What they never taught me about being a clinician investigator

List of task outside of research Meeting expectations Finding money –Research –“Financially independent” Maintaining productivity –Publish or perish? –Protecting your time Managing a team –Human Resources –Students, Research Coordinators, Administrative assistants, etc.

Meeting expectations OHRI Associate Scientist: –Expected to maintain an average of 1-2 peer reviewed grants: total yearly amount of $75 - $150 K –Expected to produce 2 publications as a First or Senior Author/year One of these publications should be in a high profile journal (Impact Factor > 5) –Expected to be recognized by the national and international community in their field as evidenced by invited presentations (i.e. symposia, seminars outside of the city), invitations to review grants and manuscripts, etc. –The expectation is that Associate Scientist will attract graduate students, post-doctoral fellows, or clinical fellows and will teach on average 2-4 hrs/year or participate in resident training. –Any other activities that the scientist becomes involved in i.e. memberships, leadership roles, and committee chair roles, etc. will be supplementary to the expectations and will be taken into consideration when being evaluated.

Meeting expectations University of Ottawa In order to become an Associate Professor: –Have a major responsibility for an independent research program and/or play a documentable leadership role in a collaborative research effort. –To have regular publications in peer-reviewed media. The faculty member is a major author, defined as first or last author. In the case of collaborative studies, the faculty member has a significant role in the research, which includes intellectual input into the project and/or publication as documented in the CV. –To have funding support, usually federal or national peer-reviewed. –To have presented at national/international meetings. –Supportive of students and trainees pursuing research. –Emerging regional/national recognition in a focused area of research expertise. –Demonstrable contribution to education in area of clinical or research expertise with a positive impact on learners. –Minimum of 5 years experience.

Finding money Research Start low and aim high (for pilot or proof of concept) »Department of Medicine grant (i.e. local) »PSI grants »Small grants to hire med students, grad student, etc Laundered money from industry-sponsored trial CIHR, NCIC, H&S: –Be persistent: It took me 11 submissions… –Expect less money than what you asked for…

Finding money Salary support –You should be protected for 2-3 years That is not very long in the research world –Too junior for Young Investigator Awards Alternatives: –CIHR RCT Mentoring –CIHR Clinician-Scientist program

Maintaining productivity Mentorship Local National/international Networking Participate in Canadian/US initiatives –E.g. for me was CRTI from ASH Take advantage of meeting to get to know people –E.g. “Meet the Expert” or “Small Group Sessions” at meeting –Go to everything aiming trainees (lunch + networking)

Maintaining productivity Collaborating –You cannot do your trial by yourself! –Collaborate on other trials Accepting to participate in no-money (even losing) generating peer-reviewed trials from other centers –Takes a lot of work (OHREB, RC, etc) It will help in the end »Networking »Papers (if local PI, etc) »They will also accept your no-money generating peer- reviewed trials E.g. VECTOR, Canadian Critical Care Group

Maintaining productivity Expect delays, delays and more delays with any projects –Annoying when you start! –Example: You are interested in participating to an-industry sponsored trial (You need to plan 9 months in advance) OHRI Contract office needs to have a look at the confidentiality agreement before you sign it. »3-4 weeks (back and forth between them and company) You read the protocol and think that this is an important study »Submit to health Canada (2-3 months) to have a letter of no objection Submit to OHREB (2-3 months) You Have OHREB approval »OHRI Contract office needs to negotiate with the company regarding the terms of the contract (2 months) You can start enrolling patients

Expect delays, delays and more delays –Example: Me and Rebecca Auer are collaborating on a peri-op thromboprophylaxis study. We want to do a small pilot study of 20 patients Apply for a Department of Medicine grant to do a pilot study –2 months Apply to the companies to have the drug free of charge –3 applications sent – one successful –2-3 months Submit to health Canada (2-3 months) to have a letter of no objection Submit to OHREB (2-3 months) –Major revisions –Minor revisions OHREB approval

Delays Have numerous things going at the same time to maintain constant productivity…

Time Protection You should have 75-80% protected time Required if you want to be a successful investigator Expect more > 25% Clinical Service 14 weeks of service; 2 ½ half days of clinic »In real world: Much more than that (e.g. with F/U, calls, dictations, etc) »Things that you are not used too as a Resident/Fellow Time management –Keep time for yourself You will have to learn to say “No”

Managing a team You are now responsible for other peoples salary… –RC, techs, etc You now have to manage people Contracts Vacations Conflicts between team members Etc