The surgeon-scientist has a long track record of advancing medicine, from discovering insulin to successful cellular and organ transplantation.(1, 2) Yet, with growing pressures and responsibilities in medicine (3), including balancing clinical productivity, administrative and regulatory burdens, clinical work hour expectations, and other environmental pressures, there has been an overall decline in the number surgeon-scientists and in their funding, as well as in federal research funding to surgical departments (3-6). Under these conditions, the aspiring surgeon-scientist cannot rely solely upon passion, devotion, creativity, and good scientific questions. Rather, strategy and research training are needed to learn to adequately balance all responsibilities while simultaneously advancing a research program. Many surgical residency training programs provide structured research experiences; however, this is variable in surgical fellowship training creating a common hiatus in research productivity. However, with the focused strategies outlined below, it remains possible to be successful in scholarly pursuit during fellowship training:
Start early: You must start building a structure as soon as you match. The foundation for success is in identifying projects likely to be successful with the resources and mentorship that will be available to you.
- Identify projects: Scientific theory would suggest that to ask a question, first you need to master what is known in your area of interest so that you can than identify where the scientific gaps are. However, it is difficult to build something from the ground up using classic scientific theory in such a short clinically focused fellowship training period. As such, in a seemingly reverse manner, your research success during fellowship training may not necessarily start with de novo scientific questioning, but rather with cataloging what investigators are doing at the institution you will be training at, and then working backward to figure out what interests you and will be possible within those spaces.
- Identify research mentors: A good mentorship relationship often starts with a good mentee. Like everything else, the more you put into something, the more you get out, and finding the right fit for you is central to success. As soon as you have matched into your fellowship training position, this is the time to begin to explore. Start by examining the faculty list within the division/department you are joining. Use the faculty website and profiles that detail research efforts, to begin to understand the faculty research portfolios. Speak to faculty within your current circle that may know and have existing relationships with those at the institution you will be attending for fellowship training. After you have done your due diligence in investigating, you can start by communicating through email, with an attached curriculum vitae, and a request for a remote meeting. Research faculty are by default collaborators. They wish to share their interests with others. If you schedule a meeting, come with an agenda in mind. A general meeting agenda could start by sharing your background and interests, why you are interested in learning from their work, and how you intend to move forward. After you meet, if you think the faculty and their research align with your interests in doing research during your fellowship training, make sure to let them know and initiate engagement with them and their team.
- Build rapport with your mentor and their team: Initially reaching out, meeting with a mentor, and voicing your interest and desire to work with them is only the beginning. Often faculty researchers will have organized research meetings, infrastructure, collaborators, and funding avenues. Once you have identified a mentor, capitalize on the post-COVID-19 academic era by attending remote research meetings with your future mentor even before you start fellowship training. There is no more outstanding way to stay up to date than simply being present and hearing about it.(7)
- Set up PubMed search functions: Create an NCBI account (https://www.ncbi.nlm.nih.gov) and set up advanced searches that send you abstracts daily to stay updated in your area of interest.(8)
- Identify resources and build timelines: No sustained research efforts can happen entirely without funding or support. Address early any scholarship or funding opportunities with your mentor. Start by setting a timeline to understand the deadlines for national, regional, and local funding opportunities available to trainees. Find funding mailing lists, and subscribe to them. Considering writing at least one application for funding, even if only for the experience of getting your ideas on paper. Although securing research funding is not expected of fellows, if you build a timeline, have a plan to apply for seed/societal funds, and attend research meetings before you have initiated fellowship training, or early in your fellowship training, you are setting yourself up for success and productivity during the rest of your career. This allows you to ‘try on for size’ a combined practice of being a surgeon focused on clinical excellence while maintaining research productivity.
- Network The more connections, the better. You won’t know what someone may have to offer you without making a connection. The first place to start with this is the combination of your mentor and your timeline. Make sure your timeline entails a plan to submit abstracts to national meetings, and that your mentor knows you want to meet their collaborators at these meetings. For every person you make a scientific connection to, engage with them, learn about their science, and follow-up with them.
Think early and often about the future:
- Generate data, and write, write, write: If you have set yourself up to ‘hit the ground running’ when you start your fellowship training with the above strategies, you will then be able to generate data and begin writing early. As much as possible, you should have a goal of writing for every abstract and manuscript deadline within reason during your fellowship training. In this process, you will develop a back and forth with your mentor for editing that will help move the research needle forward at all times.
- Maintain up-to-date curriculum vitae (CV): Every abstract you write, research presentation you give, medical student you mentor, etc., should end up on your CV. Update your CV in real-time to keep track of your entire research portfolio and to be ready for when you begin job searching as an aspiring surgeon-scientist.
- Begin the job search related to research: If you think a research path is part of your future, it is essential to use your fellowship training time to test out being a busy surgeon with a research portfolio. If you determine this is the right career path for you, then your job search should include the following research considerations: availability of research resources (facilities, equipment, staff, access to collaborators), training opportunities, committed mentorship (experience, funded, etc.), and departmental support in the form of finances, time, and training. These combinations will help develop you into the best version of yourself as a surgeon-scientist, and will optimize a supportive environment and ultimately success in research.
Blog adapted from a chapter written for a handbook being created in a collaborative effort between the Association for the Surgery of Trauma associate members leadership, Surgical Critical Care Program Directors Society, and the Eastern Association for the Surgery of Trauma, 2022.
- Goldstein AM, Blair AB, Keswani SG, Gosain A, Morowitz M, Kuo JS, Levine M, Ahuja N, Hackam DJ, Basic Science Committee of the Society of University S. A Roadmap for Aspiring Surgeon-Scientists in Today’s Healthcare Environment. Ann Surg. 2019;269(1):66-72.
- Toledo-Pereyra LH. Nobel Laureate surgeons. J Invest Surg. 2006;19(4):211-8.
- Keswani SG, Moles CM, Morowitz M, Zeh H, Kuo JS, Levine MH, Cheng LS, Hackam DJ, Ahuja N, Goldstein AM, et al. The Future of Basic Science in Academic Surgery: Identifying Barriers to Success for Surgeon-scientists. Ann Surg. 2017;265(6):1053-9.
- Mann M, Tendulkar A, Birger N, Howard C, Ratcliffe MB. National institutes of health funding for surgical research. Ann Surg. 2008;247(2):217-21.
- Rangel SJ, Efron B, Moss RL. Recent trends in National Institutes of Health funding of surgical research. Ann Surg. 2002;236(3):277-86; discussion 86-7.
- Hu Y, Edwards BL, Brooks KD, Newhook TE, Slingluff CL, Jr. Recent trends in National Institutes of Health funding for surgery: 2003 to 2013. Am J Surg. 2015;209(6):1083-9.
- Golden N, Devarajan K, Balantic C, Drake J, Hallworth MT, Morelli TL. Ten simple rules for productive lab meetings. PLoS Comput Biol. 2021;17(5):e1008953.
- Chapman D. Advanced search features of PubMed. J Can Acad Child Adolesc Psychiatry. 2009;18(1):58-9.