214 F.E. Nwariaku

Picking the right technique(s) for your project is very important.

First, newer techniques are generally considered to be superior by reviewers. However some new techniques have not been adequately validated.Also, new techniques are generally more difficult and require a learning curve. As such the new investigator has to decide whether to (a) continue to use familiar techniques learned during training and maximize productivity, or (b) develop a new technique to establish independence.This decision is guided by superiority of the new approach over the old, applicability of the new technique to the project, available resources, feasibility of the new approach, and cost.

Some new techniques are easily acquired, especially if it involves purchasing a new piece of equipment. Biomedical companies continue to strive to make measuring biological activity simpler, faster, and more accurate. Unfortunately, many of these machines come with a significantly large price tag. The price tag also includes service contracts and disposables. The new scientist should include all these costs in the calculation about whether to purchase the equipment. The patient-oriented researcher also has to deal with more powerful computing power, and expensive costs for detailed sophisticated biostatistical analysis. A relatively useful tactic is to use institutional core facilities when possible. Some cancer centers offer significant discounts to their members. It can also be helpful to teach in some basic science departments in return for discounts for use of core facilities. Examples of these facilities include molecular imaging, flow cytometry, confocal microscopy, tissue profiling cores, transgenic cores, etc. Collaborating with colleagues who also serve as core Directors (if your research has the scientific basis and is similar) is also a good way of getting free core services. Negotiation is key.

Program Leadership

Leading a research effort is truly an immense privilege. The surgeon-scientist has an opportunity to direct the search for new knowledge in a new field, share that information with the scientific community, and shape young minds as they

Chapter 13. Setting Up a “Lab” 215

begin their own quest for scientific inquiry. This privilege comes with significant responsibilities. The Principal Investigator/Program Leader has similar responsibilities to the CEO of any company. They need to provide strategic direction for the research program, recruit and retain good personnel, and put out a great product. A short list of responsibilities for the laboratory leader includes:

•Setting scientific direction

•Motivating personnel

•Communication

•Resolving conflict

•Mentoring

•Ensuring good academic output

Summary

In setting up a new research program, the new scientist has a tremendous opportunity to make important contributions to the health sciences and hopefully improve the lives and health of many people. Despite the numerous pitfalls, a methodical strategic plan, smart recruitment, and creative budgeting can all greatly improve the chances of setting up a successful research enterprise. It is hoped that the contents of this chapter will assist in some small way and ease the transition from new scientist to established successful surgeon-scientist.

Selected Readings

Making the Right Moves: A Practical Guide to Scientific Management for Postdocs and New Faculty. 2nd ed. Howard Hughes Medical Institute and Burroughs Welcome Fund; 2006. Available at: http://www.hhmi. org/resources/labmanagement/mtrmoves_download.html. Accessed January 2011.

Barker H. At the Helm: A Laboratory Navigator. Upper saddle river, NJ Cold Spring Harbor Laboratory Press; 2002.

Harmening DM. Laboratory Management: Principles and Processes. Upper saddle river, NJ Prentice Hall; 2003.

Part IV

Work-Life Balance

Chapter 14

Work–Life Balance

and Burnout

Kathrin Troppmann and Christoph Troppmann

Keywords  Lifestyle •Work–life balance • Burnout • Surgery

• Satisfaction

Introduction

Serious consideration of work–life balance and its impact on professional performance and family life have been anathema to generations of surgeons in training and in practice for much of the past century.William Halsted (1852–1922), the father of the first formal surgical residency training program in the USA at Johns Hopkins Hospital, demanded continuity of care from his residents. The restrictive lifestyle and extreme personal sacrifice that characterized Halsted’s training program in the waning years of the nineteenth century remained pervasive in most American surgical training programs for much of the twentieth century – well into the 1960s and 1970s.During those

C. Troppmann ( )

Department of Surgery, University of California, Davis,

Sacramento,

CA, USA

H. Chen and L.S. Kao (eds.), Success in Academic Surgery,

219

DOI 10.1007/978-0-85729-313-8_14,

© Springer-Verlag London Limited 2012

220 K. Troppmann and C. Troppmann

earlier days, surgical residents frequently lived on hospital premises during their residencies, were strongly discouraged from starting families, and were not receiving salaries. Instead, they were gratified with room and board,hospital clothing,and with professional education and training. The Medicare and MedicaidAct of 1965,which was primarily designed to provide for medical care for the elderly and the poor, became one of the first agents of change in the surgical residents’ lives in that it provided for a substantial salary.1 The basic underpinnings of the surgical residency changed gradually, with surgical resi- dents now at least physically spending part of their lives out- side of their training institutions. It was not until the beginning of this new millennium, in the wake of the highly publicized Libby Zion case, that the Accreditation Council for Graduate Medical Education (ACGME) designed and mandated the 80-h workweek for surgical and other residents,placing,among other measures, a cap on the length of the shifts that could be worked.2 Not surprisingly, this change regarding surgical resi- dents’ work hours generated vocal dissent from some of those representing prior surgical generations. For instance, Josef Fischer, M.D. stated “…the imposition, from without, of the 80 hour work week is seen as damaging to the essence of sur- gery’s being. It is the denial of the foundation of one of the most closely guarded and almost religiously regarded axioms of surgical care: the concept of continuity of care…”3

Nonetheless, the recognition of the importance of, and the focus on,work–life balance and related issues have continued to increase, fueled in part by the entry of Generation Y and the Millennials into the surgical workforce and by the increasing presence of women in the surgical workplace over the past decade and a half.4, 5

This trend has been most strikingly evidenced by the appearance of peer-reviewed articles dedicated to surgeons’ work–life balance, lifestyle, career satisfaction, and burnout, to name only a few issues.The articles are being published in steadily increasing numbers in highly regarded scientific mainstream surgical journals.5-23 This latest evolution has thus rendered the study, analysis, and discussion of these topics completely acceptable – even for those academic and