How Academics Work

[NotChoCheez!]

In the spirit of Doc B's "How Hospitals Work" I want to start a thread asking about academics. How do you get a job, get promoted, etc. I'm putting it here instead of the general forum because I suspect that EM academics are different than the other specialties (which is why I would even consider EM academics).

One other rumor I want to confirm/dispell is that if you work in a residency program at a state university that you are technically an employee of the state and have malpractice protection like VA employees (i.e. they can sue the government, but not you). Is this true? If so, that would make academics more attractive (you would be able to practice evidence-based medicine instead of CYA medicine).

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[bartleby]

I am faculty in a state university hospital where this is pretty much the case. My practice has changed less than I would have thought given the absence of the malpractice issue, but I've always been somewhat of a minimalist. It lets your focus be exclusively on what's right rather than some idea of what's "defensible" when you're getting sweated by some lawyer in a deposition.

One other rumor I want to confirm/dispell is that if you work in a residency program at a state university that you are technically an employee of the state and have malpractice protection like VA employees (i.e. they can sue the government, but not you). Is this true? If so, that would make academics more attractive (you would be able to practice evidence-based medicine instead of CYA medicine).

 

[NotChoCheez!]

I am faculty in a state university hospital where this is pretty much the case. My practice has changed less than I would have thought given the absence of the malpractice issue, but I've always been somewhat of a minimalist. It lets your focus be exclusively on what's right rather than some idea of what's "defensible" when you're getting sweated by some lawyer in a deposition.

That has got to be a HUGE fringe benefit, one that I've never really heard mention when talking about the benefits of academia.

So, in what way does EM differ from IM or Surgery in terms of academia? Is there a certain minimum amount of publications that you need per year? Also, I imagine that the research you do is interesting clinical stuff instead of excruciating basic science research (no offense to all those mud phuds out there.)

 

[BKN]

That has got to be a HUGE fringe benefit, one that I've never really heard mention when talking about the benefits of academia.

So, in what way does EM differ from IM or Surgery in terms of academia? Is there a certain minimum amount of publications that you need per year? Also, I imagine that the research you do is interesting clinical stuff instead of excruciating basic science research (no offense to all those mud phuds out there.)

I am a faculty member and a P.D. I sit on a tenure and promotion committee. EM academics are both the same and different. The type of research can be clinical, basic science or translational. Clinical research in an ED is more difficult than in other specialties, because you only have the patients for a couple of hours, you can't control what kind of patients present and to get informed consent without coercion is problematic. T&P decisions are made at the instituional level with a common guideline and E.P.s are frequently disadvantaged becuse of the very large clinical load and the requirement to supervise 24/7.

I assume you are an undergrad or a medical student. If so, your best bet to learn about this is to volunteer to help someone in EM research. If a resident, you should look to your mentors in your department. A medical student or resident can learn a lot by attending the Society for Academic Emergency Medicine meeting (usually in May).

By the way, I notice both you and Bartleby are in Texas. As am I. The answer about malpractice actually applies to Federal Hospitals and State of Texas institutions but not to most states. Just another reason to live here in heaven.

 

[NotChoCheez!]

I am a faculty member and a P.D. I sit on a tenure and promotion committee. EM academics are both the same and different. The type of research can be clinical, basic science or translational. Clinical research in an ED is more difficult than in other specialties, because you only have the patients for a couple of hours, you can't control what kind of patients present and to get informed consent without coercion is problematic. T&P decisions are made at the instituional level with a common guideline and E.P.s are frequently disadvantaged becuse of the very large clinical load and the requirement to supervise 24/7.

I assume you are an undergrad or a medical student. If so, your best bet to learn about this is to volunteer to help someone in EM research. If a resident, you should look to your mentors in your department. A medical student or resident can learn a lot by attending the Society for Academic Emergency Medicine meeting (usually in May).

By the way, I notice both you and Bartleby are in Texas. As am I. The answer about malpractice actually applies to Federal Hospitals and State of Texas institutions but not to most states. Just another reason to live here in heaven.

Yup, right on the money. I'm an MS2. I suppose my naivety shines through! I really am glad that there's a forum where I can get real honest-to-goodness attendings to talk to me. It beats stalking them in the ED to ask them questions. I really appreciate it.

I agree that Texas is the place. Plus, if I decide to go into academia, there are plenty of medical schools, so hopefully SOMEBODY will take me.

 

[NotChoCheez!]

I am a faculty member and a P.D. I sit on a tenure and promotion committee. EM academics are both the same and different. The type of research can be clinical, basic science or translational. Clinical research in an ED is more difficult than in other specialties, because you only have the patients for a couple of hours, you can't control what kind of patients present and to get informed consent without coercion is problematic. T&P decisions are made at the instituional level with a common guideline and E.P.s are frequently disadvantaged becuse of the very large clinical load and the requirement to supervise 24/7.

I assume you are an undergrad or a medical student. If so, your best bet to learn about this is to volunteer to help someone in EM research. If a resident, you should look to your mentors in your department. A medical student or resident can learn a lot by attending the Society for Academic Emergency Medicine meeting (usually in May).

By the way, I notice both you and Bartleby are in Texas. As am I. The answer about malpractice actually applies to Federal Hospitals and State of Texas institutions but not to most states. Just another reason to live here in heaven.

Oops, I wasn't done when I posted. Oh well, this makes a good post pad (we can pull ahead of Pathology, I just know it!)

As far as research goes, should I try to get involved in something now, and do it a few hours a week? Or would it be more efficient to take a couple of months elective time in clinics and do a project full time?

Thanks for all your help!

 

[BKN]

Oops, I wasn't done when I posted. Oh well, this makes a good post pad (we can pull ahead of Pathology, I just know it!)

As far as research goes, should I try to get involved in something now, and do it a few hours a week? Or would it be more efficient to take a couple of months elective time in clinics and do a project full time?

Thanks for all your help!

As a launching pad to residency, either can help. Yor goal is to be seen as a seriously motivated EM student. It keeps you in the minds of your mentors when it's time to write letters of recommendation. For academics, your goal is to get papers written and published. At the student and resident level you will essentially always be as a junior author on ongoing projects. Choose your research mentor wisely, pick someone with a successful track record of publishing. You don't want to do a lot of voluntary work (which you hardly have time for) and have the project collapse or never get finished.

bkn (residency director and former research director)

p.s. Yor primary job is to learn medicine. Research is a faculty reponsibility. Do this extra stuff only if your own academics are in good order. When I look at an application for residency, the transcript, the LORs and the MLEs are the major screens. Research is just icing which can differentiate two good candidates.

 

[EctopicFetus]

BKN,

What program are you with?

 

[BKN]

BKN,

What program are you with?

Texas Tech, El Paso

 

[roja]

The 'state employee' issue depends on where you practice. In texas, the state school affiliates are in fact state employees. (one of the reasons I want to come back to Texas academia) However, here in NY, the attendings in our academic institution are not state employees. They can get sued but thier malpractice is covered by the hospital. (a benefit one should consider when getting a job in EM)

I personally didn't even know I was going to go into EM until I was at the absolute end of my third year (never even considered it). I did some research my fourth year. Its much better to take the above advice. Study well, do well on step 3, do well in clinicals. If you have some time, it doesn't hurt to get a little research. But research will not compensate for a weak academic record.

I started doing a significant amount of research my second year of residency (spent most of my first year pursuing ultrasound RDMS status).

If you think you want to do academics, shadowing an academic EMP occasionally can help you figure out if its the path you want to take. Especially as EM tends to be one of those absolute love it or hate it fields. Same goes for academics. (I have always been a die hard academician and am fellowship bound. I have friends that can't wait to get out of academics and get into the 'real' world.