Lessons To Be Learned from Academic Setbacks

Academic medicine is facing one of its most critical challenges with workforce shortages, burnout, and, overall, a rapidly changing and challenging healthcare environment. Anesthesiology has been one of the most critically hit healthcare fields with story after story of a diminished workforce. Hospital solutions involve disruption of services and shutting down revenue generating operating rooms with only essential operating sites staffed. Leaders in academic or private practices that have remained relatively stable are not relaxed and think this could be them tomorrow. Amidst all this background turmoil, imagine an academic setback?

Furthermore, in today’s world of social media an academic setback is not merely your own private failure; it will be broadcast to all and sundry. The academic setback we are speaking of is not merely rejection of a paper or project. It is a more personal setback of your dreams, goals, aspirations—and even of yourself. How does one recover from such a devastation and what can be learned?

Leaving is one of the easiest solutions. Attrition of physicians is at an all time high of 38.3% of females and 34.2% of males as reported by Chen et al.¹ Financially, among other reasons, this may not be a viable solution. Another is litigation: a former disinformation scholar with Harvard recently filed a complaint with the Massachusetts attorney general’s office against the university, alleging undue influence by Meta on independent research. Considering the increased reputational hit, this is not necessarily a pathway forward that most would choose to go.

The academic physician is one who has made a commitment to education, research, and furthering of the field. This requires dedication beyond the 40-hour work week and takes away from personal and family time. Nonclinical time without supported grant is becoming rare due to short staffing. So, what can be learned from an academic setback?

There are definite consequences of emotional failure which can take a toll on a person’s mental health and well-being. Our training may not have prepared us for this failure, especially later in our career. Studies from Tartas et al² on the early career setbacks of medical students mention reaching out to advisors and mentors. It is crucial to recognize if you need professional mental health assistance.

The most important lesson that comes from an academic setback is to reject the feeling that the setback reflects your personal abilities or attributes. One should recognize that academic setbacks may be even more widespread than we know or realize. In confidential, protected spaces academic setbacks may be shared more so than via public-facing venues. It is regarded as a taboo topic and there is an element of victim shaming. Is it truly possible that people who have invested so much in their career and ambition would simply toss it aside?

We live in a world of polarization that, unfortunately, does not allow for all viewpoints and ideas to be expressed, and this atmosphere is encroaching into academia. We are in a field that is still dominantly represented by white males. Although women and minorities are slowly progressing into leadership and positions of influence (societal leadership, editorial positions) there are different standards applied, especially to minority women of color.

Anecdotally, the advice also offered is see beyond your field to view a wider scope. A vice chair from an academic institution once shared that her biggest advances and sponsorship came from outside of her department. This also relates to accessing external networks, although it may be difficult to suddenly expand. LinkedIn has been popular for quite some time among professional groups in business, although it remains a relatively novel channel for physicians. Recruiters, professional societies, and hospital leadership belong to LinkedIn, and it has become a place to explore career, educational, and other opportunities.

Another approach is to generalize your approach from a fellowship trained specialty to something more general, such as an intensive care physician to a generalist. Part of this strategy is to remove yourself from a pressure cooker environment and another is to add value, although this may not be a permanent solution.

Coaching has also been touted during these times, delivering an unbiased supporter who maintains confidentiality. Coaching can facilitate global insight and the regaining of confidence, allowing one the space to reflect on the situation and find resolution.

This is not by any means a comprehensive list of lessons learned or even a strategy after an academic setback however defined, large or small. These are some thoughts offered on a wide range of concerns regarding academic setbacks. Unfortunately, academic anesthesia faces workforce shortages that are stressing our healthcare systems. We need every anesthesiologist we have, and it is imperative to retain those of us who wish to remain.

References:

Ya-Wen Chen, C. Orlas, T. Kim, D.C. Chang, C.M. Kelleher. Workforce attrition among male and female physicians working in US academic Hospitals, 2014-2019. July 2023 JAMA Network Open 6(7):e2323872. doi:10.1001/jamanetworkopen.2023.23872

M. Tartas, M. Walkiewicz, W. Budzinski, M. Majkowicz, K. Wojcikiewicz. The sense of coherence and styles of success in the medical career: a longitudinal study, 2014 Nov 28 BMC Medical Education.doi: 10.1186/s12909-014-0254-5.

Author

Vidya T. Raman, MD, MBA, FASA, FAAP

The Ohio State University

Wexner Medical Center

Columbus, Ohio