“Publish or Perish” Part 2: 10 Tricks to Maintain Academic Productivity During Clinical Training

As promised, here are my top 10 strategies for fellows looking to be published in a peer-reviewed journal. I also advise you to take a look at this recent article from JACC for some additional tips. Read Part 1 here. 

1. Find a mentor early
Seek out someone at your institution who is known for publishing papers, is active in clinical research, and is interested in graduate training. Most importantly, talk to your   peers and find someone with proven past experience working with residents and fellows. This person will be pivotal in advancing your entire career, so do not put this off.

2. Accept the fact your first paper will not be published in NEJM, JACC, or the Lancet
Publishing in a top-tier journal requires time, energy, experience, and data that most trainees do not have. Case reports are often much easier to prepare but harder to get published, given that they are not often cited. JACC: Cardiovascular Interventions and the American Journal of Medicine maintain dedicated case sections in each issue. Alternatively, look into writing book chapters. Many academic professors are routinely asked to write chapters, but, because they lack the time, they often look for interested fellows to help out. While a book chapter might require more time than a case report, it is a guaranteed publication. 

3. Start working on larger projects
When you are working on a smaller project, there is often downtime while the case report or book chapter is being reviewed by the senior author or after it has been submitted. Make the most of this gap and start working on a bigger project. By the time you have submitted your first case report or book chapter, you will have had time to come up with a question and understand the resources at your disposal (ie, preexisting internal databases and national databases) to help find answers. Alternatively, your mentor may have some unfinished projects that he or she wants you to tackle. Regardless, the key point is to keep going.

4. Learn how to speed through the IRB
Most of the studies in which fellows are typically involved are retrospective series with waivers of consent, so the institutional review board (IRB) review process can and should be expedited. All in all, this process should not take more than a few weeks, and most IRB applications require standard language for many sections that can simply be copied and pasted from a prior IRB. Do not reinvent the wheel here. Ask a senior fellow for a copy of an already approved IRB and use that as a template. 

5. Enlist help from your colleagues
If you are proceeding by creating or updating a preexisting database for a research topic, talk with a colleague using the same database to answer a different question. Because data mining from charts, cath films, and echos can take up to 2 hours per patient, depending on the extensiveness of your database, I advise looking for at least 2-3 different questions to ask from the same database. That way, each of you can take the lead writing different papers and everyone involved has a vested interest in collecting data faster.

6. Do not miss deadlines
Marking deadlines on your calendar forces you to keep working and making progress on your project. If you are unable to write an entire paper in time, at least you can work toward analyzing the data and creating tables and figures—this is usually half the battle to getting the larger project completed—which might leave you with enough for an abstract to present at a major meeting. The bonus of submitting to these meetings is that, if accepted, the abstracts get published to journals such as JACC and CCI. 

7. Buckle down
First attempts at writing scientific papers will always be the hardest and most challenging, so keep at it. Write a paragraph here and there, and the next thing you know, half the paper is written. Do not wait for the final version before you have your mentor review it, however. He or she can make edits and guide you as you go. Believe it or not, the more times you do this, the easier it will become. 

8. Have an eye for detail
After you have spent many months working on a paper, details suddenly become very important. Journals are presented with many research papers competing for limited space. If editors or managing editors have to spend much time correcting your grammar or reformatting the paper to their specifications, they will probably just reject it. Take time to carefully read their respective instructions to authors—following them to the letter will improve your chances. 

9. Move on from rejection
When it comes to rejection, you will likely experience as much, if not more, from journals as you did from high school love interests. But do not let all your hard work go to waste. Review the comments from reviewers to see where your paper is lacking and make the proper adjustments. Look for similar journals and resubmit per the next journal’s specifications. If you get rejected from 2 different journals, it might be time to go back to the drawing board and obtain more data or ask your question from a different angle. Either way, be persistent.

10. Remember to have fun
Some days, research can be as much fun as a colonoscopy without sedation. But if your research aligns with your personal interests, the work should be mostly fun and the projects far more fulfilling when they come to fruition. Successful projects can possibly translate into more in-depth, multicenter endeavors that can further establish your career. It is also worth noting that if you have given your all and the “fun” is still missing, perhaps academic cardiology is not something worth pursuing. This is perfectly alright, and recognizing this early during training will serve you best.