DedicatedTime_Final 2.9.2026 ===

Hello, and welcome to another episode of Behind the Knife. My name is Elizabeth Magno. I'm a general surgery resident at the University of Nebraska and behind the Knife Fellow. Today we're going to be diving into research career development time, often referred to as the research years, how to decide if it's right for you, how to fund it, and how to make the most of the time if you choose to pursue it. I'm joined by my co-fellows here at Behind the Knife, as well as Dr. Daniel Nusbaum, associate Professor of Surgery at Duke University. Dr. Nusbaum is an HPB surgical oncologist, clinical trialist and translational researcher, and he's bringing the faculty perspective, especially when it comes to funding opportunities, mentorship, and career development. Let's start off by introducing each of our behind the Knife Surgical Education fellows. I'm Nicole, would you like to start? Sure. So I'm Nicole Petco. I'm a second year research resident at Emory University, and I went out after my second year. I'm currently working in a bariatric patient reported outcome measures lab.

I can go next. My name is Agnes. I went out after my third year. I at Creighton University in Phoenix. And interestingly, we don't go out for research. Most of the residencies like geared towards going out into general surgery. So it was like a bit of a transition for me to go out and I had to find funding myself. So my program right now is a T 32 program and I'm focused on basic science and colon cancer and mismatch repair proteins. Hey guys. I'm Emma Burke. I'm in my second year of research at Baylor College of Medicine in Houston. I went out after my second clinical year and I'm doing surgical education and trauma clinical research. Hey guys. I'm Michelle Abella. I'm a resident at UNC. I'm currently in my second year of research and we go out after our third year and I do, we bench pancreas cancer research. Hi everyone. I'm Kara Mutton. I'm a resident at Maine Medical Center, but I'm doing my research time at Tufts Medical Center. I went out for research after my third year, and my research focuses on computer vision and AI applications and surgery. Very cool. So we got a diversity of perspectives, what we're doing with our

time, so that's exciting. And then Dr. Nesbaum, do you think I did you justice with your introduction? Yeah, no thanks Liz. You know, I, I help run the residency research fellowship at Duke, so that's, I think, what's most pertinent to our conversation here. Perfect. We're gonna start with the big theoretical. Why do residents take time off? All right. I think we can start by addressing a misconception and people take time off 'cause they feel like they have to. I don't think that's so much the case anymore and I hope that everybody that goes out has a real interest that really wants. To do something. 'cause I don't think that there's a lot of fellowships anymore that you really have to take time off for unless you actually want to. I think that that's often what you're told that you need to do it for fellowship. Although it may be encouraged in certain settings, there's so many more reasons and benefits that you get over the research time that isn't to be overlooked. You know, my bias on calling it research time is that's not an accurate depiction of what you're doing. Right. I prefer the term professional development time. You know, so many people use this time to go back to school. I really focused a

lot of, especially at the beginning of my research time on learning how to do different like statistical methods and qualitative research methods, because quite honestly, I'll never have this kind of time again where I can just read all these papers, you know, take mini courses and seminars and things. So I think it's about a lot more than just even doing the research and getting the publications and going to meetings. My second bias is that it's also a great time to just live a normal nine to five schedule. Yeah. You know, I have a daughter that's been like a highlight of my research time. Right. So I think there's a lot of benefits that come even beyond just how much you can pad your cv. I think something really special about academic development time is that you really have this unique opportunity to learn something that is completely new and different. You know, for example, my research is in computer vision and ai. I have no background in computer science. I get to, as part of my master's degree, take classes and machine learning and computer vision and, and learn all these really cool things that I otherwise wouldn't have the opportunity to do so that are applicable to my research. And I think that's an interesting place to be where you actually have the time and space

to learn and new skill you really want to pursue you later on in your career. I totally agree with that. It starts that thread in these years that you'll then really continue throughout the rest of your career ideally, or you'll figure out what you don't like and that's another win too. I remember when I was applying for residency, there were a few programs that required research years, or you apply into a seven year track. When I was at that stage, I was like, there's no way I'm gonna do a seven year residency program. I'm just gonna do my five and get out of it, and then cut to now I am doing those research years and coming from a program that doesn't require us to go out on research or professional development time. And a lot of my co-residents don't take time off though when I was deciding whether to take time off or continue on, it was many of the points that Kara and Emma have already shared, just like this. Time in our lives that we get to develop all these different skills, and I'm taking a lot of classes in statistics and how to do like a good translational research. And in the future it'll help me align my goals and being the surgeon scientist that I want to be. But while it's not required for everyone, it

definitely allows us to grow outside of surgery itself and to just become a more fleshed out provider. Dr. Nesbaum, what do you think the biggest benefits of taking career development time in residency is? So I would start this by just saying we represent a sliver of the whole. Training environment in general. So between all of us on the call, we represent sort of a spectrum of how academic our programs are, but we all offer some degree of academic opportunity, and that's probably not true for the majority of training programs out there. So my exposure has really been to sort of like highly academic training programs. So there's a lot I don't know about community-based programs that traditionally go straight through. Where the goal is to complete your training, possibly go on to do a clinical fellowship, and then you know, practice surgery and your entire career is essentially focused on clinical medicine and, and that's great and important, and it probably represents most of people who are doing general surgery training, but for those

of us in the room who kind of have the opportunity to pursue academic or other non entirely clinical activities. I think it provides a a few different benefits. Number one is it just sort of breaks up your clinical residency. I mean, surgery residency is pretty grueling, especially the first couple of years. I think it gives you an opportunity to pause, sort of like reset part of your life and just get on a little bit of a normal schedule again before completing the three really, really rigorous, more difficult clinically years. So I think it provides just a nice break within your general surgery training. Now that's obviously not the reason to do it. It's an additional benefit. I think the reasons to do it are twofold. I think number one, if you want to do something as part of your career that's not entirely clinically focused, and that can be so broadly defined, this is your opportunity to get your toes in the water and figure out what it is you might be interested in. Whether that's doing basic science

research, whether that's doing clinical research, whether that's doing trials. Whether that's doing education or policy work or healthcare management on the business side, it's an opportunity to just figure out what you might be interested in doing outside of clinical medicine. Many people don't end up doing exactly what it is they spent their time doing, so I think it's also just an opportunity to. Develop some maturity to develop some content expertise and just figure out, you know, how might you broaden your career beyond being a, a clinical surgeon, if that's what your interest is. That's incredibly well said. I agree. The skill development that you get over this time is. Something that you just would not be able to do without taking dedicated time to to go do it. But the perspective that not everybody does this and it's not necessarily a hundred percent necessary to be a really good, strong general surgeon is key to note. That leads us really well into our next question, which is, do I have to take dedicated time? In my opinion, the answer is an

obvious no. No matter what your future path is. If you just want to be a, I mean, I shouldn't say just, but if your goal is to be an entirely clinical surgeon. Clearly you don't need to do this. You might still benefit from it, but you don't need to do this. And at the same time, if at some point you decide to pivot and do something that's not entirely clinical, not having done research in residency is not going to hold you back from that. Like if you really want to do this and you have the capacity and the time and, and the strong interest in doing it, and you're in a setting. Where your employer will let you pivot and expand what you do, then this isn't gonna be like the right limiting step in whether or not you can do that. But I think it definitely makes it easier if you have a strong inkling that you want to have some academic focus or some focus that's not entirely clinical. Like this is a great opportunity to build some skills in that area, and it's a whole lot easier to kind of get that first job with the expectation. You're not going to be 100% clinical.

You also have an interest in X, Y, or Z if you've already pursued that. I agree to build on that a little bit too. The opportunities have to line up to be what you want in order to go out. So for me, I wanted to do a Master's of Health Professions education. I wanted this focus in bariatric clinical outcomes, but also education. And my program worked with me to get me different opportunities. Now, if those didn't all line up, I probably wasn't gonna go out, because you can get your master's when you're an attending, you can go back and do these other things. So you wanna make sure that if you're going out and you're choosing to take this time, that it's really gonna be something that's gonna benefit you and that you're interested in. You don't wanna go out into something that really you don't see yourself doing or that you're kind of being forced into. I think the better question to this is, do I have to take dedicated time? Is really. Do I have to take dedicated time to become the kind of surgeon that I want? And the honest answer to that is it really depends. So it depends on what you want your career to look like. Many residents build strong academic and clinical careers without ever stepping out, and many residents also match very competitive

fellowships like CT and Surge on, even without stepping out for research. Granted, the encouragement isn't always to do that, but I think it's really asking what you want out of the time is the The key thing. Yeah, I mean, I think. And this is, this is true for kind of every decision you make throughout your career. Like you have to be very true to yourself. You're gonna get a lot of external pressures or recommendations on what your career should look like, and you can even convince yourself that that's how you want it to look based on sort of what your mentors might tell you or what sort of like programmatic focus of your. Training program is, but I would just like continuously ask myself, is this what I want my career to look like? Is this what I want to focus on? And if you are on this path where the answer is clearly no, like you would be much happier and more fulfilled doing something else, like pivot towards that. But at the same time, if you know the answer is yes, you want to do something, then take advantage of the opportunity that your program gives you and spend a couple of years gaining that expertise. And again, it doesn't have to align

exactly perfectly with what your long-term goals are. It can be close because you'll grow, you'll gain, you know, expertise. And I, I think sometimes by doing something that's a little bit out of your comfort zone, you might actually learn quite a bit more. I totally agree. So now that we talked a little bit about if you have to or not and what to think about when you're approaching dedicated time, let's dive into a little bit how to get set up with a project and how to get set up with a mentor. I think this is a really great question to ask and, and one that's kind of hard to answer because. The niche and the mentor really go hand in hand. It's great when you have a mentor who's really excited about something and that also fuels your excitement for whatever that topic or whatever that research project is. In my particular case, I had broad interests and it was a little bit of funneling down of who did I think would be a good mentor and where could I get the funding to do that, because my funding didn't come from within my institution itself, and I was really fortunate to be able to talk to a couple of different people to figure out. Yes, this is

something I'm interested in, and yes, I think this person is going to be a really good fit for long-term mentorship. Yeah, to kind of build on that too, we start early. We start our intern year where we have to start identifying a mentor and maybe thinking generally about a topic for a project. With that, I started with my assigned mentor and you know, she got me connected to someone else and it was almost like a phone tag. I kept meeting with different people until I found my current mentor. She was interested in research and she had the experience that I needed to help guide me. But also the time and commitment to help me get projects across the finish line. So I think sometimes things just fall into your lap when you get talking to the right people. Yeah, and I think from somebody who does web bench research, your options to start are a little bit more limited because you need somebody that has a lab and has funding. And so like I was fortunate enough to have this great mentor at UNC who has funding, had this well established lab, has all these amazing grad students that have already mentored residents. So I think it may just be luck too. Yeah, education research is also pretty limited. Not every surgical department has the infrastructure to support it, or even

the resident cohort class size to support it. I was pretty adamant when I went through the match that I wanted to do surgical education research, and that was important to me. I ended up choosing a program that. Did not have it established, but was very supportive of starting it. Actually, my chairman matched me with my PhD mentor for education. I will say though, going off of what Nicole said with just finding things that fall into your lap, my trauma Outcomes research mentor, he sent out a mega blast email to like all the residents one day and was like, Hey, does anyone wanna write a paper with me? I emailed him back. Yes. And now that's been like just as productive, if not more so productive than my education research. I'm starting my own like multicenter trial, like I'm doing all these other things just because I answered yes to an email. So even if it's not the like box you put yourself into start saying yes to those opportunities sometimes actually turns into something even better than you could have predicted. I love that point, Emma, though. I was one who in my undergrad time I had done basic science research in a lab. Granted I was. An undergrad biology student. So I was kind of doing the not as fun in thought provoking part of the research

and I hated it. And I thought, I'm never gonna do basic science research again. This is so painful. And then now I'm dedicating two years of my life to bench work and I love it. Right. And a lot of that was. One, finding a disease process and the science that was most interesting to me. And then some of that was luck that I got connected with Dr. Barrett, who's a trauma surgeon, does a lot in coagulation. And I just got super excited about fibrinolysis. You know, like who would've thought it. Yeah. And I think the same thing when I was in undergrad, I didn't have as much exposure. Um, but I remember our lab studied a lot of like epigenetic things and I remember being very interested in what we were studying, but I wasn't contributing too much. Cut to when I had to email different people to find a project and find something that I could get plugged into. Since it wasn't away from my institution, I didn't have as many mentor connections. I think the secret is just meeting with a lot of people, a lot of different labs, and just seeing what kind of research they're doing and from just meeting with them, you can get the sense of how you can contribute if you like mesh well with your mentor, with the other people that are in the lab and trying to follow those.

Things through Dr. Nussbaum. Off outta curiosity, what did you do for your research time in residency and how has it helped you today? When I was deciding what I wanted to do for my research time, I knew that I wanted to do surgical oncology as a fellowship. I really didn't know what I wanted my career to look like beyond that. But I was at a program that required two years of research and I had a clinical mentor, Dr. Tyler, and he basically said, you are going to work with Chris Wood, who's a new faculty at Duke. He's looking for people in his lab. He's whip smart, he's got great ideas. You're gonna be doing really novel stuff. This is the right place for you. And it wasn't like, oh, you absolutely have to do this, but it was, this is a great opportunity. You should pursue this. And that's what I ended up doing. I met with Chris. It worked out really well. I spent three years learning from him doing, um, you know, basic and translational science. And I, I think one important point there is you don't necessarily have to discover this on your own, and there's no

perfect situation that you are going to figure out. If people who have your best interest at heart say there's a great opportunity for you to learn in a field that you're interested in, like sometimes that's the best opportunity. We are starting to work on this with our residents from literally the day they walk in the door. I met with all the new interns this year, one week after they started, and we just started having conversations, what might you be interested in? You start with kind of these organic conversations, and over time you can start to build an opportunity that might fit for them. Oh, you're interested in this? Well. There aren't funded researchers who do exactly this, but they do things that are similar to this. You should meet with X, Y, and ZI. I tell the resident there's not a perfect opportunity for most people. There's lots of really good opportunities. So explore those and then I try and get people to commit early. We go in after our second year, I try and get people to commit by the end of their first year. Find something that just feels right, and then spend that next year really crafting what your two year opportunity's gonna

look like. Because two years goes by really fast. It seems like a lot of time, but like any new job, the first three months, you're just getting your feet wet. You're trying to get used to a new building and new ways of doing things. And next thing you know, you're already in your second year and you're trying to figure out like, how am I gonna wrap all this stuff up? So I think as much as you can prepare on the front end, the most you're gonna make of that experience. And so I tell people, like the best advice I can give them is choose something that generally feels right. By the end of their intern year. That is great advice, and I think getting those feelers out early is also a great way to set up those projects to hit the ground running. Before you start, we can dive into the funding Part of this funding is really complicated. NH funding T 32 grants F 32 grants, loan repayment programs, and it gets very complicated and kind of scary because. If you don't have a stable salary, obviously that is something you need to be able to do and like focus and enjoy your research years. As we get started, we'll start talking the most broad, so the

NIH or the National Institute of Health. Lots of surgical residents are funded through NIH through either T 32 or F 32 grants. We have Agnes here who has gotten a T 32 institutional training grant, do you wanna talk a little bit more about how you applied for this grant, how you got it? Things you learned along the way? Yeah, definitely. So, T 32 is an NIH grant that's actually given to institutions. And institutions then split up that money in whatever way they see fit, whether it's hiring three researchers or four, it's really up to the discretion of the institution. So all these programs are, have their unique applications. Like my program, I had to apply to the institution and not to the NIH specifically. So the funding comes from the NIH. They give you a lot of the structure for the things that are required of the people who are receiving this funding. For example, I need to turn in like a research report at the end of my time and then have multiple check-ins with my PDs and people at my institution who are overseeing

this grant. Then the day-to-day work of who's doing the experiments or what kind of lab you're working in is really up to the institution. So my institution allowed us to pick between 20 different mentors. So I just had to meet with the different mentors, see who I clicked best with. Once we breach an agreement, this is what my project is gonna be, then my funding was routed through that way. There's also another program similar to the T 32, which calls an F 32, which is the funding is then given to you as an individual and not to the institution. This is similar to the T 32, but it's more competitive in that you'd have to create like your own research proposal. Identify a mentor early on before you apply and outline all the things that you want to do, and then apply to the NIH For T 30 twos, there's a, there's a website which we'll link in our show notes, but. Every single T 32 program that's in the country, all their information is on this website. So you can just go through and see what institutions are offering them, what kind of focus they have, and whatever interests you, you can apply through their

means. I really just Googled a bunch of different programs that were focusing on, like cancer biology, and that's how I applied to different programs and. Was this stuff that stemmed from your mentor and then you applied for the grant? Or did you have a project idea in mind, start applying and then find a mentor? What series of sequences did you go through? Yeah, so for my T 32, I actually applied to the T 32 program initially. So I applied by giving like a research statement, like why I wanted to be a part of a T 32 program, um, and my cv. And once I got accepted or conditionally accepted, they wanted me to find a mentor. So I reached out to the people that were in the institution offering positions available, told them my interests, and once I was paired, then my project was fully set and it was fully accepted. Very cool. Very, very cool. So I'm also on a T 32, but the way that that T 32 works a little differently. The way I found my position is that the principal investigator of. The lab that I'm in reached out to program directors in the area looking for residents to apply because of the timing

of when MT 30 twos are granted anywhere between the late winter, early spring, but the funding wasn't actually dispersed until May. So I had been conditionally accepted into a lab just by reaching out on my own, and then was accepted into the T 32, the May, right before the July I went out for research. So every program is a little bit different and it's really worth looking into how the structure of the programs work, especially when it comes time to apply, considering all of the deadlines that you'd need to reach. So at at Duke, we actually require that the residents submit an F 32 application. Unless they've either secured funding through another program already or their research site is totally irrelevant to something that an F 32 might actually fund. But writing a scientific F 32 during your clinical time is exceedingly difficult. It is a ton of work. You are often writing about a topic that you really know very little about.

I think back to like the hardest thing I did, it was probably balancing writing my F 32 while being a second year resident. I mean, I remember coming home and sitting at my desk and spending like two hours getting two sentences that seemed coherent, dad, and then falling asleep at my desk. That being said, I do think it is a great exercise for what? Trying to pursue funding while being a busy clinician looks like it's really hard, so getting a look into it early is valuable, but probably more importantly than just like the quote unquote life lesson, you generate so much text that is so useful for the rest of your career pursuing funding. You put together a bio sketch. That bio sketch is going to be like a living document for the rest of your career and just getting those words on paper initially. The next grant you submit, you're just gonna edit that. Like my bios sketch today is just a adapted version of the bio sketch I first put together, you know, when I was a second year resident. So I think it's an

immensely valuable experience, number one, in learning how to put together an innate style grant. Number two, even if it doesn't get funded and the funding landscape is so difficult right now, you will gain by just having that text available and saved, like the next time you have to go about a similar activity. It's gonna be so much easier because you've done it once. Our next NH based grant is gonna be the loan repayment program, which is a little different as the LRP pays off a chunk of your student loans. The loan repayment program is a federal program through the NIH. It pays up to $50,000. Per year towards your student loans. It's designed to support early researchers spreading at least 50% of their efforts and time on research. So eligibility is demonstrating a commitment to research through writing a grant. Do need to have two dedicated years, and you're supposed to apply before you go out. So you would be applying in that year, leading up to research time. So the pros is it's a massive financial benefit for

residents. It takes a large chunk of your loans away. Cons, it's, it's A NIH application, so it takes a lot of time and you have to apply while you're still clinical. Yeah, it's actually pretty similar to a F 32 grant I think. So that. They're pretty well funded this year. I looked it up recently. I think it was like 61% got funded. It's wonderful that they have this program. Yeah, so everybody listening to this should apply. I think that if you can put together your thoughts in a coherent plan, like doing the application is the hardest part. Then you can get a hundred thousand dollars back for your loans for your hard work. It is nice to watch that number go down instead of up for once. Exactly. And then the deadlines in November. Let's talk a little bit about societal grants or foundational grants, so I can talk a little bit about these different society grants. A lot of the different surgical societies, A-C-S-A-A-S-T-A-A-S-S-U-S, alphabet soup. All have these different foundational grants. With these grants, it was nice because they're a lot shorter and some of the requirements

overlap. So like I was able to kind of write like a two page research proposal for some of them and then be able to submit that to multiple of the societies. So that felt a little bit better, I think, than the F 32 grants. It is alphabet soup. You are right. And does anyone wanna talk about departmental grants? I'm funded by my department, so not quite a grant per se, but the way my fund research funding works is. Half of my salary is paid for by the Department of Surgery at Baylor College of Medicine, and the other half of my salary is paid for by the Department of Education that we have at Baylor College of Medicine. So that gives me actually really nice flexibility to kind of work in both departments and work on some initiatives that are totally separate from what surgeons are doing, because I have that funding that comes from the Department of Education at my institution. You know, when I was looking into funding opportunities for education, it's quite sad actually when you're trying to look for education funding. But a couple of the big organizations like Josiah, Macy, the a MA, some of those offer some grants that I've applied for during research time as well. But my

day-to-day salary is paid by my department. For our med student listeners, that is something if you know that you're really interested in research could be something you can ask at, you know, the residency, interviews, residency socials. 'cause I think it might sway how you do your rank list is if they offer funding, if it's something that you're really passionate about. And I will say too, like I didn't lose any of my status as a trainee at my institution. So like I moonlight, I'm still in their malpractice. Like I have these other opportunities because I maintain my connections with my institution. Dr. Nobo, how does it work for programs that it's mandatory for research? Is it on the resident to find their own research or, you know, is Duke good at come in on the back end and support everybody? So I, I think it's different for every program. I mean, I can only speak to our program. All in all, we're close to 10 residents a year, so about 20 residents over two years who need to be funded, plus any resident who wants to spend more time in the lab, and that's really expensive. I only started learning about this when I took on this role. It's not just your salary, it's all the cost of

fringe benefits. So you can basically take your salary and, you know, multiply it by 0.25 and add that so it, it comes to around a hundred grand a year per resident. So that gets really pricey really quickly. If you're a program that's gonna require research or academic development, you have to put your money where your mouth is, right? Like, you can't expect everybody to come up with, you know, a couple of hundred thousand dollars of funding. Over two years. So Dr. Harpo, who has led this program for the past decade, brought in a number of institutional training grants. He brought in multiple slots for the surgical oncology T 32. Dr. Kirk, who was our recent, you know, our most recent chairman before Dr. Allen took over, and he's the co-PI with Dr. Harpo on the search on T 32. Has, uh, advanced Immunobiology T 32. Dr. Harpel brought in what's called an R 38, which is a newer grant, which, you know, operates pretty similarly to a T 32, providing institutional research slots. Our arrangement with the VA

allows us to bring one to two residents per year as a VA quality scholar, so we're really lucky to have all of these spots. I, it would be very challenging without them. We hope every year that one or two residents get an individual F 32 or a foundational grant or something else that helps to fray some of that cost. But I think the question is, what do you do with the residents where there's no T 32 slot for what they're interested in? So our department will pay 50% of a resident's entire costs, and the expectation is whoever they work with, that person's responsible for the other 50%. It's actually not that complicated. If somebody wants to go and do research, they're really only gonna have a good experience if that person can fund at least 50% of their research. Like research was really expensive. So if you find a mentor who can't fund 50% of a residence, you know, salary and fringe, it's probably not the best experience for you. And so what we do, we basically tell whether it's a PhD or an educational

researcher or anyone else. We're gonna defray 50% of the costs of a really highly motivated, very intelligent, hardworking postdoc. So you're basically getting someone to come work with you for 50 cents on the dollar, and that arrangement's worked really well for us. It's just everybody has some skin in the game. What advice you give to your residents who are approaching these kind of complicated funding when you are meeting with them as a mentor? This, these are with pretty simple questions. I start by asking them like, where do you see yourself in. 10 or 12 years. You know, you finish fellowship. What do you want your faculty position to look like? They might not know the answer to that, but it's a pretty good place to start. And if they can answer that first question, you say, okay, what are the gaps in your current skillset to achieving that? Like, what are the skills you would wanna acquire? What's the expertise you would wanna acquire? What are the experiences you haven't had yet that you think are going to help you get to that, and then you start sort of building a academic development plan based around that?

Again, like I said earlier, there's no perfect experience. There's lots of really, really good experiences and all of us. Have gaps in, in our sort of expertise for where we want to be 10 years from now. I think if you think you know down the line and say, well, what do I need to learn to actually get there? It's a good starting point. How do you guys approach projects? Specifically saying yes to get enough on your plate to occupy your time, but also knowing when to say no to not be overwhelmed and still protect a little bit of your time for. Seeing loved ones and not quite acting like a full-blown surgical resident. I think this is a hard question. It involves setting boundaries, and as clinical residents, we're not very good with that. So when you come into professional development time, I think that's a skill you really have to focus on. Far as for me, you know, when I went out, a lot of different attendings came to me with project ideas in various stages. I had to be selective about which ones I choose, and part of that is like if I think that they're gonna be a supportive mentor to get them across the finish line, versus if I think it's just an idea

that doesn't really have a lot of oomph behind it. But with that also I think it's important to be realistic about your timeline. So when someone comes to me and it's a topic I'm interested in, sometimes I have to say, you know what? I really wanna help, but I probably don't have time to give to that project until six months from now. And then it kind of puts it back in their court and sometimes they're like, that's totally fine. You know, I'd rather have your help, but let's just wait until you have time. Other times they're like, no, I have, I have a deadline. I have to move on. But I think you have to be really selective. You wanna be very mindful and budget extra time so that you can accept these things without overstretching yourself. Very good points, Nicole. I also think that early on in my research time, I was saying yes to a lot more and filling my plate a little bit more. And I think that provided the opportunities to do my basic science stuff. But then also some education based stuff as well as outcomes research, or for example, this surgical education fellowship on Behind the Knife, which we all obviously have along our two years as well. And I think that helped me know the things that I really enjoyed

doing and the things that I maybe didn't enjoy doing as much. And then now getting towards the end of my two years, I have narrowed down. The project, so we can't leave this podcast episode without talking a little bit about what is something that you wish you knew before you got started? I wish I would've been proactive about applying for, um, committees and like national societies as a PGY two. Like I should have done that honestly the year before I went out so that my leadership roles could have started during my research time. Now a lot of mine are gonna bleed into my clinical time, but like I know for example, especially some of the trauma organizations, like you can only apply for membership like once or twice a year and then you can't get in for like six months to a year. My tip revolves around being able to budget your time. This was something that I struggled with 'cause I went from a very structured day in the clinic and then I had all this free time and I had a to-do list, but I didn't really have, you know, deadlines that were closed, like they were months away. I think I spent a lot of my early research time not being productive 'cause I was just doing a little bit here and a little

bit there and I really had to figure out how I was gonna manage my day to day life. I think the biggest thing that I took away from this is like you can either be time-based or task-based. So if you're time-based, you set a set amount of time, you're gonna write for that much time or you're gonna chart review for that much time. And if you're task-based, which is kind of how I lean, I like chart review all at once. So I'll do that for a few days and then get through that and then I'll move on to my next task. But if you don't have a game plan for managing your time, you're gonna lose track of time. And like we said, these two years go by fast. What I would say is like a final piece of advice is if you have something that you're really passionate about or like a skill that you really wanna develop, or you know you really wanna do research time, don't let the fear of not finding funding be the reason you don't have academic development time. Echoing that completely. I've really enjoyed my time during research and I think a lot of the things that I wished I had taken earlier in college or undergrad or med school, like those skills that are stuff that I'm working on right now, like for example, I really like stats. I've been able to devote my time during my research

to just like take some stats, classes, whatever you're to start in, like be sure to explore them and go wherever they take you essentially. Yeah, I feel like being open-minded is incredibly, you never know what you're gonna find and kind of fall in love with It's okay too to like take some time and do some fun stuff. I have had a lot of fun over the last two years. I've traveled home. I've seen my family way more. Things that I would not have been able to do because of the moonlight, like, you know, a little bit of extra change in the pocket from Moonlighting Plus, um, a lot of extra time and my weekends has been. Irreplaceable and you can do all of those things and incredibly boost your cv, learn a new skill, get a Master's, get a. Bunch of publications that make you feel really cool when you PubMed yourself. Like all of that is possible in your research time, which is really fulfilling. I would add from the K programmatic leadership side, you don't know who is ultimately going to gravitate towards a very academic career. It is

very difficult to predict whose work is really gonna resonate with them. You can have some residents, um, who you predict this is going to be the most academically minded faculty member one day. They end up doing something entirely clinical and there's nothing wrong with that. And at the same time, you could have people where you think, you know, this person just does not seem like they're interested in academics and they spend a few years in the lab and something just clicks and they become the most academically minded person. And that's why I've really advocated for Duke remaining a program where everybody's required to do research. Because I think unless you cast a wide net, you are just not going to capture everybody who might be interested in this type of stuff. So I think there's so much opportunity. To figure out what you actually want your career to look like. Alright, and with that, I think we can round up this episode. Thank you everyone for listening in, and thank you to the fellows as well as Dr. Nussbaum for your time. This was fabulous. I hope this gave you guys a little bit of insight into how to think about researchers, how to approach them, working through that alphabet soup that is funding,

and I hope everyone learns something and with that guy dominate the day.