All right, so this is piggybacking off of Doug's earlier talk about CVs, just a little bit on networking. This is a talk I give to my fellows. And also, my husband is a cardiologist with an interest in sleep medicine, and he's just evaluating for the Sleep Society an app, the apps for getting good sleep and wellness. And Calm actually has really good data behind it, believe it or not. So there's the free version that's not as good, but there's a paid version. And I don't know. He was just looking up the data. He's presenting it next week, and it's actually pretty good. So you can try that. Good sleep cannot be overemphasized. OK, so a little bit about networking. I think that this is so, so important, and you guys are starting it right now. These people that you're meeting here, you're going to see probably, at least if you're in academics, you see them throughout your career at meetings and other things. And so this is sort of the beginning of your networking, right? You guys have probably been doing it in fellowship a little bit, too. There's some online chat stuff and things that I'm not totally aware of. But it can help you determine your career goals. You may meet some people that are doing something, and you're like, ooh, that's cool. I could do that. I may have opened your eyes to large polypore section. You're like, ooh, I should do that. It can help you assess where you are compared to other people and sort of what they did. And also, if you're interested in research, research collaboration. A lot of people meet up with people at meetings and find out they have the same research interests and maybe start doing some multi-center trials or whatever with them. Reputation and relationships are everything in medicine, and GI is a small world. So you need to be thinking about that in your interactions with people. And I really think with networking, you're going to have better outcomes. You think of complicated patients and how you assemble a team to sort of think about that. Similarly, having the expertise of other people. I talk about patients and sort of things going on in my work with other people to find out sort of how if they've handled a situation similarly or a patient similarly. So these are things that you can do as you're networking. And where do you do it? Conferences, associations, online, all the things that I don't do. Your coworkers. And how to network. Practice your elevator speech can be used in person, online, or via email if you're trying to reach out to someone that you don't really know. And then if you do reach out to someone, so you meet someone at a meeting who gave a talk and you're really interested in maybe having them help you with something, and you sort of make a pitch to them and they seem receptive, circle back with those people. Be helpful. Don't add a burden to someone who you're trying to get to help you. Maybe, hey, can you write a letter in support of whatever? Sure. I'm going to write it for you and then you can edit it and sign it. Things like that. But remember that people remember you better if you expressed an interest in them. It sort of gets those juices flowing. So that may make those connections more viable. So that's the end of my networking. So just quickly on promotion. This is really important if you're going into an academic career. You need to know what the criteria are for your institution, and they are different for every institution. Harvard is actually extreme. I just wrote a letter for my good friend Jennifer and it blew me away, actually. Very different from Case Western. You need to know what materials you need. Case is actually very, you know, their requirements are more stringent than a lot of other places. So it's very interesting because as people will ask me to write letters, they say, would this person get promoted in your institution is one of the many questions that Harvard doesn't ask that question. Timeline. They don't really care. What are the timelines? You know, like, you know, you kind of how long should I be here working before I think about getting promoted? When you're taking a job in an academic institution, if you've done a fellowship, you should be able to come in and assistant professor level, not instructor level. So that's something that typically you will, you know, and that appointment, especially if you've done any little bit of research, you're going to do teaching, you're going to be at the main campus should be automatic. Unless you're at Harvard. Oh, unless you're at Harvard, then you probably get a short white coat and you're some, you're an instructor for like, what, a decade before you can. I have a colleague who's my year who's still an instructor. And it really depends upon where you are. So my husband's at the Cleveland Clinic. They're like not all about the whole academic-y thing. My husband stayed at assistant for a long time until he suddenly realized that I was getting promoted and he's like, shit, you know. So I actually helped him just FYI. So these are the academic ranks, right? So instructor, most places, if you've done a fellowship, you will not start out as a clinical instructor. You'll start out as an assistant professor. But there are places that have instructor and senior instructor. You know, Cleveland Clinic actually started out as staff cardiologist or staff whatever. Assistant professor, associate professor, which is where we talk about award of tenure and then full professor. So tenure track is far less common now. I think unless you're a big researcher, you're not going to end up being on tenure track. And so most people are non-tenure track. They do review with tenure track teaching and service. But research is clearly the big thing. You're supported by grants. That's a little more of a dying thing, I would say, at this point. So you have to look at the criteria. So at case, I mean, I sort of did this for my fellows. But there are these areas of, you can see how good I am with PowerPoint. Clinical service, teaching, and research, and then administrative and professional service. So you have to pick one area as your strength. That will be your focus. And then you have to look at your reputation beyond your institution. If you are going for associate, it's a regional recognition. And for full professor, national or international. So these are the things you need to think about. And I would recommend once you get a job, if you're going to an academic place, look and see what their packet looks like. Professional societies is different. CV requirements, everything. And it's nice to start out at the beginning knowing that so you know where you're going. So Doug talked about this a little bit, but how to document the quality of your clinical service. So obviously your board certification and recertification. You want to document your reputation for excellence in your specialty. So your invited memberships or fellowships in professional societies, leadership in professional societies. Awards for clinical services. Bogus as these ridiculous best doctor and top doctor and women in medicine and excellence and all this other nonsense, put it on your CV, you know, right? I mean, you might as well. Well, the interesting thing about that is that our institution, some of the best doctors lists are physician nominated. So they actually view that not equivalent to your manuscripts, but it was shocking to me that that actually counted. I don't know. So I'm on our promotions and tenure committee. I don't think that's ever come up as like, oh, they're a top doctor, but I don't know. I put it on mine. There's like a women excellence in medicine thing and I don't know. Okay. Document of scholarly activities that influence the practice of medicine nationally. So guideline committees are great committees to be on, but you actually have to do something. So it's not just that you're on it, right? It's not that you're just on your hospital's education, whatever. I mean, you have to sort of annotate in your CV and I don't know if you talked about this, Doug, but like if you are doing something, you kind of want to annotate like what you're doing in there to make us understand as we're reading your CV, sort of what you do. If you just list it, I was on this committee, but if you're on a committee and you did a guideline wrote first author on a guideline for a yada, yada, yada, you know, it can't just be that you're on a committee. You need to show that you've done some work. Promotion as an authority is indicated by consultations, invited lectures and seminars. You know, they're always dying for people to do grand rounds at local places. Get yourself doing grand rounds at, you know, affiliated hospital or whatever. Invited writings, you know, if they ask you to do an editorial, letters from department chairs or division directors, Doug talked about this a little bit. That's something that I never actually really did. I think when it came time for promotion, those sort of things I worked out, but, you know, these are the sort of things that you need to start thinking about. I forget if I have a slide on this, but, you know, I am a big proponent of getting, doing work for your state society. If you want to get regional recognition, that is a really easy way. Free labor, they are dying to have people. And actually when my husband was sort of realizing that, you know, nothing was going on with promotion and his chief at the time was not really, you know, didn't push him along. You guys have to take responsibility for this. So you've got to seek out these opportunities. He looked up the state society and it's like all his former fellows were on it. So next thing you know, he's a trustee, he's on the chair of this and whatever. And all that stuff counts. I mean, all that stuff is great for associate professor. And then you meet people there and then next thing you're on national things. So I really think you need to think about this early on if you're really interested in promotion. Do you have to get promoted? No, you don't. But I think if you're in academics, it kind of seems like you don't really want to die an assistant professor. I don't know. But, you know, it's up to you. Yes, Jen. You need to know your institution. So if you work with the California system, if you don't make it through the associate by seven years, you're actually going to get discharged. Oh, interesting. Okay. You know, so important things to believe in. That's interesting. So. So they put you on the clinical track. I might. You even think it was a clinical thing. Because tenure, we know that there is a clock. But for clinical, oh, that's interesting. So I would really recommend if you're interested, state societies are looking for people. And it's a great way to network within your state and get that regional recognition. So a little bit on research. You know, it can be lab, clinical, public health, educational. If you're interested in education, you can do research in education. You can't just say I teach fellows to get promoted on education. It has to be a little more than that. You have to look at your impact. You have to demonstrate your impact on the field. Team science is really valued now. It used to not be a thing, but now it is a thing. So these things can be important on your CV as well. And obviously funded research, both, you know, NIH Foundation and industry research. So administrative and professional service. So, you know, when you first start out, you know, someone was saying you got to say no. Karen was saying you got to say no. But at the beginning, don't say no. Pretty much say yes to a lot of things. I mean, unless it's like something you absolutely would hate. I said yes to lots of things. I was on the Faculty Senate. I mean, I don't even remember what I did for half of this stuff. But I said yes to everything. You can say no as you start getting a little busier and a little, you know, you're feeling like, okay, you got promoted. You're moving on to the next thing. Maybe you stopped doing some local hospital committees that were not interesting to you, but you only did it for your promotion. That's totally legit. I think that, you know, medical school committees. So I've also been involved with the medical school. You need to have teaching as part of your packet. I was involved with the medical school with our GI block, and now I am the block co-leader. So I've been doing that for 18 years. And I've really enjoyed doing that, actually. But it was something that initially I just said yes to because one of my colleagues was like, come on, do it with me. And it's been really good for her. And it's also been good for me because now I don't give any lectures, but I have my junior faculty give lectures and get involved and try and explain to them the importance of being part of that as part of their promotion. So participation in research review committees, service on editorial boards of scientific journals is important. And leadership in committees. I mean, I cannot say enough about how much the ASG has helped my career, being part of the ASG, meeting all of these people who then can, you know, help me network and figure out what I want to do. I mean, I've had so many meetings where I've just sat with someone, Grace Elta, you know, Karen Woods, Colleen Schmidt, Jen Lightdale. I mean, all these people who just, you know, it's sort of how people, you know, seeing how people did, does that fit with me and my goals? And, you know, again, about this when to say yes and when to say no. We had a long conversation in Vegas one time. I remember Jen was actually wanted, they wanted her to be NASPGAM president a lot earlier, but her kids were young. And she was like, I just said, no, not now. And I was just so impressed with that, because you just wonder, is that opportunity ever going to come again, right? And it did. And she's president of NASA again now. So I mean, amazing, right? So I think it's a world that we're navigating, especially, I would say, you don't really, really know what you're doing. Get the guidance of other people who've done it before you to help you figure out what the right thing is to do. But I really think the ASG has been really wonderful for me. And all the work that I've done here has really enhanced my career, not just for promotion. But I noticed when COVID hit, and we stopped meeting and doing all this stuff, how boring my job was. I mean, it was the same thing every week, scoping patients, clinic, whatever. And it wasn't broken up like things like this. Like Friday, I leave, and I don't work Friday. And I go to ASGE and do it. I mean, it really enhances your life, I personally think. So I'm a big proponent of doing things a little bit outside of just your everyday work. Again, teaching can be in lots of different settings. And you should look and see at your institution what you can get involved with early on, if you're in an academic institution. Even if you're not, if you're in practice and you want to teach fellows, and maybe they don't get fellows, and maybe you can set up something so you do teach fellows. If you're like, I don't want to go into academics, but I really like teaching fellows, that's one option. You can do leadership and design, all kinds of things, right? Doesn't always have to be academic leadership. And then there's teaching administration that you can get involved with, with the fellowship if you want to. Can you be an associate program director and get involved that way? Service on educational committees and all that stuff. They're always looking for that at the hospital. I mean, I'm on like five different things. I apparently didn't say no to. So your quality of teaching, you'll be evaluated by your trainees. Everybody knows, everybody sort of has to do this right. You guys fill out evaluations, and we fill out evaluations. You'll need letter support by trainees. I never really sought that out until I got promoted, was going to get promoted, and I just listed chief residents and things. It's probably good to be organized about that, but I was not. Dissemination of teaching outside your institution, as I said. And then publications regarding teaching. So you can actually, even if you don't do research, you can do scholarly activity within education. So if education is your thing, there are a lot of things like Doug was talking about in your institution, if it's associated with the university, there's lots of teaching educational opportunities. Even with the medical school, they always have seminars going on and things like that. So if you're interested in teaching, not necessarily research, you can do all kinds of things with scholarship and teaching. And again, things you will need. Your CV. You will need a teaching portfolio. Unless you're a research person, you probably will, it will strengthen your application to have a teaching portfolio. It's a couple pages of what your philosophy is of teaching and how you've taught and things like that. And we do a lot of CV reviews. So our promotions committee through the Department of Medicine, not the school, we do CV reviews. So if you say, hey, I think I'm ready to go up for promotion. We just do a CV review and let you know and give you feedback as to where there are gaps. I mean, it's something your chief can do as well, or a colleague. So there are a number of women who have posted their CVs and their teaching portfolios online for other women to look at, to see what are they looking for. You need a chief's nominating letter, which is usually pretty self-explanatory, and then letters from external referees. And this is where the ASG has played a big part for me. It's hard to meet full professors who are at arm's length. You can't have trained them. You can't have trained under them. You can't have written papers with them. It is not that easy to find people who will take their time out of their lives to write a letter for you to help you get promoted. And in a case, even going up from assistant to associate, you have to be a full professor. So it's different in other places. Some can be associates writing letters, but for us it was full professors. So a lot of the women that I've met through LEAD, through the women's anything, have emailed me. Hey, can you write a letter for me? I mean, I might have met them for five minutes. But it's those connections. And I mean, I do write letters for people I have never met. That's also a possibility. But I think you're more likely to get someone to actually take the time to write the letter if they've ever met you. Hey, I met you at da-da-da-da-da, and I was wondering if you could write me a letter. So it must be letter writing season, because I am getting inundated. But it's a lot of letters. I mean, it's 10, 12 letters. And usually they have your chief put six names out, which sometimes works. But I usually just, I would give them all the names, if I knew the people who would write letters for me. But again, being involved with the ASGE has been huge. All the people that I had write my letters were people that I met through the ASGE. Because in Cleveland, I can't even get Cleveland Clinic people or Metro people to write my letters. Like, I don't know about Boston. Do they do that? Do they care about where it is? Well, so like in Cleveland, like I know a lot of the Cleveland Clinic people who I've never worked on, but they won't let us use Cleveland. Maybe because it's part of the medical school, I don't know. Oh, yeah. Just a point, then. Oh, but actually, I learned a lot about the process. And it's pretty onerous, is the truth. But what they have, at least at Harvard, is you're allowed a couple of people who are not in your field. They can't be in your department. And the Department of Pediatrics, that's what it is. You can't be in your department. Department of Pediatrics for us is huge, like many departments. So it's 17 different divisions. So I had to have, I'm lucky I have anesthesiologists. You could have gastroenterologists, but they had to be at the other hospitals. I'm trying to think. And it couldn't be very many. It was like two or three that were internal. Yeah, so this is the important stuff to figure out, because it's really, every place is very different. Yeah. That letter from external referees, it is where the networking matches what you're going to need for promotion. Because the truth is, whoever is on this promotion committee had no idea that Ashley and I know each other very well. We keep winding up at meetings together. We've sat on committees together. Maybe they figured that out. Maybe they didn't. But yes, I sort of knew that things were in the works, because you texted. You said, oh my goodness, I'm writing your letter. And I was like, OK, thank goodness, because it's been almost a year. But then you said it was very intense, so I don't know. Yeah, I don't know. So thank you for doing it. But yes, it is helpful to have somebody who knows you. Well, they were sending it to the wrong email. So they were like, hey, even if you just call us, that was really wild. We'll just do a phone call. So anyway, so it is pretty interesting how different all the different institutions are. So I just would advise, like Doug was saying, find out what their CV format is. Cornell has an interesting. I wrote some letters for people at Cornell. Theirs is like really different than ours. So just know what it is, and then it's easier. Just put your stuff in their format. Because we get CVs sometimes that are just horrible. The dates are all like their publications are in crazy different orders. It's not organized. You just need to be able to read a story like Doug was saying. And I don't think it has to be focused like if you started out in IBD, and then you did advanced endoscopy stuff. I don't think that matters. It's just more like understanding your teaching way, what did you do, and really making it stand out that you have national or regional recognition. You know what I mean? Make sure all those elements are there. So again, CV reviews, your institution. I would think your chief, but if they're not particularly interested, someone else, even in another division. My friend who's the vice chair of the Promotions Committee is infectious diseases. We review CVs all the time from anyone who's interested, especially women, just because that's our thing. But again, the CV is your critical document. Keep it current. Find out your standard format. And then the weakest part of most candidates' record is their teaching. So when you do a grand rounds, when you do an M&M, when you do a med surge, all those things, especially early on. I mean, honestly, for me, I've done med surge. I've done M&Ms. And I haven't put them on, but I'm in a little different place. Where you are now, every abstract, every. I pub med myself. So we have an annual meeting with our chief. So we have to do this faculty activity summary. And so I actually Google myself. I mean, that's how ridiculously bad I am at it to figure out what I've done. And then I just add it onto my CV. But you should not do that. You should be more proactive, for sure. Yeah, I mean, it's really smart just to, yeah, even if you print out something you've been asked to give a talk, whatever. I think it's really important to document that stuff. And promotion is all on you. Like I said, except for in California, you can die an assistant professor. Nobody will really care. But if you care, you have to make it. I remember I was sort of, my chief was retiring. And we had someone who was sort of filling in as acting. And then when Fabio came, he's like, you need to get promoted. And he really sort of started that ball rolling for me. And I hadn't really thought about it at all. And then he got me promoted. And then he got me promoted again. But you have to sort of make it your goal to be the one responsible for that and keeping your CV up to date. So again, this is a case timeline. But it takes a long time. The minute you put your stuff in, it is a year and a half. So it is not quick. Typically, it's five years of work before you apply for associate and then another five. That's not a strict thing. There are people who come in who got late to the game, like my husband, and then three years later gets promoted to the next thing. So it doesn't necessarily mean that, but it's generally in. But you can see, it's a long timeline. But it's a year and a half before you'll get through this process. So you need to start thinking about it. So yeah, you start at 2019. It's 2021. And also, you can also find out some people get more money when they get promoted. Our institution gives you more vacation time, which is tricky, because your RVUs, although the benchmark will go down for you as you go up, they know you're never going to take your six weeks of vacation, really. So it's kind of tricky on their part. But some places will give you more money. You guys get more money? You actually get more for going from assistant to associate percentage-wise than you do associate to full. But you get your sabbatical, although I still haven't taken one, as an associate, you have to get permission for what you're doing. If you're a full professor, you can just do whatever you want. But I haven't done it either. Yeah. Anyway, so it's different everywhere you go. So you could find that out, too. Not that that's going to be the end all there. But again, it's a continuous process. You think about it every year. I think hit the ground running. Start thinking about it. Start thinking about maybe where you want to be. You don't have to have an exact map. But I think just start thinking about it in the back of your mind. And again, we have an annual faculty evaluation. It's pretty loosey-goosey. But they do make you, the medical school does make you put together all the publications you've done. And it's a pain in the neck, but it's good because it keeps you going, even if you didn't want to. And what you're doing, what teaching you're doing, it makes you outline how many hours you're with the fellows and residents and medical school. So it's sort of good. And then when you meet with your division chief, you need to set the agenda, figure out, hey, here's the deal. This is what I'm doing. What do you think? How can this work? And I think it's really important to write your goals down. It's kind of a pain in the neck as that is, too. And I try and tell this to my junior faculty of, OK, what are your goals? And what are you doing right now? And which of those things are going to achieve your goals? And if those things aren't achieving your goals, then get rid of them. Be a little more pointed as you're, I mean, at the beginning, you're saying yes to everything. But as you're sort of started figuring out where you're going to go with your life and your career, start narrowing it down and focusing it so that you are going in the right direction to get promoted. Because it kind of would stink if you're doing all these things, and then you get to promotion, and we're sort of like, well, someone's all over the place. There are gaps here and there and everywhere. So I think it's really important to identify those gaps once you sort of figure out where you want to go. But take control. You're responsible for your own promotion and tenure. You're responsible for your teaching and sort of what you're involved in, not your chair. You need to take control. But get advice from a lot of people from a lot of different places. I think it's really helpful. Again, like I said, I won't belabor it, but State Society is a great place to go. Know your institution's template for your CV and their criteria for promotion. And just ask for help, because everybody on this side of the room has been through that already. Thank you. Thanks, Ashley.

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