Otolaryngologists with a desire to broaden their careers beyond traditional medical practice have several options. Programs exist that can open doors into medical leadership, health policy work, clinical and outcomes research and public office. Opportunities are available at all stages of a physician’s career. Here’s a look at a handful of programs that aim to provide physicians with the tools they need to take their careers in a new direction.
Robert Wood Johnson Foundation Clinical Scholars
Gordon Sun, MD, knew he wanted not only to impact individual patients’ lives as a doctor but also to have an effect on a whole neighborhood, city or population. A research rotation at the beginning of his third year of residency showed him that he had an aptitude for research and medical writing. So he set out to marry his interest in population health with research. His mentors pointed him to Jay F. Piccirillo, MD, the first otolaryngologist to go through the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program. After hearing about the program from Dr. Piccirillo, director of Washington University’s Clinical Outcomes Research Office in the department of otolaryngology-head and neck surgery, Dr. Sun applied in his fourth year of residency, was accepted and entered the program in July 2011.
“Training with the RWJF Clinical Scholars program will be useful in the future if I am approached with a systematic problem that needs to be solved, an issue that will impact public health and public safety,” Dr. Sun said. “With the right leadership training and research background, I will be able to both address the problem and disseminate the results accurately.”
The program offers graduate-level study and research in a university-based, post-residency training program. It generally involves two years of study, with protected time for research.
On average, 24 scholars are selected annually. They train at the University of California, Los Angeles; University of Michigan; University of Pennsylvania or Yale University. Scholars receive stipends comparable to those for similar research training positions. The U.S. Department of Veterans Affairs (VA) covers the stipends for half of the scholars, and local VA affiliates provide in-kind research and faculty support to all scholars.
Participants conduct research projects in an area of their interest. The program includes leadership training and education about community-based participatory research. Dr. Sun, conducting his training at the University of Michigan, is researching outcomes among veterans with head and neck cancer. His position is supported jointly by the VA and RWJF.
After Dr. Sun completes the program, he plans to go into a practice with a strong clinical research emphasis. He believes practicing medicine is necessary to maintain a connection with patients and stay current in medical practice and technology. But, he added, “to perform high-impact research, I’ll need time and resources, which will require long-term dedication to a shared vision between myself and the program with which I’ll work.”
RWJF Health Policy Fellows
Physicians interested in hands-on policy experience and leadership training might consider the Robert Wood Johnson Foundation Health Policy Fellows program. Aimed at midcareer health professionals, the program features a one-year stay in Washington, D.C.
Robert H. Miller, MD, MBA, was on a traditional academic path at Tulane University when the chancellor, who had gone through the fellowship program, suggested he apply. “I wasn’t a policy wonk and didn’t really think I’d get accepted,” said Dr. Miller, executive director of the American Board of Otolaryngology and physician editor of ENT Today. But he was chosen, and the experience was life changing. “I went there as the chairman of a department, and when I came back to Tulane, I became vice chancellor of the medical center,” he said.
The fellowship begins each September with an orientation in which participants meet with executive branch officials, members of Congress and health care interest group leaders. Fellows participate in seminars on health economics, federal health programs, the congressional budget process, policy issues and the federal decision-making process. In January, they embark on full-time assignments with members of Congress or in the executive branch.
Dr. Miller served as a staff member for John Breaux, who at the time was a Democratic senator for Louisiana. He worked on four pieces of legislation, three of which became law. One measure created Medicare coverage for colorectal cancer screening. “It’s going to prevent some people from getting colorectal cancer or dying from it, and that’s a good feeling,” Dr. Miller said.
Next year the program will award up to six grants of up to $165,000. Fellows receive up to $94,000 for the D.C. stay in salary, plus fringe benefits or fellowship stipend.
The pay is lower than surgeons make, and it takes participants away from medical practice for a year, Dr. Miller said. For him and his family, however, it was worth it. His wife and children were exposed to wonderful opportunities in Washington, he said. “What I got out of it was there are so many different things in life that you can do that you really need to look beyond the straight and narrow path,” he added.
AMPAC Political Training
Physicians contemplating becoming more involved in politics or running for office can turn to two programs offered by the American Medical Association’s political action committee, AMPAC. One is the AMPAC Campaign School, which is geared toward physicians, physician spouses, residents and medical students. The annual five-day program features a simulated campaign for the U.S. House of Representatives. Attendees participate in nightly exercises on strategy, vote targeting, advertising and public speaking. The second option is an annual Candidate Workshop, designed to help physicians make the leap from the exam room to the campaign trail. At the three-day workshop, political veterans give advice about politics and the sacrifices needed to mount a competitive campaign. Participants learn how and when to make the decision to run, the importance of a disciplined campaign, how to fundraise and what kind of media advertising is right for them. AMPAC covers the cost of hotel rooms, most meals, faculty and materials for the two programs, but not transportation.
“AMPAC graduates have played an important role in electing leaders at all levels who understand the issues most important to physicians,” said Robert Puchalski, MD, an otolaryngologist and AMPAC Board of Directors member. “These physicians and their spouses have volunteered on campaigns, participated in fundraising efforts, provided their expertise on health care policy issues, and attended hearings and other events.”
Six AMPAC graduates serve in Congress, 16 hold elected office at the state and local level and one was appointed director of the Iowa Department of Public Health. Many physicians are able to continue to practice while serving in elected office, especially at the state and local level, Dr. Puchalski said.
Medical Research
Another route that allows otolaryngologists to influence their field is involvement in the Building Evidence for Successful Treatments in Otolaryngology (BEST ENT) network of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). Several efforts fall under the BEST ENT umbrella, including the Surgical Consumer Assessment of Healthcare Providers and Systems Pilot, the Centralized Otolaryngology Research Efforts grant program, two multi-institutional research studies, and the AAO-HNS Outcomes Research and Evidence-Based Medicine, Patient Safety and Quality Improvement, and Research Steering committees.
The Creating Healthcare Excellence through Education and Research (CHEER) network, funded by the National Institute on Deafness and Other Communication Disorders, is another opportunity for otolaryngologists to be involved in practice-based research initiatives.
Many physicians need to be intellectually stimulated above and beyond clinical practice, and involvement in research can meet that need, said David L. Witsell, MD, MHS, CHEER principal investigator.
Dr. Witsell used tinnitus, a focus of the CHEER network, to illustrate how the program works. Otolaryngologists or otologists studying tinnitus as part of the network would most likely be engaged in an initiative aimed at clinical effectiveness research on interventions for tinnitus in the practice-based context. Participation would allow them to collaborate with peers through systematic collection of data within clinical practice and simultaneously within a smartly written research protocol. They would have conversations with peers on the latest questions about tinnitus, the most recent diagnostic criteria, and the treatments that most need evaluation.
“Once the results come out, the CHEER clinicians would get the results first.” Dr. Witsell said. “They’d get the sense of pride because the research belongs to the practitioners and the patients.”