(3-6 years)

Two problems: 1) Life intercedes on this long path, 2) We do ~8 years of research training before faculty, PhD does 12-15

What is academic medical school science

Derives from medieval guilds – universitas means guild

• Explains puzzling features of academia

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Academic medical school developed as an organic public-private partnership

• The medical school operates more like a traditional corporation, but still holds to

values and protocols of the guild

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We are in a hybrid guild-corporate structure

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Ambition and obsession on the physician-scientist path

As a consequence, our careers are defined by both ambition and obsession

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Balancing these forces is key: with ambition alone the sacrifices aren’t worth it. With obsession alone we cannot sustain the resources for this work.

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What are the roles of a Principal Investigator

Startup CEO

Manager

Craftsperson

Colleague

Scholar

Mentor to young scientists

Marketing

Data analysis

Grant writer

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You’re probably not automatically good at all of these

Hard things

• One must maintain focus on a goal for 20 years
• Life intercedes: children, partners, parents, health, existential issues, changes in scientific funding

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• Excess of options: clinical, translational, basic, collaborative, interesting topics

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• If you manage 10 people, 2 at any given time will have significant life issues

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Other observations about the junior faculty period

• Recruiting good people and getting funding to support them are the most central things

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• As physician-scientists, we are still learning more about the craft as Assistant Professors

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Other observations about the junior faculty period

• What do you really care about?

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• What value are you providing to the guild, the corporation, the society, future generations?

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Define areas of obsession

“Say yes to everything before you’re 40, and say no to everything after you’re 40.” – Atul Gawande

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