1/ We're welcoming a new group of fellows spending 2 years researching with us... Here are the three most common questions they ask mentors (and how to address them):
#MedEd #FOAMed #Mentoring
2/ To start, some upfront principles. The goals of focused research time at this career stage include: transferable skills, developing a mission & vision, and growing your community.
3/ So you ask a mentee, "What do you want to do?"

Some have a polished answer, some fake a polished answer, eventually most admit, "I'm not really sure!"

MENTEE QUESTION 1: "How do I move forward when I don't know where I'm going?"
4/ If your direction is not clear, focus on projects and mentors that can give you transferable skills. I often start mentees with a Medicare Claims project because it includes so many valuable transferable skills.
5/ It's worth noting, the transferable skills may need multiple projects. In fact, early work should be heavily mentor led with "graduated independence" to the mentee overtime. (The parallels to teaching surgery really come through: From,"Bovie here..." to "Start the case...")
6/ By project 2-3, Fellows start to hone in the direction of their work.

MENTEE QUESTION 2: I know what what I want to do, how do I go faster?

And well, there are two types of people in the world... early on, be the 2nd.
7/ There is so much up front investment to learn a new dataset, method, cohort, content area. For whatever reason, once fellows master one dataset, they love trying to conquer a new one😩

It slows down your productivity...
8/ One you learn a dataset, method, cohort, stick to it for at least 2-3 projects. As @jdimick1 often teaches, "compound your advantages."....
9/ My first fellow project was about Critical Access Hospitals and took me a year. Before it I had never heard of CAHs. Once I learned how unique they were and had created cohorts in Medicare, I then used same data to study access, test policy incentives & estimate ACA $ savings.
10/ Eventually, fellows get their skills, develop their mission and now need to build community to scale up their work. Or as mentees often say...

MENTEE QUESTION 3: How do I scale my impact?!
11/ Scaling impact of your work has a lot of approaches...

I'm obliged to tell you that use of a #VisualAbstract has been shown in RCT x6 to get your work read more often. Our Orig crossover trial @AnnalsofSurgery here (journals.lww.com/annalsofsurger… ) next 5 below.
12/ But the other important strategy to scaling your work is working alongside others with humble curiosity. I tried writing a grant on surgical access and it scored "Not Discussed"... then I met @DrJohnScott ...Learned I had some serious blind spots about understanding access...
13/ Lots of tough brotherly love, but @DrJohnScott graciously schooled me up. We went from a single PI not-worth-discussing grant to a way more robust model (initial paper in @Health_Affairs here: healthaffairs.org/doi/abs/10.137… ) and a Co-PI fundable R01 score.
14/ In summary, advice to fellows:
1. Move Forward - by focusing on transferable skills
2. Go Faster - by compounding your advantages
3. Scale Impact - by collaborating with humble curiosity

Excited to dig in with the new fellows! @UMichCHOPFellow @UM_IHPI @ncspMICHIGAN

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More from @AndrewMIbrahim

May 24
1 / Do you also hate the current format of conference posters? So much great content buried behind bad design.

Here are 4 design strategies to help improve the poster for accessibility and engagement.

(Thread below, Video here: ) #MedEd #FOAMed
Image
2 / Simplify your format.

Shorten the title. Get rid of sections you don't need. Image
3 / Think of the sections more like slides instead of paragraphs.

Imagine each section as slide that you will be narrating. It will help you remove a lot of unnecessary text. Image
Read 6 tweets
Jul 5, 2023
1 / So great to welcome our new residents to the hospital!

While not a complete list, here are some "Common Intern Calls" you will likely encounter and some approaches to handling them.
#MedEd #FOAMED
2/ Some upfront principles. For awhile, everything will be a, "first time" so you won't have all the answers. Don't let that discourage you. Try to get more data, see the patient, then pass it up to someone more senior to help you problem solve.
3 / Remember, the variation in death after surgery is NOT because some hospitals have more or less complications; it's our ability to recognize & respond to rescue patients when things go wrong.

Landmark classic from @AmirGhaferi @jdimick1 in @NEJM : https://t.co/WOCDdlM2AFnejm.org/doi/full/10.10…
Read 19 tweets
May 16, 2023
1/ Like many research groups, we @UMichCHOPFellow have an office building full of cubicles... as we've changed so much over the last 3 years, so did our space. Here is an update on our office space redesign pilot and what we're learning so far... Image
2/ At our core, we're a busy group centered around research grants and training fellows. While numbers don't really capture the core of our mission, we put out a little over a paper a day, and manage about $1m/month in active funding. Image
3/ Like many research groups, we had a very dense cubicle footprint that was pinnacle of 1990s office design. When everyone was in person and needed a landline, this was really productive. Image
Read 20 tweets
Feb 5, 2023
Thread /
The 5 sections of an effective Specific Aims Page when writing a R01. #ASC2023 #FOAmed

1/ Introduce the topic.
Less numbers (everyone has stats), keep it short and pithy. Communicate the fierce urgency of NOW.
2/ Create knowledge gaps.
Make clear is what known and unknown, stick to relevant gaps, and establish a pattern of parallel writing.
3/ Introduce your approach.
Contrast the gaps you just laid out in the prior section, emphasize your differentiators and streamline redundancy.
Read 6 tweets
Aug 30, 2021
🧵
1 /
What is the lasting legacy of racist housing policy on modern outcomes after surgery?

Important work led by @DiazAdrian10 out ahead of print today in @AnnalsofSurgery : journals.lww.com/annalsofsurger…
2/ In the 1930s, US Govt. Home Owners Loan Corporation (HOLC) used racial composition of neighborhoods to determine creditworthiness & label them ‘‘Best’’, ‘‘Still Desirable’’, ‘‘Definitely Declining’’, & ‘‘Hazardous.’’ Lenders used these maps to inform home loan approvals.
3/ Despite ongoing fights for racial equity including Supreme Court case striking down racial covenants in 1948 and the Fair Housing Act of 1968, neighborhood segregation, discriminatory lending practices and a widening racial wealth gap persisted.
Read 9 tweets
Jul 2, 2020
1/ Happy July 1st! I remember my intern year getting a lot of pages & struggling to work through them. Overtime, I saw the patterns & took notes... so I present to you: Common Intern Calls

(Yes - as an intern I didn't know how to forward the pagers)
#FOAMed #MedTwitter #July1st
2/ This isn't an exhaustive list-but illustrative examples of common surgery intern calls. An upfront take home message, you'll rarely go wrong if you:
1. Get more Data - repeat vitals, labs
2. See the patient - sick? not sick?
3. Pass it up - get a senior involved when unsure
3 / Some context: As the landmark work led by @AmirGhaferi demonstrated, variation in surgical mortality is influenced by our ability to recognize problems early & address them before they domino. Intern call = find the first domino & address early!
nejm.org/doi/full/10.10…
Read 21 tweets

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