Category: Career

Posts by Jano Klimas about the academic career and the long and harrowing journeys of academics.

Mentoring in Addiction Health Services Research: Transitions are not always smooth

What makes a good mentor? What are the criteria for a mentor/mentee working relationship? Is it the number or similarity of their publications on their CVs? Is it the academic profile at the institution homepage?  The answers probably vary depending on time, place, personalities and expertise. Read more about my most recent mentoring experience below.

October 15th, the AddictionHealth Services Research conference launched a new AHSR Mentor/Mentee Program.  This program provided early career investigators an informal opportunity to connect with senior researchers/faculty/administrators.  Through this program, the early career researchers had an opportunity to establish connections, gather feedback on their research goals, or ask questions pertinent to their work.  All AHSR presenters and registered attendees were welcome to participate.


All of the mentors had substantial expertise. Some have been working on integrating addiction treatment with primary care and medical care since the mid-1990s.  Others worked with large data sets and traditional claims and utilization analysis.  Others analyzed the quality and quantity of addiction treatment services for veterans.  There were experts on person centered care, the criminal justice system and treatment for incarcerated individuals, and on organizational change.
The goals of the program were to connect senior researchers with new/young researchers to improve dialogue in the field, foster open relationships (with the potential for future work projects), and share knowledge. The program participants:
  • read the circulated list of Mentors (with links to additional information on their research).
  • nominated their top three Mentor selections to ensure a reasonable number of requests across Mentors.
  • received a reply with the Mentor contact information to setup a meeting time.

A Mentor/Mentee Meeting Room at the conference was available throughout the event.  No booking was required.
The program gave me valuable time with an expert, a research leader, who would otherwise be unavailable to talk and advice. During this time, we came up with a mission statement and a plan for the transition to my new fellowship at the University of British Columbia in Canada. The plan is to use the mission statement for contacts with people whose work I admire, or would like to work with. Informational interviews with these people will help me orientate in the new environment and move my career forward.

I’m a psychologist who’s trained in science and is interested in improving addiction health services through practical implementation research. I’m a scientist interested in communicating with the public, arts and blending the scientist-artist career. In this Canadian fellowship, I’m studying ways of how to integrate addiction medicine education into the training for medical doctors.


The Addiction Health Services Research Conference (AHSR) is an annual meeting which embraces the challenge, celebrates success, and leads the way toward more effective implementation science. Text taken from: http://www.ahsr2013.com/about.php

The best time for writing

Is there such a thing? Yes, there is, but it’s different for everybody. If you haven’t found your best time for writing, read more about my search for this writers’ Holy Grail

Waiting for the motivation fairy that never comes is a bad habit among many writers. I used to wait until the time was “right” for writing too. However, thanks to the mentorship of Dr McCarty, during my NIDA INVEST Fellowshiplast year, thanks to Zinsser’s books and to workshopswith Hugh Kearns, I’ve discovered that to write a lot means to write every day. It doesn’t mean writing lengthy texts daily, but every little helps when it comes to writing, too.
(c) Jano Klimas
 
Research articles are the bread and butter of my day job. Publications are the currency of science. A daily writing practice in the morning helps keep up the momentum and keep my job. Besides, I enjoy writing and welcome any opportunity to translate what we, the scientists, think and do, into a more reader-friendly language of non-specialist audience.
It took me a while to discover that I am a science writer – a journalist who writes about science. Although unpaid, my science blogs cover interesting articles, conferences and trainings. These essays are difficult to write, but not as difficult as academic papers. I write them on one afternoon, early each week. Most recently, my science writing was awarded 4thplace in the 2014 Andreas McEntee Medical Writing competition.
Generating new, fiction material is the easiest of all my writings. It started with a creative, prompt-based writing course in Portland, Oregon. Since then, I tend to scribble down snippets, tidbits … anytime they surprise me. It’s good to always keep a notepad on you – you never know which of these odd lings will become your next gem short story or haiku. Being systematic about these scatterings is harder than recording them as they arrive to me from the creativity ether. My current schedule and discipline allow me to spend one evening per week connecting, expanding and elaborating on them and another evening editing the results of my brainstorming. I’d love to do more of that though.

Does it work? When doctors need evidence

Healthcare professionals can generate important clinical questions for addiction research. Answering such questions by conducting a Cochrane review of evidence is a satisfying learning process and can contribute to drugs policy. This article summarises the experiences of an addiction medicine researcher conducting a Cochrane review, developing and evaluating a researcher-facilitated programme for medical student research activity in general practice.

photo credit: theconversation.net

One summer afternoon in 2010, an interview with a family physician in Dublin opened my eyes about talking therapies for drink problems among people who also used other drugs. “Does counselling work for these people?” the doctor asked.  “Yes”, I was absolutely convinced about it, but I had no evidence for my faith. Surprised by his interest, I sent him the only two studies on the topic that I knew of; never heard back from him.

I searched for more studies without success. Many studies on general population showed up in my internet search, but none for people who also used other drugs.
This made me doubt my beliefs. At that time, a national funding agency announced a call for Cochrane training fellowships. Cochrane collaboration hosts the largest database of systematic reviews to inform healthcare decisions. Cochrane reviews are the jaguars of medical evidence synthesis. The fellowship was a godsend. I could use the funding to learn from Cochrane gurus and answer the Dublin doctor’s question by making the most of all available literature. My supervisor introduced me to a Cochrane author, Dr Liam Glynn, who reviewed self-management strategies for high blood pressure. He agreed to mentor my fellowship. We booked the title for our review with the Cochrane Drug andAlcohol Review Group in Italy and started to work on it when we got the funding.
The review found very few studies, most of which didn’t have a control group or randomised patients without drink problems; we could not give any recommendations to doctors.
The next step in the quest for the answer, we approached patients with dual drug and alcohol problems and fed their ideas back to the experts. Expert consensus recommendations are standard in the absence of scientific studies. The group had to rely on semi-structured interviews with doctors and patients and “B class” evidence from my review. The result of their consensus was a manual for family doctors.
Having developed the manual, we tested its value to answer our original question: “Does it work?” The new pilot trial encourages doctors to ask people who use illicit drugs about alcohol and to help those with mild problems; severe problems are best treated by a specialist.  Sixteen general practices (GPs) in two deprived regions will be randomised to receive the manual-based training or to keep doing what they do. The latter group will be trained later.
When I finished my Cochrane training and review, it was time for me to give back and teach medical students because the fellowships worked on the pay-it-forward model. Equipping the new generation of doctors with critical literature review and appraisal skills was my contribution to the improvement of addiction healthcare delivery. The aim of our teaching project was to create and evaluate a training-through-research programme for medical students, facilitated by a seasoned researcher.
We offered online webinars, methodological advice, mentoring, and one-one interaction. Our medical school emailed all students and we randomly selected a handful needed for our research projects. Collaborators from biostatistics, psychiatry and public health aided the programme. The students presented their work at four conferences and wrote three academic papers for medical journals.
Teaching literature reviews to medical students was a rewarding learning experience. I learned that the quality and commitment of students varies; different expectations led to different work processes and outputs. Some students submitted their work in more finished stage than others; competing priorities precluded achievement of higher standards. The manuscript preparation, submission and publication processes were too long for short student projects, although some students persevered and remained involved until the end.
From a personal perspective, I still don’t know whether counselling works for drink problems in people who also use other drugs, but I’ve learned how to query the literature when doctors need evidence.

This post is based on our presentation at the INMED conference in Belfast, and o recent article in the Substance Abuse journal. References:
  • Klimas, J., & Cullen, W. (2014). Addressing a Training Gap through Addiction Research Education for Medical Students: Letter to editor. Substance Abuse. doi: 10.1080/08897077.2014.939802
  • Klimas, J., & Cullen, W. (2014). Teaching literature reviews: researcher-facilitated programme to support medical student research activity in general practice. Poster presented at the Annual scientific meeting of the Irish Network of Medical Educators, February 21, Belfast, NI.

 

Think Broad: Irish Research Council ELEVATE Postdoctoral Fellowship Awards launched today

“You cannot hope to build a better world without improving the individuals” – Marie Skłodowska-Curie

September 17th – the Irish Research Council is pleased to announce the launch of the International Career Development Awards – the ELEVATE Fellowships. Over 20 awardees confirmed their attendance. The speakers have been invited to give Awardees useful perspectives and food for thought before heading off on the international phase of this Fellowship. The launch has been a nice opportunity to meet fellow Awardees on this cohort.
The event took place in the Irish Research Council’s building, Brooklawn House, Crampton Avenue (off Shelborune Road), Dublin 4, Ireland, from 10am to 4.30pm.
Programme of the day:
10.00am-10.30am:      Welcome by the Irish Research Council
Introduction to Council Enterprise Team
Introduction to ELEVATE 2014 cohort
10.30am-12.30pm:      Dr. Janet Metcalf, Chair & Head of Vitae, ‘Careers for Researchers’
12.30pm-1.45pm:        Lunch and Networking
1.45pm-4.00pm:          Barbara Moynihan, On Your Feet ‘Present with Power’
Dr Metcalf’s talk focused on broadening the Fellows’ career aspirations: “I’ve never had any career plan, any career goal. Only two principles: catch every ball that’s thrown at me and make sure my decisions are widening my options, not narrowing them.”

Dr Janet Metclaf, photosource: vitae
 ELEVATEFellowship is a funding scheme of Irish Research Council which aims to fund Irish-based experienced researchers who have gained most of their research experience in Ireland so that they can acquire new skills and expertise while conducting high-level research abroad for two years and then return to Ireland for one final year with their newly acquired knowledge and expertise. The Irish Research Council International Career Development Fellowships are Co-funded by European Union through the Marie Sklodowska Curie Actions. In 2013, 15 researchers received the Fellowships for different projects from time travel through nanotechnologies to diamonds. The council funded similar schemes in the past, for example, the EMPOWER 2011-12 or INSPIRE 2009-11. This year, 25 fellowships were awarded to 5 academic and 20 industry-based projects. Text taken from www.research.ie
Barbara Monynihan, source: onyourfeet
 Irish Research Council (@IrishResearch) funds excellent researchers across all disciplines and encourages interdisciplinary research and engagement with enterprise.  The Council facilitates the career development of researchers by funding those at an early stage of their research career to associate with established research teams who have achieved international recognition for their work. The Council aims to support an expertise-driven research system in order to enhance Ireland’s innovation capacity and skills base in a rapidly changing global environment where knowledge is key to economic, social and cultural development. The Council is further committed to facilitating the integration of Irish researchers in all disciplines within the European Research Area. Text taken from www.research.ie
Maria “Manya” Salomea Sklodowska
© ACJC – Archives Curie et Joliot-Curie
 Marie Skłodowska-Curie actions (MSCA) are European research grants for scientists in Europe and abroad. The objective of the MSCA is to support the career development and training of researchers – with a focus on innovation skills – in all scientific disciplines through worldwide and cross-sector mobility. For this, the MSCA provide grants at all stages of researchers’ careers, from PhD candidates to highly experienced researchers, and encourage transnational, intersectoral and interdisciplinary mobility. The MSCA will become the main EU programme for doctoral training, funding 25 000 PhDs.
Endowing researchers with new skills and a wider range of competences, while offering them attractive working conditions, is a crucial aspect of the MSCA. In addition to mobility between countries, the MSCA also seek to break the real and perceived barriers between academic and other sectors, especially business. The MSCA follow a “bottom-up” approach, i.e. individuals and organisations working in any area of research can apply for funding. Several MSCA initiatives promote the involvement of industry etc. in doctoral and post-doctoral research. Text taken from www.ec.europa.eu

I will be awarded the ELEVATE to do research on better addiction medicine education for doctors in Ireland and in Canada (www.addictionmedicinefellowship.org). Watch this space for more information.

Take precautions: improve or improv-ise?

“A ship is safe in harbor, but that’s not what ships are for.” ― William G.T. Shedd

How much uncertainty can you live with? A lot, at least I thought so until I started a new course in improvisation. Improv is a bit like acting without a script. Scary? Here’s how this new experience helped me to lighten up my life.

Uncertainty is the only certainty there is, and knowing how to live with insecurity is the only security.” – J. A. Paulos

Before the improv course, precaution was my modus operandi. I was prepared, over-prepared and hyper-prepared for anything and everything. Like many other people, over-preparation was my way of coping with the uncertainty of life. I learned that careful preparation improved my performance and outcomes. This improvement, however, had limits and I couldn’t do better regardless of how much time I spent with preparation.

Life is what happens to you while you’re busy making other plans” – J Lennon

Figure 1 Neil Curran (R) photo credit: lowerthetone.com
 The Improv course with NeilCurran re-defined perfection for me. Over-preparation can often lead to a stilted impression. As if the spirit of doing things evaporated the moment you get in front of your audience, committee, boss or panel – you replace the addressee. Furthermore, you can only prepare for things you can foresee. But there are always unforeseen events. Improvisation helps you react to those challenges. Like any other art, it gives you the freedom of being here and now and reacting to whatever comes your way. It’s a way of being. An other paradigm. Some critics may say improvisation is lousiness, lack of knowledge or skill, neglect or laziness – something that should be avoided. The opposite is truth; improv skills allow you to respond when you run out of your prepared responses – to transcend yourself.

Improv and medical profession

The role of improv in medical profession is bigger than you might think. Although there are strict procedures and guidelines for most medical procedures, there’s still a lot that we don’t know and therefore – cannot regulate. Clinical intuition is invaluable in unregulated or over-regulated situations. Similar to improv, intuiting is reacting to the situation based on previous knowledge, experience and trust in the process. Atul Gawande, in his book The Checklist Manifesto, advocates using checklist to make sure the basics are done. This creates room for clinical wisdom and intuition to deal with unforeseen events. Instead of making rigid orders to doctors and thereby stripping their responsibility and clinical judgment away, the Checklist helps people make sure they do the basic and essential things, leaving enough space for intuition and … you’ve guessed it – for improvisation.