When to Get Involved in Extracurricular Scholarly Work?

Starting a new residency is tough. With new opportunities come new challenges: balancing between learning a new discipline and getting involved in scholarly endeavors can be stressful in its own right.

A sound advice I heard as a first year resident was to hold off unnecessary involvement early during the residency. A free license to procrastinate.

However, procrastination implies a postponing of something inevitable, not to mention that research and quality improvement projects are parts of the residency requirement.

So the question remains, when does it make sense to get involved? And how?

This post is a compilation of advice I heard as a first year resident, and how I waded through the waters of academic radiology training.

Be a Good Clinical Radiologist First

This is the most popular advice. It is also the best one.

In almost any type of clinical work from hypothesis-driven research to case reports to quality improvement, the inspiration and sometimes validity of one’s work arises from clinical knowledge. The only way to know the knowledge gap in liver MRI is to know everything there exists about liver MRI. Translational imaging tools are only valuable in the hands of a competent clinical radiologist. Quality improvement arguments are only compelling when you can be convinced that the system design constrains the department from providing the best care.

This advice warrants no debate – it is a fact in my book.

Start When You are Ready (or not)

On the very broad level this appears to be sound advice: don’t take on any new responsibilities if you are currently feeling overwhelmed. However, waiting for readiness can be problematic in its own right.

1. You are never “ready”

Readiness is a subjective term and a moving target. As a new resident in radiology, you will find that there is always more to know.

There is always a criteria for grading a particular lesion you have not yet learned. There is always a diagnosis in the classic differential of a finding you haven’t committed to memory and/or seen. In fact, while a year’s worth of training effectively prepares most residents for overnight call, few people feel ready to do so.

At some level, one has to humbly accept that radiology is sufficiently complex that one cannot hope to “feel ready” enough to spare attention elsewhere. Thus, making that leap of faith may be necessary.

2. Opportunities favor the prepared – so get prepared

Sometimes inspiration will hit, or opportunity will arise when you least expect it. There is no research project worklist waiting for you to double click on your favorite entry. Some of the most interesting work I got involved in arose in conversation, over food, through colleagues.

Readiness is a subjective term and a moving target, and keeping a fluid interpretation of what constitutes a “cool project” will help hone your sixth sense while wading through the field of radiology and feel the right moment to dive into the deep end.

Have a Focused Portfolio

I have mixed feeling about this advice. Having a focused portfolio helps you tell a story of your career progression. However, this strict approach causes a chicken-or-egg problem: how exactly do you find that focus?

The benefit of academic training is the access of people and resources in your program while searching for that unique voice with which you speak your career. That voice can be “wow that subspecialty is really boring,” or “I love this.” However, coming to either conclusion without first getting some hands-on experience would be short-changing what your program offers.

My approach ended up being somewhere in the middle of the road. I began pursuing radiology informatics but did not specifically narrow that interest further to a clinical interest. I worked on projects related to CT urography, radiology education, and MSK radiology. Some projects became successful while some were dead-ends, and the whole experience helped me steer my opinion towards a more informed career choice.

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Howard Chen
Vice Chair for Artificial Intelligence at Cleveland Clinic Diagnostics Institute
Howard is passionate about making diagnostic tests more accurate, expedient, and affordable through disciplined implementation of advanced technology. He previously served as Chief Informatics Officer for Imaging, where he led teams deploying and unifying radiology applications and AI in a multi-state, multi-hospital environment. Blog opinions are his own and in no way reflect those of the employer.

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