Abstract
Introduction
There is no clear career path for aspiring academics, making it difficult for those interested to view this as an option. This is concerning given the decline in recruitment into all areas of academic medicine, including psychiatry. There are concerns that academic psychiatrists are ‘an endangered species’ and, if a new generation of researchers are not developed, may become ‘extinct’ (Henderson et al., 2014). While students express high levels of interest in research on finishing medical school, this interest wanes as their careers progress (Straus et al., 2006). We hypothesized that the lack of a clear pathway to academia could be a major barrier and surveyed experienced academics to inform potential psychiatric academics regarding how to approach a successful career.
Methods
We surveyed a group of experienced and successful academics (the Editorial Board of the Australian & New Zealand Journal of Psychiatry [ANZJP]) about their careers. We posed a series of open questions exploring their careers in academia, asking specifically about how and why they started out in research, barriers encountered and aspects that were helpful when starting out. We also asked them to reflect on satisfaction with their academic pursuits, career highlights and whether pursuing academia has conferred any disadvantages for them. Finally, we requested advice for clinicians wanting to get started in academia and a reflection on the benefits of promoting an academic culture.
Results
The entire editorial board (n = 8) responded promptly and enthusiastically to our survey. Six completed detailed written responses, while two chose to respond by interview. The majority of respondents were male (87.5%) and based in Australia (75%). Six respondents were psychiatrists and two were psychologists.
Respondents were introduced to an academic culture early on, with just one exception. This likely led to research and teaching opportunities that otherwise would not have eventuated. An early interest in academia was fostered by exposure to helpful role models, including lecturers, family members and peers. Relationships with role models and mentors were, almost uniformly, endorsed by those surveyed as critical to career progression. While this was most apparent in the early years, it was not uncommon for respondents to continue to consult their mentors throughout their careers. Those who did not have mentors, or who had periods in their careers without their guidance, reported that this was difficult and led to mistakes. Initial obstacles to pursuing an academic career ranged from the practical (distractions, lack of research training, funding) to the philosophical (is the work meaningful or worthwhile?). Despite the barriers encountered, respondents had established a pattern of academic productivity early on. Protected time was key in developing an academic interest and beginning a career, and even experienced academics cited a lack of time and ‘headspace’ as key barriers in producing good-quality academic work.
In response to the pros and cons of pursuing academia as a career, respondents were ‘perfectly satisfied’ with their careers. While it was felt that this was a tough path, academic work was described as very rewarding. A number of benefits, including the expected academic achievements, were expounded. However, a common and less expected theme was the relationships that had developed as a result of their academic career. Key benefits and disadvantages are summarized in Table 1. While academics overall felt that the benefits of their career path outweighed the disadvantages, there were some clear negatives. Financial considerations were the most commonly reported downside. In addition, many found it difficult to balance part-time clinical and academic work, reporting that this impinged on personal time and space. Several respondents commented on strategies that they had developed to manage this, including a blanket rule regarding not working at home and consciously increasing their efficiency while working.
Most commonly endorsed pros and cons of an academic career.
Discussion
The responses from the established academics surveyed for this article indicate that an academic career is rewarding and challenging, with key highlights being the mental stimulation and benefits of unique relationships enjoyed through several stages of the typical career. The theme of relationships developed throughout, or as a result of, academic careers had an Eriksonian flavor, where friendships and collaborations (Intimacy) were a prominent feature early in academic careers, with a stronger focus on mentorship (Generativity) developing over the course of the career. This developmental approach may help aspiring academics know where to focus their energy early in their careers.
Several respondents highlighted the financial disincentives encountered when committing their time to academia. On further consideration of this response, it became clear that devoting time to academia incurs a financial opportunity cost, driven by a passion for creating or translating new evidence into clinical practice. Financial costs are also incurred when taking time off to complete formal research training (e.g. PhD study) and, more significantly, throughout an academic career due to academic work being less well remunerated than clinical work throughout Australasia. Clinician academics offer an essential service to prevent a ‘valley of death’ between scientific advances and patient care (Butler, 2008). However, gaining competency in research methodologies (particularly statistics) and dealing with the demands associated with gaining ethical approval and funding to conduct trials can be extremely demanding and time-consuming. In-vesting in personal research education is an opportunity cost no matter when it occurs; however, arguably the later it is, the harder it is to juggle with other employment and family demands. This potentially has a larger impact on female academics and could contribute to the lower presence of female academics as authors in higher impact journals and as journal editors. However, once the investment is made, academia is potentially a very rewarding experience. A medical student, intern, resident medical officer or trainee is much more likely to have the time and enthusiasm to undertake this endeavor. To their credit, many medical schools and specialist training programs (including the Royal Australian and New Zealand College of Psychiatrists [RANZCP]) have incorporated compulsory research components and other opportunities for budding clinicians to become early career researchers without delaying their progression through their medical education. The RANZCP training program allows for Stage 3 trainees to prospectively accredit time spent in undertaking research, particularly in completing higher degrees.
These initiatives go some way to promote early research experiences and to limit the potential impact of taking time out from training or delaying entry into the specialist workforce to gain these skills.
Suggestions for developing an academic career
Respondents suggested several ways to engage oneself in such an academic milieu. Mentors and employers played a particularly key role in encouraging them to invest their time in honing academic skills early in their careers. Finding an academic mentor and developing a relationship with them were crucial for career development and sustained motivation. Mentors may be able to arrange involvement in current research projects and assist with planning and executing emerging research ideas. In addition, mentors may foster teaching or peer-review opportunities. Respondents suggested approaching potential mentors and discussing research interests. However, a good interpersonal relationship may be more important than shared research interests. In addition to mentorship, employers should be encouraged to facilitate opportunities to conduct research and educate the future generations of clinicians. Protected research time was noted by the respondents as key to productivity. Trainees with an academic interest should be supported to apply for prospective accreditation of time away from clinical rotations when conducting research. Developing Stage 3 research positions is a key way that this could be promoted, offering academically inclined trainees an opportunity to test out and develop their interest in this rich area. Exploring other local options for access to protected research time could also help to test out potential academic interest. The Scholarly Project (a RANZCP fellowship requirement) can be used as an opportunity to develop academic skills and explore interest in academic work. Choosing a supervisor who you may like as a mentor would be a helpful approach. We suggest aiming to publish your scholarly project if possible, to experience the process of planning, executing and publishing a paper, and to experience the warm glow that follows publication. Successful research projects during training have been found to be predictive of later research work (Leahy et al., 2008). Starting a journal club in your clinical team or registrar group is a good way to practice reading, analyzing and discussing academic literature. This may lead to research ideas and help to foster an interest in academic work. In addition, relationships and collaborations with like-minded peers could develop.
Limitations
These results are limited by our small sample size. However, the qualitative approach enriches our understanding of the career paths taken by a number of different individuals, and several clear themes were identified. Our sample comprises successful academics who continue to work in the area, leading to a selection bias in favor of pursuing an academic career. However, responses to larger surveys have garnered similar positive views regarding research careers (Mills et al., 2019). To better understand the potential downsides, it would be useful to interview people who have started out in academia but opted not to continue with it. In addition, research and editorial work is not the sole way of contributing academically. Clinical leaders, teachers and clinician-researchers have invaluable advice to give to aspiring academics and could usefully be asked about their experiences.
Conclusion
There was agreement that there is a ‘desperate’ need to nurture and develop the next generation of clinical academic researchers. While there are high levels of interest in the early post-graduate years, this interest often wanes over the course of training, leading to a dearth of clinician academics. Therefore, prospective academics need to be encouraged and supported in exploring whether this career path is for them. We will end with some advice procured from members of the Editorial Board: ‘just try it’. ‘Test out your ideas, and practice. Don’t expect perfection and success in everything you do—you just need to be good-enough, not perfect’. ‘The road is bumpy and you are going to be bruised. But bruises don’t matter. The most important thing is not to take it personally’.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship and/or publication of this article.
