Academic Surgery: Research Time, Surgeon-Scientists, and Future Development

The State of Academic Surgery

• 🎯 The University of Michigan's surgical department is a well-resourced academic health center with seven clinical divisions and a robust research enterprise spanning basic science, translational science, health services, and education research.
• ⚠️ Despite being well-resourced, the department, like others, faces threats to funding from various perspectives, including clinical revenue, leading to cautious engagement with the future of academic surgery.

Surgeon-Scientists and Career Paths

• 💡 A study in Annals of Surgery found that only 17% of general surgery graduates from academic programs become academic surgeon-scientists, a number the editor-in-chief, Dr. Justin Dimick, finds unsurprising given the broad definition of academic surgeons.
• 🔑 Key drivers for academic career choice include longitudinal mentorship and infrastructure, though the mythology of the individual "triple threat" is being replaced by the need for diverse teams with specialized roles (clinical pace-setters, innovators, educators, scientists).
• 🧠 The concept of a "surgeon-scientist" is broad, encompassing anyone pursuing scholarly work, not just NIH-funded clinician-scientists, who represent a minority even in highly academic institutions.

Training and Research for Trainees

• 🔬 The current model of mid-residency dedicated research years (e.g., for a PhD) presents challenges, including the potential for research to become obsolete by the time trainees enter the job market.
• 🧩 Alternative solutions like longitudinal integrated research experiences or adding research to fellowship are considered, but the mid-residency break is seen as valuable for general surgery training.
• 📈 Re-entry into research after clinical training requires structured support, protection, and good mentorship, especially for those aiming for hardcore science careers.

The "Checkbox" Mentality and Fellowship Goals

• 📊 The majority of general surgery residents may pursue research primarily as a "checkbox" to enhance their CVs for competitive fellowship applications, rather than a genuine aspiration to be a surgeon-scientist.
• 🚀 Top training programs aim to cultivate leaders who change the field through science, clinical innovation, and leadership, suggesting that if research feels like a checkbox, a trainee might not be aligned with their career goals.

New Initiatives at Annals of Surgery

• 🌟 Annals of Surgery is launching a new section focused on professional and leadership development for surgeons, soliciting perspectives on these themes.
• 🤖 Additionally, a section on artificial intelligence is being developed, and interested individuals are encouraged to submit ideas for solicited perspectives.