like “outcomes research,” which was reporting outcomes in a more detailed fashion. The field of health
services research was introduced to me by a woman,
Catarina Kiefe, MD, Ph D, who became one of my most
significant mentors at UAB. She is a prominent health
services researcher and chair of preventative medicine.
I had a research idea that she helped me frame so that
it was not just an outcomes project; it was more of
a health services project. She successfully mentored
me in getting funding and getting my project off the
ground. That is when I made the transition from bench
research to health services research, which has been
the primary focus of my research career ever since.
Like many surgeon-scientists, you have experienced gaps between your dedicated research
time in training and your first faculty position.
How did you maintain your research goals and
interests, given the challenges you faced early on
in your career as faculty?
When I arrived at UAB, I was not sure what my academic focus would be other than teaching residents.
It took me some time and meeting with many different people to solidify my goals. Having my MPH
opened doors for me. It allowed me to meet with clinical researchers with well-established funding to talk
about how we could do that type of research in surgery. I believe that my MPH was particularly valuable
because I had the training and knowledge required
to transition to a health services research career. Dr.
Kiefe was intrigued by surgery and thought it was an
untapped area of health services research.
In some ways, I think it was the right time and the
right place with the right mentor that set me on this
path. It was not a specific vision that I had for myself
when I took that position. I knew I wanted to do some
sort of science. I had that intellectual curiosity; I just
did not have a mentor or a role model for what it looked
like. I had to go outside the department of surgery and
meet with different types of researchers. A couple of
people took me under their wing and helped me along.
They were amazing mentors to me and helped me get
my career going. They were incredibly supportive.
Did the department offer you a start-up package
to help you become an established researcher? Did
you have protected research time, for example?
Honestly, protected time was not something I had
discussed when I accepted the position. When I first
went to UAB, I had a part-time appointment at the
VA hospital. On the university side, we were so tight
for inpatient beds and OR time that it was difficult to
build my clinical practice until our new hospital was
completed three years later. My division chief, Selwyn
M. Vickers, MD, FACS—a Past-Governor of the ACS
and now the dean of medicine at UAB—was very supportive and encouraging of my scientific endeavors.
I never felt the pressure to produce more clinically,
only academically. Once I received my funding, I was
able to accommodate my schedule to develop specific
protected time for research. I received funding from
the U.S. Department of Veterans Affairs, which provided full support for my research time. It was a good
structure to protect my time during daytime hours.
Most academic surgeons end up pushing most of their
academic time to nights and weekends. You can have
protected time on paper, but it is up to you to ensure
you use it in that way. Having that grant funding from
the VA allowed me to focus that time on my research.
After you were established with your research,
did you experience any major setbacks?
Yes, we had an incident where our research center
had a data breach, and we were shut down for 15
months, meaning we could not access our data. We
technically could not do research during that time, at
PROFILES IN SURGICAL RESEARCH
Having my MPH opened doors for me. It allowed me to meet with
clinical researchers with well-established funding to talk about how
we could do that type of research in surgery. I believe that my MPH
was particularly valuable because I had the training and knowledge
required to transition to a health services research career.