Balancing Clinical Work and Research During Fellowship Training

Balancing Clinical Work and Research During Fellowship Training

Inas Abuali, MD, FACP

Jan 11, 2021

The winter months are often accompanied by a mid-academic year slump. Perhaps you know the feeling: You have committed to several projects at the beginning of the year and have rapidly approaching deadlines. Your clinical load is getting heavier and the folder of to-read articles is exponentially growing. If, like me, you are in your final year of training, then the all-consuming job search (a full-time job on its own) is likely occupying most of your time, and you are thinking that you probably need to start studying for boards at some point, too!

Amidst all this frenzy, the email that just popped into your inbox is an invitation to collaborate on a research project or to serve on a new committee. You are delighted to be offered this opportunity and you attempt to resist the knee-jerk reflex of immediately typing back, “Yes, count me in!” Before you compose that email reply, here are a few tips based on my own ongoing attempts to strike a balance between my clinical duties and my scholarly activities during fellowship.

  1. Maintain a list of projects that you are currently working on.

This list should be constantly updated with progress status, collaborators, relevant deadlines, and timelines. It will help you stay on track in terms of your various commitments and will give you a quick overview on how a new project can (or can’t) fit within your evolving academic portfolio. It serves to keep you honest, in a way—and helps you answer the important question of whether or not you truly have time for that new opportunity!

  1. Assess the amount of protected research time that you need during your fellowship training.

While ACGME mandates 18 months of clinical training in a 36-month combined hematology and oncology fellowship program, there is significant variation among programs in terms of research time. We each have a different career path requiring a modified training experience. Work with your program director and mentor(s) on figuring out how much time you require and how to best schedule it throughout the 3 years of training.

  1. Rethink the definition of “scholarly activities.”

While ACGME expects fellows to pursue a “scholarly activity” during their training, the definition for that is flexible. You may find that you are not passionate about the traditional lab research or clinical trials route, which is completely fine. There is an emerging recognition of the value of quality improvement and patient safety initiatives, medical education, and curriculum design. There are various retrospective chart reviews that can be performed. Serving on a committee and making relevant contributions is another form of scholarly activity, and it can lead to terrific networking opportunities and fruitful exchange of ideas and projects. Spend some time reflecting on what “research” actually means to you and what opportunities within it align with your career goals.

  1. Explore various areas of interest until you find your specific niche.

You can learn a new skill from every project and every mentor even if it is not directly related to your specific subspecialty focus. The same goes for various research types, which you can explore until you decide on a specific career path. It is completely acceptable to have a diverse academic portfolio that is narrowed down later in your career according to your various interests.

  1. Successful collaboration with others is key.

The reason prolific researchers can juggle numerous commitments simultaneously often lies in their ability to collaborate well with others. A project can continue to move forward as different team members devote time and skills at various phases. We each bring in a unique skill set to the rest of the team. Your role and contribution will vary in your different endeavors, and a successful collaboration can bring out your best work. Remember to also explore inter-institutional opportunities via social media or professional societies and meetings for ongoing exchange of ideas.

  1. Quality over quantity.

I think that is one of the hardest lessons to grasp as a trainee, as we are often hard-wired to fear missing out on opportunities and constantly feel that we are not doing “enough.” Resist the temptation to say “yes” prior to evaluating the impact of a new project and what skills you hope to acquire through it. If you are unavailable to pick up a specific project, refer another colleague and leave the channels of collaboration open for a future date when you have more availability. Remember that one project done well is better than a hasty attempt to put several half-baked activities together at the eleventh hour.

  1. Build and maintain a solid professional reputation.

Make sure that you deliver on your commitments and adhere to deadlines. You do not want to be the person delaying the progress of a project or leaving the rest of your team in a lurch after realizing at the last minute that you cannot devote the necessary time.

If you must back out of a commitment, have an honest conversation with your team and explain that you have overextended yourself and cannot meet a deadline. Evaluate whether you require an extension or whether you need to step back altogether. If it is the latter, then try to recommend another person who can fill in this gap.

As I take another look at my evolving list of projects and updated timelines, I admit that finding the right balance is an ongoing work-in-progress for me. I am typing this article after spending the past weekend working for about 20 hours to meet three upcoming deadlines! One thing, however, that has helped me recently was running new projects by my “joy-meter.” Prior to responding to a new opportunity, I ask myself if pursuing it will bring me joy. As I move forward with my career, I seek fulfilling roles and tasks. For example, I recently started working with an amazing team of like-minded women on projects related to social justice. Working on something I am deeply passionate about with a research team that brings out the best in me truly feels less like work and more like an ongoing source of joy.

Happy new year, and I hope that 2021 helps you find your joy in your academic pursuits!


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