The Challenge

There is growing interest in different ways to garner academic promotion in today's medical school. In response, clinician-educator tracks have burgeoned in recent years.13 Although extramural funding is not required for advancement in all tracks, almost all promotions still require scholarly activity. At most institutions publication in peer-reviewed journals is an essential component in this. Although seemingly straightforward, acquiring a sufficient number of peer-reviewed papers remains a significant barrier to promotion for many highly skilled, busy program directors, designated institutional officials, teachers, and academic clinicians.46 The Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements note that “Some members of the faculty should also demonstrate scholarship by one or more of the following…publication of original research or review articles.”7 

What Is Known

Although publication is fundamental for academic advancement, writing papers can seem difficult if not impossible for many clinical faculty, including those who focus on medical education. Publishing in peer-reviewed journals requires directed effort, yet the payoffs can be sizable. Besides climbing the academic ladder, promotions at medical schools are usually accompanied by salary increases. Other benefits include developing a greater depth of knowledge in a niche area. With such expertise comes regional, national, and even international recognition, along with opportunities to present scholarly work at conferences. Scholarship is also important to faculty's role in mentoring residents in their scholarship endeavors, a role that is required by the ACGME: “Faculty should encourage and support residents in scholarly activities.”7 Finally, and perhaps most importantly, scholarly pursuits and academic productivity may improve faculty job satisfaction.5,6,8 

Rip Out action items

Faculty and trainees must:

  1. Identify and develop areas of interest and write ideas down; think of their educational program like a laboratory

  2. Find mentors to assist with specific development tasks

  3. Identify or develop a writing group

  4. Clarify authorship byline issues of the team

  5. Review common program requirements for faculty scholarship

  6. Test the simulation methodology, keeping detailed notes on benefits, challenges, and opportunities for future refinement in their local setting

Action Items

What Can You Start TODAY?

The task of writing can seem daunting, especially for individuals who have not written before or have not written recently. As with any undertaking, begin with small steps.

  1. Look around and reflect on the questions that arise day to day in your clinical and educational activities. Take notes and jot down ideas of interest as they come to mind.

  2. Consider past presentations from different venues, such as case conferences or grand rounds. Many of these existing talks can be transformed into a targeted review article that might help launch a more substantial original research project.

  3. Reconsider those unfinished, “back burner” projects, such as preliminary data presented as a poster at a meeting but never written in manuscript form.

  4. If at all possible, select a subject of personal interest. As potential topics are considered, clinicians should honestly reflect on whether they are willing to put in the necessary time reading, exploring, and ultimately writing about a particular subject. Having a personal interest in a topic can improve the likelihood of success.

  5. Identify a trusted colleague to help guide the process. Success with writing, similar to success in other areas, comes easier with good mentorship. Having multiple mentors/collaborators with different skills and perspectives is useful.

What Can You Do Long Term?

  1. Talk to colleagues and network whenever and wherever possible, looking for opportunities for scholarship outside of your immediate clinical setting. Identify faculty across your institution, regionally, or nationally who may have shared or complementary interests. Be creative and look for opportunities to collaborate.

  2. Partner with colleagues who enjoy writing. Some clinicians can feel overwhelmed at the prospect of writing a paper. Others simply believe that they cannot write. Like any pursuit, writing can be learned, and it gets easier with time.

  3. Maintain a collection of well-written, well-organized papers to use as models.

  4. Develop or join a writing group. Two or three faculty members who share research interests might form a “writing group,” which could also include residents. When done correctly, this arrangement cannot only help generate ideas for papers, but scheduled meetings and deadlines will help keep everyone on task and accountable.9 

  5. Consult a librarian to learn current search strategies. Besides writing skills, research techniques are critical. Invest in a hands-on class that demonstrates use of a reference manager.

  6. Gain familiarity with the institution's requirements for promotion as well as the actual process and timeline.

  7. Divide tasks among coauthors (or “writing group” members). Sharing the work among colleagues who have different skill sets can be an effective way to get through the necessary logistics. Middle authorship on multiple papers is an excellent resume builder, especially for residents. The team should be clear on authorship and contribution requirements related to bylines.10 

  8. Carefully read and follow the “Instructions for Authors” prior to submitting a manuscript. Pay particular attention to required format, word count, table and figure limitations, and reference style.

Resources

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Author notes

Preeti N. Malani, MD, MSJ, is Associate Professor of Medicine in the Divisions of Infectious Diseases and Geriatric Medicine, University of Michigan Health System, and the Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Ann Arbor Healthcare System; Monica L. Lypson, MD, MHPE, FACP, is Assistant Dean for Graduate Medical Education and Associate Professor of Internal Medicine & Medical Education at the University of Michigan Medical School.