AGA Programs

Joining Gastroenterology as an editorial fellow is an invaluable experience for the future scientific career. When I joined the fellowship, my main objectives were to learn important aspects about scientific publishing, while improving my editorial and writing skills. Importantly, participating in the fellowship would allow me to determine fields in gastroenterology and hepatology that need more intensive research, evaluate and review manuscripts submitted to a high-impact journal, learn which aspects are important for manuscripts to be considered for publication, and learn how to prepare concise summaries to share with readers. As an editorial fellow, I would not only work with experts on manuscript review and editing, but also be mentored by experts in the field to prepare for a career in scientific publishing.

The application process is easy and straightforward. A curriculum vitae, motivation letter, and conflict of interest form are needed to be considered for the position. Furthermore, a letter of recommendation has to be provided from senior faculty. For the latter, it is beneficial to have worked with someone who is currently active in scientific publishing.

After joining the editorial board, fellows are assigned to associate editors based on their previous experience. Fellows are expected to peer-review manuscripts and discuss their reviews with the associate editors during a brief call or by email, where it is also determined whether additional feedback from the board of editors is needed to move manuscripts forward. If so, fellows are given the opportunity to present manuscripts they reviewed to the editorial board and prepare the decision letter with comments to the authors and editors. This experience teaches which qualities manuscripts need to fulfill to be considered for publication, and how to communicate decisions to authors. During the meetings with the editorial board, fellows are also encouraged to provide feedback for additional manuscripts discussed.

Additionally, fellows have the chance to work on the “Covering the Cover” section of the journal under close mentorship of the responsible editors. Here, they learn to draft short synopses of submitted manuscripts that should be highlighted in the respective sections to give readers a brief overview of important pieces of research with potential clinical applicability. This experience teaches how to write concisely and rephrase the main message of manuscripts without overstating findings and conclusions. Additionally, fellows are invited to write commentaries on recent articles published in other journals and highlight these to Gastroenterology’s readership. This experience teaches how to critically comment on published literature and point out its strengths and limitations. Overall, these learning experiences improve not only editorial and writing skills, but also knowledge in the respective areas of research.

Finally, fellows have the opportunity to write a commentary about a topic of their choice. This experience allows fellows to deepen their expertise in an area of research on an emerging topic they would like to highlight to their readers. Since this type of article is peer reviewed, reviewers’ comments help identify weaknesses of the initially submitted manuscript and increase the awareness about factors that need to be addressed to finally provide a high-quality article that is of value to Gastroenterology’s readership.

Concluding, being an editorial fellow for Gastroenterology is an extremely valuable experience. From an editorial aspect, fellows learn to review, summarize, and comment on submitted manuscripts, as well as which factors need to be addressed by manuscripts to be considered for publication to a high-impact journal. Additionally, fellows network with leaders in the field and expand their knowledge on topics they had not worked on previously. Overall, the fellowship helps improve editorial and writing skills, while staying current in the literature, a skill set that can be applied broadly in the future medical and scientific career.

Dr. Kefalakes is a clinical fellow and research group leader in the department of gastroenterology, hepatology, and endocrinology at Hannover (Germany) Medical School. She has nothing to declare.

Joining Gastroenterology as an editorial fellow is an invaluable experience for the future scientific career. When I joined the fellowship, my main objectives were to learn important aspects about scientific publishing, while improving my editorial and writing skills. Importantly, participating in the fellowship would allow me to determine fields in gastroenterology and hepatology that need more intensive research, evaluate and review manuscripts submitted to a high-impact journal, learn which aspects are important for manuscripts to be considered for publication, and learn how to prepare concise summaries to share with readers. As an editorial fellow, I would not only work with experts on manuscript review and editing, but also be mentored by experts in the field to prepare for a career in scientific publishing.

The application process is easy and straightforward. A curriculum vitae, motivation letter, and conflict of interest form are needed to be considered for the position. Furthermore, a letter of recommendation has to be provided from senior faculty. For the latter, it is beneficial to have worked with someone who is currently active in scientific publishing.

After joining the editorial board, fellows are assigned to associate editors based on their previous experience. Fellows are expected to peer-review manuscripts and discuss their reviews with the associate editors during a brief call or by email, where it is also determined whether additional feedback from the board of editors is needed to move manuscripts forward. If so, fellows are given the opportunity to present manuscripts they reviewed to the editorial board and prepare the decision letter with comments to the authors and editors. This experience teaches which qualities manuscripts need to fulfill to be considered for publication, and how to communicate decisions to authors. During the meetings with the editorial board, fellows are also encouraged to provide feedback for additional manuscripts discussed.

Additionally, fellows have the chance to work on the “Covering the Cover” section of the journal under close mentorship of the responsible editors. Here, they learn to draft short synopses of submitted manuscripts that should be highlighted in the respective sections to give readers a brief overview of important pieces of research with potential clinical applicability. This experience teaches how to write concisely and rephrase the main message of manuscripts without overstating findings and conclusions. Additionally, fellows are invited to write commentaries on recent articles published in other journals and highlight these to Gastroenterology’s readership. This experience teaches how to critically comment on published literature and point out its strengths and limitations. Overall, these learning experiences improve not only editorial and writing skills, but also knowledge in the respective areas of research.

Finally, fellows have the opportunity to write a commentary about a topic of their choice. This experience allows fellows to deepen their expertise in an area of research on an emerging topic they would like to highlight to their readers. Since this type of article is peer reviewed, reviewers’ comments help identify weaknesses of the initially submitted manuscript and increase the awareness about factors that need to be addressed to finally provide a high-quality article that is of value to Gastroenterology’s readership.

Concluding, being an editorial fellow for Gastroenterology is an extremely valuable experience. From an editorial aspect, fellows learn to review, summarize, and comment on submitted manuscripts, as well as which factors need to be addressed by manuscripts to be considered for publication to a high-impact journal. Additionally, fellows network with leaders in the field and expand their knowledge on topics they had not worked on previously. Overall, the fellowship helps improve editorial and writing skills, while staying current in the literature, a skill set that can be applied broadly in the future medical and scientific career.

Dr. Kefalakes is a clinical fellow and research group leader in the department of gastroenterology, hepatology, and endocrinology at Hannover (Germany) Medical School. She has nothing to declare.

Joining Gastroenterology as an editorial fellow is an invaluable experience for the future scientific career. When I joined the fellowship, my main objectives were to learn important aspects about scientific publishing, while improving my editorial and writing skills. Importantly, participating in the fellowship would allow me to determine fields in gastroenterology and hepatology that need more intensive research, evaluate and review manuscripts submitted to a high-impact journal, learn which aspects are important for manuscripts to be considered for publication, and learn how to prepare concise summaries to share with readers. As an editorial fellow, I would not only work with experts on manuscript review and editing, but also be mentored by experts in the field to prepare for a career in scientific publishing.

The application process is easy and straightforward. A curriculum vitae, motivation letter, and conflict of interest form are needed to be considered for the position. Furthermore, a letter of recommendation has to be provided from senior faculty. For the latter, it is beneficial to have worked with someone who is currently active in scientific publishing.

After joining the editorial board, fellows are assigned to associate editors based on their previous experience. Fellows are expected to peer-review manuscripts and discuss their reviews with the associate editors during a brief call or by email, where it is also determined whether additional feedback from the board of editors is needed to move manuscripts forward. If so, fellows are given the opportunity to present manuscripts they reviewed to the editorial board and prepare the decision letter with comments to the authors and editors. This experience teaches which qualities manuscripts need to fulfill to be considered for publication, and how to communicate decisions to authors. During the meetings with the editorial board, fellows are also encouraged to provide feedback for additional manuscripts discussed.

Additionally, fellows have the chance to work on the “Covering the Cover” section of the journal under close mentorship of the responsible editors. Here, they learn to draft short synopses of submitted manuscripts that should be highlighted in the respective sections to give readers a brief overview of important pieces of research with potential clinical applicability. This experience teaches how to write concisely and rephrase the main message of manuscripts without overstating findings and conclusions. Additionally, fellows are invited to write commentaries on recent articles published in other journals and highlight these to Gastroenterology’s readership. This experience teaches how to critically comment on published literature and point out its strengths and limitations. Overall, these learning experiences improve not only editorial and writing skills, but also knowledge in the respective areas of research.

Finally, fellows have the opportunity to write a commentary about a topic of their choice. This experience allows fellows to deepen their expertise in an area of research on an emerging topic they would like to highlight to their readers. Since this type of article is peer reviewed, reviewers’ comments help identify weaknesses of the initially submitted manuscript and increase the awareness about factors that need to be addressed to finally provide a high-quality article that is of value to Gastroenterology’s readership.

Concluding, being an editorial fellow for Gastroenterology is an extremely valuable experience. From an editorial aspect, fellows learn to review, summarize, and comment on submitted manuscripts, as well as which factors need to be addressed by manuscripts to be considered for publication to a high-impact journal. Additionally, fellows network with leaders in the field and expand their knowledge on topics they had not worked on previously. Overall, the fellowship helps improve editorial and writing skills, while staying current in the literature, a skill set that can be applied broadly in the future medical and scientific career.

Dr. Kefalakes is a clinical fellow and research group leader in the department of gastroenterology, hepatology, and endocrinology at Hannover (Germany) Medical School. She has nothing to declare.

On the top left of my desktop is an electronic sticky note entitled, “Apply in Future.” This was where the AGA editorial fellowship was listed when I first started GI fellowship. My interest in the behind-the-scenes of scientific publishing developed early. I wanted to learn not only about the decision-making by the editorial board but also other aspects that impact the process from submission to publication. While waiting for my opportunity to apply, I became a reviewer for several journals and then an associate editor of ACG Case Reports Journal, which gave me some insight.

I applied to the editorial fellowship as a second-year fellow, to start as a third-year fellow. I figured this would give me several chances to apply again if I was not selected! I started off by talking to my program director to ensure that I would have enough time, given other responsibilities. The application consisted of a cover letter, where I expressed why I was interested, particularly focusing on my passion for research and my experience with scientific publishing, a letter of recommendation, and a CV. I was ecstatic when I was selected for the AGA editorial fellowship for Clinical Gastroenterology and Hepatology (CGH), whose editorial board’s mission best aligned with my interests.

Dr. Jonathan Buscaglia was the editorial fellows’ mentor for CGH – he met with us and provided an outline of the year. For the first 6 months, I was a reviewer for submitted manuscripts within my topic of interest – pancreaticobiliary diseases and advanced endoscopy and technology. Dr. Buscaglia gave me feedback on my reviews to improve my critical assessment of study designs and interpreted results. After 6 months as a reviewer, I took on the role of an associate editor. I selected reviewers, evaluated the reviews, and made the decision to accept or reject a manuscript. I presented my assigned manuscript at the weekly board of editors meeting, which was one of the biggest learning experiences. Leading researchers from all over the world gathered at a virtual table and discussed whether each study would have clinical impact on the medical community. Each editor contributed a unique perspective that facilitated a robust and thoughtful discussion of each manuscript brought to the table. I was in awe each week.

What I have learned so far during my year as an AGA editorial fellow with CGH has shaped my approach to personal research and will continue to do so as I develop my research career. It has greatly improved my assessment of the literature and I hope to continue to be involved in the critical review process, especially as a reviewer in my early career, and eventually, a part of an editorial board for a journal that truly impacts clinical medicine, such as Clinical Gastroenterology and Hepatology.
 

Dr. Trieu is a gastroenterology and hepatology fellow at Loyola University Medical Center, Maywood, Ill. She has no conflicts of interest to disclose.

On the top left of my desktop is an electronic sticky note entitled, “Apply in Future.” This was where the AGA editorial fellowship was listed when I first started GI fellowship. My interest in the behind-the-scenes of scientific publishing developed early. I wanted to learn not only about the decision-making by the editorial board but also other aspects that impact the process from submission to publication. While waiting for my opportunity to apply, I became a reviewer for several journals and then an associate editor of ACG Case Reports Journal, which gave me some insight.

I applied to the editorial fellowship as a second-year fellow, to start as a third-year fellow. I figured this would give me several chances to apply again if I was not selected! I started off by talking to my program director to ensure that I would have enough time, given other responsibilities. The application consisted of a cover letter, where I expressed why I was interested, particularly focusing on my passion for research and my experience with scientific publishing, a letter of recommendation, and a CV. I was ecstatic when I was selected for the AGA editorial fellowship for Clinical Gastroenterology and Hepatology (CGH), whose editorial board’s mission best aligned with my interests.

Dr. Jonathan Buscaglia was the editorial fellows’ mentor for CGH – he met with us and provided an outline of the year. For the first 6 months, I was a reviewer for submitted manuscripts within my topic of interest – pancreaticobiliary diseases and advanced endoscopy and technology. Dr. Buscaglia gave me feedback on my reviews to improve my critical assessment of study designs and interpreted results. After 6 months as a reviewer, I took on the role of an associate editor. I selected reviewers, evaluated the reviews, and made the decision to accept or reject a manuscript. I presented my assigned manuscript at the weekly board of editors meeting, which was one of the biggest learning experiences. Leading researchers from all over the world gathered at a virtual table and discussed whether each study would have clinical impact on the medical community. Each editor contributed a unique perspective that facilitated a robust and thoughtful discussion of each manuscript brought to the table. I was in awe each week.

What I have learned so far during my year as an AGA editorial fellow with CGH has shaped my approach to personal research and will continue to do so as I develop my research career. It has greatly improved my assessment of the literature and I hope to continue to be involved in the critical review process, especially as a reviewer in my early career, and eventually, a part of an editorial board for a journal that truly impacts clinical medicine, such as Clinical Gastroenterology and Hepatology.
 

Dr. Trieu is a gastroenterology and hepatology fellow at Loyola University Medical Center, Maywood, Ill. She has no conflicts of interest to disclose.

On the top left of my desktop is an electronic sticky note entitled, “Apply in Future.” This was where the AGA editorial fellowship was listed when I first started GI fellowship. My interest in the behind-the-scenes of scientific publishing developed early. I wanted to learn not only about the decision-making by the editorial board but also other aspects that impact the process from submission to publication. While waiting for my opportunity to apply, I became a reviewer for several journals and then an associate editor of ACG Case Reports Journal, which gave me some insight.

I applied to the editorial fellowship as a second-year fellow, to start as a third-year fellow. I figured this would give me several chances to apply again if I was not selected! I started off by talking to my program director to ensure that I would have enough time, given other responsibilities. The application consisted of a cover letter, where I expressed why I was interested, particularly focusing on my passion for research and my experience with scientific publishing, a letter of recommendation, and a CV. I was ecstatic when I was selected for the AGA editorial fellowship for Clinical Gastroenterology and Hepatology (CGH), whose editorial board’s mission best aligned with my interests.

Dr. Jonathan Buscaglia was the editorial fellows’ mentor for CGH – he met with us and provided an outline of the year. For the first 6 months, I was a reviewer for submitted manuscripts within my topic of interest – pancreaticobiliary diseases and advanced endoscopy and technology. Dr. Buscaglia gave me feedback on my reviews to improve my critical assessment of study designs and interpreted results. After 6 months as a reviewer, I took on the role of an associate editor. I selected reviewers, evaluated the reviews, and made the decision to accept or reject a manuscript. I presented my assigned manuscript at the weekly board of editors meeting, which was one of the biggest learning experiences. Leading researchers from all over the world gathered at a virtual table and discussed whether each study would have clinical impact on the medical community. Each editor contributed a unique perspective that facilitated a robust and thoughtful discussion of each manuscript brought to the table. I was in awe each week.

What I have learned so far during my year as an AGA editorial fellow with CGH has shaped my approach to personal research and will continue to do so as I develop my research career. It has greatly improved my assessment of the literature and I hope to continue to be involved in the critical review process, especially as a reviewer in my early career, and eventually, a part of an editorial board for a journal that truly impacts clinical medicine, such as Clinical Gastroenterology and Hepatology.
 

Dr. Trieu is a gastroenterology and hepatology fellow at Loyola University Medical Center, Maywood, Ill. She has no conflicts of interest to disclose.

Introduction

The virtual space has created new opportunities for gastroenterology fellows, but direct conversations about education and career development on the national level have been limited. On Oct. 16, 2021, the American Gastroenterological Association and EndoscopyNow hosted an online Fellows Forum titled “Navigating New Frontiers of Training in Gastroenterology.” Close to 100 fellows attended and had the chance to listen to discussions from a national panel of faculty with expertise in medical education, ask candid questions, and share experiences in breakout rooms specific to their year of training. Reading materials were also provided, which are cited throughout this article. What follows is a rundown of the discussion and points of particular interest for fellows.

What do fellows value?

Dr. Laura Raffals kicked off the event by asking fellows to create word clouds related to their challenges (“Balance” was the most common answer) and joys (“Family”). These answers underscore that, when faced with pressures to be 100% at work and home, it is human connection, particularly family, that sustains us. Fellows, however, worried that spending time with family conflicted with spending time on GI training and that they would be perceived as “that person who always leaves early.”¹

Attendees discussed that “there are only 168 hours in a week,” (time is a zero-sum game), and it is important to be self-aware and honest about one’s personal values and commit the commensurate time and energy to those values. Consider personal development exercises.² Faculty have a crucial role in coaching fellows on time management based on personal values.³
 

Has COVID-19 reduced fellows’ endoscopic skills?

One brave attendee asked: Is this generation of fellows “weaker” because of limited scoping during the pandemic? Faculty discussed that, even prepandemic, it was “not all about quantity; the quality of exposure matters just as much.” From their perspective, prepared, goal-directed, and helpful fellows would maximize learning during endoscopy blocks (see below). Lawrence Schiller, MD, providing the long view, reassured fellows that with a proactive attitude it all evens out in the end.

Fellows reflected that, although social isolation and burnout were rampant, some individuals stepped up to do extra work, supported colleagues with personal or family health issues, and scoped COVID-positive patients if others could not. In future years, the pandemic will be seen as a case study for those in leadership positions. The decisions that health systems, administrators, and providers made will be remembered, as well as how algorithms for “practice as usual” changed.⁴

What fellows can do to maximize endoscopic learning (attendings’ perspective):

• Know the patient before the case. Prior endoscopy reports, patient comorbidities, and medical history including details like anticoagulation use or issues with anesthesia.
• Help the work flow (and reduce the attending’s stress level). Consent patients and complete preprocedure paperwork if possible.
• Come into the scope block with a plan. Example: “I want to get to the cecum. The attending can withdraw, and I will take out polyps we find.”
• Ask about decision-making. Example: “Why did you choose to place a clip over that polypectomy site?” or “Why did you choose that instrument and not the other?”
• Give feedback on problematic behavior. Attendings that treat fellows like burdens and undermine fellow scope time should be reported. Fellows may be concerned about being perceived as a “troublemaker,” but discussing these situations with program directors is a civic duty.

How can we improve diversity?

We cannot wait for, and must instead proactively recruit, diverse trainees, as well as create inclusive environments. Mentorship is key. However, recent work showing imbalances in gender of mentor-mentees and extra pressure on women mentors raises concerns about sustainability.^5,6 The panel suggested that interested fellows could engage students earlier in the pipeline, participate in community awareness and exposure programs, and dedicate education time to health equity.⁷ Fellows raised concerns about barriers for international medical graduates, which would require institutional and federal policy changes would to implement change.

How can fellows develop better practice patterns?

Sri Komanduri, MD, focused on complex endoscopic cases.⁸ Having live video, using polls, and listening to other attendings comment on cases was illuminating and sometimes humbling. The panel discussed that simulation labs could strongly enhance endoscopic skill training, but if unavailable, companies are often willing to sponsor events for teaching purposes.⁹ If training on specific topics is not offered at an institution, regional weekend courses are also an option.

Raman Muthusamy, MD, MS, discussed his philosophy towards endoscopic complications: be prepared and follow your instinct if something feels off. He and Dr. Ikuo Hirano emphasized the importance of following up with patients after a complication. The panel also suggested that fellows can build quality improvement experience by contributing to GI morbidity and mortality conferences or start them if not already offered.
 

Where is the future headed?

Amrita Sethi, MD, outlined the trend towards virtual platforms and getting the global GI community involved in education efforts. She pointed out the need for a gold standard on assessing competency in endoscopy. From a practice perspective, implementation of telemedicine in GI merits further study, as so far this technology has been attractive to providers and patients alike. Todd Baron, MD, stressed that newer technologies, including artificial intelligence, will not replace the endoscopist but may reduce the need for screening procedures and instead increase demand for specific diagnostic and therapeutic procedures. He used the examples of therapeutic applications of endoscopic ultrasound and the development of single-use duodenoscopes.

Concerns about transitioning from training to independent practice

During the third-year breakout session, fellows discussed anxieties about starting practice and living up to expectations: “What if it’s my first week and there’s something I can’t do?” Faculty recommended getting to know colleagues at a new institution, being confident in your training, and staying engaged with your own complications.¹⁰ Fellows described the surprising amount of time and energy they dedicated to the job search and got counseling from Dr. Schiller, who recommended defining what “success” and “satisfaction” look like (again, defining one’s values). He recommended that, for fellows looking at private practice positions, one should ask: How much autonomy do I want? How much business risk am I willing to accept? Fellows need more formal education on practice management and the “business side” of gastroenterology.¹¹

Conclusions

The 2021 AGA EndoscopyNow forum was unique in its discussion of issues impacting GI fellows. The forum revealed that worries about personal well-being, training quality, and future career prospects have affected fellows everywhere: you are not alone. Presentations and lively conversation between seasoned faculty who reflected on career development, education, and medical management demonstrate the importance of seeking advice from colleagues and mentorship. Based on this event, future sessions with conversations between faculty and fellows to assess needs and set priorities for directions in training would be welcome.

Dr. Liu is a gastroenterology fellow, Northwestern University, Chicago. The author has no conflicts of interest to disclose.

References 

1. Katzka DA and Proctor DD. Gastroenterology. 2009;136(4):1147-8.

2. Sull D and Houlder D. Do Your Commitments Match Your Convictions? Harv Bus Rev. 2005 Jan 1. https://hbr.org/2005/01/do-your-commitments-match-your-convictions.

3. Keswani RN et al. Gastroenterology. 2020;159(1):26-9.

4. Sethi A et al. Clin Gastroenterol Hepatol. 2020;18(8):1673-81.

5. Rabinowitz LG et al. Gastrointest Endosc. 2021;93(5):1047-56.e5.

6. Rabinowitz LG et al. Gastrointest Endosc. 2020;91(1):155-61.

7. Lee-Allen J, Shah BJ. Gastroenterology. 2021;160(6):1924-8.

8. Richter JM et al. Am J Gastroenterol. 2016;111(3):348-52.

9. Muthusamy VR and Komanduri S. Clin Gastroenterol Hepatol. 2019 Mar;17(4):580-3.

10. Liu H and Boyatzis RE. Front Psychol. 2021. doi: 10.3389/fpsyg.2021.685829.

11. Amann ST et al. “Words” to practice by: A guide to understand the business vernacular of a healthy practice. https://webfiles.gi.org/links/pm/TheHealthOfMyPracticeToolboxPMCommitteeToolbox.pdf.
 

Introduction

The virtual space has created new opportunities for gastroenterology fellows, but direct conversations about education and career development on the national level have been limited. On Oct. 16, 2021, the American Gastroenterological Association and EndoscopyNow hosted an online Fellows Forum titled “Navigating New Frontiers of Training in Gastroenterology.” Close to 100 fellows attended and had the chance to listen to discussions from a national panel of faculty with expertise in medical education, ask candid questions, and share experiences in breakout rooms specific to their year of training. Reading materials were also provided, which are cited throughout this article. What follows is a rundown of the discussion and points of particular interest for fellows.

What do fellows value?

Dr. Laura Raffals kicked off the event by asking fellows to create word clouds related to their challenges (“Balance” was the most common answer) and joys (“Family”). These answers underscore that, when faced with pressures to be 100% at work and home, it is human connection, particularly family, that sustains us. Fellows, however, worried that spending time with family conflicted with spending time on GI training and that they would be perceived as “that person who always leaves early.”¹

Attendees discussed that “there are only 168 hours in a week,” (time is a zero-sum game), and it is important to be self-aware and honest about one’s personal values and commit the commensurate time and energy to those values. Consider personal development exercises.² Faculty have a crucial role in coaching fellows on time management based on personal values.³
 

Has COVID-19 reduced fellows’ endoscopic skills?

One brave attendee asked: Is this generation of fellows “weaker” because of limited scoping during the pandemic? Faculty discussed that, even prepandemic, it was “not all about quantity; the quality of exposure matters just as much.” From their perspective, prepared, goal-directed, and helpful fellows would maximize learning during endoscopy blocks (see below). Lawrence Schiller, MD, providing the long view, reassured fellows that with a proactive attitude it all evens out in the end.

Fellows reflected that, although social isolation and burnout were rampant, some individuals stepped up to do extra work, supported colleagues with personal or family health issues, and scoped COVID-positive patients if others could not. In future years, the pandemic will be seen as a case study for those in leadership positions. The decisions that health systems, administrators, and providers made will be remembered, as well as how algorithms for “practice as usual” changed.⁴

What fellows can do to maximize endoscopic learning (attendings’ perspective):

• Know the patient before the case. Prior endoscopy reports, patient comorbidities, and medical history including details like anticoagulation use or issues with anesthesia.
• Help the work flow (and reduce the attending’s stress level). Consent patients and complete preprocedure paperwork if possible.
• Come into the scope block with a plan. Example: “I want to get to the cecum. The attending can withdraw, and I will take out polyps we find.”
• Ask about decision-making. Example: “Why did you choose to place a clip over that polypectomy site?” or “Why did you choose that instrument and not the other?”
• Give feedback on problematic behavior. Attendings that treat fellows like burdens and undermine fellow scope time should be reported. Fellows may be concerned about being perceived as a “troublemaker,” but discussing these situations with program directors is a civic duty.

How can we improve diversity?

We cannot wait for, and must instead proactively recruit, diverse trainees, as well as create inclusive environments. Mentorship is key. However, recent work showing imbalances in gender of mentor-mentees and extra pressure on women mentors raises concerns about sustainability.^5,6 The panel suggested that interested fellows could engage students earlier in the pipeline, participate in community awareness and exposure programs, and dedicate education time to health equity.⁷ Fellows raised concerns about barriers for international medical graduates, which would require institutional and federal policy changes would to implement change.

How can fellows develop better practice patterns?

Sri Komanduri, MD, focused on complex endoscopic cases.⁸ Having live video, using polls, and listening to other attendings comment on cases was illuminating and sometimes humbling. The panel discussed that simulation labs could strongly enhance endoscopic skill training, but if unavailable, companies are often willing to sponsor events for teaching purposes.⁹ If training on specific topics is not offered at an institution, regional weekend courses are also an option.

Raman Muthusamy, MD, MS, discussed his philosophy towards endoscopic complications: be prepared and follow your instinct if something feels off. He and Dr. Ikuo Hirano emphasized the importance of following up with patients after a complication. The panel also suggested that fellows can build quality improvement experience by contributing to GI morbidity and mortality conferences or start them if not already offered.
 

Where is the future headed?

Amrita Sethi, MD, outlined the trend towards virtual platforms and getting the global GI community involved in education efforts. She pointed out the need for a gold standard on assessing competency in endoscopy. From a practice perspective, implementation of telemedicine in GI merits further study, as so far this technology has been attractive to providers and patients alike. Todd Baron, MD, stressed that newer technologies, including artificial intelligence, will not replace the endoscopist but may reduce the need for screening procedures and instead increase demand for specific diagnostic and therapeutic procedures. He used the examples of therapeutic applications of endoscopic ultrasound and the development of single-use duodenoscopes.

Concerns about transitioning from training to independent practice

During the third-year breakout session, fellows discussed anxieties about starting practice and living up to expectations: “What if it’s my first week and there’s something I can’t do?” Faculty recommended getting to know colleagues at a new institution, being confident in your training, and staying engaged with your own complications.¹⁰ Fellows described the surprising amount of time and energy they dedicated to the job search and got counseling from Dr. Schiller, who recommended defining what “success” and “satisfaction” look like (again, defining one’s values). He recommended that, for fellows looking at private practice positions, one should ask: How much autonomy do I want? How much business risk am I willing to accept? Fellows need more formal education on practice management and the “business side” of gastroenterology.¹¹

Conclusions

The 2021 AGA EndoscopyNow forum was unique in its discussion of issues impacting GI fellows. The forum revealed that worries about personal well-being, training quality, and future career prospects have affected fellows everywhere: you are not alone. Presentations and lively conversation between seasoned faculty who reflected on career development, education, and medical management demonstrate the importance of seeking advice from colleagues and mentorship. Based on this event, future sessions with conversations between faculty and fellows to assess needs and set priorities for directions in training would be welcome.

Dr. Liu is a gastroenterology fellow, Northwestern University, Chicago. The author has no conflicts of interest to disclose.

References 

1. Katzka DA and Proctor DD. Gastroenterology. 2009;136(4):1147-8.

2. Sull D and Houlder D. Do Your Commitments Match Your Convictions? Harv Bus Rev. 2005 Jan 1. https://hbr.org/2005/01/do-your-commitments-match-your-convictions.

3. Keswani RN et al. Gastroenterology. 2020;159(1):26-9.

4. Sethi A et al. Clin Gastroenterol Hepatol. 2020;18(8):1673-81.

5. Rabinowitz LG et al. Gastrointest Endosc. 2021;93(5):1047-56.e5.

6. Rabinowitz LG et al. Gastrointest Endosc. 2020;91(1):155-61.

7. Lee-Allen J, Shah BJ. Gastroenterology. 2021;160(6):1924-8.

8. Richter JM et al. Am J Gastroenterol. 2016;111(3):348-52.

9. Muthusamy VR and Komanduri S. Clin Gastroenterol Hepatol. 2019 Mar;17(4):580-3.

10. Liu H and Boyatzis RE. Front Psychol. 2021. doi: 10.3389/fpsyg.2021.685829.

11. Amann ST et al. “Words” to practice by: A guide to understand the business vernacular of a healthy practice. https://webfiles.gi.org/links/pm/TheHealthOfMyPracticeToolboxPMCommitteeToolbox.pdf.
 

Introduction

The virtual space has created new opportunities for gastroenterology fellows, but direct conversations about education and career development on the national level have been limited. On Oct. 16, 2021, the American Gastroenterological Association and EndoscopyNow hosted an online Fellows Forum titled “Navigating New Frontiers of Training in Gastroenterology.” Close to 100 fellows attended and had the chance to listen to discussions from a national panel of faculty with expertise in medical education, ask candid questions, and share experiences in breakout rooms specific to their year of training. Reading materials were also provided, which are cited throughout this article. What follows is a rundown of the discussion and points of particular interest for fellows.

What do fellows value?

Dr. Laura Raffals kicked off the event by asking fellows to create word clouds related to their challenges (“Balance” was the most common answer) and joys (“Family”). These answers underscore that, when faced with pressures to be 100% at work and home, it is human connection, particularly family, that sustains us. Fellows, however, worried that spending time with family conflicted with spending time on GI training and that they would be perceived as “that person who always leaves early.”¹

Attendees discussed that “there are only 168 hours in a week,” (time is a zero-sum game), and it is important to be self-aware and honest about one’s personal values and commit the commensurate time and energy to those values. Consider personal development exercises.² Faculty have a crucial role in coaching fellows on time management based on personal values.³
 

Has COVID-19 reduced fellows’ endoscopic skills?

One brave attendee asked: Is this generation of fellows “weaker” because of limited scoping during the pandemic? Faculty discussed that, even prepandemic, it was “not all about quantity; the quality of exposure matters just as much.” From their perspective, prepared, goal-directed, and helpful fellows would maximize learning during endoscopy blocks (see below). Lawrence Schiller, MD, providing the long view, reassured fellows that with a proactive attitude it all evens out in the end.

Fellows reflected that, although social isolation and burnout were rampant, some individuals stepped up to do extra work, supported colleagues with personal or family health issues, and scoped COVID-positive patients if others could not. In future years, the pandemic will be seen as a case study for those in leadership positions. The decisions that health systems, administrators, and providers made will be remembered, as well as how algorithms for “practice as usual” changed.⁴

What fellows can do to maximize endoscopic learning (attendings’ perspective):

• Know the patient before the case. Prior endoscopy reports, patient comorbidities, and medical history including details like anticoagulation use or issues with anesthesia.
• Help the work flow (and reduce the attending’s stress level). Consent patients and complete preprocedure paperwork if possible.
• Come into the scope block with a plan. Example: “I want to get to the cecum. The attending can withdraw, and I will take out polyps we find.”
• Ask about decision-making. Example: “Why did you choose to place a clip over that polypectomy site?” or “Why did you choose that instrument and not the other?”
• Give feedback on problematic behavior. Attendings that treat fellows like burdens and undermine fellow scope time should be reported. Fellows may be concerned about being perceived as a “troublemaker,” but discussing these situations with program directors is a civic duty.

How can we improve diversity?

We cannot wait for, and must instead proactively recruit, diverse trainees, as well as create inclusive environments. Mentorship is key. However, recent work showing imbalances in gender of mentor-mentees and extra pressure on women mentors raises concerns about sustainability.^5,6 The panel suggested that interested fellows could engage students earlier in the pipeline, participate in community awareness and exposure programs, and dedicate education time to health equity.⁷ Fellows raised concerns about barriers for international medical graduates, which would require institutional and federal policy changes would to implement change.

How can fellows develop better practice patterns?

Sri Komanduri, MD, focused on complex endoscopic cases.⁸ Having live video, using polls, and listening to other attendings comment on cases was illuminating and sometimes humbling. The panel discussed that simulation labs could strongly enhance endoscopic skill training, but if unavailable, companies are often willing to sponsor events for teaching purposes.⁹ If training on specific topics is not offered at an institution, regional weekend courses are also an option.

Raman Muthusamy, MD, MS, discussed his philosophy towards endoscopic complications: be prepared and follow your instinct if something feels off. He and Dr. Ikuo Hirano emphasized the importance of following up with patients after a complication. The panel also suggested that fellows can build quality improvement experience by contributing to GI morbidity and mortality conferences or start them if not already offered.
 

Where is the future headed?

Amrita Sethi, MD, outlined the trend towards virtual platforms and getting the global GI community involved in education efforts. She pointed out the need for a gold standard on assessing competency in endoscopy. From a practice perspective, implementation of telemedicine in GI merits further study, as so far this technology has been attractive to providers and patients alike. Todd Baron, MD, stressed that newer technologies, including artificial intelligence, will not replace the endoscopist but may reduce the need for screening procedures and instead increase demand for specific diagnostic and therapeutic procedures. He used the examples of therapeutic applications of endoscopic ultrasound and the development of single-use duodenoscopes.

Concerns about transitioning from training to independent practice

During the third-year breakout session, fellows discussed anxieties about starting practice and living up to expectations: “What if it’s my first week and there’s something I can’t do?” Faculty recommended getting to know colleagues at a new institution, being confident in your training, and staying engaged with your own complications.¹⁰ Fellows described the surprising amount of time and energy they dedicated to the job search and got counseling from Dr. Schiller, who recommended defining what “success” and “satisfaction” look like (again, defining one’s values). He recommended that, for fellows looking at private practice positions, one should ask: How much autonomy do I want? How much business risk am I willing to accept? Fellows need more formal education on practice management and the “business side” of gastroenterology.¹¹

Conclusions

The 2021 AGA EndoscopyNow forum was unique in its discussion of issues impacting GI fellows. The forum revealed that worries about personal well-being, training quality, and future career prospects have affected fellows everywhere: you are not alone. Presentations and lively conversation between seasoned faculty who reflected on career development, education, and medical management demonstrate the importance of seeking advice from colleagues and mentorship. Based on this event, future sessions with conversations between faculty and fellows to assess needs and set priorities for directions in training would be welcome.

Dr. Liu is a gastroenterology fellow, Northwestern University, Chicago. The author has no conflicts of interest to disclose.

References 

1. Katzka DA and Proctor DD. Gastroenterology. 2009;136(4):1147-8.

2. Sull D and Houlder D. Do Your Commitments Match Your Convictions? Harv Bus Rev. 2005 Jan 1. https://hbr.org/2005/01/do-your-commitments-match-your-convictions.

3. Keswani RN et al. Gastroenterology. 2020;159(1):26-9.

4. Sethi A et al. Clin Gastroenterol Hepatol. 2020;18(8):1673-81.

5. Rabinowitz LG et al. Gastrointest Endosc. 2021;93(5):1047-56.e5.

6. Rabinowitz LG et al. Gastrointest Endosc. 2020;91(1):155-61.

7. Lee-Allen J, Shah BJ. Gastroenterology. 2021;160(6):1924-8.

8. Richter JM et al. Am J Gastroenterol. 2016;111(3):348-52.

9. Muthusamy VR and Komanduri S. Clin Gastroenterol Hepatol. 2019 Mar;17(4):580-3.

10. Liu H and Boyatzis RE. Front Psychol. 2021. doi: 10.3389/fpsyg.2021.685829.

11. Amann ST et al. “Words” to practice by: A guide to understand the business vernacular of a healthy practice. https://webfiles.gi.org/links/pm/TheHealthOfMyPracticeToolboxPMCommitteeToolbox.pdf.
 

Matthew Whitson, MD, MSEd (lead host)

Walk us through your current GI role and your path to getting there:

I am currently the GI fellowship director at Hofstra-Northwell, by way of Mount Sinai in New York City for medical school and residency and the University of Pennsylvania, Philadelphia, for GI fellowship. I’m about 60:40 clinical and scholarship. My clinical focus is in esophageal and swallowing disorders, which came about because of mentorship and clinical exposure while at UPenn. During my fellowship, I also got a master’s in medical education again because of the tremendous sponsorship from the faculty and leadership. I have educational roles in the medical school, the internal medicine residency, and, of course, the GI fellowship.

What is your favorite part about your current role? Least favorite part?

Favorite part: working with students and trainees. When you see a medical concept click for them and then see them apply that concept, or that skill, into practice it is incredibly rewarding. Least favorite part: the amount of written documentation needed to run a fellowship.

What are your interests outside of work?

I love going to see live music in New York and touring the museums of New York, preferably the MOMA, or getting to Storm King (an expansive sculpture garden) outside of the city when we can. Anytime we can get outside to go hiking or play golf is a good day.

What advice would you give to…

• Someone who matches into GI on Dec. 2: Celebrate; you’ve earned it! Those projects you started during residency – finish them now. Otherwise, it’s super hard to get them done during fellowship, especially if you are training at a different institution for GI fellowship.
• Someone who just graduated from GI fellowship: Negotiate that contract, and then negotiate it again. Have a budget, and don’t spend that “attending money” on anything major for at least 6 months.

How do you see the future of GI changing as a new generation of trainees enters the workforce?

The way we access information is changing. Everything is at the tip of your fingers at any time, so much so, it can be overwhelming. I think that learning how to critically appraise and access clinically appropriate data is a skill that everyone will need going forward. I think it will take an even more central role in our medical education. Beyond this, the importance of shared decision-making with your patients will continue to increase in the world of personalized medicine, as will the assortment of noninvasive testing options.

Why did you want to host this podcast?

Reading about mentorship, sponsorship, career development, etc. is important, but it doesn’t do these topics justice. It is such a nuanced thing and talking about it, exploring it, teasing it out is just so fun. I find these topics to be fascinating, and I wanted to talk with experts and hear how they approached difficult situations. Plus, I was a radio DJ when younger and have always dreamed of doing something in the audio medium as a professional.


What’s your favorite episode so far?

I won’t say favorite, but I think the Laurie Keefer episode is up there. It was such a nice conversation about a challenging concept: Building resilience in our trainees and ourselves. I learned a lot from her and have begun integrating some of these skills into my work as a program director.


What’s the best piece of advice you’ve gotten that’s helped you in your career so far?

I’m going to adopt this from a mentor of mine, but it’s the “me or my family rule.” What would you want done if the patient in front of you were your family member? If you keep that as your “True North,” then I think you are off to a good start as a clinician.

Nina Nandy, MD, MS (co-host)

Walk us through your current GI role and your path to getting there:

I think the biggest decision to make in medical school is medicine or surgery, and most things will fall under one of those categories. I liked the problem solving of medicine and the hands-on work of surgery, so I was leaning toward a procedural field then met some wonderful mentors in GI when I was in medical school. I think every field of medicine has a particular personality, and when I met gastroenterologists, it clicked with me, and I thought “I’ve found my people.” So, I went to residency in internal medicine with the goal of GI or bust. I am currently a practicing gastroenterologist, and I do general GI, liver disease, and motility.



What is your favorite part about your current role? Least favorite part?

I really love GI. I feel like I’ve found my calling, and its really exciting to be able to say that. What drew me to GI was the use of technology and minimally invasive endoscopy to see a person inside out and understand their pathology, the mix of chronic and acute conditions, and the educational aspect of talking to folks in clinic. I like putting people at ease, and GI is a great field for jokes. My least favorite part is doing peer-to-peers with insurance companies to get inflammatory bowel disease drugs approved.



What are your interests outside of work?

Outside of work, this podcast, and being division vice chief, I like to learn languages. I speak five and am working on a sixth. I’m writing a secret screenplay. I play piano and guitar, which reminds me of a quote: “All my life I wanted to play guitar badly. And now I play guitar. Badly.” I also love art; I use oil paint, acrylics, pen and ink, mixed media. I love to dance and am just getting into Peloton. But perhaps my most important role is maintaining the Instagram account for my two famous cats who will hopefully enable me to retire early. Are you out there, Purina?



What advice would you give to…

• Someone who matches into GI on Dec. 2: First of all, celebrate! Treat yo’self; you did it! Welcome to the most exciting field of medicine. But seriously, congratulate yourself for your hard work and don’t worry about being terrible at scoping because there’s a learning curve. Don’t worry about what you need to study because you are going to do it. Come in with an inquisitive, open mind. Don’t turn down consults because they seem ridiculous. You can always learn something! I think the best thing to do in fellowship is to do everything. Learn that motility and capsule, cannulate that common bile duct, place that esophageal stent! You won’t have this kind of support in the future, and you should get comfortable with everything possible while you can.
• Someone who just graduated from GI fellowship: As with those matching into GI, celebrate! Treat yo’self; you did it! I think this is the hardest transition; you don’t have that safety net anymore. You are the be-all, end-all last stop on the train. Just kidding. It seems that way, but you can always collaborate with colleagues and look things up on UpToDate. You know more than you think, and it is a continuous learning process, so it’s okay to have questions; it means you care. Yes, there will be more responsibility, and you need to keep up on path and your inbox because it will pile up. You need to think about appropriate follow-up and resources to offer your patients. You can keep up on current guidelines through your GI societies; do continuing medical education and postgraduate courses as well.

How do you see the future of GI changing as a new generation of trainees enters the workforce?

I think the future of GI is innovation, technology, social media, multidisciplinary learning. GI is a technology-centered field, and there will be new developments in medical devices and basic science research, such as the microbiome, which holds the key for numerous pathogenic processes. Physicians will need to be physician-scientists, physician-innovators, physician-business people, and physician-leaders. We must learn things beyond our own field to be successful in this changing world.



Why did you want to host this podcast?

I wanted to host this podcast because I think there is so much in fellowship we learn about GI but also so much we don’t learn about GI careers and the “real world” of practice. I wanted to create content focused on career development for early GIs and trainees and discuss “everything you wanted to know in fellowship but were afraid to ask.” I wanted to interview real successful people in the field, whether it be focusing on a career in medical education, basic science research, transplant hepatology, therapeutic endoscopy, or private practice. There are a lot of podcasts that do a great job focusing on guidelines, case reports, and research, but we wanted to take this one in a different direction. It is a great way to reach a broad audience across many platforms.



What’s your favorite episode so far?

I really like the Janice Jou episode. Not just because I’m on it, but also because she is a great, a dynamic, speaker, and our conversation was so effortless, and because she is a phenomenal program director and educator and has such valuable advice for trainees and early career gastroenterologists, drawing from her own experiences. Her tips – or rather “Janice jewels,” as I am trying to trademark on negotiation – are excellent. Check it out!



What’s the best piece of advice you’ve gotten that’s helped you in your career so far?

Don’t buy a house right out of training. Also, “live your life, not someone else’s.”

C.S. Tse, MD (co-host)

Walk us through your current GI role and your path to getting there:

I grew up in Toronto and moved to the United States for medical school at the Yale University, New Haven, Conn., and internal medicine residency at the Mayo Clinic in Rochester, Minnesota. During my residency, I became interested in gastroenterology with a particular interest in inflammatory bowel disease after studying the postoperative outcomes of IBD patients on biologics and examining the clinical course of IBD patients with coexistent celiac disease. I am a third-year gastroenterology fellow at Brown University. I will spend a year as the advanced IBD fellow at the University of California–San Diego from July 2021 to June 2022. My current research examines IBD patients’ quality of care and the psychosocial impacts on patients’ disease course. I am working with the Crohn’s and Colitis Foundation’s IBD Qorus Learning Health System to improve the quality of care and outcomes of patients with IBD. 



What is your favorite part about your current role? Least favorite part?

My favorite part of my current role is to combine patient care with clinical research, particularly for patients with IBD. My least favorite part is encountering “red tape” that may give a false sense of productivity but not actually be beneficial for patient care. Some of this is discussed in this article from the Harvard Business Review.



What are your interests outside of work?

I serve as the National President of the American Medical Women’s Association (AMWA) Residents & Fellows Division. I am a Core Faculty member of the AMWA IGNITE MD program, which is a nation-wide initiative to educate and empower female medical trainees. I currently serve as an abstract reviewer for Digestive Diseases Week® (since 2018). I previously served as an abstract reviewer and judge for the American Medical Association’s Scientific Symposium (2019 & 2020). Outside of work, I enjoy hiking, traveling, and reading.

 

What advice would you give to someone who matches into GI on Dec. 2:

Identify mentors early. (You can have more than one!) Try to imagine where you want your career to be in 5 years – generalist vs. specialist. Will you have a niche in practice? Is advanced endoscopy (ERCP, EUS, etc.) going to be a part of your practice? Academic, private practice, community practice, or hybrid? Knowing your goals will help tailor the GI fellowship experience to get you to where you want to be in your career. GI fellowship may be like a buffet table where there are many opportunities and options, but one can rarely do it all! Choosing and pursuing experiences that ultimately align with your goals can help you make the most out of your time during GI fellowship training. 



How do you see the future of GI changing as a new generation of trainees enters the workforce?

I think that there will be more integration of information technology and artificial intelligence into GI, just as for the rest of society. For example, we can see this clearly illustrated in the rapid uptake of telemedicine (including GI) during COVID-19. 



Why did you want to host this podcast?

I am intrigued by the opportunity to connect with GIs broadly through this AGA podcast. It is a portable way to use on-demand technology to engage in conversations relevant to other early GIs who may not be conventionally addressed by other means, such as journal articles, conferences, traditional didactics, and books. 



What’s your favorite episode so far?

Janice Jou’s podcast was phenomenal in providing mentorship advice (at a distance) to trainees who are interested in an academic career in clinical medicine.



What’s the best piece of advice you’ve gotten that’s helped you in your career so far?

“We are what we repeatedly do. Excellence, therefore, is not an act, but a habit.” This advice is most commonly credited to Aristotle.


Be sure to subscribe wherever you listen to podcasts or listen on the AGA website: https://gastro.org/podcast.
 

Dr. Whitson is GI fellowship director, Zucker School of Medicine at Hofstra-Northwell, Great Neck, N.Y. @MJWhitsonMD. Dr. Nandy is a gastroenterologist at Presbyterian Medical Group, Albuquerque, N.M. @NinaNandyMD. Dr. Tse is a GI fellow at Brown University, Providence, R.I. @CSTseMD.

Matthew Whitson, MD, MSEd (lead host)

Walk us through your current GI role and your path to getting there:

I am currently the GI fellowship director at Hofstra-Northwell, by way of Mount Sinai in New York City for medical school and residency and the University of Pennsylvania, Philadelphia, for GI fellowship. I’m about 60:40 clinical and scholarship. My clinical focus is in esophageal and swallowing disorders, which came about because of mentorship and clinical exposure while at UPenn. During my fellowship, I also got a master’s in medical education again because of the tremendous sponsorship from the faculty and leadership. I have educational roles in the medical school, the internal medicine residency, and, of course, the GI fellowship.

What is your favorite part about your current role? Least favorite part?

Favorite part: working with students and trainees. When you see a medical concept click for them and then see them apply that concept, or that skill, into practice it is incredibly rewarding. Least favorite part: the amount of written documentation needed to run a fellowship.

What are your interests outside of work?

I love going to see live music in New York and touring the museums of New York, preferably the MOMA, or getting to Storm King (an expansive sculpture garden) outside of the city when we can. Anytime we can get outside to go hiking or play golf is a good day.

What advice would you give to…

• Someone who matches into GI on Dec. 2: Celebrate; you’ve earned it! Those projects you started during residency – finish them now. Otherwise, it’s super hard to get them done during fellowship, especially if you are training at a different institution for GI fellowship.
• Someone who just graduated from GI fellowship: Negotiate that contract, and then negotiate it again. Have a budget, and don’t spend that “attending money” on anything major for at least 6 months.

How do you see the future of GI changing as a new generation of trainees enters the workforce?

The way we access information is changing. Everything is at the tip of your fingers at any time, so much so, it can be overwhelming. I think that learning how to critically appraise and access clinically appropriate data is a skill that everyone will need going forward. I think it will take an even more central role in our medical education. Beyond this, the importance of shared decision-making with your patients will continue to increase in the world of personalized medicine, as will the assortment of noninvasive testing options.

Why did you want to host this podcast?

Reading about mentorship, sponsorship, career development, etc. is important, but it doesn’t do these topics justice. It is such a nuanced thing and talking about it, exploring it, teasing it out is just so fun. I find these topics to be fascinating, and I wanted to talk with experts and hear how they approached difficult situations. Plus, I was a radio DJ when younger and have always dreamed of doing something in the audio medium as a professional.


What’s your favorite episode so far?

I won’t say favorite, but I think the Laurie Keefer episode is up there. It was such a nice conversation about a challenging concept: Building resilience in our trainees and ourselves. I learned a lot from her and have begun integrating some of these skills into my work as a program director.


What’s the best piece of advice you’ve gotten that’s helped you in your career so far?

I’m going to adopt this from a mentor of mine, but it’s the “me or my family rule.” What would you want done if the patient in front of you were your family member? If you keep that as your “True North,” then I think you are off to a good start as a clinician.

Nina Nandy, MD, MS (co-host)

Walk us through your current GI role and your path to getting there:

I think the biggest decision to make in medical school is medicine or surgery, and most things will fall under one of those categories. I liked the problem solving of medicine and the hands-on work of surgery, so I was leaning toward a procedural field then met some wonderful mentors in GI when I was in medical school. I think every field of medicine has a particular personality, and when I met gastroenterologists, it clicked with me, and I thought “I’ve found my people.” So, I went to residency in internal medicine with the goal of GI or bust. I am currently a practicing gastroenterologist, and I do general GI, liver disease, and motility.



What is your favorite part about your current role? Least favorite part?

I really love GI. I feel like I’ve found my calling, and its really exciting to be able to say that. What drew me to GI was the use of technology and minimally invasive endoscopy to see a person inside out and understand their pathology, the mix of chronic and acute conditions, and the educational aspect of talking to folks in clinic. I like putting people at ease, and GI is a great field for jokes. My least favorite part is doing peer-to-peers with insurance companies to get inflammatory bowel disease drugs approved.



What are your interests outside of work?

Outside of work, this podcast, and being division vice chief, I like to learn languages. I speak five and am working on a sixth. I’m writing a secret screenplay. I play piano and guitar, which reminds me of a quote: “All my life I wanted to play guitar badly. And now I play guitar. Badly.” I also love art; I use oil paint, acrylics, pen and ink, mixed media. I love to dance and am just getting into Peloton. But perhaps my most important role is maintaining the Instagram account for my two famous cats who will hopefully enable me to retire early. Are you out there, Purina?



What advice would you give to…

• Someone who matches into GI on Dec. 2: First of all, celebrate! Treat yo’self; you did it! Welcome to the most exciting field of medicine. But seriously, congratulate yourself for your hard work and don’t worry about being terrible at scoping because there’s a learning curve. Don’t worry about what you need to study because you are going to do it. Come in with an inquisitive, open mind. Don’t turn down consults because they seem ridiculous. You can always learn something! I think the best thing to do in fellowship is to do everything. Learn that motility and capsule, cannulate that common bile duct, place that esophageal stent! You won’t have this kind of support in the future, and you should get comfortable with everything possible while you can.
• Someone who just graduated from GI fellowship: As with those matching into GI, celebrate! Treat yo’self; you did it! I think this is the hardest transition; you don’t have that safety net anymore. You are the be-all, end-all last stop on the train. Just kidding. It seems that way, but you can always collaborate with colleagues and look things up on UpToDate. You know more than you think, and it is a continuous learning process, so it’s okay to have questions; it means you care. Yes, there will be more responsibility, and you need to keep up on path and your inbox because it will pile up. You need to think about appropriate follow-up and resources to offer your patients. You can keep up on current guidelines through your GI societies; do continuing medical education and postgraduate courses as well.

How do you see the future of GI changing as a new generation of trainees enters the workforce?

I think the future of GI is innovation, technology, social media, multidisciplinary learning. GI is a technology-centered field, and there will be new developments in medical devices and basic science research, such as the microbiome, which holds the key for numerous pathogenic processes. Physicians will need to be physician-scientists, physician-innovators, physician-business people, and physician-leaders. We must learn things beyond our own field to be successful in this changing world.



Why did you want to host this podcast?

I wanted to host this podcast because I think there is so much in fellowship we learn about GI but also so much we don’t learn about GI careers and the “real world” of practice. I wanted to create content focused on career development for early GIs and trainees and discuss “everything you wanted to know in fellowship but were afraid to ask.” I wanted to interview real successful people in the field, whether it be focusing on a career in medical education, basic science research, transplant hepatology, therapeutic endoscopy, or private practice. There are a lot of podcasts that do a great job focusing on guidelines, case reports, and research, but we wanted to take this one in a different direction. It is a great way to reach a broad audience across many platforms.



What’s your favorite episode so far?

I really like the Janice Jou episode. Not just because I’m on it, but also because she is a great, a dynamic, speaker, and our conversation was so effortless, and because she is a phenomenal program director and educator and has such valuable advice for trainees and early career gastroenterologists, drawing from her own experiences. Her tips – or rather “Janice jewels,” as I am trying to trademark on negotiation – are excellent. Check it out!



What’s the best piece of advice you’ve gotten that’s helped you in your career so far?

Don’t buy a house right out of training. Also, “live your life, not someone else’s.”

C.S. Tse, MD (co-host)

Walk us through your current GI role and your path to getting there:

I grew up in Toronto and moved to the United States for medical school at the Yale University, New Haven, Conn., and internal medicine residency at the Mayo Clinic in Rochester, Minnesota. During my residency, I became interested in gastroenterology with a particular interest in inflammatory bowel disease after studying the postoperative outcomes of IBD patients on biologics and examining the clinical course of IBD patients with coexistent celiac disease. I am a third-year gastroenterology fellow at Brown University. I will spend a year as the advanced IBD fellow at the University of California–San Diego from July 2021 to June 2022. My current research examines IBD patients’ quality of care and the psychosocial impacts on patients’ disease course. I am working with the Crohn’s and Colitis Foundation’s IBD Qorus Learning Health System to improve the quality of care and outcomes of patients with IBD. 



What is your favorite part about your current role? Least favorite part?

My favorite part of my current role is to combine patient care with clinical research, particularly for patients with IBD. My least favorite part is encountering “red tape” that may give a false sense of productivity but not actually be beneficial for patient care. Some of this is discussed in this article from the Harvard Business Review.



What are your interests outside of work?

I serve as the National President of the American Medical Women’s Association (AMWA) Residents & Fellows Division. I am a Core Faculty member of the AMWA IGNITE MD program, which is a nation-wide initiative to educate and empower female medical trainees. I currently serve as an abstract reviewer for Digestive Diseases Week® (since 2018). I previously served as an abstract reviewer and judge for the American Medical Association’s Scientific Symposium (2019 & 2020). Outside of work, I enjoy hiking, traveling, and reading.

 

What advice would you give to someone who matches into GI on Dec. 2:

Identify mentors early. (You can have more than one!) Try to imagine where you want your career to be in 5 years – generalist vs. specialist. Will you have a niche in practice? Is advanced endoscopy (ERCP, EUS, etc.) going to be a part of your practice? Academic, private practice, community practice, or hybrid? Knowing your goals will help tailor the GI fellowship experience to get you to where you want to be in your career. GI fellowship may be like a buffet table where there are many opportunities and options, but one can rarely do it all! Choosing and pursuing experiences that ultimately align with your goals can help you make the most out of your time during GI fellowship training. 



How do you see the future of GI changing as a new generation of trainees enters the workforce?

I think that there will be more integration of information technology and artificial intelligence into GI, just as for the rest of society. For example, we can see this clearly illustrated in the rapid uptake of telemedicine (including GI) during COVID-19. 



Why did you want to host this podcast?

I am intrigued by the opportunity to connect with GIs broadly through this AGA podcast. It is a portable way to use on-demand technology to engage in conversations relevant to other early GIs who may not be conventionally addressed by other means, such as journal articles, conferences, traditional didactics, and books. 



What’s your favorite episode so far?

Janice Jou’s podcast was phenomenal in providing mentorship advice (at a distance) to trainees who are interested in an academic career in clinical medicine.



What’s the best piece of advice you’ve gotten that’s helped you in your career so far?

“We are what we repeatedly do. Excellence, therefore, is not an act, but a habit.” This advice is most commonly credited to Aristotle.


Be sure to subscribe wherever you listen to podcasts or listen on the AGA website: https://gastro.org/podcast.
 

Dr. Whitson is GI fellowship director, Zucker School of Medicine at Hofstra-Northwell, Great Neck, N.Y. @MJWhitsonMD. Dr. Nandy is a gastroenterologist at Presbyterian Medical Group, Albuquerque, N.M. @NinaNandyMD. Dr. Tse is a GI fellow at Brown University, Providence, R.I. @CSTseMD.

Matthew Whitson, MD, MSEd (lead host)

Walk us through your current GI role and your path to getting there:

I am currently the GI fellowship director at Hofstra-Northwell, by way of Mount Sinai in New York City for medical school and residency and the University of Pennsylvania, Philadelphia, for GI fellowship. I’m about 60:40 clinical and scholarship. My clinical focus is in esophageal and swallowing disorders, which came about because of mentorship and clinical exposure while at UPenn. During my fellowship, I also got a master’s in medical education again because of the tremendous sponsorship from the faculty and leadership. I have educational roles in the medical school, the internal medicine residency, and, of course, the GI fellowship.

What is your favorite part about your current role? Least favorite part?

Favorite part: working with students and trainees. When you see a medical concept click for them and then see them apply that concept, or that skill, into practice it is incredibly rewarding. Least favorite part: the amount of written documentation needed to run a fellowship.

What are your interests outside of work?

I love going to see live music in New York and touring the museums of New York, preferably the MOMA, or getting to Storm King (an expansive sculpture garden) outside of the city when we can. Anytime we can get outside to go hiking or play golf is a good day.

What advice would you give to…

• Someone who matches into GI on Dec. 2: Celebrate; you’ve earned it! Those projects you started during residency – finish them now. Otherwise, it’s super hard to get them done during fellowship, especially if you are training at a different institution for GI fellowship.
• Someone who just graduated from GI fellowship: Negotiate that contract, and then negotiate it again. Have a budget, and don’t spend that “attending money” on anything major for at least 6 months.

How do you see the future of GI changing as a new generation of trainees enters the workforce?

The way we access information is changing. Everything is at the tip of your fingers at any time, so much so, it can be overwhelming. I think that learning how to critically appraise and access clinically appropriate data is a skill that everyone will need going forward. I think it will take an even more central role in our medical education. Beyond this, the importance of shared decision-making with your patients will continue to increase in the world of personalized medicine, as will the assortment of noninvasive testing options.

Why did you want to host this podcast?

Reading about mentorship, sponsorship, career development, etc. is important, but it doesn’t do these topics justice. It is such a nuanced thing and talking about it, exploring it, teasing it out is just so fun. I find these topics to be fascinating, and I wanted to talk with experts and hear how they approached difficult situations. Plus, I was a radio DJ when younger and have always dreamed of doing something in the audio medium as a professional.


What’s your favorite episode so far?

I won’t say favorite, but I think the Laurie Keefer episode is up there. It was such a nice conversation about a challenging concept: Building resilience in our trainees and ourselves. I learned a lot from her and have begun integrating some of these skills into my work as a program director.


What’s the best piece of advice you’ve gotten that’s helped you in your career so far?

I’m going to adopt this from a mentor of mine, but it’s the “me or my family rule.” What would you want done if the patient in front of you were your family member? If you keep that as your “True North,” then I think you are off to a good start as a clinician.

Nina Nandy, MD, MS (co-host)

Walk us through your current GI role and your path to getting there:

I think the biggest decision to make in medical school is medicine or surgery, and most things will fall under one of those categories. I liked the problem solving of medicine and the hands-on work of surgery, so I was leaning toward a procedural field then met some wonderful mentors in GI when I was in medical school. I think every field of medicine has a particular personality, and when I met gastroenterologists, it clicked with me, and I thought “I’ve found my people.” So, I went to residency in internal medicine with the goal of GI or bust. I am currently a practicing gastroenterologist, and I do general GI, liver disease, and motility.



What is your favorite part about your current role? Least favorite part?

I really love GI. I feel like I’ve found my calling, and its really exciting to be able to say that. What drew me to GI was the use of technology and minimally invasive endoscopy to see a person inside out and understand their pathology, the mix of chronic and acute conditions, and the educational aspect of talking to folks in clinic. I like putting people at ease, and GI is a great field for jokes. My least favorite part is doing peer-to-peers with insurance companies to get inflammatory bowel disease drugs approved.



What are your interests outside of work?

Outside of work, this podcast, and being division vice chief, I like to learn languages. I speak five and am working on a sixth. I’m writing a secret screenplay. I play piano and guitar, which reminds me of a quote: “All my life I wanted to play guitar badly. And now I play guitar. Badly.” I also love art; I use oil paint, acrylics, pen and ink, mixed media. I love to dance and am just getting into Peloton. But perhaps my most important role is maintaining the Instagram account for my two famous cats who will hopefully enable me to retire early. Are you out there, Purina?



What advice would you give to…

• Someone who matches into GI on Dec. 2: First of all, celebrate! Treat yo’self; you did it! Welcome to the most exciting field of medicine. But seriously, congratulate yourself for your hard work and don’t worry about being terrible at scoping because there’s a learning curve. Don’t worry about what you need to study because you are going to do it. Come in with an inquisitive, open mind. Don’t turn down consults because they seem ridiculous. You can always learn something! I think the best thing to do in fellowship is to do everything. Learn that motility and capsule, cannulate that common bile duct, place that esophageal stent! You won’t have this kind of support in the future, and you should get comfortable with everything possible while you can.
• Someone who just graduated from GI fellowship: As with those matching into GI, celebrate! Treat yo’self; you did it! I think this is the hardest transition; you don’t have that safety net anymore. You are the be-all, end-all last stop on the train. Just kidding. It seems that way, but you can always collaborate with colleagues and look things up on UpToDate. You know more than you think, and it is a continuous learning process, so it’s okay to have questions; it means you care. Yes, there will be more responsibility, and you need to keep up on path and your inbox because it will pile up. You need to think about appropriate follow-up and resources to offer your patients. You can keep up on current guidelines through your GI societies; do continuing medical education and postgraduate courses as well.

How do you see the future of GI changing as a new generation of trainees enters the workforce?

I think the future of GI is innovation, technology, social media, multidisciplinary learning. GI is a technology-centered field, and there will be new developments in medical devices and basic science research, such as the microbiome, which holds the key for numerous pathogenic processes. Physicians will need to be physician-scientists, physician-innovators, physician-business people, and physician-leaders. We must learn things beyond our own field to be successful in this changing world.



Why did you want to host this podcast?

I wanted to host this podcast because I think there is so much in fellowship we learn about GI but also so much we don’t learn about GI careers and the “real world” of practice. I wanted to create content focused on career development for early GIs and trainees and discuss “everything you wanted to know in fellowship but were afraid to ask.” I wanted to interview real successful people in the field, whether it be focusing on a career in medical education, basic science research, transplant hepatology, therapeutic endoscopy, or private practice. There are a lot of podcasts that do a great job focusing on guidelines, case reports, and research, but we wanted to take this one in a different direction. It is a great way to reach a broad audience across many platforms.



What’s your favorite episode so far?

I really like the Janice Jou episode. Not just because I’m on it, but also because she is a great, a dynamic, speaker, and our conversation was so effortless, and because she is a phenomenal program director and educator and has such valuable advice for trainees and early career gastroenterologists, drawing from her own experiences. Her tips – or rather “Janice jewels,” as I am trying to trademark on negotiation – are excellent. Check it out!



What’s the best piece of advice you’ve gotten that’s helped you in your career so far?

Don’t buy a house right out of training. Also, “live your life, not someone else’s.”

C.S. Tse, MD (co-host)

Walk us through your current GI role and your path to getting there:

I grew up in Toronto and moved to the United States for medical school at the Yale University, New Haven, Conn., and internal medicine residency at the Mayo Clinic in Rochester, Minnesota. During my residency, I became interested in gastroenterology with a particular interest in inflammatory bowel disease after studying the postoperative outcomes of IBD patients on biologics and examining the clinical course of IBD patients with coexistent celiac disease. I am a third-year gastroenterology fellow at Brown University. I will spend a year as the advanced IBD fellow at the University of California–San Diego from July 2021 to June 2022. My current research examines IBD patients’ quality of care and the psychosocial impacts on patients’ disease course. I am working with the Crohn’s and Colitis Foundation’s IBD Qorus Learning Health System to improve the quality of care and outcomes of patients with IBD. 



What is your favorite part about your current role? Least favorite part?

My favorite part of my current role is to combine patient care with clinical research, particularly for patients with IBD. My least favorite part is encountering “red tape” that may give a false sense of productivity but not actually be beneficial for patient care. Some of this is discussed in this article from the Harvard Business Review.



What are your interests outside of work?

I serve as the National President of the American Medical Women’s Association (AMWA) Residents & Fellows Division. I am a Core Faculty member of the AMWA IGNITE MD program, which is a nation-wide initiative to educate and empower female medical trainees. I currently serve as an abstract reviewer for Digestive Diseases Week® (since 2018). I previously served as an abstract reviewer and judge for the American Medical Association’s Scientific Symposium (2019 & 2020). Outside of work, I enjoy hiking, traveling, and reading.

 

What advice would you give to someone who matches into GI on Dec. 2:

Identify mentors early. (You can have more than one!) Try to imagine where you want your career to be in 5 years – generalist vs. specialist. Will you have a niche in practice? Is advanced endoscopy (ERCP, EUS, etc.) going to be a part of your practice? Academic, private practice, community practice, or hybrid? Knowing your goals will help tailor the GI fellowship experience to get you to where you want to be in your career. GI fellowship may be like a buffet table where there are many opportunities and options, but one can rarely do it all! Choosing and pursuing experiences that ultimately align with your goals can help you make the most out of your time during GI fellowship training. 



How do you see the future of GI changing as a new generation of trainees enters the workforce?

I think that there will be more integration of information technology and artificial intelligence into GI, just as for the rest of society. For example, we can see this clearly illustrated in the rapid uptake of telemedicine (including GI) during COVID-19. 



Why did you want to host this podcast?

I am intrigued by the opportunity to connect with GIs broadly through this AGA podcast. It is a portable way to use on-demand technology to engage in conversations relevant to other early GIs who may not be conventionally addressed by other means, such as journal articles, conferences, traditional didactics, and books. 



What’s your favorite episode so far?

Janice Jou’s podcast was phenomenal in providing mentorship advice (at a distance) to trainees who are interested in an academic career in clinical medicine.



What’s the best piece of advice you’ve gotten that’s helped you in your career so far?

“We are what we repeatedly do. Excellence, therefore, is not an act, but a habit.” This advice is most commonly credited to Aristotle.


Be sure to subscribe wherever you listen to podcasts or listen on the AGA website: https://gastro.org/podcast.
 

Dr. Whitson is GI fellowship director, Zucker School of Medicine at Hofstra-Northwell, Great Neck, N.Y. @MJWhitsonMD. Dr. Nandy is a gastroenterologist at Presbyterian Medical Group, Albuquerque, N.M. @NinaNandyMD. Dr. Tse is a GI fellow at Brown University, Providence, R.I. @CSTseMD.

The AGA Trainee and Early Career Committee was formed in 2013 to address the needs of those at the beginning of their careers in gastroenterology. The committee is composed of 12 trainee and early career members, whose mission is to develop and support programs relevant to the needs of young clinicians and researchers in the field of GI. In an initial needs assessment, a survey of GI fellows/trainees was undertaken, which revealed a gap in preparation for the transition from fellowship to practice. In particular, respondents expressed a desire to better understand issues related to practice skills, including health care economics, billing/coding, contract negotiation, and health policy. In addition, some trainees felt uncomfortable bringing questions about their private practice job search to academic faculty, who in turn may not have the necessary experience to provide answers regarding various private practice models and opportunities. Furthermore, fellows have little time and opportunity to learn about the rapidly shifting health care environment that will directly affect their future GI practice. To address these unmet needs, the AGA Trainee and Early Career Committee (in partnership with the Practice Management and Economics Committee as well as the Education and Training Committee) developed a workshop to educate fellows and early career GIs about practice and employment models, contracts and negotiations, compliance, health care policy, and other pertinent topics.

These workshops were designed with a half-day curriculum and based regionally to facilitate attendance as well as to capture the local practice patterns in different regions. They were launched during the 2014-2015 academic year in three cities – Boston, Los Angeles, and Chicago – and received extremely positive feedback from participants.

Since then, 16 additional workshops have been held in the following locations: Columbus, Ohio; Philadelphia; Houston; San Diego; New York; Stanford, Calif.; Pinehurst, N.C.; and Iowa City, Iowa (simulcast). At various times, workshops were held in partnership with local societies such as the New York Society of Gastrointestinal Endoscopy, the North Carolina Society of Gastroenterology, and the Texas Society of Gastrointestinal Endoscopy, which offered additional opportunities for networking. Overall, the 19 regional practice skills workshops held over the last 4 years have reached 420 fellows and early career GIs.

Dr. Ketwaroo is assistant professor, Baylor College of Medicine, and therapeutic endoscopist, Michael E DeBakey VA Medical Center, Houston. Dr. Liang is instructor of medicine, division of gastroenterology, NYU Langone Health, and staff physician, VA New York Harbor Health Care System. Ms. Brown is senior manager of constituency programs, AGA. Ms. NuQuay is senior director, member relations and constituency programs, AGA.

The AGA Trainee and Early Career Committee was formed in 2013 to address the needs of those at the beginning of their careers in gastroenterology. The committee is composed of 12 trainee and early career members, whose mission is to develop and support programs relevant to the needs of young clinicians and researchers in the field of GI. In an initial needs assessment, a survey of GI fellows/trainees was undertaken, which revealed a gap in preparation for the transition from fellowship to practice. In particular, respondents expressed a desire to better understand issues related to practice skills, including health care economics, billing/coding, contract negotiation, and health policy. In addition, some trainees felt uncomfortable bringing questions about their private practice job search to academic faculty, who in turn may not have the necessary experience to provide answers regarding various private practice models and opportunities. Furthermore, fellows have little time and opportunity to learn about the rapidly shifting health care environment that will directly affect their future GI practice. To address these unmet needs, the AGA Trainee and Early Career Committee (in partnership with the Practice Management and Economics Committee as well as the Education and Training Committee) developed a workshop to educate fellows and early career GIs about practice and employment models, contracts and negotiations, compliance, health care policy, and other pertinent topics.

These workshops were designed with a half-day curriculum and based regionally to facilitate attendance as well as to capture the local practice patterns in different regions. They were launched during the 2014-2015 academic year in three cities – Boston, Los Angeles, and Chicago – and received extremely positive feedback from participants.

Since then, 16 additional workshops have been held in the following locations: Columbus, Ohio; Philadelphia; Houston; San Diego; New York; Stanford, Calif.; Pinehurst, N.C.; and Iowa City, Iowa (simulcast). At various times, workshops were held in partnership with local societies such as the New York Society of Gastrointestinal Endoscopy, the North Carolina Society of Gastroenterology, and the Texas Society of Gastrointestinal Endoscopy, which offered additional opportunities for networking. Overall, the 19 regional practice skills workshops held over the last 4 years have reached 420 fellows and early career GIs.

Dr. Ketwaroo is assistant professor, Baylor College of Medicine, and therapeutic endoscopist, Michael E DeBakey VA Medical Center, Houston. Dr. Liang is instructor of medicine, division of gastroenterology, NYU Langone Health, and staff physician, VA New York Harbor Health Care System. Ms. Brown is senior manager of constituency programs, AGA. Ms. NuQuay is senior director, member relations and constituency programs, AGA.

The AGA Trainee and Early Career Committee was formed in 2013 to address the needs of those at the beginning of their careers in gastroenterology. The committee is composed of 12 trainee and early career members, whose mission is to develop and support programs relevant to the needs of young clinicians and researchers in the field of GI. In an initial needs assessment, a survey of GI fellows/trainees was undertaken, which revealed a gap in preparation for the transition from fellowship to practice. In particular, respondents expressed a desire to better understand issues related to practice skills, including health care economics, billing/coding, contract negotiation, and health policy. In addition, some trainees felt uncomfortable bringing questions about their private practice job search to academic faculty, who in turn may not have the necessary experience to provide answers regarding various private practice models and opportunities. Furthermore, fellows have little time and opportunity to learn about the rapidly shifting health care environment that will directly affect their future GI practice. To address these unmet needs, the AGA Trainee and Early Career Committee (in partnership with the Practice Management and Economics Committee as well as the Education and Training Committee) developed a workshop to educate fellows and early career GIs about practice and employment models, contracts and negotiations, compliance, health care policy, and other pertinent topics.

These workshops were designed with a half-day curriculum and based regionally to facilitate attendance as well as to capture the local practice patterns in different regions. They were launched during the 2014-2015 academic year in three cities – Boston, Los Angeles, and Chicago – and received extremely positive feedback from participants.

Since then, 16 additional workshops have been held in the following locations: Columbus, Ohio; Philadelphia; Houston; San Diego; New York; Stanford, Calif.; Pinehurst, N.C.; and Iowa City, Iowa (simulcast). At various times, workshops were held in partnership with local societies such as the New York Society of Gastrointestinal Endoscopy, the North Carolina Society of Gastroenterology, and the Texas Society of Gastrointestinal Endoscopy, which offered additional opportunities for networking. Overall, the 19 regional practice skills workshops held over the last 4 years have reached 420 fellows and early career GIs.

Dr. Ketwaroo is assistant professor, Baylor College of Medicine, and therapeutic endoscopist, Michael E DeBakey VA Medical Center, Houston. Dr. Liang is instructor of medicine, division of gastroenterology, NYU Langone Health, and staff physician, VA New York Harbor Health Care System. Ms. Brown is senior manager of constituency programs, AGA. Ms. NuQuay is senior director, member relations and constituency programs, AGA.

In March 2018, the American Gastroenterological Association (AGA) and American Association for the Study of Liver Diseases (AASLD) sponsored the Academic Skills Workshop in Charlotte, N.C. This year’s chairs Barbara Jung, MD, and Michael W. Fried, MD, FAASLD, as well as codirectors Marcia Cruz-Correa, MD, PhD, AGAF, FASGE, and Raymond Chung, MD, FAASLD, led a 2-day workshop featuring educational sessions and opportunities for mentorship and networking in academic gastroenterology and hepatology. The workshop featured sessions on how to navigate the job market, map out a career trajectory, develop fruitful mentoring relationships, apply for grant funding, and showcase research through manuscripts and oral presentations. Fellows and junior faculty from academic institutions across the United States were able to come together. Herein, two participants share their experiences at this event.

Clinical perspective from Sarah R. Lieber, MD

As a second-year gastroenterology fellow and aspiring transplant hepatologist, I found that this workshop provided an excellent framework and foundation for launching a career in academics and clinical research. It was especially effective at providing practical tips and tools for fellows and junior faculty on how to find an academic job, apply for research funding, and conduct written and oral presentations.

I was particularly moved by the personal stories and anecdotes from faculty members – many of whom are renowned leaders in the fields of GI and hepatology – who divulged the challenges and insecurities they had to overcome early in their careers. Sheila E. Crowe, MD, FRCPC, FACP, FACG, AGAF, gave an especially poignant talk on her career path from fellowship to becoming AGA president. She discussed the challenges unique to women in academic GI and hepatology, but left me feeling empowered and inspired by showcasing the many talents and success stories of her female colleagues and herself as well.

On Saturday, the AASLD held a special session that highlighted the personal stories and career trajectories of clinicians and researchers in the forefront of the field of hepatology – including AASLD president-elect Michael W. Fried, MD, FAASLD, and current AASLD President Ana Lok MD, FAASLD – among others. They emphasized the power of collaborative research that included harnessing the tools of molecular biology and Big Data to investigate the role of the microbiome and other novel subjects in liver disease. They advised us to seek out formal training when available, including master degrees or biostatistics training, to help us develop the skill sets necessary as independent researchers. They elaborated about their experiences serving on professional committees and giving oral presentations – essential to their career development – which allowed them to carve out a research niche and gain recognition as experts in their fields.

There were several powerful lessons and important themes that I take away from this workshop. The first is the importance of citizenship: Being a successful academician means not only putting in the clinical hours and being a prolific researcher but also being a good citizen. Supporting your colleagues, teaching mentees, and being a “team player” are all elements crucial to forming meaningful relationships and standing out as a valuable individual in your department. Second, perseverance is equally important; whether you are resubmitting applications for grant funding or reaching out to mentors in your area of interest, perseverance is the key to a successful career in academics. Third, remember that there is the important distinction between mentorship and sponsorship. While it is essential to have a selfless and supportive mentor who helps you cultivate your clinical and research interests, it is equally important to find a sponsor: an influential academician who can help you launch your career by acting as your advocate and opening doors to professional opportunities. Finally,you must always deliver. When mentors and sponsors give you opportunities to showcase your talents, always invest the time and effort to provide a high-quality performance. Be a good citizen who perseveres, seek out influential mentorship and sponsorship, and deliver on important professional tasks which will prime you to succeed as an academic clinical researcher in GI and hepatology.
 

Basic scientist perspective from Ana Maldonado-Contreras, PhD

The AGA-AASLD Workshop represented an ideal opportunity to regain perspective on my overall career plan. This year, Dr. Jung restructured the format of the program by substituting “lecture-style” sessions with fully interactive discussion panels in which trainees had the opportunity to initiate discussions about various topics of interest. The faculty leading these interactive sessions were committed to providing honest and clear answers to all of our questions. I believe this was a unique opportunity to go beyond PowerPoint presentations to actually gain insights on the dynamics of an academic department. We learned from department chairs what is considered during hiring, promoting, or allocating funds to make their team successful. Among the topics discussed, collegiality and selfless peer support were highlighted among the qualities of an appreciated department member. Panelists insisted that a balancing act between team support and one’s productivity is fundamental to thriving and maintaining focus.

Another topic with personal relevance was securing funding for my newly formed laboratory – and I was not alone! Prior to the meeting, participants were divided into small groups and assigned to a faculty mentor. Each participant was asked to share a research proposal and CV with her respective mentor. Then, each group had the opportunity to meet during the afternoon mentoring sessions. My group was composed of four participants interested in learning more about National Institutes of Health (NIH) funding strategies based on our current situations. Our assigned mentor, John Inadomi, MD – who thoroughly read our proposals and knew who we were before our encounter – provided practical advice about grant mechanisms to pursue given our current positions and provided detailed tips for successful applications. Dr. Inadomi also was greatly insightful about NIH study sessions and the entire review process. This person-to-person interaction was extremely helpful as it opened the possibility of discussing singularities of each participant’s career plans. Similarly, on the next day we had face time with David Saslowsky, PhD, program director of the National Institute of Diabetes and Digestive and Kidney Diseases at NIH. Dr. Saslowsky also reviewed our research proposals and discussed potential venues for funding within the NIDDK based on individual career trajectories.

Most of the second day was dedicated to reviewing grant opportunities and pertinent tips on how to get funded. We discussed the “most common mistakes” made by junior faculty on grant applications and ways to avoid them. All panelists agreed that the most common mistake is overambition. They advised us to critically consider the aims and activities proposed and, more importantly, seek out advice from mentors with more experience in grant writing.

Undoubtedly, networking with other peers represented an essential part of the experience at this academic workshop. As trainees, we were able to connect with not only seasoned colleagues but also with peers facing the same career challenges. Senior faculty were amazingly personable and committed to sharing experiences with the next generation of clinicians and scientists. They shared their failures, frustrations, and fears as well as their successes. Each story and the words of encouragement from this great community of scientists and clinicians helped me realize my hidden strengths and how to build from my past accomplishments to excel on my path toward becoming a fully independent researcher.
 

Dr. Lieber is a clinical epidemiology fellow, department of medicine, division of gastroenterology and hepatology, University of North Carolina (UNC), Chapel Hill; Dr. Maldonado-Contreras is an instructor in the department of microbiology and physiological systems and the Center for Microbiome Research, University of Massachusetts, Worcester.

In March 2018, the American Gastroenterological Association (AGA) and American Association for the Study of Liver Diseases (AASLD) sponsored the Academic Skills Workshop in Charlotte, N.C. This year’s chairs Barbara Jung, MD, and Michael W. Fried, MD, FAASLD, as well as codirectors Marcia Cruz-Correa, MD, PhD, AGAF, FASGE, and Raymond Chung, MD, FAASLD, led a 2-day workshop featuring educational sessions and opportunities for mentorship and networking in academic gastroenterology and hepatology. The workshop featured sessions on how to navigate the job market, map out a career trajectory, develop fruitful mentoring relationships, apply for grant funding, and showcase research through manuscripts and oral presentations. Fellows and junior faculty from academic institutions across the United States were able to come together. Herein, two participants share their experiences at this event.

Clinical perspective from Sarah R. Lieber, MD

As a second-year gastroenterology fellow and aspiring transplant hepatologist, I found that this workshop provided an excellent framework and foundation for launching a career in academics and clinical research. It was especially effective at providing practical tips and tools for fellows and junior faculty on how to find an academic job, apply for research funding, and conduct written and oral presentations.

I was particularly moved by the personal stories and anecdotes from faculty members – many of whom are renowned leaders in the fields of GI and hepatology – who divulged the challenges and insecurities they had to overcome early in their careers. Sheila E. Crowe, MD, FRCPC, FACP, FACG, AGAF, gave an especially poignant talk on her career path from fellowship to becoming AGA president. She discussed the challenges unique to women in academic GI and hepatology, but left me feeling empowered and inspired by showcasing the many talents and success stories of her female colleagues and herself as well.

On Saturday, the AASLD held a special session that highlighted the personal stories and career trajectories of clinicians and researchers in the forefront of the field of hepatology – including AASLD president-elect Michael W. Fried, MD, FAASLD, and current AASLD President Ana Lok MD, FAASLD – among others. They emphasized the power of collaborative research that included harnessing the tools of molecular biology and Big Data to investigate the role of the microbiome and other novel subjects in liver disease. They advised us to seek out formal training when available, including master degrees or biostatistics training, to help us develop the skill sets necessary as independent researchers. They elaborated about their experiences serving on professional committees and giving oral presentations – essential to their career development – which allowed them to carve out a research niche and gain recognition as experts in their fields.

There were several powerful lessons and important themes that I take away from this workshop. The first is the importance of citizenship: Being a successful academician means not only putting in the clinical hours and being a prolific researcher but also being a good citizen. Supporting your colleagues, teaching mentees, and being a “team player” are all elements crucial to forming meaningful relationships and standing out as a valuable individual in your department. Second, perseverance is equally important; whether you are resubmitting applications for grant funding or reaching out to mentors in your area of interest, perseverance is the key to a successful career in academics. Third, remember that there is the important distinction between mentorship and sponsorship. While it is essential to have a selfless and supportive mentor who helps you cultivate your clinical and research interests, it is equally important to find a sponsor: an influential academician who can help you launch your career by acting as your advocate and opening doors to professional opportunities. Finally,you must always deliver. When mentors and sponsors give you opportunities to showcase your talents, always invest the time and effort to provide a high-quality performance. Be a good citizen who perseveres, seek out influential mentorship and sponsorship, and deliver on important professional tasks which will prime you to succeed as an academic clinical researcher in GI and hepatology.
 

Basic scientist perspective from Ana Maldonado-Contreras, PhD

The AGA-AASLD Workshop represented an ideal opportunity to regain perspective on my overall career plan. This year, Dr. Jung restructured the format of the program by substituting “lecture-style” sessions with fully interactive discussion panels in which trainees had the opportunity to initiate discussions about various topics of interest. The faculty leading these interactive sessions were committed to providing honest and clear answers to all of our questions. I believe this was a unique opportunity to go beyond PowerPoint presentations to actually gain insights on the dynamics of an academic department. We learned from department chairs what is considered during hiring, promoting, or allocating funds to make their team successful. Among the topics discussed, collegiality and selfless peer support were highlighted among the qualities of an appreciated department member. Panelists insisted that a balancing act between team support and one’s productivity is fundamental to thriving and maintaining focus.

Another topic with personal relevance was securing funding for my newly formed laboratory – and I was not alone! Prior to the meeting, participants were divided into small groups and assigned to a faculty mentor. Each participant was asked to share a research proposal and CV with her respective mentor. Then, each group had the opportunity to meet during the afternoon mentoring sessions. My group was composed of four participants interested in learning more about National Institutes of Health (NIH) funding strategies based on our current situations. Our assigned mentor, John Inadomi, MD – who thoroughly read our proposals and knew who we were before our encounter – provided practical advice about grant mechanisms to pursue given our current positions and provided detailed tips for successful applications. Dr. Inadomi also was greatly insightful about NIH study sessions and the entire review process. This person-to-person interaction was extremely helpful as it opened the possibility of discussing singularities of each participant’s career plans. Similarly, on the next day we had face time with David Saslowsky, PhD, program director of the National Institute of Diabetes and Digestive and Kidney Diseases at NIH. Dr. Saslowsky also reviewed our research proposals and discussed potential venues for funding within the NIDDK based on individual career trajectories.

Most of the second day was dedicated to reviewing grant opportunities and pertinent tips on how to get funded. We discussed the “most common mistakes” made by junior faculty on grant applications and ways to avoid them. All panelists agreed that the most common mistake is overambition. They advised us to critically consider the aims and activities proposed and, more importantly, seek out advice from mentors with more experience in grant writing.

Undoubtedly, networking with other peers represented an essential part of the experience at this academic workshop. As trainees, we were able to connect with not only seasoned colleagues but also with peers facing the same career challenges. Senior faculty were amazingly personable and committed to sharing experiences with the next generation of clinicians and scientists. They shared their failures, frustrations, and fears as well as their successes. Each story and the words of encouragement from this great community of scientists and clinicians helped me realize my hidden strengths and how to build from my past accomplishments to excel on my path toward becoming a fully independent researcher.
 

Dr. Lieber is a clinical epidemiology fellow, department of medicine, division of gastroenterology and hepatology, University of North Carolina (UNC), Chapel Hill; Dr. Maldonado-Contreras is an instructor in the department of microbiology and physiological systems and the Center for Microbiome Research, University of Massachusetts, Worcester.

In March 2018, the American Gastroenterological Association (AGA) and American Association for the Study of Liver Diseases (AASLD) sponsored the Academic Skills Workshop in Charlotte, N.C. This year’s chairs Barbara Jung, MD, and Michael W. Fried, MD, FAASLD, as well as codirectors Marcia Cruz-Correa, MD, PhD, AGAF, FASGE, and Raymond Chung, MD, FAASLD, led a 2-day workshop featuring educational sessions and opportunities for mentorship and networking in academic gastroenterology and hepatology. The workshop featured sessions on how to navigate the job market, map out a career trajectory, develop fruitful mentoring relationships, apply for grant funding, and showcase research through manuscripts and oral presentations. Fellows and junior faculty from academic institutions across the United States were able to come together. Herein, two participants share their experiences at this event.

Clinical perspective from Sarah R. Lieber, MD

As a second-year gastroenterology fellow and aspiring transplant hepatologist, I found that this workshop provided an excellent framework and foundation for launching a career in academics and clinical research. It was especially effective at providing practical tips and tools for fellows and junior faculty on how to find an academic job, apply for research funding, and conduct written and oral presentations.

I was particularly moved by the personal stories and anecdotes from faculty members – many of whom are renowned leaders in the fields of GI and hepatology – who divulged the challenges and insecurities they had to overcome early in their careers. Sheila E. Crowe, MD, FRCPC, FACP, FACG, AGAF, gave an especially poignant talk on her career path from fellowship to becoming AGA president. She discussed the challenges unique to women in academic GI and hepatology, but left me feeling empowered and inspired by showcasing the many talents and success stories of her female colleagues and herself as well.

On Saturday, the AASLD held a special session that highlighted the personal stories and career trajectories of clinicians and researchers in the forefront of the field of hepatology – including AASLD president-elect Michael W. Fried, MD, FAASLD, and current AASLD President Ana Lok MD, FAASLD – among others. They emphasized the power of collaborative research that included harnessing the tools of molecular biology and Big Data to investigate the role of the microbiome and other novel subjects in liver disease. They advised us to seek out formal training when available, including master degrees or biostatistics training, to help us develop the skill sets necessary as independent researchers. They elaborated about their experiences serving on professional committees and giving oral presentations – essential to their career development – which allowed them to carve out a research niche and gain recognition as experts in their fields.

There were several powerful lessons and important themes that I take away from this workshop. The first is the importance of citizenship: Being a successful academician means not only putting in the clinical hours and being a prolific researcher but also being a good citizen. Supporting your colleagues, teaching mentees, and being a “team player” are all elements crucial to forming meaningful relationships and standing out as a valuable individual in your department. Second, perseverance is equally important; whether you are resubmitting applications for grant funding or reaching out to mentors in your area of interest, perseverance is the key to a successful career in academics. Third, remember that there is the important distinction between mentorship and sponsorship. While it is essential to have a selfless and supportive mentor who helps you cultivate your clinical and research interests, it is equally important to find a sponsor: an influential academician who can help you launch your career by acting as your advocate and opening doors to professional opportunities. Finally,you must always deliver. When mentors and sponsors give you opportunities to showcase your talents, always invest the time and effort to provide a high-quality performance. Be a good citizen who perseveres, seek out influential mentorship and sponsorship, and deliver on important professional tasks which will prime you to succeed as an academic clinical researcher in GI and hepatology.
 

Basic scientist perspective from Ana Maldonado-Contreras, PhD

The AGA-AASLD Workshop represented an ideal opportunity to regain perspective on my overall career plan. This year, Dr. Jung restructured the format of the program by substituting “lecture-style” sessions with fully interactive discussion panels in which trainees had the opportunity to initiate discussions about various topics of interest. The faculty leading these interactive sessions were committed to providing honest and clear answers to all of our questions. I believe this was a unique opportunity to go beyond PowerPoint presentations to actually gain insights on the dynamics of an academic department. We learned from department chairs what is considered during hiring, promoting, or allocating funds to make their team successful. Among the topics discussed, collegiality and selfless peer support were highlighted among the qualities of an appreciated department member. Panelists insisted that a balancing act between team support and one’s productivity is fundamental to thriving and maintaining focus.

Another topic with personal relevance was securing funding for my newly formed laboratory – and I was not alone! Prior to the meeting, participants were divided into small groups and assigned to a faculty mentor. Each participant was asked to share a research proposal and CV with her respective mentor. Then, each group had the opportunity to meet during the afternoon mentoring sessions. My group was composed of four participants interested in learning more about National Institutes of Health (NIH) funding strategies based on our current situations. Our assigned mentor, John Inadomi, MD – who thoroughly read our proposals and knew who we were before our encounter – provided practical advice about grant mechanisms to pursue given our current positions and provided detailed tips for successful applications. Dr. Inadomi also was greatly insightful about NIH study sessions and the entire review process. This person-to-person interaction was extremely helpful as it opened the possibility of discussing singularities of each participant’s career plans. Similarly, on the next day we had face time with David Saslowsky, PhD, program director of the National Institute of Diabetes and Digestive and Kidney Diseases at NIH. Dr. Saslowsky also reviewed our research proposals and discussed potential venues for funding within the NIDDK based on individual career trajectories.

Most of the second day was dedicated to reviewing grant opportunities and pertinent tips on how to get funded. We discussed the “most common mistakes” made by junior faculty on grant applications and ways to avoid them. All panelists agreed that the most common mistake is overambition. They advised us to critically consider the aims and activities proposed and, more importantly, seek out advice from mentors with more experience in grant writing.

Undoubtedly, networking with other peers represented an essential part of the experience at this academic workshop. As trainees, we were able to connect with not only seasoned colleagues but also with peers facing the same career challenges. Senior faculty were amazingly personable and committed to sharing experiences with the next generation of clinicians and scientists. They shared their failures, frustrations, and fears as well as their successes. Each story and the words of encouragement from this great community of scientists and clinicians helped me realize my hidden strengths and how to build from my past accomplishments to excel on my path toward becoming a fully independent researcher.
 

Dr. Lieber is a clinical epidemiology fellow, department of medicine, division of gastroenterology and hepatology, University of North Carolina (UNC), Chapel Hill; Dr. Maldonado-Contreras is an instructor in the department of microbiology and physiological systems and the Center for Microbiome Research, University of Massachusetts, Worcester.

I have been a member of the American Gastroenterological Association since my first year of GI fellowship. Out of all the GI professional societies, I have always considered it to be my home. AGA is the organization I turn to for direction on providing high-value and quality care to my patients, up-to-date information on research and technology innovations in our specialty, education and training programs for the next generation of gastroenterology and hepatology providers, and for my own continued learning. I have received so many benefits from my membership and am always looking to pay back my appreciation. A wonderful way to do this was through my participation in the Future Leaders Program, which “provides a pathway within the organization for selected participants to network, connect with mentors, develop leadership skills, and learn about AGA’s governance and operations while advancing their careers and supporting the profession.” I can honestly say that the program delivers on all of these promises.

Copyright Expressive Images

The program started with a meeting at AGA headquarters in Bethesda, Md., where we were introduced to key AGA staff, learned about the core mission and goals of AGA, and received training in leadership skills. I was able to gain invaluable insight into the leadership and governance of the AGA and now have a better understanding of the AGA’s commitment to maintaining a vital organization. At this meeting, we were assigned two mentors – one for career coaching and one to guide us through our main project. We worked closely with these mentors throughout the program, and I have no doubt these relationships will continue well into the future. For the main project we were assigned to a team with another participant to research and develop a project that aligned with the overall strategic plan of the AGA and fulfilled a need or gap within the organization. The projects covered topics such as ways to engage early-career professionals in the AGA Community, enhance access to the AGA guidelines, increase membership, highlight top publications from the AGA journals, expand networking among fellows and early career members, develop education metrics, and provide educational opportunities for international members. We worked on our main project remotely with our teams over 6 months, culminating in a final presentation that was shared with all participants in the Future Leaders Program, as well as AGA committees. Some of these projects already are being implemented. It was a truly amazing experience to work closely with the knowledgeable and dedicated AGA staff, gain skills in teamwork and strategic planning, and hear about the innovative ideas from all the participants in the Future Leaders Program.

In addition to the initial meeting in Bethesda, we attended a reception at Digestive Disease Week^® with alumni from the prior class of Future Leaders, a face-to-face meeting in Washington held in conjunction with the AGA Joint Committee Meetings, participated in Advocacy Day after the fall meeting, and attended some virtual roundtable discussions. One of the virtual discussions focused on our final project, which allowed us to apply our skills in strategic planning on a smaller scale to proposals for microvolunteerism. These proposals allow for convenient, short-term volunteer activities that move forward the mission of the AGA and cultivate local leaders. The microvolunteerism proposals are a fantastic example of AGA leadership’s understanding that utilizing and engaging members is one of the best ways to ensure a vital and relevant organization. I am excited to see some of the proposals come to fruition over the next few years.

Through the Future Leaders Program, I not only learned a lot about the AGA but also a great deal about myself. I learned about my own leadership style, which for those of you who know me would not be surprised to find out is “harmony.” I see the possibilities in others and try to capitalize on this potential to achieve our mutual goals. I learned how this leadership style can contribute to organizations as a whole, but also the importance of incorporating multiple leadership styles in all projects. This is valuable information that I have no doubt will help throughout my career. This program also provided an opportunity for me to connect and network with colleagues across the country whom I may not have otherwise met. These connections resulted in new research collaborations, as well as new friendships. As the 2018 AGA Future Leaders Program came to a close, I found myself with a deeper understanding of the mission and vision of the AGA, opportunities for more involvement, and a stronger commitment to our organization. I hope to one day participate as a mentor to other future leaders in the program. I encourage everyone interested in gaining leadership skills and more insight into the governance and operations of the AGA to apply.

Since the AGA Future Leaders Program began in the spring of 2015, two classes of 18 participants and nine mentors have participated in the 18-month comprehensive leadership development program. Nearly all of the Future Leaders Program alumni are serving the AGA in a variety of leadership capacities including serving on committees, the editorial boards, or volunteering as speakers and authors for AGA publications and events.

The next Future Leaders Program will begin in the spring of 2019 and the opportunity to apply will launch this fall.


Dr. Weiss is assistant professor, division of gastroenterology and hepatology; director, UW Health Gastrointestinal Genetics Clinic, University of Wisconsin School of Medicine and Public Health, Madison.

I have been a member of the American Gastroenterological Association since my first year of GI fellowship. Out of all the GI professional societies, I have always considered it to be my home. AGA is the organization I turn to for direction on providing high-value and quality care to my patients, up-to-date information on research and technology innovations in our specialty, education and training programs for the next generation of gastroenterology and hepatology providers, and for my own continued learning. I have received so many benefits from my membership and am always looking to pay back my appreciation. A wonderful way to do this was through my participation in the Future Leaders Program, which “provides a pathway within the organization for selected participants to network, connect with mentors, develop leadership skills, and learn about AGA’s governance and operations while advancing their careers and supporting the profession.” I can honestly say that the program delivers on all of these promises.

Copyright Expressive Images

The program started with a meeting at AGA headquarters in Bethesda, Md., where we were introduced to key AGA staff, learned about the core mission and goals of AGA, and received training in leadership skills. I was able to gain invaluable insight into the leadership and governance of the AGA and now have a better understanding of the AGA’s commitment to maintaining a vital organization. At this meeting, we were assigned two mentors – one for career coaching and one to guide us through our main project. We worked closely with these mentors throughout the program, and I have no doubt these relationships will continue well into the future. For the main project we were assigned to a team with another participant to research and develop a project that aligned with the overall strategic plan of the AGA and fulfilled a need or gap within the organization. The projects covered topics such as ways to engage early-career professionals in the AGA Community, enhance access to the AGA guidelines, increase membership, highlight top publications from the AGA journals, expand networking among fellows and early career members, develop education metrics, and provide educational opportunities for international members. We worked on our main project remotely with our teams over 6 months, culminating in a final presentation that was shared with all participants in the Future Leaders Program, as well as AGA committees. Some of these projects already are being implemented. It was a truly amazing experience to work closely with the knowledgeable and dedicated AGA staff, gain skills in teamwork and strategic planning, and hear about the innovative ideas from all the participants in the Future Leaders Program.

In addition to the initial meeting in Bethesda, we attended a reception at Digestive Disease Week^® with alumni from the prior class of Future Leaders, a face-to-face meeting in Washington held in conjunction with the AGA Joint Committee Meetings, participated in Advocacy Day after the fall meeting, and attended some virtual roundtable discussions. One of the virtual discussions focused on our final project, which allowed us to apply our skills in strategic planning on a smaller scale to proposals for microvolunteerism. These proposals allow for convenient, short-term volunteer activities that move forward the mission of the AGA and cultivate local leaders. The microvolunteerism proposals are a fantastic example of AGA leadership’s understanding that utilizing and engaging members is one of the best ways to ensure a vital and relevant organization. I am excited to see some of the proposals come to fruition over the next few years.

Through the Future Leaders Program, I not only learned a lot about the AGA but also a great deal about myself. I learned about my own leadership style, which for those of you who know me would not be surprised to find out is “harmony.” I see the possibilities in others and try to capitalize on this potential to achieve our mutual goals. I learned how this leadership style can contribute to organizations as a whole, but also the importance of incorporating multiple leadership styles in all projects. This is valuable information that I have no doubt will help throughout my career. This program also provided an opportunity for me to connect and network with colleagues across the country whom I may not have otherwise met. These connections resulted in new research collaborations, as well as new friendships. As the 2018 AGA Future Leaders Program came to a close, I found myself with a deeper understanding of the mission and vision of the AGA, opportunities for more involvement, and a stronger commitment to our organization. I hope to one day participate as a mentor to other future leaders in the program. I encourage everyone interested in gaining leadership skills and more insight into the governance and operations of the AGA to apply.

Since the AGA Future Leaders Program began in the spring of 2015, two classes of 18 participants and nine mentors have participated in the 18-month comprehensive leadership development program. Nearly all of the Future Leaders Program alumni are serving the AGA in a variety of leadership capacities including serving on committees, the editorial boards, or volunteering as speakers and authors for AGA publications and events.

The next Future Leaders Program will begin in the spring of 2019 and the opportunity to apply will launch this fall.


Dr. Weiss is assistant professor, division of gastroenterology and hepatology; director, UW Health Gastrointestinal Genetics Clinic, University of Wisconsin School of Medicine and Public Health, Madison.

I have been a member of the American Gastroenterological Association since my first year of GI fellowship. Out of all the GI professional societies, I have always considered it to be my home. AGA is the organization I turn to for direction on providing high-value and quality care to my patients, up-to-date information on research and technology innovations in our specialty, education and training programs for the next generation of gastroenterology and hepatology providers, and for my own continued learning. I have received so many benefits from my membership and am always looking to pay back my appreciation. A wonderful way to do this was through my participation in the Future Leaders Program, which “provides a pathway within the organization for selected participants to network, connect with mentors, develop leadership skills, and learn about AGA’s governance and operations while advancing their careers and supporting the profession.” I can honestly say that the program delivers on all of these promises.

Copyright Expressive Images

The program started with a meeting at AGA headquarters in Bethesda, Md., where we were introduced to key AGA staff, learned about the core mission and goals of AGA, and received training in leadership skills. I was able to gain invaluable insight into the leadership and governance of the AGA and now have a better understanding of the AGA’s commitment to maintaining a vital organization. At this meeting, we were assigned two mentors – one for career coaching and one to guide us through our main project. We worked closely with these mentors throughout the program, and I have no doubt these relationships will continue well into the future. For the main project we were assigned to a team with another participant to research and develop a project that aligned with the overall strategic plan of the AGA and fulfilled a need or gap within the organization. The projects covered topics such as ways to engage early-career professionals in the AGA Community, enhance access to the AGA guidelines, increase membership, highlight top publications from the AGA journals, expand networking among fellows and early career members, develop education metrics, and provide educational opportunities for international members. We worked on our main project remotely with our teams over 6 months, culminating in a final presentation that was shared with all participants in the Future Leaders Program, as well as AGA committees. Some of these projects already are being implemented. It was a truly amazing experience to work closely with the knowledgeable and dedicated AGA staff, gain skills in teamwork and strategic planning, and hear about the innovative ideas from all the participants in the Future Leaders Program.

In addition to the initial meeting in Bethesda, we attended a reception at Digestive Disease Week^® with alumni from the prior class of Future Leaders, a face-to-face meeting in Washington held in conjunction with the AGA Joint Committee Meetings, participated in Advocacy Day after the fall meeting, and attended some virtual roundtable discussions. One of the virtual discussions focused on our final project, which allowed us to apply our skills in strategic planning on a smaller scale to proposals for microvolunteerism. These proposals allow for convenient, short-term volunteer activities that move forward the mission of the AGA and cultivate local leaders. The microvolunteerism proposals are a fantastic example of AGA leadership’s understanding that utilizing and engaging members is one of the best ways to ensure a vital and relevant organization. I am excited to see some of the proposals come to fruition over the next few years.

Through the Future Leaders Program, I not only learned a lot about the AGA but also a great deal about myself. I learned about my own leadership style, which for those of you who know me would not be surprised to find out is “harmony.” I see the possibilities in others and try to capitalize on this potential to achieve our mutual goals. I learned how this leadership style can contribute to organizations as a whole, but also the importance of incorporating multiple leadership styles in all projects. This is valuable information that I have no doubt will help throughout my career. This program also provided an opportunity for me to connect and network with colleagues across the country whom I may not have otherwise met. These connections resulted in new research collaborations, as well as new friendships. As the 2018 AGA Future Leaders Program came to a close, I found myself with a deeper understanding of the mission and vision of the AGA, opportunities for more involvement, and a stronger commitment to our organization. I hope to one day participate as a mentor to other future leaders in the program. I encourage everyone interested in gaining leadership skills and more insight into the governance and operations of the AGA to apply.

Since the AGA Future Leaders Program began in the spring of 2015, two classes of 18 participants and nine mentors have participated in the 18-month comprehensive leadership development program. Nearly all of the Future Leaders Program alumni are serving the AGA in a variety of leadership capacities including serving on committees, the editorial boards, or volunteering as speakers and authors for AGA publications and events.

The next Future Leaders Program will begin in the spring of 2019 and the opportunity to apply will launch this fall.


Dr. Weiss is assistant professor, division of gastroenterology and hepatology; director, UW Health Gastrointestinal Genetics Clinic, University of Wisconsin School of Medicine and Public Health, Madison.

When I entered the Gastroenterology Editorial Fellowship last year, many of my cofellows asked, “What exactly is an editorial fellowship?” After completing the program, I can now reflect on what was truly a fantastic year-long experience that complemented my final year of fellowship training.

Manuscripts certainly don’t review and accept themselves into journals, and fellowship training usually gives little insight into how manuscripts move through the submission, peer review, and production processes. What happens while authors wait for an editorial decision?

Since its first publication in 1943, Gastroenterology has importantly affected clinical care and the direction of research in our field. The quality of the American Gastroenterological Association’s flagship journal is derived from the sweat and muscle put in daily by gastroenterology-oriented and hepatology-oriented professionals who strive to transform the steady stream of cutting-edge manuscript submissions into an influential monthly publication read by a broad audience of clinicians, trainees, academic researchers, and policy makers. Without a doubt, this fellowship provided me with a sincere appreciation for the dedication that the board of editors puts into the peer review process and into maintaining the quality of monthly publications.

Near the beginning of my editorial fellowship, I spent a week at Vanderbilt University with the on-site editors. This was an irreplaceable opportunity for a trainee like myself to meet with both clinical- and research-oriented academic gastroenterologists who integrate demanding editorial roles into busy and fulfilling professional careers. Throughout my week there, I met with editors and staff who held various roles within the journal. Overall, this experience taught me about what metrics the journal uses to ensure quality, how manuscripts move from submission to publication, and how the direction and content of the journal is directed toward both AGA members and a broader readership.

At its core, the fellowship was focused on teaching the fundamental process of peer review. High-quality reviews for Gastroenterology provide consultative content and methodological expertise to editors who can then provide direction and make editorial recommendations to the authors. During my fellowship, I learned how to write a structured and nuanced review on the basis of novelty, clinical relevance and effects, and methodological rigor. I was paired with one of the associate editors on the basis of my primary content area of interest and regularly provided reviews for original article submissions. As the year progressed, I become more comfortable with reviewing beyond my immediate knowledge base. I also became more adept at providing detailed comments that would be insightful and accessible to both authors and editors.

Each week, I participated in a phone call with the board of editors, which was composed of thought leaders with content expertise in both gastroenterology and hepatology. During the call, we would thoughtfully critique some of the most cutting-edge research in our field; each manuscript often represented the culmination of years of meticulous work by research groups and multinational collaborations. From a fellow’s perspective, these calls gave me access to what may be the most insightful discussions taking place in our field, discussions which could have potential implications on future disease management principles and clinical practice guidelines. Through our meetings, it became apparent how much work goes into finding quality reviewers and how much time goes into assimilating the resulting recommendations into a cohesive discussion. This was an opportunity to learn how associate editors walk the entire board through a manuscript: from a basis of current knowledge and practice, through the conduct and findings of a particular study, and ultimately, to how study findings might affect the field.

What I came away with the most from the Gastroenterology Editorial Fellowship was an appreciation for the importance of the editorial and peer review process in maintaining the integrity and detail needed in high-quality research. Ultimately, this fellowship gave me a meaningful and immediate way to give back to the field that I can continue over the course of my professional career. I am certain that this unique program will continue to give future editorial fellows the skills and motivation they need to become actively involved in the editorial and peer review processes when they are beginning their independent careers.
 

Dr. Shah, MD, MBA, is an assistant professor; he is also the director of the Center for Gastrointestinal Motility in the division of gastroenterology in the department of internal medicine at Dartmouth-Hitchcock Medical Center, Lebanon, N.H.

When I entered the Gastroenterology Editorial Fellowship last year, many of my cofellows asked, “What exactly is an editorial fellowship?” After completing the program, I can now reflect on what was truly a fantastic year-long experience that complemented my final year of fellowship training.

Manuscripts certainly don’t review and accept themselves into journals, and fellowship training usually gives little insight into how manuscripts move through the submission, peer review, and production processes. What happens while authors wait for an editorial decision?

Since its first publication in 1943, Gastroenterology has importantly affected clinical care and the direction of research in our field. The quality of the American Gastroenterological Association’s flagship journal is derived from the sweat and muscle put in daily by gastroenterology-oriented and hepatology-oriented professionals who strive to transform the steady stream of cutting-edge manuscript submissions into an influential monthly publication read by a broad audience of clinicians, trainees, academic researchers, and policy makers. Without a doubt, this fellowship provided me with a sincere appreciation for the dedication that the board of editors puts into the peer review process and into maintaining the quality of monthly publications.

Near the beginning of my editorial fellowship, I spent a week at Vanderbilt University with the on-site editors. This was an irreplaceable opportunity for a trainee like myself to meet with both clinical- and research-oriented academic gastroenterologists who integrate demanding editorial roles into busy and fulfilling professional careers. Throughout my week there, I met with editors and staff who held various roles within the journal. Overall, this experience taught me about what metrics the journal uses to ensure quality, how manuscripts move from submission to publication, and how the direction and content of the journal is directed toward both AGA members and a broader readership.

At its core, the fellowship was focused on teaching the fundamental process of peer review. High-quality reviews for Gastroenterology provide consultative content and methodological expertise to editors who can then provide direction and make editorial recommendations to the authors. During my fellowship, I learned how to write a structured and nuanced review on the basis of novelty, clinical relevance and effects, and methodological rigor. I was paired with one of the associate editors on the basis of my primary content area of interest and regularly provided reviews for original article submissions. As the year progressed, I become more comfortable with reviewing beyond my immediate knowledge base. I also became more adept at providing detailed comments that would be insightful and accessible to both authors and editors.

Each week, I participated in a phone call with the board of editors, which was composed of thought leaders with content expertise in both gastroenterology and hepatology. During the call, we would thoughtfully critique some of the most cutting-edge research in our field; each manuscript often represented the culmination of years of meticulous work by research groups and multinational collaborations. From a fellow’s perspective, these calls gave me access to what may be the most insightful discussions taking place in our field, discussions which could have potential implications on future disease management principles and clinical practice guidelines. Through our meetings, it became apparent how much work goes into finding quality reviewers and how much time goes into assimilating the resulting recommendations into a cohesive discussion. This was an opportunity to learn how associate editors walk the entire board through a manuscript: from a basis of current knowledge and practice, through the conduct and findings of a particular study, and ultimately, to how study findings might affect the field.

What I came away with the most from the Gastroenterology Editorial Fellowship was an appreciation for the importance of the editorial and peer review process in maintaining the integrity and detail needed in high-quality research. Ultimately, this fellowship gave me a meaningful and immediate way to give back to the field that I can continue over the course of my professional career. I am certain that this unique program will continue to give future editorial fellows the skills and motivation they need to become actively involved in the editorial and peer review processes when they are beginning their independent careers.
 

Dr. Shah, MD, MBA, is an assistant professor; he is also the director of the Center for Gastrointestinal Motility in the division of gastroenterology in the department of internal medicine at Dartmouth-Hitchcock Medical Center, Lebanon, N.H.

When I entered the Gastroenterology Editorial Fellowship last year, many of my cofellows asked, “What exactly is an editorial fellowship?” After completing the program, I can now reflect on what was truly a fantastic year-long experience that complemented my final year of fellowship training.

Manuscripts certainly don’t review and accept themselves into journals, and fellowship training usually gives little insight into how manuscripts move through the submission, peer review, and production processes. What happens while authors wait for an editorial decision?

Since its first publication in 1943, Gastroenterology has importantly affected clinical care and the direction of research in our field. The quality of the American Gastroenterological Association’s flagship journal is derived from the sweat and muscle put in daily by gastroenterology-oriented and hepatology-oriented professionals who strive to transform the steady stream of cutting-edge manuscript submissions into an influential monthly publication read by a broad audience of clinicians, trainees, academic researchers, and policy makers. Without a doubt, this fellowship provided me with a sincere appreciation for the dedication that the board of editors puts into the peer review process and into maintaining the quality of monthly publications.

Near the beginning of my editorial fellowship, I spent a week at Vanderbilt University with the on-site editors. This was an irreplaceable opportunity for a trainee like myself to meet with both clinical- and research-oriented academic gastroenterologists who integrate demanding editorial roles into busy and fulfilling professional careers. Throughout my week there, I met with editors and staff who held various roles within the journal. Overall, this experience taught me about what metrics the journal uses to ensure quality, how manuscripts move from submission to publication, and how the direction and content of the journal is directed toward both AGA members and a broader readership.

At its core, the fellowship was focused on teaching the fundamental process of peer review. High-quality reviews for Gastroenterology provide consultative content and methodological expertise to editors who can then provide direction and make editorial recommendations to the authors. During my fellowship, I learned how to write a structured and nuanced review on the basis of novelty, clinical relevance and effects, and methodological rigor. I was paired with one of the associate editors on the basis of my primary content area of interest and regularly provided reviews for original article submissions. As the year progressed, I become more comfortable with reviewing beyond my immediate knowledge base. I also became more adept at providing detailed comments that would be insightful and accessible to both authors and editors.

Each week, I participated in a phone call with the board of editors, which was composed of thought leaders with content expertise in both gastroenterology and hepatology. During the call, we would thoughtfully critique some of the most cutting-edge research in our field; each manuscript often represented the culmination of years of meticulous work by research groups and multinational collaborations. From a fellow’s perspective, these calls gave me access to what may be the most insightful discussions taking place in our field, discussions which could have potential implications on future disease management principles and clinical practice guidelines. Through our meetings, it became apparent how much work goes into finding quality reviewers and how much time goes into assimilating the resulting recommendations into a cohesive discussion. This was an opportunity to learn how associate editors walk the entire board through a manuscript: from a basis of current knowledge and practice, through the conduct and findings of a particular study, and ultimately, to how study findings might affect the field.

What I came away with the most from the Gastroenterology Editorial Fellowship was an appreciation for the importance of the editorial and peer review process in maintaining the integrity and detail needed in high-quality research. Ultimately, this fellowship gave me a meaningful and immediate way to give back to the field that I can continue over the course of my professional career. I am certain that this unique program will continue to give future editorial fellows the skills and motivation they need to become actively involved in the editorial and peer review processes when they are beginning their independent careers.
 

Dr. Shah, MD, MBA, is an assistant professor; he is also the director of the Center for Gastrointestinal Motility in the division of gastroenterology in the department of internal medicine at Dartmouth-Hitchcock Medical Center, Lebanon, N.H.

Medicine is an evolving field, and in this era of ever-changing medicine, physicians-in-training often lag behind in understanding the nuances of “real-world” medicine. From negotiating job contracts to understanding medical billing, coding systems, and performance metrics, physicians who are fresh out of training often feel ill prepared to deal with these issues that are rarely discussed during fellowship.

The American Gastroenterological Association’s Regional Practice Skills Workshops are designed to fill this void and provide the tools necessary to navigate the challenging transition from training into practice. Since the first pilot workshops were held in 2014, AGA’s Trainee and Early Career Committee has been diligently working to expand the number of workshop sites so that more trainees can benefit from them. This year, workshops will be held in Columbus, Ohio (Feb. 24), and in Philadelphia (April 11). An exciting development in 2017 was the opportunity to live stream the event held at the University of California, Los Angeles, to Stanford (Calif.) University and the University of Iowa, Iowa City.

This aforementioned workshop at UCLA was divided into two sessions. The first was focused on “Practice Options,” with talks geared toward highlighting the different practice models available in the GI market, including positions in academia, private practice, and mixed environments.

William Chey, MD, a professor of medicine at the University of Michigan, Ann Arbor, shared his experience as an academic gastroenterologist as well as his experience in managing a GI consulting firm. His advice to young gastroenterologists was to diversify. He suggested options such as working for pharmaceutical companies, being involved in drug trials, working in the innovation industry, and proactively seeking leadership positions in different organizations. V. Raman Muthusamy MD, AGAF, a clinical professor of medicine at UCLA, led the discussion with the million-dollar question: What is my net worth? He suggested doing some homework before negotiating one’s salary by visiting the Medical Group Management Association’s website. Having this information can provide a trainee with a head start in the negotiation process. Dr. Muthusamy recommended recalculating one’s net worth every 5 years and renegotiating your contract based on this information. In addition to possibly leading to a salary boost, such knowledge will render internal validation and boost self-confidence about one’s skill set. Keep in mind however, that checking this too often can be adversely distracting. Lynn S. Connolly, MD, also of UCLA brought to light the important fact that female gastroenterologists are often paid lower salaries than their male counterparts, even after adjusting for vacation time, practice type, and work hours. She urged female gastroenterologists not to undervalue themselves and avoid falling into this pitfall. Lin Chang, MD, a professor of medicine at UCLA, reinforced the need for young GI fellows to be passionate about the path they choose and to not make random choices or decisions based on convenience alone.

Gareth Dulai, MD, a gastroenterologist with Kaiser Permanente in Downey, CA, discussed the advantages of working in a big company, including salaries that are transparent and match the national average. One also does not have to worry about hiring staff and managing overhead costs. Martha Hierro, MD, who has been in private practice since fellowship, felt that a private group practice enables a higher salary potential and better flexibility with one’s schedule. Her group also has a pathology lab, research lab, and imaging center, which further augments the group’s earnings. The downsides to private practice, compared with bigger academic settings, include cumbersome negotiations with insurance companies and financial constraints when purchasing new technology. She advised young GI physicians to go through the partnership clause very carefully before joining any private practice. She recommended being prepared and fully informed before negotiating a contract, including speaking to other practicing gastroenterologists in the area about the earning potential in the practice. In the end, both speakers agreed that all types of practices have pros and cons and one can always move from one setting to another.

For young GI fellows who want to work as administrators, the common consensus among the panel members was that fellows should attend leadership courses at national meetings early in training and participate in the committees of national organizations like the AGA. Reaching out to educators and mentors is of key importance. Dr. Chey recommended that, when fellows are provided with an opportunity to work with a potential mentor, they should think it through before accepting the opportunity and, if they do accept it, make sure they finish the task in a timely manner.

The second session of the workshop was geared toward the interview process. James H. Tabibian, MD, PhD, of the University of California, Davis, shared some useful tips for job hunting. It is never too early to start the process of job hunting, and timing depends on the type of position one is seeking. For a competitive position, it may be best to start the process early. When looking for jobs, contact methods could include in-person encounters at national meetings, such as Digestive Disease Week, or through a mutual colleague or mentor. Emails to potential future employers should be succinct with an updated resume attached. Most importantly, make sure to follow up in a professional manner.

Dr. Connolly, who also spoke about interviewing, pointed out that one should always ask questions about the program and never offer any negative information about oneself. Discussing salary potential during an interview may not be perceived as a positive sign. One might ask the interviewer about what things the interviewer enjoys the most at work, what defines success in this position at the institution, what constitutes an ideal candidate for the program, and what is the growth plan for the program over the next 5-10 years. For subspecialty interviews, some questions that are good to ask include the volume of procedures done at the institute, what might a typical day for a fellow look like, where do fellows typically work after finishing, and how is the call schedule set up. In the end, look confident, be humble, and believe in yourself. You control how you are perceived.
 

Once you are offered a job, the next big task is contract negotiation. Negotiating a contract can be very time consuming and stressful. Some key concepts to keep in mind are: a) prepare ahead of time and know the institution well; b) the more offers you have, the more leverage you can get; c) take adequate time to evaluate the contract before signing; d) establish which clauses are nonnegotiable for you; e) try to get something back for everything you give up during negotiations; f) do not negotiate with yourself; g) keep calm and be flexible; and h) know what you want out of your job. Always keep in mind base salary and bonuses, student loan repayment, relocation expenses, medical and disability insurance, and malpractice insurance coverage. Always consider the possibility of buying into the practice. Be wary of indemnification and unreasonable noncompete clauses.

Overall, my colleagues and I found the workshop to be extremely informative. The live stream format was very well received, and as an audience, we felt engaged and encouraged to participate. We certainly appreciated the opportunity to ask questions in real time. This format allowed all our fellows to participate without needing to travel and to gain access to invaluable content that will surely help us in making important career decisions.
 

Dr. Ashat is a first-year gastroenterology fellow at The University of Iowa, Iowa City.

Medicine is an evolving field, and in this era of ever-changing medicine, physicians-in-training often lag behind in understanding the nuances of “real-world” medicine. From negotiating job contracts to understanding medical billing, coding systems, and performance metrics, physicians who are fresh out of training often feel ill prepared to deal with these issues that are rarely discussed during fellowship.

The American Gastroenterological Association’s Regional Practice Skills Workshops are designed to fill this void and provide the tools necessary to navigate the challenging transition from training into practice. Since the first pilot workshops were held in 2014, AGA’s Trainee and Early Career Committee has been diligently working to expand the number of workshop sites so that more trainees can benefit from them. This year, workshops will be held in Columbus, Ohio (Feb. 24), and in Philadelphia (April 11). An exciting development in 2017 was the opportunity to live stream the event held at the University of California, Los Angeles, to Stanford (Calif.) University and the University of Iowa, Iowa City.

This aforementioned workshop at UCLA was divided into two sessions. The first was focused on “Practice Options,” with talks geared toward highlighting the different practice models available in the GI market, including positions in academia, private practice, and mixed environments.

William Chey, MD, a professor of medicine at the University of Michigan, Ann Arbor, shared his experience as an academic gastroenterologist as well as his experience in managing a GI consulting firm. His advice to young gastroenterologists was to diversify. He suggested options such as working for pharmaceutical companies, being involved in drug trials, working in the innovation industry, and proactively seeking leadership positions in different organizations. V. Raman Muthusamy MD, AGAF, a clinical professor of medicine at UCLA, led the discussion with the million-dollar question: What is my net worth? He suggested doing some homework before negotiating one’s salary by visiting the Medical Group Management Association’s website. Having this information can provide a trainee with a head start in the negotiation process. Dr. Muthusamy recommended recalculating one’s net worth every 5 years and renegotiating your contract based on this information. In addition to possibly leading to a salary boost, such knowledge will render internal validation and boost self-confidence about one’s skill set. Keep in mind however, that checking this too often can be adversely distracting. Lynn S. Connolly, MD, also of UCLA brought to light the important fact that female gastroenterologists are often paid lower salaries than their male counterparts, even after adjusting for vacation time, practice type, and work hours. She urged female gastroenterologists not to undervalue themselves and avoid falling into this pitfall. Lin Chang, MD, a professor of medicine at UCLA, reinforced the need for young GI fellows to be passionate about the path they choose and to not make random choices or decisions based on convenience alone.

Gareth Dulai, MD, a gastroenterologist with Kaiser Permanente in Downey, CA, discussed the advantages of working in a big company, including salaries that are transparent and match the national average. One also does not have to worry about hiring staff and managing overhead costs. Martha Hierro, MD, who has been in private practice since fellowship, felt that a private group practice enables a higher salary potential and better flexibility with one’s schedule. Her group also has a pathology lab, research lab, and imaging center, which further augments the group’s earnings. The downsides to private practice, compared with bigger academic settings, include cumbersome negotiations with insurance companies and financial constraints when purchasing new technology. She advised young GI physicians to go through the partnership clause very carefully before joining any private practice. She recommended being prepared and fully informed before negotiating a contract, including speaking to other practicing gastroenterologists in the area about the earning potential in the practice. In the end, both speakers agreed that all types of practices have pros and cons and one can always move from one setting to another.

For young GI fellows who want to work as administrators, the common consensus among the panel members was that fellows should attend leadership courses at national meetings early in training and participate in the committees of national organizations like the AGA. Reaching out to educators and mentors is of key importance. Dr. Chey recommended that, when fellows are provided with an opportunity to work with a potential mentor, they should think it through before accepting the opportunity and, if they do accept it, make sure they finish the task in a timely manner.

The second session of the workshop was geared toward the interview process. James H. Tabibian, MD, PhD, of the University of California, Davis, shared some useful tips for job hunting. It is never too early to start the process of job hunting, and timing depends on the type of position one is seeking. For a competitive position, it may be best to start the process early. When looking for jobs, contact methods could include in-person encounters at national meetings, such as Digestive Disease Week, or through a mutual colleague or mentor. Emails to potential future employers should be succinct with an updated resume attached. Most importantly, make sure to follow up in a professional manner.

Dr. Connolly, who also spoke about interviewing, pointed out that one should always ask questions about the program and never offer any negative information about oneself. Discussing salary potential during an interview may not be perceived as a positive sign. One might ask the interviewer about what things the interviewer enjoys the most at work, what defines success in this position at the institution, what constitutes an ideal candidate for the program, and what is the growth plan for the program over the next 5-10 years. For subspecialty interviews, some questions that are good to ask include the volume of procedures done at the institute, what might a typical day for a fellow look like, where do fellows typically work after finishing, and how is the call schedule set up. In the end, look confident, be humble, and believe in yourself. You control how you are perceived.
 

Once you are offered a job, the next big task is contract negotiation. Negotiating a contract can be very time consuming and stressful. Some key concepts to keep in mind are: a) prepare ahead of time and know the institution well; b) the more offers you have, the more leverage you can get; c) take adequate time to evaluate the contract before signing; d) establish which clauses are nonnegotiable for you; e) try to get something back for everything you give up during negotiations; f) do not negotiate with yourself; g) keep calm and be flexible; and h) know what you want out of your job. Always keep in mind base salary and bonuses, student loan repayment, relocation expenses, medical and disability insurance, and malpractice insurance coverage. Always consider the possibility of buying into the practice. Be wary of indemnification and unreasonable noncompete clauses.

Overall, my colleagues and I found the workshop to be extremely informative. The live stream format was very well received, and as an audience, we felt engaged and encouraged to participate. We certainly appreciated the opportunity to ask questions in real time. This format allowed all our fellows to participate without needing to travel and to gain access to invaluable content that will surely help us in making important career decisions.
 

Dr. Ashat is a first-year gastroenterology fellow at The University of Iowa, Iowa City.

Medicine is an evolving field, and in this era of ever-changing medicine, physicians-in-training often lag behind in understanding the nuances of “real-world” medicine. From negotiating job contracts to understanding medical billing, coding systems, and performance metrics, physicians who are fresh out of training often feel ill prepared to deal with these issues that are rarely discussed during fellowship.

The American Gastroenterological Association’s Regional Practice Skills Workshops are designed to fill this void and provide the tools necessary to navigate the challenging transition from training into practice. Since the first pilot workshops were held in 2014, AGA’s Trainee and Early Career Committee has been diligently working to expand the number of workshop sites so that more trainees can benefit from them. This year, workshops will be held in Columbus, Ohio (Feb. 24), and in Philadelphia (April 11). An exciting development in 2017 was the opportunity to live stream the event held at the University of California, Los Angeles, to Stanford (Calif.) University and the University of Iowa, Iowa City.

This aforementioned workshop at UCLA was divided into two sessions. The first was focused on “Practice Options,” with talks geared toward highlighting the different practice models available in the GI market, including positions in academia, private practice, and mixed environments.

William Chey, MD, a professor of medicine at the University of Michigan, Ann Arbor, shared his experience as an academic gastroenterologist as well as his experience in managing a GI consulting firm. His advice to young gastroenterologists was to diversify. He suggested options such as working for pharmaceutical companies, being involved in drug trials, working in the innovation industry, and proactively seeking leadership positions in different organizations. V. Raman Muthusamy MD, AGAF, a clinical professor of medicine at UCLA, led the discussion with the million-dollar question: What is my net worth? He suggested doing some homework before negotiating one’s salary by visiting the Medical Group Management Association’s website. Having this information can provide a trainee with a head start in the negotiation process. Dr. Muthusamy recommended recalculating one’s net worth every 5 years and renegotiating your contract based on this information. In addition to possibly leading to a salary boost, such knowledge will render internal validation and boost self-confidence about one’s skill set. Keep in mind however, that checking this too often can be adversely distracting. Lynn S. Connolly, MD, also of UCLA brought to light the important fact that female gastroenterologists are often paid lower salaries than their male counterparts, even after adjusting for vacation time, practice type, and work hours. She urged female gastroenterologists not to undervalue themselves and avoid falling into this pitfall. Lin Chang, MD, a professor of medicine at UCLA, reinforced the need for young GI fellows to be passionate about the path they choose and to not make random choices or decisions based on convenience alone.

Gareth Dulai, MD, a gastroenterologist with Kaiser Permanente in Downey, CA, discussed the advantages of working in a big company, including salaries that are transparent and match the national average. One also does not have to worry about hiring staff and managing overhead costs. Martha Hierro, MD, who has been in private practice since fellowship, felt that a private group practice enables a higher salary potential and better flexibility with one’s schedule. Her group also has a pathology lab, research lab, and imaging center, which further augments the group’s earnings. The downsides to private practice, compared with bigger academic settings, include cumbersome negotiations with insurance companies and financial constraints when purchasing new technology. She advised young GI physicians to go through the partnership clause very carefully before joining any private practice. She recommended being prepared and fully informed before negotiating a contract, including speaking to other practicing gastroenterologists in the area about the earning potential in the practice. In the end, both speakers agreed that all types of practices have pros and cons and one can always move from one setting to another.

For young GI fellows who want to work as administrators, the common consensus among the panel members was that fellows should attend leadership courses at national meetings early in training and participate in the committees of national organizations like the AGA. Reaching out to educators and mentors is of key importance. Dr. Chey recommended that, when fellows are provided with an opportunity to work with a potential mentor, they should think it through before accepting the opportunity and, if they do accept it, make sure they finish the task in a timely manner.

The second session of the workshop was geared toward the interview process. James H. Tabibian, MD, PhD, of the University of California, Davis, shared some useful tips for job hunting. It is never too early to start the process of job hunting, and timing depends on the type of position one is seeking. For a competitive position, it may be best to start the process early. When looking for jobs, contact methods could include in-person encounters at national meetings, such as Digestive Disease Week, or through a mutual colleague or mentor. Emails to potential future employers should be succinct with an updated resume attached. Most importantly, make sure to follow up in a professional manner.

Dr. Connolly, who also spoke about interviewing, pointed out that one should always ask questions about the program and never offer any negative information about oneself. Discussing salary potential during an interview may not be perceived as a positive sign. One might ask the interviewer about what things the interviewer enjoys the most at work, what defines success in this position at the institution, what constitutes an ideal candidate for the program, and what is the growth plan for the program over the next 5-10 years. For subspecialty interviews, some questions that are good to ask include the volume of procedures done at the institute, what might a typical day for a fellow look like, where do fellows typically work after finishing, and how is the call schedule set up. In the end, look confident, be humble, and believe in yourself. You control how you are perceived.
 

Once you are offered a job, the next big task is contract negotiation. Negotiating a contract can be very time consuming and stressful. Some key concepts to keep in mind are: a) prepare ahead of time and know the institution well; b) the more offers you have, the more leverage you can get; c) take adequate time to evaluate the contract before signing; d) establish which clauses are nonnegotiable for you; e) try to get something back for everything you give up during negotiations; f) do not negotiate with yourself; g) keep calm and be flexible; and h) know what you want out of your job. Always keep in mind base salary and bonuses, student loan repayment, relocation expenses, medical and disability insurance, and malpractice insurance coverage. Always consider the possibility of buying into the practice. Be wary of indemnification and unreasonable noncompete clauses.

Overall, my colleagues and I found the workshop to be extremely informative. The live stream format was very well received, and as an audience, we felt engaged and encouraged to participate. We certainly appreciated the opportunity to ask questions in real time. This format allowed all our fellows to participate without needing to travel and to gain access to invaluable content that will surely help us in making important career decisions.
 

Dr. Ashat is a first-year gastroenterology fellow at The University of Iowa, Iowa City.

The readership of Gastroenterology includes a broad distribution of stakeholders in digestive health, including those with vested interests in clinical practice, education, policy, clinical investigation, and basic research. One of our most critical constituencies, however, is trainees and early-career GIs. In an effort to support such individuals, our editorial team has developed a freshly minted 1-year editorial fellowship for Gastroenterology. The overarching purpose of this fellowship is to mentor an outstanding trainee for future editorial leadership roles in scientific publishing, as a means to promote the interests of trainee and early-career GI constituencies within the AGA and Gastroenterology. This fellowship is available to exceptional second- or third-year fellows through an application process. The intent of this training is to allow the selected applicant to become intimately involved with Gastroenterology’s entire editorial process, including peer review, editorial oversight, manuscript selection for publication, production, and postpublication activities. Our first fellow, Eric Shah, MD, MBA, was selected from a highly competitive pool of exceptional applicants, and began his fellowship on July 1, 2017.

AGA Institute

This year, we have been delighted to work with Dr. Shah as our inaugural Gastroenterology fellow. Dr. Shah has a unique background, having pursued a joint MD and MBA (earning both concurrently), while also following venture-oriented interests in developing GI technology from academia. Dr. Shah began his research career under the mentorship of Mark Pimentel, MD, and Gil Melmed, MD, at Cedars-Sinai as part of a Research Honors Program. Since that time, he has focused on evaluating the comparative efficacy, durability, and harm associated with pharmacotherapy in functional bowel disorders. Dr. Shah was accepted into the GI fellowship training program at the University of Michigan and received a slot on the T32 training grant to study cost-effectiveness and qualitative research techniques to address gaps in the care of functional bowel disorders. His work under the mentorship of William Chey, MD, Ryan Stidham, MD, and Philip S. Schoenfeld, MD, has flourished and culminated in an oral presentation and several posters for DDW 2017, as well as several first-author manuscripts that have been submitted. Dr. Shah has fully embraced the Gastroenterology fellowship and has far surpassed our high expectations for this position.
 

VIDEO SOURCE: AMERICAN GASTROENTEROLOGICAL ASSOCIATION

In addition to creating an editorial fellowship, our team has also developed other components within the journal that specifically target trainees and early-career GIs. The Mentoring, Education and Training section – initiated in 2011 through the vision and insight of Bishr Omary MD, PhD, and John Del Valle, MD, at the University of Michigan – has been extremely effective in highlighting critical issues relevant to trainees, young faculty, and early-career GIs. Topics have included mentoring advice not only for individuals in academic or private practice careers but also industry careers and midlevel providers. Other topics have included Accreditation Council for Graduate Medical Education milestones, career advancement for clinician-educators, sex and ethnic diversity, and maintenance of certification, as well as guidance regarding nontraditional funding mechanisms such as philanthropy. Potential future topics will include information about major new public and private funding initiatives, comments and input from National Institutes of Health officials, and reports of funding trends relevant to both physician scientists and clinicians. We are fortunate to have Prateek Sharma, MD, lead this section, and his depth of experience as an exceptional mentor has provided the requisite expertise.

Additionally, we offer a reduction in page charges to junior investigators (within 7 years of fellowship) who are the corresponding authors of exceedingly important original Gastroenterology manuscripts. These manuscripts from junior investigators will be highlighted in both print and online versions of Gastroenterology. We are using the journal to expand electronic access to educational offerings for new technologies, training, self-assessment, and practice improvement to establish the AGA as the ultimate resource for junior academicians and practicing physicians. We are also currently integrating Gastroenterology more closely into other AGA educational efforts that target young physicians, such as the AGA Education and Training Committee.

At Gastroenterology, we are acutely aware of the needs and obstacles facing trainees, young faculty, and early-career GIs. We have boldly adopted a multidimensional approach to provide guidance and opportunities to overcome these challenges, including the creation of the nascent Editorial Fellowship. We welcome applications for the next fellowship, which will be announced by the AGA in the spring of 2018!
 

Dr. Peek is the Mina Wallace Professor of Medicine, Cancer Biology, and Pathology, Microbiology, and Immunology, and director, division of gastroenterology, hepatology and nutrition, Vanderbilt University Medical Center, Nashville, Tenn. He has no conflicts of interest.

The readership of Gastroenterology includes a broad distribution of stakeholders in digestive health, including those with vested interests in clinical practice, education, policy, clinical investigation, and basic research. One of our most critical constituencies, however, is trainees and early-career GIs. In an effort to support such individuals, our editorial team has developed a freshly minted 1-year editorial fellowship for Gastroenterology. The overarching purpose of this fellowship is to mentor an outstanding trainee for future editorial leadership roles in scientific publishing, as a means to promote the interests of trainee and early-career GI constituencies within the AGA and Gastroenterology. This fellowship is available to exceptional second- or third-year fellows through an application process. The intent of this training is to allow the selected applicant to become intimately involved with Gastroenterology’s entire editorial process, including peer review, editorial oversight, manuscript selection for publication, production, and postpublication activities. Our first fellow, Eric Shah, MD, MBA, was selected from a highly competitive pool of exceptional applicants, and began his fellowship on July 1, 2017.

AGA Institute

This year, we have been delighted to work with Dr. Shah as our inaugural Gastroenterology fellow. Dr. Shah has a unique background, having pursued a joint MD and MBA (earning both concurrently), while also following venture-oriented interests in developing GI technology from academia. Dr. Shah began his research career under the mentorship of Mark Pimentel, MD, and Gil Melmed, MD, at Cedars-Sinai as part of a Research Honors Program. Since that time, he has focused on evaluating the comparative efficacy, durability, and harm associated with pharmacotherapy in functional bowel disorders. Dr. Shah was accepted into the GI fellowship training program at the University of Michigan and received a slot on the T32 training grant to study cost-effectiveness and qualitative research techniques to address gaps in the care of functional bowel disorders. His work under the mentorship of William Chey, MD, Ryan Stidham, MD, and Philip S. Schoenfeld, MD, has flourished and culminated in an oral presentation and several posters for DDW 2017, as well as several first-author manuscripts that have been submitted. Dr. Shah has fully embraced the Gastroenterology fellowship and has far surpassed our high expectations for this position.
 

VIDEO SOURCE: AMERICAN GASTROENTEROLOGICAL ASSOCIATION

In addition to creating an editorial fellowship, our team has also developed other components within the journal that specifically target trainees and early-career GIs. The Mentoring, Education and Training section – initiated in 2011 through the vision and insight of Bishr Omary MD, PhD, and John Del Valle, MD, at the University of Michigan – has been extremely effective in highlighting critical issues relevant to trainees, young faculty, and early-career GIs. Topics have included mentoring advice not only for individuals in academic or private practice careers but also industry careers and midlevel providers. Other topics have included Accreditation Council for Graduate Medical Education milestones, career advancement for clinician-educators, sex and ethnic diversity, and maintenance of certification, as well as guidance regarding nontraditional funding mechanisms such as philanthropy. Potential future topics will include information about major new public and private funding initiatives, comments and input from National Institutes of Health officials, and reports of funding trends relevant to both physician scientists and clinicians. We are fortunate to have Prateek Sharma, MD, lead this section, and his depth of experience as an exceptional mentor has provided the requisite expertise.

Additionally, we offer a reduction in page charges to junior investigators (within 7 years of fellowship) who are the corresponding authors of exceedingly important original Gastroenterology manuscripts. These manuscripts from junior investigators will be highlighted in both print and online versions of Gastroenterology. We are using the journal to expand electronic access to educational offerings for new technologies, training, self-assessment, and practice improvement to establish the AGA as the ultimate resource for junior academicians and practicing physicians. We are also currently integrating Gastroenterology more closely into other AGA educational efforts that target young physicians, such as the AGA Education and Training Committee.

At Gastroenterology, we are acutely aware of the needs and obstacles facing trainees, young faculty, and early-career GIs. We have boldly adopted a multidimensional approach to provide guidance and opportunities to overcome these challenges, including the creation of the nascent Editorial Fellowship. We welcome applications for the next fellowship, which will be announced by the AGA in the spring of 2018!
 

Dr. Peek is the Mina Wallace Professor of Medicine, Cancer Biology, and Pathology, Microbiology, and Immunology, and director, division of gastroenterology, hepatology and nutrition, Vanderbilt University Medical Center, Nashville, Tenn. He has no conflicts of interest.

The readership of Gastroenterology includes a broad distribution of stakeholders in digestive health, including those with vested interests in clinical practice, education, policy, clinical investigation, and basic research. One of our most critical constituencies, however, is trainees and early-career GIs. In an effort to support such individuals, our editorial team has developed a freshly minted 1-year editorial fellowship for Gastroenterology. The overarching purpose of this fellowship is to mentor an outstanding trainee for future editorial leadership roles in scientific publishing, as a means to promote the interests of trainee and early-career GI constituencies within the AGA and Gastroenterology. This fellowship is available to exceptional second- or third-year fellows through an application process. The intent of this training is to allow the selected applicant to become intimately involved with Gastroenterology’s entire editorial process, including peer review, editorial oversight, manuscript selection for publication, production, and postpublication activities. Our first fellow, Eric Shah, MD, MBA, was selected from a highly competitive pool of exceptional applicants, and began his fellowship on July 1, 2017.

AGA Institute

This year, we have been delighted to work with Dr. Shah as our inaugural Gastroenterology fellow. Dr. Shah has a unique background, having pursued a joint MD and MBA (earning both concurrently), while also following venture-oriented interests in developing GI technology from academia. Dr. Shah began his research career under the mentorship of Mark Pimentel, MD, and Gil Melmed, MD, at Cedars-Sinai as part of a Research Honors Program. Since that time, he has focused on evaluating the comparative efficacy, durability, and harm associated with pharmacotherapy in functional bowel disorders. Dr. Shah was accepted into the GI fellowship training program at the University of Michigan and received a slot on the T32 training grant to study cost-effectiveness and qualitative research techniques to address gaps in the care of functional bowel disorders. His work under the mentorship of William Chey, MD, Ryan Stidham, MD, and Philip S. Schoenfeld, MD, has flourished and culminated in an oral presentation and several posters for DDW 2017, as well as several first-author manuscripts that have been submitted. Dr. Shah has fully embraced the Gastroenterology fellowship and has far surpassed our high expectations for this position.
 

VIDEO SOURCE: AMERICAN GASTROENTEROLOGICAL ASSOCIATION

In addition to creating an editorial fellowship, our team has also developed other components within the journal that specifically target trainees and early-career GIs. The Mentoring, Education and Training section – initiated in 2011 through the vision and insight of Bishr Omary MD, PhD, and John Del Valle, MD, at the University of Michigan – has been extremely effective in highlighting critical issues relevant to trainees, young faculty, and early-career GIs. Topics have included mentoring advice not only for individuals in academic or private practice careers but also industry careers and midlevel providers. Other topics have included Accreditation Council for Graduate Medical Education milestones, career advancement for clinician-educators, sex and ethnic diversity, and maintenance of certification, as well as guidance regarding nontraditional funding mechanisms such as philanthropy. Potential future topics will include information about major new public and private funding initiatives, comments and input from National Institutes of Health officials, and reports of funding trends relevant to both physician scientists and clinicians. We are fortunate to have Prateek Sharma, MD, lead this section, and his depth of experience as an exceptional mentor has provided the requisite expertise.

Additionally, we offer a reduction in page charges to junior investigators (within 7 years of fellowship) who are the corresponding authors of exceedingly important original Gastroenterology manuscripts. These manuscripts from junior investigators will be highlighted in both print and online versions of Gastroenterology. We are using the journal to expand electronic access to educational offerings for new technologies, training, self-assessment, and practice improvement to establish the AGA as the ultimate resource for junior academicians and practicing physicians. We are also currently integrating Gastroenterology more closely into other AGA educational efforts that target young physicians, such as the AGA Education and Training Committee.

At Gastroenterology, we are acutely aware of the needs and obstacles facing trainees, young faculty, and early-career GIs. We have boldly adopted a multidimensional approach to provide guidance and opportunities to overcome these challenges, including the creation of the nascent Editorial Fellowship. We welcome applications for the next fellowship, which will be announced by the AGA in the spring of 2018!
 

Dr. Peek is the Mina Wallace Professor of Medicine, Cancer Biology, and Pathology, Microbiology, and Immunology, and director, division of gastroenterology, hepatology and nutrition, Vanderbilt University Medical Center, Nashville, Tenn. He has no conflicts of interest.