THE FELLOWS’ CORNER

Starting your first faculty position

Ending your fellowship and beginning your first facultyposition can be a scary time for even the brightest andmost talented fellows. It means leaving the safe and pro-tected environment of a training program and steppinginto the real world of clinical, teaching, and research expec-tations. In this month’s section of the Fellows’ Corner,Dr John Carethers provides us with some important pointsto help us make a smooth transition from fellow to juniorfaculty member.

Jonathan M. Buscaglia, MDFellows’ Corner Editor

Therapeutic Endoscopy FellowJohns Hopkins Hospital

Baltimore, Maryland, USA

The transition from fellowship to faculty can be challeng-ing. Fellows lose the structure that a GI fellowship providesunder Accreditation Council for Graduate Medical Educa-tion guidelines, and they must adjust to a self-motivatingand less-organized structure of a junior faculty member. Fur-thermore, they are expected to grow into an expert with su-perb teaching and clinical skills in a specific area ofgastroenterology. It is certainly laudatory that a GI divisionhas offered a faculty position to a fellow, because this im-plies that the current faculty place trust in that fellow to en-hance the division as a whole. Indeed, a fellow’s acceptanceof such a position means that a ‘‘match’’ of the division’sneedsdbe it developing a new program or fulfilling a clini-cal or teaching needdis also a ‘‘match’’ for the fellow to be-gin his or her academic growth.

How does a brand new faculty member get off on theright foot for future success? In addition to being an out-standing clinician, teacher, or researcher (serving the tripar-tite mission of most academic GI divisions), havingknowledge of your institution’s academic tracks, makinguse of mentors, and becoming valuable to your institutionare key items to be aware of when commencing a successfulacademic career.

Most institutions have 3 academic tracks that define mostof its faculty: the physician-scientist, the clinical researcher,and the clinical educator. A physician-scientist is one whowill need protected time (w75%) for basic research, will

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require laboratory space either independently or initiallywith a research mentor, and is expected to derive a majorportion of his or her salary from research grants. Eventualpromotion is weighted toward quality research publicationsand the ability to obtain grant funding. Clinical researchers,who often have an MPH degree or equivalent, will need25% to 50% protected time for research to conduct investi-gator-initiated studies or other trials, with the clinical settingequivalent to their laboratory. Some of their salary is ex-pected to be derived from the research studies that theyconduct. Promotion is weighted toward scholarly activityand clinical expertise. Clinical educators, on the other

hand, spend the majority of their time conducting clinicalcare while teaching students, residents, and fellows in thesesettings. Most of their salary is derived from clinical income.Promotion is weighted toward clinical expertise and teach-ing evaluations. Thus, a new faculty member should befamiliar with their specific academic track and the expecta-tions of that track for advancement. The academic trackwith a job description that lists the expected time for re-search, clinical, and teaching, along with the expected salaryand startup package, are typically spelled out in the initialoffer letter or contract.

Mentorship is probably the major item that determinessuccess for most junior faculty. Research mentors guidea new faculty member in their basic or clinical researchand help them to keep focus, often for several years afterjoining the faculty. It is imperative to find a person who iswilling to invest in you as a developing academician. Thereis no better success for senior faculty than having a juniorfaculty member succeed in his or her goals. However, men-torship is not limited to those in the research setting, and

Key Points

d Develop an early understanding of the vari-ous academic tracks at your institution

d Know what is expected for eventualpromotion

d Use mentor(s) to guide you in your profes-sional and academic development

d Become a valuable team player to your GIdivision and institution

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Carethers Starting your first faculty position

junior faculty may have other mentors that can provide ad-vice on career development, gender-based issues, politicalissues, and so forth. Some mentors can even be outsideyour current institution.

Value to any GI division means that a faculty member hasbecome a critical and desirable part of the division. Devel-oping a local or national reputation for research, being a su-perb teacher and clinician, and being a fair team playercreates value for any GI division. It is these qualities thatwill make a faculty member desirable to any institution, aswell as for recruitment to other institutions. Good luck!

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DISCLOSURE

None of the authors of this month’s Fellows’ Corner haveany disclosures to state.

John M. Carethers, MDProfessor of Medicine

Chief, Division of GastroenterologyUniversity of California, San Diego

Veterans Affairs San Diego Healthcare SystemSan Diego, California, USA

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