Establishing and Maintaining a Career as a Clinical Investigator

GI Education Series: Key Elements of Academic Life Establishing and Maintaining a Career as a Clinical Investigator Ray E. Clouse, M.D. Professor of Medicine and Psychiatry

Research mentors….. • Need not be experts in all your fields of interest • Provide examples in their areas of expertise • Prevent mistakes in your early efforts • Offer a foot in the door to accelerate your course Investigative Career Evolution Mentoring by Dr. David Alpers 1978 Psychiatric disorder in GI illness Collaboration with Dr. Patrick Lustman Mind-body relationships 1981 Defining esophageal motor disorders Collaboration with Dr. Annamaria Staiano 1982 Spastic disorders as a functional marker Description of antidepressants for FGIDs 1985 Limited industry funding Origin of high-resolution manometry Co-investigator, NIH funding 1990 Treatment trials for diabetic depression Industry partnerships 2002 Depression and insulin resistance 2004 Creation of high-definition manometry Patent applications

Select broad themes in need of research • Parallel clinical and investigative interests • Begin a simultaneous goal of clinical expertise • Narrow the clinical focus as early as possible Investigative Career Evolution Mentoring by Dr. David Alpers 1978 Psychiatric disorder in GI illness Collaboration with Dr. Patrick Lustman Mind-body relationships 1981 Defining esophageal motor disorders Collaboration with Dr. Annamaria Staiano 1982 Spastic disorders as a functional marker Description of antidepressants for FGIDs 1985 Limited industry funding Origin of high-resolution manometry Co-investigator, NIH funding 1990 Treatment trials for diabetic depression Industry partnerships 2002 Depression and insulin resistance 2004 Creation of high-definition manometry Patent applications

Let discoveries help refine research directions • Orient research questions to funding sources • Capitalize on perseverance • Combine clinical and investigative notoriety to • reach “thought leader” status Investigative Career Evolution Mentoring by Dr. David Alpers 1978 Psychiatric disorder in GI illness Collaboration with Dr. Patrick Lustman Mind-body relationships 1981 Defining esophageal motor disorders Collaboration with Dr. Annamaria Staiano 1982 Spastic disorders as a functional marker Description of antidepressants for FGIDs 1985 Limited industry funding Origin of high-resolution manometry Co-investigator, NIH funding 1990 Treatment trials for diabetic depression Industry partnerships 2002 Depression and insulin resistance 2004 Creation of high-definition manometry Patent applications

The Successful Clinical Investigator Must Write • Your ideas are not known or valuable unless they are exposed for consideration and discussion • Publication track record is essential to remain competitive for sustained funding • Reaching “thought leader” status requires a broad sphere of influence • Successful evolution of your own thoughts requires critical feedback

Investigative Career Evolution Mentoring by Dr. David Alpers 1978 Psychiatric disorder in GI illness Collaboration with Dr. Patrick Lustman Mind-body relationships 1981 Defining esophageal motor disorders Collaboration with Dr. Annamaria Staiano 1982 Spastic disorders as a functional marker Description of antidepressants for FGIDs 1985 Limited industry funding Origin of high-resolution manometry Co-investigator, NIH funding 1990 Treatment trials for diabetic depression Industry partnerships 2002 Depression and insulin resistance 2004 Creation of high-definition manometry Patent applications

Great Collaborations Rodgers & Hammerstein Capitalize on disparate skills of the collaborators Masters & Johnson Collective momentum to accomplish a difficult project Antony & Cleopatra Joining forces to conquer otherwise insurmountable hurdles Sherlock Holmes & Watson Complementary roles or personalities The Lenon Sisters The power of similarity James Kilpatrick & Shana Alexander Energy of dialogue and dissimilar views

Collaboration and Productivity

Personal Qualities of a Good Collaborator • Honesty • Openness • Fairness • Industry • Respect • Reliability Disclosure, constructive criticism Availability, problem resolution Giving credit where credit is due Effort, carrying ones weight Appreciation of each contribution Delivering on time McGovern V, et al. Setting Up Collaborations. In: BWF, HHMI. Making the Right Moves: A Practical Guide to Scientific Management for Postdocs and New Faculty, 2004

Assessing a Collaborative Opportunity • Do I need this collaboration in order to move my own work forward? Is there a missing piece that I must have? • Even if not strictly necessary, will a collaboration help me make a significant scientific contribution? • Do I have the expertise or resources sought by the other collaborator? • Can this collaboration be conducted efficiently? • Is there funding for the work envisioned? • Can I afford the time?

Is this person someone with whom I want to collaborate? • Are our professional and scientific interests compatible? • Will this person be accessible to me and consistently interested in the project? • What exactly is being asked of me? • Can I exclude potential conflicts, either professional or institutional? • Before making a decision, consider all factors. A good collaboration can take your research in an unexpected course; a bad one will siphon off energy and demoralize you. McGovern V, et al. Setting Up Collaborations. In: BWF, HHMI. Making the Right Moves: A Practical Guide to Scientific Management for Postdocs and New Faculty, 2004

Academic Expectations Can Deter Collaboration • Independent ideas • Research identity • Independent funding • His or her “own” lab • Principal investigator

The Mantle of Leadership Belongs to the “Team” • In a complex and technologically sophisticated society, the most urgent projects require coordinated contributions of many talented people • We cling to the romantic idea that great things usually are accomplished by larger-than-life individuals working alone • Despite evidence to the contrary, we still tend to think of achievement in terms of the Great Man or Great Woman, instead of the Great Group Even the Lone Ranger belonged to a team Bennis W, Biederman PW. Organizing Genius: The Secrets of Creative Collaboration. Cambridge, Mass.; Perseus, 1997

When timely information is the most important commodity, collaboration is not simply desirable, it is inevitable • In all but the rarest cases, one is too small a number to produce greatness • New leadership paradigms: • Not great leaders alone, but great leaders who exist in a fertile relationship with a great group • Creative alliances wherein leader and team achieve something together that neither could achieve alone • The leader finds greatness in the group and helps members find it in themselves Bennis W, Biederman PW. Organizing Genius: The Secrets of Creative Collaboration. Cambridge, Mass.; Perseus, 1997

Summary • Clinical investigators are a heterogeneous group with a similar “phenotype” • Multi-tasking is essential and should be enjoyed • Active clinical practice is required to establish credibility with practitioners and remain in touch with clinical trends and needs • Expert status should be a goal

Summary, continued • A specific focus of investigation should be developed within a broad area of clinical interest • Collaborate • Funding = freedom! • Funding accelerates attainment of endpoints and decreases multi-tasking requirements over time

Establishing and Maintaining a Career as a Clinical Investigator