C. MORE ABOUT RESEARCH

with in terms of time, resources and advice. Take care not to abuse such relationships by reaching out unnecessarily or not following through on advice provided if relevant (measure your questions ahead of time and anticipate the recommendations). Stay active in your subspecialty society and attend your subspecialty society meeting. While mentorship can be time consuming and somewhat difficult to foment, sponsorship is a lesser form of support that can be critical for promotion within a society. While a mentor is someone you may call to ask a question regarding a clinical or academic matter, a sponsor can be someone who may nominate or recommend you for a certain task or opportunity within a society. Know that you will not be handed a plenary session presentation just because you did a fellowship and work at an academic medical center. Such speaking opportunities come with relentless research submission and specialty section participation, along with support from leadership within the society. Be friendly and social at your meetings and connect with some sponsors!

B.4. Conclusion

Academic urology can be an extremely rewarding career path. It basically boils down to a focused clinical/research interest that you then promote within your division, hospital system and society by way of clinical practice and research and presentation. For those interested in additional reading regarding a career in academic medicine, consider Dr. Joseph V. Simone’s work, “Understanding Academic Medical Centers: Simone’s Maxims” (Clinical Cancer Research 1999; 5(9): 2281-2285).

WATCH: Julie Riley, MD, discusses academic practice as part of the AUA2019 Young Urologists Forum program. APPENDIX C: MORE ABOUT RESEARCH

The field of urology prides itself on being a champion of medical progress. Urologists have received two Nobel Prizes and have made significant advances in the understanding of diseases and applications of novel technologies. In fact, contemporary urologic research takes on many forms: basic science, translational science, clinical research, and health sciences/comparative effectiveness research are just some areas of scientific investigation that urology surgeon-scientists pursue. Participating in research is central to the job satisfaction of many physicians. The opportunity to advance medicine, be on the cutting-edge of clinical care and immersed in the world of ideas clearly satisfies some of the intrinsic rewards that many physicians sought when entering medicine. Furthermore, success in research also affords opportunities for leadership roles within one’s institution and professional groups, and often offers a seat at the table with policy makers and industry leaders. Importantly, physician researchers continue to remain leaders in training the next generation of practitioners. Participation in research clearly has its well-known challenges, such as decreased funding opportunities, a smaller number of like-minded peers, “publish or perish” pressures and a limited number of role models and mentors. In addition, institutions are financially challenged to support non-grant funded clinical research. The research community is increasing outside of urology and, in some instances, conducting research requires foregoing income from clinical activities. As such, individuals motivated to establish a dynamic research career must be well informed and well prepared for the challenges ahead.

C.2 Research as a Job Function

After completing residency/fellowship, the new practicing urologist interested in pursuing research is faced with a new challenge: how to efficiently and productively manage both a clinical practice and a research program and best prepare for longterm success. Two major goals of a clinical practice are to make sure one can provide effective and safe care as well as be available to patients and their families. One of the major objectives of a research program is to pursue discovery that will impact current knowledge while contributing to the future well-being of patients. Nonetheless, both areas have to be financially viable and sustainable long-term. When considering a career with a significant research component, junior faculty members should have a clear understanding of several factors that are critical to success: • Finding a mentor, or better yet a collection of mentors with strengths in different areas, is the first and probably most important step. Mentors are individuals who have “been there and done that” and can provide crucial career and research guidance to you.

• Know exactly what type of institutional support/ commitment each potential job is willing to provide (e.g., startup funds, cost-sharing of salary short falls, etc.). • Assess the types of resources that are available.

For example, will you have to start your own tumor bank or can you draw on an existing one?

Is there a database already established or will you need to build one on your own? • Surveying potential collaborations available institutionally or regionally (e.g., other institutes, industry, etc.) is key. The strength of each must be weighed against the type of research you want to pursue as well as your ultimate career goals.

C.3 Obtaining Funding

Numerous public and private sources support scientific studies and young researchers. These include the National Institutes of Health (NIH), the nation’s largest funder of academic research, the U.S. Department of Defense Congressionally Directed Research Programs, U.S. Department of Veterans Affairs, and private funders such as foundations, societies (e.g., American Cancer Society or urology societies), advocacy organizations and other funding groups. In addition to the federal and private foundation sources, there are local research grants (your own academic institution, local charities and organizations, health insurance companies/payers), industry (pharmaceutical and medical device) and private donors (endowments, gifts, etc.) as well as crowdsourcing platforms. The AUA is committed to supporting urologic research through funding, education and advocacy. Through the Rising Stars in Urology Award, the Research Scholar Awards, the Residency Research Awards and the new Leadership in Education, Achievement and Diversity (LEAD) Program – as well as other internal and external funding awards – the AUA and Urology Care Foundation have been providing support to young urology researchers for 45 years. More information can be found at https:// www.AUAnet.org/research/research-overview. The NIH Guide (grants.nih.gov) is a comprehensive resource for funding opportunities and materials to guide researchers through the process. The Research Project Grant (R01) is the original and, historically, oldest grant mechanism used by NIH. The R01 provides support for health-related research and development based on the mission of the NIH. R01s are submitted in response to Program Announcements (PA) or Requests for Applications (RFA). The following NIH research awards are also typically available for early-career investigators, although each NIH institute may not offer all of these mechanisms: • Mentored Research Scientist Career Development

Award (K01) • Independent Research Scientist Development

Award (K02) • Mentored Clinical Scientist Research Career

Development Award (K08) • Clinical Scientist Institutional Career

Development Program Award (K12) • Career Transition Award (K22) • Mentored Patient-Oriented Research Career

Development Award (K23) • Small Research Grant (R03) • Academic Research Enhancement Award (R15) • Exploratory/Developmental Research Grant

Award (R21) • Clinical Trial Planning Grant Program (R34) • Program Project Grant (P01) Grant applications are peer-reviewed by standing or ad hoc review groups and scored based on significance, investigator credentials, innovation and research approach and environment. Funding decisions are determined by the score, the “fit” with the mission of the institute and approval of the institute’s Advisory Council. Critically important to applying for research funding is being prepared to submit a grant application that has the best chance of success. Therefore, physician scientists in particular, who typically have less exposure to grant writing than their PhD-trained peers, would do well to participate in courses that focus on urology grant writing and grantsmanship. The AUA provides the following courses on these subjects: • Early Career Investigators Workshop (a 2.5-day workshop held at the AUA headquarters that includes one-on-one mentoring by NIH-funded faculty) https://www.AUAnet.org/research/ research-education-and-events/early-careerinvestigator-workshop • Writing a Successful Career Development Award

Application (an online course available on

AUAUniversity) https://auau.AUAnet.org/content/ writing-successful-career-development-awardapplication-2018