Category: Primary care

Mentors wanted: What to look for in mentorship

Finding a mentor can be a challenge for many junior academics because some supervisors don’t have time to mentor researchers. If you are seeking a mentor, I can’t tell you what to look for in a mentorship, but I can tell you what I look for in it. If it inspires you to act or clarifies things for you, please share them using the comments section below.

What’s the difference?
I am a big believer in mentoring / coaching. I use those terms interchangeably because of the great overlap between them (Figure 1). For me, mentoring is about giving advice, information or direction. Coaching is about setting goals, prioritizing and finding motivation to stick with the task. Counselling goes deeper than mentoring or coaching and it may deal with emotions or childhood.
 

Figure 1. Overlap

Internal or external?
It’s great that you are seeking a mentor. We all need one (or two). An external mentor, who’s not an academic doesn’t always understand the fine points of your career track, which may be an advantage. On the other hand, an internal mentor may be too focused on the career track and hesitating to see where your life is going as a whole.
Some universities have internal mentoring programs, others offer coaching as well. For example, the Faculty of Medicine at University of British Columbia (UBC) has a peer mentor program, a career planning program, a research mentorship program and a rural physician mentoring program. UBC’s free coaching services can be accessed through this web link: http://www.hr.ubc.ca/coaching/
What do you want in a mentor? What are you really looking for?
If the “top athletes and singers have coaches”, as Atul Gawandewrites, why should you?
What I want from mentoring is to have someone with whom I can discuss where my life is going, where my work is going, where my passion lies and how to integrate them all.
Academic or non-academic, a mentor should be able to help distance myself from the immediate tasks and focus on the bigger picture; my life as a whole, not just work.
Other people may need a mentor to talk about the following questions:
What to do after my current contract expires?
How to invest my time, energy and money according to that?
How to supervise and mentor junior colleagues?
​Some help with writing would be welcome too.​
How much does it cost?
Mentoring is generally free. If you have to pay for mentoring, there may be a way to get this reimbursed via university/employee assistance programme or some low-cost options. Accessing Employee Assistance Program is a good option, if you can find someone who does career coaching/counselling. At UBC, there is a specific provider (Homewood Solutions) and you have to ask for counselling and then see if you can have a mentor.
Are you female?
Gender matters in academia. For example, if you are a female academic in Vancouver, BC, you may be able to access an academic mentor via an organization called SCWIST (Society of Canadian Women in Science and Technology), or the UBC Postdoctoral Association (President, Dr. Grace Lee).
Has this post clarified anything for you and what you are looking for in mentorship? If yes, please share your thoughts in a comment section below.
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Further reading

Conference of the North-American Primary Care Research Group: This is Times Square

“What’s this?” “This is Time Square” an overheard conversation made me smile and think to myself “Yes, this is the centre. North-American Primary Care Research Group conference is the “Times Square” meeting of world’s research elite.

Victor Montori from the Mayo clinic opened the conference on Saturday, November 21stwith a plenary on minimally disruptive Medicine. He urged the audience to consider the work that each patient has to do to comply with treatment. Like a canary in a mine, which stops singing and gets restless when the air in the mine becomes poisonous, the patient can signal when the burden becomes unbearable.
Our presentation was in the first of five concurrent papers sessions on education. Our chair was Janice Bellfrom Australia. One presentation was cancelled and two were merged because they were presented by one investigator (Gretchen Dickson).  Educators talked about a test measuring critical thinking, about research education, expectations of programme directors, geography of supervision and addiction medicine (see Figure 1 below). Approximately 20 people attended, the rest chose another of the competitive list of concurrent forums, workshops and the popular “ask the experts” session.
Here is my prezi (Figure 1):
Joe Selby, the director of the Patient-Centered Outcomes Research Institute, welcomed attendees on Sunday. The institute focuses on funding personalized medicine and outcomes that are meaningful for patients. It aims to speed up the infamous 17-year shelf-life of new research. The director mentioned a research question identified by a diabetic adolescent; the voice of the patient has been represented. Selby outlined what propose to not get funded (for example, effectiveness or methods proposals). The audience asked provoking questions. What’s a successful patient engagement? – (potential for exploitation can be reduced via advocacy groups). What is a patient centred outcome? There’s no validated measure of patient engagement (except the Engagement Activity Inventory enact tool).
SHORTER IS BETTER – The Blah, blah, blah problem
Workshop on writing effective research reports was facilitated by the Annals of Family Medicinejournal’s editorial group (Phillips, W., Bayliss, E., Ferrer, R., Gotler, R., Acheson, L., Balasubraanian, B., Cohen, D., Frey, J., Gill, J., Marino, M., McLellan, L., Peterson, L., Williams, R., and Stange, G.) Editors urged authors to resist the urge to fill the word limit (for example, 2500 words in medical journals). Shorter papers increase readability – more people will read it. There are two useful measures for pruning:

  • Short and familiar words
  • Short sentences
The facilitators continued with examples of short prose. Watson and Crick’slegendary Nature paper from 1953 had 903 words. Hemingway’s challenge was to tell a story in 6 words only: For sale: baby shoes never worn. Simpler writing seems smarter – Oppenheimer’s study showed that the readers can see the smoke of inflated language in research articles. The authors should always ask themselves: Would this work as a shorter piece? Similar to articles, minestrones are good with lots of ingredients but at a certain point, new ingredients do not add anything else. Following a formal lecture, the group broke into smaller groups and edited long and complicated sentences from submitted manuscripts.

NAPCRG is a multidisciplinary organization for primary care researchers. Founded in 1972 and oriented to family medicine, NAPCRG welcomes members from all primary care generalist disciplines and related fields, including epidemiology, behavioral sciences, and health services research. Text taken from www.napcrg.com

How Cochrane Keeps the Addiction Science in Check

Science isn’t infallible. Humans make mistakes even in this highly sophisticated method of understanding the world around us. Thanks God, addiction researchers get a chance to correct their error. If they publish a big error, the publication may be withdrawn. In smaller cases, the publisher issues a correction. It is interesting to see how such a correction has been issued following publication of our Cochrane systematic review of literature which. Probably this helped to keep the addiction science in check. See it for yourself below.

August 2011: “Alcohol-related brief intervention in patients treated for opiate or cocaine dependence: a randomized controlled study”

Before our review included this study, the authors reported the following figures in tables 3 and 7.

November 2011: “Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users: a Cochrane review”

 Our review was published in November 2011 and re-stated the findings of the above study as: higher rates of decreased alcohol use at three months (risk ratio (RR) 0.32; 95% confidence interval (CI) 0.19 to 0.54) and nine months (RR 0.16; 95% CI 0.08 to 0.33) in the treatment as usual group– See more at: http://summaries.cochrane.org/CD009269/ADDICTN_which-talking-therapies-counselling-work-for-drug-users-with-alcohol-problems#sthash.RcVZGdQA.dpuf

August 2013 “Correction: Alcohol-related brief intervention in patients treated for opiate or cocaine dependence: a randomized controlled study”

After the publication of our review, the authors corrected their figures in tables 1 and 5. The care-as-usual treatment for the control group was no longer stronger than the experimental intervention, the “alcohol-related brief intervention.”

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A note on causality in science

Because causal relationships are hard to prove (i.e. cause -> effect), majority of scientific publications rely on correlations. An example of a correlation is a relationship between shorter living expectancy and male gender. Men die younger than women. Although there are many plausible explanations, we cannot pinpoint a single cause.  Similarly, if an article gets corrected following a review in a major synthesis of scientific evidence – the Cochrane review – it may be a pure coincidence or it may be a consequence of the review. 

Substance Abuse Treatment, Prevention and Policy is an open-access peer-reviewed online journal that encompasses all aspects of research concerning substance abuse, with a focus on policy issues. Text taken from www.substanceabusepolicy.com

Cochrane Collaboration hosts the largest database of systematic reviews to inform healthcare decisions. Cochrane reviews are the jaguars of medical evidence synthesis. Cochrane is a global independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making the vast amounts of evidence generated through research useful for informing decisions about health. Cochrane is a not-for-profit organisation with collaborators from over 120 countries working together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest. Text taken from www.cochrane.org

Finding the Evidence for Talking Therapies: Article in the Forum magazine

In an attempt to prove that counseling works for reducing drinking in concurrent problem alcohol and illicit drug users, I ended up on a journey through research and review. Read the full article in the November issue of the Forum Magazine (Volume 31, Issue 10)

Figure 1. Photo of the article in the Forum
 

This article was inspired by an essay which won the 4th place in the 2014 Aindreas McEntee prize of the Irish Medical Writers. The competition is open to members of Irish Medical Writers, a group of doctors and journalists specialising in healthcare. Parts of it were posted in my September post here.

The Forum magazine is the official journal of the Irish College of General Practitioners ICGP. Published monthly by MedMedia since 1991, it is Ireland’s premier journal of medical education. Text taken from: http://www.icgp.ie/go/library/library_home/

Founded in 1984, the Irish College of General Practitioners or ICGP is the recognised national professional body for general practice training in Ireland.

 

How to go about getting a postdoc position? Finding funding

There probably isn’t a simple answer to this question. Everybody has a different experience. My path was one of finding my own funding to do what I liked. Other people get postdocs via other routes, but I’d hope that my story bellow illustrates one of the paths people can take.

My mentor helped me identify funding calls and write funding applications. Then, I applied for everything and some of the applications were successful. Keeping up with the current funding calls via Research Newsletters and email alerts, such as Find A Phd, helped me too. I met the collaborators for my projects at conferences and seminars.

 
My experience is from Ireland, although I have a Slovakian PhD in Social Psychology(04/2011).
First, as a Research Assistant, I applied for and was successful with getting a Cochrane Training Fellowship to complete a Cochrane Systematic review over two years – 2 days p/week – from the Health Research Board Ireland (2010-12). The fellowship examined psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users. The absence of evidence on the subject helped us to identify priorities for research.  To find out more about the Cochrane Systematic reviews of literature, go to: www.cochranecollaboration.org
Towards the end of my two-year Cochrane Fellowship, my Irish supervisors offered me two complementary part-time postdoc positions, both of which I accepted. The first was a three-year position in emergency medical science research. The second was a one-year position developing new projects in primary care settings and supervising medical students (2012-13). From a personal perspective, teaching literature reviews to medical students taught me how to address a training gap through addiction research education for medical students.
At the same time, I applied for two other grants. First was a three-year feasibility study in primary care from Health Research Board Ireland (Co-applicant). Second, an INVEST drug abuse fellowship from the National Institute for Drug Abuse – NIDA (Fellow). The feasibility study was a direct result of our efforts to highlight the problem of alcohol consumption among people receiving methadone treatment. We’ve trained family physicians in psychosocial interventions for concurrent problem and drug use disorders. Hence the title for the PINTA study.
Both were successful. Thanks to the patience and flexibility of my supervisors, I was able to combine and merge all of these opportunities. The INVEST postdoctoral fellowship was a six months job in at Oregon Health and Science Universityin Portland, OR, studying implementation of alcohol SBIRT in primary- versus secondary-care based opioid agonist treatment (2013). Our poster at the Annual Symposium of the Society for the Study of Addiction described qualitative component of the study. Training health care professionals in delivering alcohol SBIRT is feasible and acceptable for implementation among opioid agonist patients; however, it is not sufficient to maintain a sustainable change. After INVEST, I returned back to my composite Irish postdoc.
Eight months after the return back to Ireland, and one year before the end of my three-year Irish postdoc, I received another fellowship from the Irish Research Council. This International Career Development Award is co-funded by a European Union scheme called Marie Sklodowska Curie Actions. To improve the addiction medicine education for doctors (BEAMED), I’ll do an external and independent evaluation of the addiction medicine fellowship and plan a similar training in Ireland (2014-17). To learn more about the Marie Cure awards, go to: http://ec.europa.eu/research/mariecurieactions/