his mentorship through some really, really fantastic projects that we've worked on together, so thank you, Alex.

Alex: And thank you and I just like to say, joining UCSF Division of Geriatrics is one of the best decisions that I've ever made and that's because of the people I'm surrounded with. Ken Covinsky being mentored by you throughout the years, one of the world's most renowned mentors, who continually pushes me to think about palliative care and geriatrics together and what that means and what is palliation for disability.

Eric: Alex, not at all. You can't do this. This is about you. I know you're trying to deflect here, but it's not going to happen. I'm going to turn it over to Chris, I want to hit him up. Chris, any other thoughts about Alex?

Chris: Well, we are just so proud of you Alex and of Eric and what you've accomplished with the GeriPal Podcast. I remember back to 1998 when at Hartford Foundation, I think we took a chance on this bizarrely week geriatric program on the West Coast, headed by Seth Landefeld. And my colleague and I looked at our senior colleague who wanted to provide this funding and we said, "I don't see it. I don't get it. I'm not seeing it." And she saw and Southland default was able to get you guys to come and build an incredible operation that even survived after his departure and has thrived. So all of the work of people at UCSF is just so important, and is very much aimed at solving people's problems. So that's why we've been so pleased to support the effort. And we're just so delighted that you had won the Yoshikawa Award. But also, congratulations on your belated, congratulations on your promotion to full professor, although I saw when I was looking at things up that it was retroactive to 2019.

Eric: Alex, we'll put you off the hot seat for now. We do want to get to the topic at hand Academic Life Hacks. But again, a huge congratulations to your award and we just wanted to pay a little bit of our respect and honor to that.

Alex: Really unexpected and grateful that you've done this and shocked, overwhelmed. Thank you so much.

Eric: Well, let's start off. So Alex, you gave a talk on confessions of an unfocused researcher. As part of, yeah, you can put that guitar away since you're not going to play. We hear a lot in academics, like you have to find focus, you have to have a direction. Like we should have clearly defined goals, we should be working on those goals. How much of this is true? I'm going to start off with Alex and just ask around the table too about this one.

Alex: I think that's true for some people and some people are really highly focused. They're mission driven. They know exactly what they want to study and the exact problem they want to study. I think of like Rebecca Sudore, for example, in our group who is very focused on proving advanced care planning for older adults, and particularly those who are more vulnerable, those who have limited English proficiency. I think of Doug White who's a Pittsburgh, who wants to improve communication for seriously older, critically older adults in the ICU. I'm not one of those people. I'm mission driven in the sense that I'm very interested at issues at the intersection of palliative care and geriatrics, but within that, like wide range, I'm interested in all sorts of things, communication, pain, prognosis.

Alex: And I love working with mentees like Lynn Flint, who is really interested in people who cycle in and out between hospitals and rehabilitation facilities, never making it home before they die. So having that sort of broad interest and being sort of a generalist, if you will, has its own unique strengths. There are limitations there too, it's maybe harder to sell yourself as being focused on one area an inch wide, a mile deep. But for me it's enriching in that I feel intellectually engaged in so many different areas that are of interest to me. And I would say that I'm instead of being unfocused, maybe more multi-focused, have multiple areas of being of interest, rather than being unfocused. Those are some brief thoughts off top of my head.

Eric: And Ken, you've had a lot of different areas of your multifoci. Is that a word? What are your thoughts on this? How do you actually mentor people? You've done a lot of mentorship. Do you tell them, "You got to have a niche."

Ken: Yeah, no, I think I was very terrified early in my career when I was told I had to have a niche because I felt like I thought I was becoming a generalist and I thought I was looking into geriatrics because I kind of like everything. And I've talked to many mentees over the years who get similar terror when they're told like, "Okay, you're starting a 30 year research career and you're supposed to know everything you're going to be doing right now." I think maybe I shouldn't, I like to call myself unfocused, maybe that's the wrong word. That I think there's several ways to think about it, is that ideas can be broad. So being focused doesn't mean you have to be narrow. And that ideas have interconnection, so that over time, you're really have opportunities to do a lot of broad things.

Ken: I think Chris, you mentioned Seth Landefeld who was one of my pivotal mentors, who guided me through a lot of my early career. And I remember like I think he's told this to many people. I remember the comment when I kind of gave him like a running list of ideas that seems all disconnected, him telling me, "Well, Ken, you know you can do so much more in series than you can in parallel." His polite way of telling me, I think advice had really stood the test of time, you have to know what you're going to do now, you really do have to make a decision about what you're going to do over the next period of time next years. But you really can free yourself from deciding your whole life, you don't have to, whether you're a researcher or a clinician or an educator, you really don't have to know what you're going to do forever. And in fact, sometimes the best ideas are unexpected, Sometimes, if you're a good investigator, one idea leads to the next to the next one.

Eric: And Chris, from a foundation perspective, as you're looking at potential grants. I can imagine, though, like when you see somebody who has a really long track record, and a particular niche, like you may be more comfortable in supporting them. How do you think about this from a foundation perspective?

Chris: Well, I think that there are a lot of different foundations. In my particular experience of the three foundations I've been at, I've been at one of them twice. But what we actually I think most look for is not sort of this depth in a smaller and smaller subject, but rather the passion and the quality of the work. So on the one side, the difference, I think in most private funding, is that there's much more attention and concern about application and changing something from people's lives as soon as possible.

Chris: And that's grants from sort of funding of direct services to some of the more change driving things that we wanted to do, but you have to have somebody who wants to push the boundaries a little bit in academics to do things like you all have done. And you want somebody who's demonstrated competence and doing that, because those are hard things to do and it's a different set of skills than certainly bench research or clinical research or education. Changing the world is hard work.

Eric: Speaking of educational, Lynn do you think it's any different as far as academic niches as a clinician educator?

Lynn: I think it's really the same. I mean, when I think about what you all have said, I really, I would just shift instead of the word unfocused, I would use two words. I would use, it's broadly engaged. I think there's lots of people who are just really engaged in a lot of different things, and they show that passion. And I think that's what's really important to succeed in academics is to just continue, what is the work giving to you? Because if it's continues to excite you, year after year in all these different areas, then you're probably in the right space.

Eric: Yeah, I always remember we had a visiting professor come over when I was very junior faculty. And I talked about my... the challenge I had as a clinician educator is deciding like, "Am I a geriatrician? Am I a palliative care doctor? Where do I call my home?" And she said, "If I was your division chief, I would use those words, pin you to the wall and make you decide between the two." I never took that advice nor was I pinned to the wall. I actually think that was probably the best thing I've ever done is really think about and be broad enough that I'm both in geriatrics and palliative care. I'm wondering from the group, all of the clinicians here really focused on both geriatric health care, have you had similar issues as you think about what's your academic home?

Alex: Reflecting back on, when we started the GeriPal blog in 2009, there was tension between the fields of geriatrics and palliative care. They were, "Turf wars," if you will, over recruitment of fellows, who's responsible for engaging older adults in the hospital in advanced care planning type goals of care discussions. And you and I are felt really strongly that the two disciplines had more to offer to help people if they work together, collaboratively than if they were at odds. And that was one of the reasons we started the blog back then and one of the reasons we started the podcasts about five years ago now. So I've always felt like there was a need to move the fields closer together because they have more in common with each other than they do differences. And certainly there are areas of difference.

Alex: And that they have more to offer in terms of improving care for older adults and those living with serious illness if they work together. So that's been part of the mission that's sort of driven me and as a palliative care clinician, I now feel like very welcomed in the geriatric space, I'm a member of the UCSF division of geriatrics. I'm executive editor at the Journal of the American Geriatric Society. I think that in part due to our work, but largely due to work of so many people in geriatrics and palliative care, the fields have grown together, much more than they have separate. And I'm really encouraged by the direction of that movement.

Eric: I want to make sure that we got some big pillars as far as Academic Life Hacks. Again, we'd love for you guys to get on Twitter and do #AcademicLifeHacks to share your own. So we're talking about goals and focus. What about mentorship? Ken, you've been a mentor to a lot of people, including pretty much everybody on this call. I'm going to start off, what do you think makes a good mentee?

Ken: That's a really good question. I think mentees are people, I think intellectual excitement. So a mentee who really brings excitement and passion to their idea and really wants to make a difference. So that I think in academics there's often a lot of anxiety at the beginning of the career. How am I going to get my first job? How am I going to get funded? And that's all important, and part of the job of the mentor is to help them through that. But ultimately, you really have to be about the mission and not about the academic accolades because if you're about the mission, I think the academic piece often follows. So I really, I mean, I think it's intellectual excitement, and somebody who just, you're so busy, and maybe it's one more meeting. But I think a lot of times with my mentees, those are the most fun meetings I had every day and I think...

Eric: Are there things that mentees do that you find really helpful? Like, sometimes I like, I get even the small thing, sometimes I feel like are helpful as a mentor, like when they send me the calendar invite, and like questions before. And I'm just wondering from tips and tricks and hacks, are there things that you've seen mentees do, you're like, "Wow, this is helpful for me as a mentor."

Ken: Yeah, I think, I mean, it's sort of interesting because I have sort of a style in terms of, I'm not sort of the like meet every X days type of person. So I find kind of mentees who manage me are really useful to me. So mentees who kind of have some semblance about what they need from me and kind of are at least somewhat goal driven in terms of like, this is the goal and purpose of the meeting we're about to have.

Eric: Yeah, how about you, Alex, you've had a lot of mentees over time.

Alex: I also, because I'm mentored by Ken possibly, I similarly really appreciate mentees who mentor up and who are proactive about making appointments with me, scheduling meetings. I live and die by those Outlook calendar invites. I guess if I had to say, you know what makes the mentee particularly successful, I think that those mentees that are the most successful tend to do the work that they said they were going to do at the last meeting so that they come to the next meeting having just accomplished or taken a crack at, at least, what we said we were hoping to accomplish by the time the next meeting rolled around.

Alex: Sometimes mentees need more time and that's okay too. And I want to be there to support them and work through whatever issues are delaying things moving along. At the same time, for those of you who are listening, nothing will make your mentor happier than coming to the next meeting, having done what you said you accomplished and moving things forward rather than sort of retreading, whatever you discussed at the last meeting and talking about why it wasn't done.

Eric: Chris Lynn, any other additional? Oh, go ahead Ken?

Ken: Yeah, Alex, I thought that was really wise. And I thought, as you're saying this, and I think this is one of the things I've appreciated from you and also some of my current mentees, I think do this, is that a lot of the mentee mentor relationships and exchange of ideas. Like your mentees, giving you a product of paper, and you've kind of given them a thought on where to go. And part of their work is to sort of integrate those ideas, but there's those who just sort of take your ideas literally, but then there's those who are, they're really sophisticated, and they take it one step beyond what you were thinking. So it's not just that they take your track changes, but you might say something like, "This is unclear." And they come back the next time and say, "I thought about what you said this was unclear and I thought that I had to reconceptualize this." And they come back with something and you say, "Wow, I never thought of that. That is really clever and innovative."

Eric: Chris Lynn, any other additional thoughts?

Chris: Well, I think one thing, and I'm drawing on my not terribly successful academic career, but I guess I should be grateful that it led me to something else, is I think deadlines are really important. Of course, they get broken all the time, but one of the things you need to do is to kind of be made aware and make a new deadline. I think one of the things that happens is somebody slips on something, and then you don't ever get around to actually setting a new target. And then everybody's just sort of lost and stuff falls by the wayside.

Chris: And the other things that are always happening, not only the deadlines, come and go but people also forget what it was exactly that your sage words of advice were. And if you're lucky, they do against talking about and make them even better and that's great. But sometimes I think having good notes on meetings can be really important, just recognizing human frailty and being able to proactively work against it.

Eric: I've had mentees do notes of what we talked about, which is really helpful because the next meeting like two months later, there's a list of the items and potentially action items that they're going to work on that we can actually talk about which I love.

Lynn: I was going to add one more thing and then we can transition which is this is really also all about communication. And so I think one thing as a mentor that I've experienced, especially in education is that someone might come meet with me, and we'll make a plan to do something. And I think for whatever reason, that person doesn't get around to it, life gets in the way. And then I don't hear from them again, I'm ghosted. So it can be really it's... I get it, people get other interests, they move on, they get busy, but I think that communication closing any open loops is really important.

Eric: And real quick, what do you think when fellows and junior faculty members and others are looking for a mentor, are there things that they should be looking for? I'm going to open up to anybody in the group.

Lynn: Maybe someone who's won mentoring awards before. [laughter]

Eric: So a track record of good mentorship.

Lynn: Great track record...

Alex: Tricky though. If you're a junior stage, and you get a very senior mentor, there are some senior mentors who are so overwhelmed with other mentees, with clinical responsibilities, with research responsibilities. And then as people move up and become more senior, they increasingly take on administrative roles, director of this, director of that and sometimes they don't have as much time for you, as say somebody who's in more of a mid career stage. So there are trade offs there as you're you're evaluating your mentors in terms of time that they will have to dedicate to you, which is really important because it's like, if execution of a brilliant idea is 1% inspiration and 99% perspiration then mentoring is like 99% the hours and the time that you put in and 1% inspiration.

Eric: Yeah, I just want to also do a shout out to peer mentorship. I think working with each other, building those collaborations and relationships. I mean, I think we were talking about like I've done a lot with Alex and learned a lot from Alex probably more than anybody else as far as a peer mentorship relationship. Plus, I also have peer mentorship from people across the US, which has also been really helpful to build my own scholarly activity.

Chris: Sorry, just quickly, I think that it isn't like who should your mentor be or who should you pick? But what do you want to be mentored on? And you can have lots of mentors for different things. And 100% many of the things that are worthwhile getting mentorship on don't require a senior person at all.

Lynn: What I was going to say actually as I was alluding to somebody with mentorship awards is that when I was mentored by Alex, for we had a New England Journal paper, and the thing that I really appreciated about your mentorship Alex, was that you really believed on the project. Like I knew that I think could tell me here on the air, we authentically thought that was a good idea.

Eric: Oh, absolutely.

Alex: It has so much face validity. You talk to any clinician that oh, I get it. I know what you're talking about.

Lynn: So you were like all in on that project. And just had so much confidence that I left every discussion with a real belief internally like, "Oh, yeah, we need to write this and get this out there." And we are so confident in it, that we're going to resubmit it to places that are rejecting it and write our case. And that was just like really the most confidence that someone has shown in me. So thank you, Alex.

Eric: Okay. So we're talking about big pillars, we're talking about like having a focus, we've talked about a little bit about mentorship. Let's move on to another big pillar in academic scholarship and writing. You mentioned one thing is your mentor having that, like can see that same vision. What if like your mentors suggests a project for you that you don't have that passion in of, is it okay to say no? Ken, or any mentee that says no to you Ken, they're dead to you from there on out.

Ken: I'm laughing because I think one of the annoying things I do is I'm a little bit full of ideas for other people, which is the funnest ideas to have because somebody else has to do the labor on it. So I think there's incredible value in just sharing ideas. But I think mentee really has to be comfortable saying, "No, that's not me, that's not really what I'm after." And a mentor has to be comfortable accepting that outcome. I will kind of sort of say that like sometimes people keep the definitions of ideas too narrow though, because often the concept is, well, one idea isn't the right project. But some derivation of that is so that ideas do grow from each other. So a mentor should not be too fast and closing off a mentees idea because, "Oh, it's not doable, it's too much work. It takes too much resources." Because often, well, actually, there's a derivation of it where that's not true for and then sometimes mentees miss really good ideas that maybe are not the right in their original form but they're right in another form.

Alex: I think there's also a role. So having worked with Ken throughout the years, so many years, I've gotten to see behind the curtain a little bit, right? And it's been revealing, right? And one of the things that I've learned from him, from behind the curtain is this idea of the Jedi mind trick, right? These aren't the droids you're looking for. So sometimes when you suggest a project to a mentee, it's because you are aware that the mentee is heading down a very narrow constrained uninteresting avenue and you want to suggest a related but not the same project that likely is much more importance as clinically important problem and has legs right, is likely fundable et cetera. And so we use that trick as mentees, those of you who are mentees listening, it's not to say, "Don't do that, you should do this."

Alex: It's more like, well, what if we worked on this project which is more feasible, which we have data for, which is really important and building enthusiasm in the mentee for that project. I'll give a brief example. We have a lot of mentees, we've had a lot of mentees who are oncology fellows and they may be initially very active interested in whether, for a specific cancer, they're very focused on a specific type of cancer. [inaudible 00:35:07] specific type of cancer, does this anti-cancer drug work well in older adults? And that was [inaudible 00:35:16] well, that's a fairly narrow question. Let's think if we can broaden the scope of what you're asking, what are the functional impacts of treatment for older adults with cancer?

Alex: What are the cognitive impacts, thinking about ways in which we can incorporate geriatric science to a greater extent? And that's sort of the art and the communication as Lynn mentioned of this Jedi Mind Trick, that's really important part of mentorship, I'd say. And from the perspective of mentee, you don't want it to come across as you should do this project, you want it to come across as, "Wow, my mentor came up with a, made me rethink this, and in much greater sense, and I'm so enthusiastic about the new direction that this is taking."

Eric: Well, going on the scholarship path too, Lynn for clinician educators, it's often daunting. You just mentioned you published in the New England Journal like that's setting a really high bar there. And I feel like how should clinician educators think about scholarship, like when you're working 60 or 80% clinical, even 100% clinical, like the idea of scholarship seems so distant and far away, and any tips and tricks for junior faculty fellows on scholarship in non research pathways?

Lynn: I mean, I think part of it is just really thinking about the clinical, sort of either the clinical patterns that really piqued your interest or maybe really, like annoy you or you see it so often, and you think that should be different. There's something to write as a thought piece or an editorial. Just the last time I was on service, we had a situation with a patient that really brought out a lot of anger, frankly, between me and the fellow and we were talking about it and talking about and I thought, we're talking about this enough that we should be writing about this.

Eric: Can I ask, what does that actually mean? So I write about it, and then do I have to ask, like the New England Journal, are they interested? Do I sent like, what is that process from writing to publication look like? I want to ask all of you. I know Alex, you've written a ton of New England Journal, JAMA.

Lynn: That's where your mentor comes in. So when I was talking about this phenomenon with rehab to death I went straight to Alex and said, "How do I get this from A to B to Z?" And he got me there.

Eric: With a lot of hard work on Lynne's part too [laughter]. But do you do ask them when to go first? Do you submit it? Like what is that actual process?

Alex: We've done it both ways. At the New England Journal, I think for this one I think we submitted. They rejected it and we said, "Hey, all of those comments are addressable. Here's how we would change it, and then they ultimately accepted it. Is that right Lynn?"

Lynn: That is what happened.

Eric: So you didn't take a reject as I'm going to submit to another journal, you fought back.

Alex: Right. And I would say that's successful a minority of the time, but people probably aren't aware that it is a mechanism and that you can protest journals rejection.

Alex: Please don't protest all of JAGS rejections now. [laughter]

Eric: In case the audience doesn't know, Alex is now executive editor.

Alex: That's right. Yeah.

Lynn: Eric, I think from a nuts and bolts aspect, you can look on different journal websites, they are really they lay out the different types of submissions, so you can submit an article that is not a research study for a variety of different journals. And that's a great starting point. And then I think also linking up with an experienced mentor as a condition educator. And don't be afraid to cross the line and get a investigator mentor to help you.

Eric: I remember, I was at Louise Aronson talk to us about writing op eds, and she always talked about creating a list of 10 newspapers that you're going to submit it to. Start with number one, or work yourself, then number 10, and by the time you're done, you're going to get something accepted. So I love the idea of working with your mentor. Well, another piece of advice I got early on my career is never do anything for free, always make sure that you have funding for a project which is interesting because I've completely failed in that regard. Like all of our GeriPal Podcast wasn't funded until we got support from Archstone. So I never really took that to heart, should I? Ken, what are your thoughts?

Ken: That's a fascinating question. I fear that I'll get in trouble with some of the people at UCSF, who have lots of indirect class debate. But I would say the papers I am most proud of have been unfunded. And unfunded is a technical term because somebody was supporting my time and effort, but even then sometimes was done on nights and weekends. I think good scholars in all fields disassociate to some extent the money and the work. That you need the money to eat and live, but the ideas kind of have a weight of their own, and you should probably take a little bit of your time to stuff that's actually not paid for but important.

Chris: Well, I think most outsiders, outside of academics don't understand that it's not a 9:00 to 5:00 job. And that you're putting in a lot of extra time and effort, and not just pre tenure, but I think it really is driven by people's commitment to the field and to the lives of people they're trying to improve. I don't think anybody works harder than some senior faculty. But I think Lynn's point about writing, just start with writing, write to think and there's always an outlet. And going back to the focus thing, I agree on both sides. On the one hand, if you have a clear focus, it makes a lot easier for people to understand what you're about.

Chris: But if you write three of anything about some similar thing, you've got kind of a track record and getting the fourth thing published is just going to be so much easier, no matter how crappy the first three outlets were. So they're going to look at you at PubMed and say, "Hey, he's the guy who does that or she's the person who does that." So that's definitely one of the takeaways is do not let the perfect be the enemy of the good, something is better than nothing. And since you shouldn't be writing all the time anyway, it isn't a lot of extra work to send it somewhere.

Eric: So let me ask about that. So they don't tell us in academics that we're supposed to be like, in med school, that writing is important for an academic career, but it feels like it's one of the most important things, any tips and tricks for fellow junior faculty members, how to become a better writer, work out that writing muscle?

Ken: Oh, it's so hard. But I think Eric one of the things about writing and I think you use the word, Chris, think to write or write to think, is that thinking is the basic underpinnings of writing. And good thinking and good writing are almost inseparable because it's I think one of the natural evolutions of ideas for those who aren't natural, most of us aren't natural expressors of ideas, is ideas sort of tend to start out as much in our head. We kind of have this on vocalized sense of what we want to say but we don't know how to communicate it. Until you can put it into words that others understand, that idea is nothing more than washing your head, it doesn't matter that you have a good idea if no one else can follow it or interpret it. So that I think, part of learning to write, I mean some tips I learned are often saying it out loud.

Ken: Like if you're having a writer's block, trying to actually look in the mirror and say out loud, what you're trying to say, that sometimes has a mysterious way of working because it forces you to explain it to like an anonymous somebody else. I think this is where peer mentorship is often really useful is that one of the things that helped me become a better writer. I don't have permission to name her but Amy justice was one of the critical mentors in my career who was my colleague at case and we basically read each other's work. And we I think both learned we were better at teaching each other how to write than we were able to write ourselves and there's something about trying to help somebody else write that also makes you a better writer.

Eric: Yeah. I remember Sandra Moody once said to me that she actually, she blocked off time in her calendar to write. And I also, Louise Aronson is another great mentor for me around writing and the idea of just like the practice of writing. Was just watching inception over the weekend with my son. And the quote was an idea is like a virus, resilient, highly contagious, and even the smallest seed can have an idea can grow. And I like the idea of like a virus like you need to have it room to mutate. And part of that, which is the really hard thing about writing is that you're going to have to rewrite and rewrite, but each mutation is making it stronger, more contagious, more variant. Just turning the Coronavirus and delta variant. [laughter]

Lynn: I was going to carry out that theory to say you the key to say that you need to expose others to your writing.

Eric: Yeah, Let that idea mutate...

Lynn: Right, exactly. You need to not social distance with your writing. And that's the only way really is to see how it lands on other people. And your peers are great, because in general, in academics, where a lot of the time writing for our peers broadly defined, so you want the people who are your audience you want to have feedback from.

Eric: Well, let me ask about that, to go into another broad pillar of collaboration, how do we develop those connections, those collaborations either within a big institution or other institutions?

Lynn: It used to be food. [laughter]

Alex: Before endless Zoom meetings.

Lynn: Well, Alex you used to provide lunch for your mentee meetings and it definitely got me there.

Alex: Ken provides whip pastries for our work in progress sessions, definitely brings people to the table, right?

Lynn: Automatic network.

Eric: I'm going to throw out one tip, I actually like professional societies for this reason, like joining their special interest groups was a way for me as a junior faculty member just to connect the people outside of my own institution who have similar interests. And we decided that we would be writing together. And that's actually been a really important source of both letters of recommendations for me, but just the projects together.

Ken: I think one good hack, I mean along those lines, Eric, and whenever you go to a professional meeting, toss your fear aside and take somebody that you actually think might be too busy for you, but you would just love to talk to. And send them an email and butter them up, say like, "I've admired your work for a long time, I would really love to get your thoughts on what I'm doing." The majority of them will say yes. And that's I think, also a great way to network and meet people. Also some meetings, I know like SGIM and AGS have these mentoring sessions where you basically can sign up to be mentored, like a junior person and sign up to be mentored by a senior person. Those are great. And I know of a number of really good relationships that develop through those. So it's sometimes it's a little bit fearsome, maybe because you have to like write that little paragraph about what you're about and you're not sure what you're about. Just write something, just write what you're about today, and don't worry about the.. I mean just do it.

Chris: In most parts, the worst thing that can happen is somebody says no, so why not ask? And I thought it was funny, it turns out when I looked at your resume, Alex, that we've been in a lot of the same places, not at the... I haven't been to Hawaii ever. But I went to graduate school at Michigan and I think my writing really began to get better not, it still has a ways but again, get better when as a graduate student, I took a course on teaching writing to undergraduates. And again working through how to help them express the idea is just so helpful in terms of being able to improve my own writing.

Eric: Okay, last big pillar that's all we have time for. Maybe we can do kind of lightning round on this, but the idea of... I'm not even sure the right word to put on it work life balance doesn't seem right. Work life confluence of interest or conflict of interest. Lynn, I'm going to turn to you, your Twitter handle is #Lynnmomdoc.

Lynn: Yes.

Eric: Tips, tricks, hacks, succeeding in academics and also everything else in life?

Lynn: Man, that was a big question. I think my quick tip, just thinking back to this morning, I was rounding palliative care team. Today is also the first day of school for my high schooler, picture day for my middle schooler, then my elementary schooler is just lagging around with my partner. And I got multiple texts about the location of soccer cleats, and another kid asking for money and my advice is keep it real. Like I was in the middle of rounds, I was focusing on other things and instead of trying to do two things at once I said, "Excuse me, I've got some things to respond to here. And I just took a moment and told them, I don't know where the soccer cleats are, and whatever else and then move back." And so I sort of just own it and that's why it's my Twitter handle. It's just kind of what you get. I'm a mom, sometimes when I'm at work, and I'm a doctor sometimes when I'm home.

Eric: And Alex, in Krista's letter that I mentioned earlier, she talked about how as a mentor, you being a role model, not really answering emails, when you're on vacation. A couple of things about being a good role model as far as work life balance, you want to describe any tips or tricks that you have?

Alex: I mean, I just do it because in order to... I find that these are synergistic. If I'm able to get out for bike rides three times a week, if I take a great vacation and go backpacking with my kids, I'm better at work. I'm refreshed and ready to tackle problems and issues, work with mentees, etc. It's renewing these things are synergistic. And I'm so fortunate that on the GeriPal Podcast, I get to meld one of my personal interests which is playing music and learning new songs with the podcast and getting a new song request every week. That's just so fun. So if there are ways that you can merge those interests together, I'd encourage our listeners to do that.

Eric: Yeah, like Ken suggesting everything about cubs in Chicago every time he comes on the podcast. Ken or Chris, any other tips or tricks around kind of work life balance?

Eric: How about a role as often as a mentor? When you talk to your mentees about it, same thing with you Ken, anything that you've learned so you don't break them in the future?

Ken: Yeah, I think this is one of the things I've been like learning over the years. How do you deal sensitively, because I find like there's things that you're learned, and there's advice you get, but that doesn't often work for the person in front of you. And I think your job is to create a space, and you really need to kind of create a sense like you can talk to me about this. And I want to help and I want to listen. I think sometimes you could go too far though, because you could... There's times I think when people are struggling, there's times when they really want to talk about it and there's times when they really don't want to talk about it. I think I remember like I had a mentee who was going through some hard times, and I was kind of really pushing him, maybe you should take some time off. You seem to have a lot going on and he kind of said to me like this, my home life is chaotic and a mess, this is the only order I have in my life right now.

Eric: That actually reminds me of the podcast that we just did last week and part of it was on loneliness. And really, we can listen we can assess for it, but we don't always have to try to fix it is asking do they want help with it? That kind of reminds me of that. Chris, sorry, I interrupted you too.

Chris: No, no, not at all. I think that's a really important point. People don't always want you to fix their problems. Sometimes they just want you to listen and having a strong relationship is probably the key to any effectiveness. But what I wanted to just add, again to sort of expand the context from somebody outside of academic medicine. What we really appreciate most about what you do is the stuff that is slightly countercultural at least to academic medicine, things like GeriPal and the GeriPal blog and the podcast. I think there's somebody that we all know very well who's done enormous things to change the field. And she tells me that every time her chair sees her, the chair says, "Well, why don't you get more RO1s because I need the indirects. And don't get any more of those goddamn foundation grants." So our mission does have to transcend some of the practical stuff, got to feed the kids but sometimes you got to push the limits.

Eric: Yeah. I want to thank all of you for joining on this podcast. Before we end up, I really want to encourage our audience, use the #AcademicLifeHacks to share your own tips and tricks. I have a whole lot of time to go through all of it. And I'd love your thoughts too around leadership and how to build leadership skills as a fellow and a trainee. We're going to end with a little bit more of Alex's kids, Ren and Kai playing. What song is it again, Alex?

Alex: This is the Beauty of Mauna Kea by Keola Beamer.

Ken: Are there words Alex, could you sing along?

Alex: I could but I don't think would synchronize very well in Zoom unfortunately.

Eric: Ok, here we go. (song played by Renn and Kai)

Eric: In honor of Alex you I'm wearing my Hawaiian shirt. He always tries to convince me to wear more Hawaiian shirts. So all right, here we go. I'll share the screen. Big shout out to Renn and Kai for playing us that song. Thank you, Alex for being such a great friend and mentor and colleague. Thank you all of our guests today for joining us for this Academics Life Hack. Thank you Archstone Foundation for your continued support for the GeriPal Podcast. And to all our listeners, take a second, jump on Twitter if you're on it, #AcademicLifeHacks, share your own academic life hacks. We'd love to hear from them. Bye, everybody.

Alex: Bye everyone. Love the Aloha shirt, Chris.

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