1. Academic Advancement In Family Medicine: Increasing Publications And Developing a National Reputation Kurt B. Angstman, MS MD, Associate Professor Department of Family Medicine, Mayo Clinic Rochester, MN STFM Annual Spring Conference 2013

2. Conflict of Interest I do have a consulting agreement with Tamber Health. Tamber Health did not review or participate in development of abstract or presentation.

3. Introduction Development of publications Process Methods Numbers National and Internation reputation Process Methods Area of Focus

4. Associate Professor of Family Medicine National reputation acknowledgment as an authority by peers Significant publications principal author or major collaborator Effective teacher Attract and mentor students, residents, and fellows; curriculum design Institutional leader Sustained educational or administrative accomplishments

5. Professor of Family Medicine Recognized authority of national or international stature Continuity of work producing significant publications Effective and sustained leader in education Innovative and significant contributions to clinical practice Distinguished institutional service and leadership

6. Publications Initially, the number can be daunting First paper can take months, if not over a year (or more) How then are you able to get the volume??

7. Publications Write about “what you are doing…” Look for projects based on what you know and are conversant in. DON’T re-create the wheel Every new project then requires new literature search and review DON’T initially plan on large, randomized controlled studies. Much simpler to start with chart reviews, database searches, pilot studies DO develop a template

8. Publications Start small Ask others who are doing projects, papers if you can help- be a co-author Look for mentors DON’T be too choosy with journals Always peer-reviewed Impact factor is important But early in career- becoming experienced in the process is also important. Many, many journals to select from; all looking for content

9. Manuscript timelines Background and Protocol development IRB approval Data collection Analysis Draft development – tracking different drafts Involving co-authors Completing final draft Submission process Much more times consuming than appreciated Peer Review Can be significant time delay Rewrites and Re-submission Back to reviewers (and delay…) Review Page proofs Publication

10. Other authors Jodi Picoult Prolife fiction author 18 novels (as of early 2013) How she does it: While writing one book… Editing/postproduction on one Researching for her next So working on three at once…

11. Manuscript timelines From starting point to actual publication Waiting is a major component! Many times takes six to 12 months or LONGER NEED to have a few manuscripts/research projects that are at different areas on the timeline. For example- after a manuscript is completed and sent for review- this is a great time to start your next project. You know what the results are and this can help move to the next project. If you are not doing the actual data collection- also here is reasonable to start another.

12. Publications Plan on “singles” rather than swinging for the fences. One paper can change a career- but more likely you have smaller manuscripts that you keep building upon. Helps drive future direction “Science is not testing a hypothesis and getting a result- science is getting the result and saying “What now can I do with this information- what is the next study.” Sam B. MD/Phd Student at Mayo Remember to cite your prior work when appropriate

13. What is the name of this musical group? Refrain from the song is: “I am the eggman. They are the eggman”

14. What is the name of this musical group? Refrain from the song is: “Hey Jude”

15. Beatles comparison “I am the Walrus” “Hey Jude” Not EVERY song is a top 10 Not EVERY manuscript is suitable for NEJM.

16. Building success Publication in big name journals can happen Takes time Takes reputation Do the best work you can for the manuscript and try several venues for publication NOT every manuscript is going to make it (not every Beatles song was great!)

17. Selection of Journals You will be come familiar with each journal’s niche. Some journal’s will be a better fit for your research than others. Learn to “spread” your research over several journals Good for you Good for the journals

18. Publications All is well, but still how do you get the numbers… Collaborate, collaborate, collaborate Writing groups 5 people Each with an area of expertise Each one is first author on one paper per year The rest then contribute sections In 5 years, this is 25 papers for all You are first author on the papers of your area of expertise

19. Alternative option (more real world) On your 5- 10 manuscripts over 5 years Collaborate with up to 4 authors on each manuscript With 5 manuscripts/ 20 co-authors Hopefully 5-10 will include you as a co-author on their future manuscripts

20. Approach to research problems Many times data is evaluated only from one aspect Learn to broaden scope when assessing your data Generally multiple manuscripts can be derived from data sets Manuscripts from less experienced authors tend to be less focused.

22. Focus research and writing Initial research: Impact of retail clinics on repeat office visits (A on B) Impact of resident/staff paneled patients on retail clinic use (C on A) Impact on insurance coverage on retail clinic use (D on A)

23. National and International Reputation Hard to define… but know it when you see it. Components include: Number of publications Variety of journals published in IMPACT factor How often your work is cited and where it is cited Presentations Although presentations don’t count as much as publications for advancement- the variety of conferences and locations does serve as a proxy for your reputation

24. National and International Reputation Presentations Introduce yourself with your areas of interest and expertise fmdrl.org- downloads show interest in work Visiting Professorships Journal reviewer/ board etc. Focus of your work Much harder to develop a reputation if you have 2-3 manuscripts on 10 topics; you would be much better to have 10 manuscripts on a single area Define your area of interest and expertise Also--This can change over time!

25. Presentations Again- start small, start local; gradually increasing size and impact of conferences At national forums Many times initially will be poster presentations Usually there are templates to help design the poster Conceptually, try to “tell your story” in the equivalent of 8- 10 power point slides Will be easier to develop presentations in the future- if you have a consistent track record of presenting and doing well in previous years Abstracts of papers can allow for presentation of ideas, critical discussion, meeting collaborators and improving your reputation through relationships

26. Presentation Skills Workshops helpful Practice/ Practice/ Practice Stage fright- consider beta blocker KNOW YOUR AUDIENCE Nothing worse than a presentation that is “canned” Always adapt the presentation to the conference needs Please be respectful of time limits

27. VERY IMPORTANT YOU are not an expert in XYZ waiting to advance in academic rank YOU BECOME an expert over time by publications, presentations and reputation Many younger colleagues are stymied as they don’t see themselves as the expert– and they aren’t… yet

28. “ARC” of academic achievement As you are planning your career- Study design should consider: Background data Possible review manuscript, AAFP, STFM presentation Pilot study Initial project- to work the kinks out Many times information (OR process) is new and unique enough for publication Presentations locally and nationally Posters Main study Original manuscript and presentations Many times can have “side” articles of interest- but divergent enough to warrant a separate manuscript

29. “ARC” of academic achievement With research proposals- you should consider future work as you are designing it One project could have 3-4 manuscripts and 4-6 presentations from it That is how to develop focused academic study to warrant a national reputation

30. Questions?? THANK YOU! Dr. Kurt Angstman angstman.kurt@mayo.edu Department of Family Medicine Mayo Clinic Rochester MN