Independent of the track you are on, mentorship and guidance along the way are keys to success. Make sure your department has a well-defined, structured academic development program for junior faculty. This should be above and beyond the mentorship you get from research and clinical mentors. It should provide you with a basic strategy with goals and milestones that will ensure you will achieve all the necessary targets for promotion. This should include at least annual review of your progress. It should also include a formal mid-career review. Time requirements to promotion vary between institutions and between promotion tracks, but at what constitutes mid-career (3 years in many situations), you should have a comprehensive review including assembling a mock promotion package for formal review within the department and perhaps even the Dean’s office in some cases. This is a critical process to review your specific career objectives and promotion targets, to assess progress in all key areas, to identify areas where there may be deficiency that can be addressed over the remaining time, and to re-evaluate as to whether your job description and time allocations match your activities. Take this process and its findings very seriously.

Career Development Awards (CDAs)

The NIH offers a range of awards aimed at providing funding and support for protected time and concentrated research career development (Table 2.4). The VA also offers career development awards (http://www.research.va.gov/funding/ cdp.cfm).

The NIH awards generally provide support for 5 years including $50,000–75,000 per year in salary support for the young investigator in exchange for a commitment that 75% effort be directed to the research supported by the grant.They also provide $25,000–50,000 per year in research funding for supplies and equipment, and travel associated with the project. In addition, many professional societies, in collaboration with the American College of Surgeons, offer additional support for K-awardees up to an additional $75,000 per year for

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TABLE 2.4 Select NIH career development award options for young investigators

Provides an opportunity for promising postdoctoral scientists to receive both mentored and independent research support from the same award. The initial phase will provide 1–2 years of mentored support for highly promising, postdoctoral research scientists followed

by up to 3 years of independent support contingent on securing an independent research position

Adapted from National Institutes of Health (http://grants.nih.gov/training/careerdevelopmentawards.htm)

salary or expenses, so investigate whether there is one of these matching opportunities relevant for you. CDAs are likely the best, if not only, way for a young surgical investigator to get a foot in the door at NIH. If you already have a PhD and have preliminary data, going direct to an R01 mechanism is preferred. For the others, the ultimate goal for both the investigator and the NIH is to transition preliminary data acquired into a competitive R01 application by the end of the K-award period. If you are contemplating applying for a K-award, planning to do so by the third year of your faculty appointment is generally both advisable and doable. You should have identified a mentor and generated enough preliminary data to that point, and it still gives you enough time to show productivity by the time the promotion process begins.

The K08 and K23 mechanisms are most relevant, with the K08 thought to be for more basic science pursuits, and the K23 for more clinical or translational patient-oriented research. The NIH defines patient-oriented as “research conducted with human subjects (or on material of human origin such as tissues, specimens and cognitive phenomena) for which an investigator directly interacts with human subjects.”Whichever mechanism you choose, realize there are pros and cons of these awards. First, make sure your division and department are committed to you spending 75% of your time on research. Make sure you are committed to this as well. Second, since $75,000 may not be 75% of your salary, make sure there are funds outside of clinical activity available to support your time. Third, realize that if you agree to a 75% research assignment, you will need to show research productivity in line with basic science colleagues who may have fewer other responsibilities or distractions. This may set a high bar for promotion on a scientist track. Finally, make sure you know whether or not just having a K-award is enough to qualify you for promotion or whether or not an R01 is mandatory.

The nice part of the CDAs is the career development part itself. You are asked to identify weaknesses in your research portfolio and then design a curriculum to address these weaknesses through courses, training, and the like. This is an opportunity for some to explore and learn new scientific

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methodology, experience novel techniques, and even travel to learn from experts in the field. This is also another opportunity to consider whether or not the pursuit of an additional degree is desired or necessary.Many institutions have Master’s programs in either public health or in clinical and translational research where you can acquire additional skills in epidemiology, biostatistics, or other areas relevant to your program. These degrees are not necessary for a K-award, and the K-award is not necessary for participation in a Master’s program, but they are nicely compatible.

Another nice avenue through which to pursue academic career development is through involvement in academic and professional societies like the Association for Academic Surgery (AAS). The benefit is multi-faceted. First, you will meet new colleagues who have the same career goals as you and who will face the same promotion process. These people will become friends, advisors, mentors, and potential research collaborators along the way. Second, you get to present your research, often preliminary, in a constructive setting where you get critical feedback and an opportunity to cross-polli- nate ideas to improve or expand your activities. Third, these societies offer courses, like the Fundamentals of Surgical

Research Course or Career Development Course offered by the AAS, which provide you with the basic foundation on which to build your early academic career. And finally, they provide the opportunity for you to get involved in society organization and governance which allows you to start building a national reputation even early in your career.

Contemplating a Mid-Career Move?

At or about that 3-year mid-career mark, you may be contemplating a move to a different faculty position. The reasons for this vary. Some may be dissatisfied with their current position, realizing the process outlined above didn’t produce a good fit, and have concerns about achieving their goals in that environment. Others may have had a good fit, but things

(i.e., leadership, department mission or focus, mentors, etc.)