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How Will You Make Your Mark on Medicine?

— Whether in academia or practice, find a way to leave your footprint

MedpageToday
A track of human footprints in moist beach sand.
Lazarus is an adjunct professor of psychiatry.

Just as a carbon footprint measures the impact of human activities on the environment, the concept of an "academic footprint" can be used to describe the impact a physician makes in their field throughout their career.

The "academic footprint" of a physician includes the knowledge they impart, the research they conduct, the papers they publish, and the innovations they introduce. It represents their contribution to the advancement of medical science and the betterment of patient care. This footprint is not just important -- it is essential -- and can be made within and outside the halls of academia.

Physicians should aim to increase their academic footprint to enrich the medical field. The larger the academic footprint, the greater the influence and impact a physician has on the evolution of healthcare. The breadth and depth of this footprint can shape treatment protocols, influence healthcare policies, and inspire the next generation of physicians.

However, some physicians have a limited academic footprint. In the case of hospitalists, for example, that among 1,554 academic hospital medicine faculty from 25 academic medical centers, only 42 (2.7%) were full professors and 140 (9%) were associate professors. The number of publications per academic hospital medicine faculty was noticeably low, with a mean of 6.3, and more than half (51%) had no published papers. Promotion was uncommon in academic hospital medicine, which may be partially due to low rates of scholarly productivity.

Measuring the Size of a Footprint

The findings suggest that measuring a physician's academic footprint involves a variety of factors that reflect their contributions to medical science and education. One key metric is their published research, including the number of papers they've authored, the quality of the journals these papers have been published in, and the number of citations these papers receive from other researchers. This offers an indication of their contribution to advancing medical knowledge.

Altmetrics -- various "alternative" indicators of how influential published works become -- are widely used in medicine and other scholarly pursuits. Yet, these indicators are not without controversy. Nevertheless, statistics on the number of downloads/citations of papers and the prestige/competitiveness of journals and journal articles are frequently used to evaluate academic footprints.

Another important metric is physicians' involvement in teaching and mentorship. This includes the number of students they've instructed, the number of physicians they've mentored, and the feedback they've received in these roles.

Physicians' impact on clinical guidelines and policy can also be considered. This could be measured by their involvement in professional bodies, task forces, or committees that shape healthcare policies and clinical practices.

Innovation in patient care, such as the development of new treatment protocols or the introduction of novel technologies in a physician's practice, can also be a part of their academic footprint.

Doctors routinely make other invaluable contributions beyond clinical care and medical education (e.g., in areas of governance, medical leadership, quality improvement, and social justice advocacy). Also, physicians are increasingly disseminating their contributions via newer mediums such as social media and podcasts that arguably have a greater reach than traditional scholarship outlets.

Motivating Trainees to Leave Their "Mark"

It is important for physicians to motivate medical students and residents to leave their "mark" in medicine. Physicians can motivate trainees by leading through example, showing them the impact of leaving an academic footprint in medicine -- for example, by initiating the sequential steps in the adage "see one, do one, teach one."

Physicians should emphasize the benefits of an academic footprint, such as professional growth, recognition in the medical community, and the satisfaction of advancing medicine. They can also highlight that this footprint can lead to opportunities for collaboration, influence in shaping healthcare policies, and the ability to make a difference in patient care on a larger scale.

Mentorship is another effective way for physicians to motivate students and residents. Through one-on-one mentoring, physicians can guide them in their academic pursuits, provide feedback and support, and help them navigate the challenges of medical research and education.

Lastly, physicians can foster a culture of lifelong learning and curiosity. Encouraging students and residents to ask questions, seek answers, and continually expand their knowledge will naturally lead to a greater academic footprint. This can be facilitated by creating an environment that values and rewards academic contributions, innovation, and critical thinking.

Non-Academic Settings

It should be noted that while practicing in an academic medical center can facilitate academic contributions, it is not a prerequisite for leaving an academic footprint. Activities pursued outside of academic settings can also leave a lasting imprint. Physicians in private practice, for example, can conduct clinical research, contribute to medical literature, and participate in professional organizations that influence healthcare policy. They can also mentor medical students or residents in their offices or through affiliations with medical schools. An "adjunct" appointment at my medical school alma mater has enabled me to extend my academic footprint for the past two decades.

Physicians who focus on "doctoring" are still contributing to the medical field. They are applying the latest research findings to patient care, they are often involved in the education of patients and their families, and they are contributing to the collective knowledge of patient care.

Whether a doctor chooses to be involved in academia or to focus solely on clinical practice, their work is valuable and necessary. Either way, leaving a significant footprint should be a goal for every physician, just as reducing our carbon footprint is a collective responsibility. Both are about making a positive difference -- in the world and in the field of medicine.

is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia. He is the author of several books on narrative medicine, including and .