Fellows: Career Profile

Dr. Eleanor Lederer - The Senior Academic Nephrologist

Dr. Eleanor Lederer

Academic medicine encompasses a broad variety of career paths, most of which are unknown to individuals during their training. I know that when I was in training, THE role model for academic medicine was the investigator-teacher-clinician who developed a national reputation based on his/her research endeavors; “rose through the ranks” to Full Professor, Division Chief, Department Chair, Dean, Provost, President of the University or some other top position; and were sequentially presidents of multiple prestigious societies and chaired important committees. Quite a formidable challenge for the individual at the outset of his/her career. Well, times have changed in academic medicine and opportunities abound for successful careers in multiple facets of academic medicine – teaching, clinical accomplishments, research, and administration. In an academic career you can participate in many of these realms, as I have, or pick and choose the areas where you want to make your mark. A successful and fulfilling academic career can introduce you to each component and allow you to move through all of them as your career progresses. The ability to re-invent yourself, learn new skills, or perfect the ones you already have provides a degree of control over your career lifetime that does not exist in many other settings.

I have been asked many times how I chose my particular career path, how I juggled clinical and research priorities with educational responsibilities, how I achieved a balance between my work and my home life, and why I made the decision to include administration in my work portfolio. I have only two pieces of advice, principles that I followed that have guided me through what I consider a very successful and very happy career.

First, participate. One of the major joys academic clinical or research careers is interaction with your peers in exchanging ideas and problem solving. You can’t do that if you hang back, decline to join, or don’t volunteer. Being an active participant in your ventures allows you to have some control over the direction, to reap the satisfaction of completing complex tasks, and facilitates friendships that can be useful personally and professionally. Do this early on in your career. You will soon find that your ideas are just as good and just as bad as the next person’s. Those at the top were not born with great ideas. They learned how to present them and refine them by participating. You too can be that person at the top. Participating also allows you to try out new challenges and responsibilities. How can you know if you like doing research if you do not try it? How can you say you would never like being a Division Chief if you never assumed a position of clinical and fiscal responsibility such as being the Director of Outpatient Clinics or the Medical Director of Kidney Transplantation? From every position that I have held I have learned many skills and a greater understanding of how academic medicine functions. Equally importantly, I have learned whether or not I liked the type of responsibilities involved in that position. My first forays into administration were modest but I found that I derived a tremendous sense of accomplishment from organizing and growing an outpatient clinical practice. Likewise, my first clinical teaching responsibilities helped me recognize that I really enjoyed working with trainees and helping them understand nephrology. From these experiences, I felt comfortable in volunteering to work on committees for the nephrology training program directors and eventually the Executive Committee for the TPDs. Participating in multiple endeavors also helps you figure out how much you can tackle and still be able to enjoy your life outside of your career. Without the support of my family (a very understanding and contributory husband), I never would have been able to accomplish all that I have. That said, sometimes academic work was performed at odd hours or accompanied by two toddlers with crayons and coloring books. The flexibility of academic life.

Second, figure out what you love to do and do it. I am frequently asked if I chose academic medicine for the better life style, the flexibility in child-rearing, the better hours. The simple answer is no. I chose this career because I like discovery, I like teaching, and I like intellectual challenges on a daily basis. If you do not really like teaching trainees or being involved in research, choosing an academic career would be miserable even if it were only 20 hours per week, despite the free time available to you. If your real job satisfaction comes from your interactions with patients and families, then by all means you should be a practitioner. With either choice, you will find that you can define your job, your hours, and your limits. There may be more flexibility in the academic schedule; however, I guarantee that I work as many hours as any practitioner. Underneath all of the gripes about work hours and academic bureaucracy, you will find that academic nephrologists work as many hours as they do because they like what they do, not because someone is holding a gun to their head.

The bottom line is that opportunities for academic nephrologists abound in teaching, clinical program development, research, and administration at the local, regional, and national level. The nephrologist completing fellowship should know that 1) the environment for academic nephrologists is inviting, welcoming, and wide open; and 2) there is a community of academicians ready, eager, and available to help you in any way possible. Talk to your mentors and discover the many ways that we in academic nephrology have found true joy and fulfillment in our careers.