(UroToday.com) During the joint Society of Urologic Oncology / Young Urologic Oncologists Symposium on Clinical Research and Clinical Trials, Dr. Scott Eggener presented a personal perspective on building a successful career as an academic clinical researcher.
The first part of Dr. Eggener’s talk can be summed up well with one of many aphorisms, from himself and others, that he used throughout his talk: “be a respectful, classy, nudnik.” A nudnik, he clarified, is a “pestering, nagging, or irritating person.” He uses this image to evoke a peculiar combination of curiosity and persistence, with just a touch of impudence, necessary to identify important clinical questions and then answer them. Finding these questions sometimes just means “asking why” when presented with accepted dogma, he suggests, and following these questions to a meaningful conclusion can result in some of the most rewarding work of a career. He later illustrated this with two small examples from his own early experience, one in which he ran a randomized controlled trial to challenge the practice of treating elevated prostate-specific antigen with empiric antibiotics and another in which he retrospectively examined the practice of waiting at least 6 weeks after prostate biopsy to perform radical prostatectomy.
In contrast to this “signal” of meaningful clinical questions, Dr. Eggener warned against the “noise” which is often present in an early research career. He highlighted that a large body of work published regularly in Urology is retrospective with little hope of changing clinical practice. He acknowledged the pressures to produce such work with a nod to the truism “Deans don’t know how to read, but they know how to count,” and he recognized the brief satisfaction of a rapid publication. But he warned that this can be a “Faustian bargain”, and with the benefit of hindsight, he would happily trade the time he spent on many, less meaningful projects for a single more meaningful one. And while he acknowledged that some important questions can only be answered retrospectively, he suggested that the balance of meaningful work left to do in urology is skewed much more toward prospective trials than our current body of publications would suggest.
With those guiding principles in mind, Dr. Eggener turned his attention to the practicalities of “setting yourself up for success”. In keeping with avoiding “the noise”, he recommended developing the skill of saying no to requests for one’s time early in one’s career, especially to projects which, like “whiskey and cocaine”, might offer a quick high but no lasting value. Try to “enjoy the quiet time”, he said, early in your career when you are not yet clinically busy. This time can be spent wisely by establishing clinical mentors or obtaining formal training to fill in skill gaps. Playing a supportive role in others’ projects, such as reviewing/contributing to trial protocols, enrolling patients reliably to trials, and attending investigator meetings are easy ways to build connections and skills early on.
Finally, he stressed the importance of one’s institutional environment. At the University of Chicago, he is currently developing a dedicated clinical trial unit in Urology, which he hopes will provide a turn-key mechanism to rapidly develop and execute trials to answer the many outstanding questions in perioperative care while providing leadership and educational opportunities for his trainees and junior faculty. After all, you can’t make a silk purse out of a sow’s ear (to use an alternative turn of phrase), and even the most talented researcher will falter if they choose an environment which simply does not have the ability to foster their work.
Presented by: Scott E. Eggener MD, Bruce and Beth White Family Professor of Surgery and Radiology & Vice Chair, Section of Urology, University of Chicago Medical Center
Written by: Marshall Strother, MD, Society for Urologic Oncology Fellow, Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia PA @mcstroth at the 2020 Society of Urologic Oncology Annual Meeting – December 2-5, 2020 – Washington, DC