A couple of things, first, I want to congratulate you for where you are in your career. I envy you more than you could ever believe. Such an exciting time, you have your whole career in front of you and now you get to make decisions. But making decisions entails responsibility and being responsible means planning and that's most of what we're talking to you about today is your goals and planning and I'm about to put more on that pile of meeting your goals, setting goals, meeting goals, planning, etc. But I also want to make another pitch in the other direction before I tell you more about your goal orientation. Mike Tyson has said some things that I wouldn't want to repeat, that I don't have any respect for but there is one thing that he said that I thought was really poignant and that's when he was about to be in a fight and the reporter asked him what his plan was. And Tyson said, well, you know, everybody has a plan until they get punched in the face and then they stop in fear and freeze. And rhetorically, I've been punched in the face a few times in my career and my life and some of those have actually turned out to be the best opportunities I've ever had. In fact, I had a punch in my face when I was an intern in my second month when I was supposed to start my ClinEpi project and have a month off to do it because I wanted to be a general internist, I thought, and I got yanked off of my research month because one of my colleagues quit to do anesthesia and they needed a warm body on GI and I went to GI kicking and screaming and you can see where I am now, happy as a lark. So I just want to say, you know, it's important to be goal oriented and it's important to plan but I also, on the other hand, say it's important to be an opportunist. Life is full of serendipity. Be ready to seize the moment. All kinds of that stuff has happened in my life and I look back at it and I'm stunned at how seizing the opportunity has helped me and I don't want you to not be goal oriented and I don't want you to not plan. Those things are important and I'm going to add to that, like I said, but also it's important to be an opportunist, love life as an opportunist. Alright, let's for a little while talk about building your brand because you're special. You're same but you're different and you want to capitalize on that. You're going to climb the academic ladder or maybe not, whatever ladder you're going to climb. I have nothing to disclose. So these are the objectives. They're spelled out for you and let's start with the brand building part. And where to start with building your personal brand is by exploring yourself, self exploration with blatant honesty. Who are you? What's most important to you? What effort, time and resources are you willing to invest or able to invest? What do you feel? What do you feel your best talents are? What do others say your talents are? That's important too because I couldn't always recognize what my best talents were and I actually listened to other people who are like, nah, it's not that, it's actually this and you need to think about this and guess what, they were right. Also what do you really love to do? You know, because if you love to do it, you'll feel like you can do it forever and we do want some durability here, which doesn't mean you can't change it up, but what sacrifices are you and your loved ones prepared to make? Some of us might be in situations where we can do whatever we want because the decisions that we make don't impact others directly. But for many, that's not the case and you need to make decisions together or if you have a family as a group because all are impacted, a lot to think about. And what are your immediate options now and what options do you need to be able to keep in your pocket later? You know, I like to think of my life and my career as a book and it's a book of different chapters. I haven't worked at the same place the whole time and what I've ended up doing isn't what I thought exactly that I was going to do. And some of where I've ended up has to do with my wife's career, which has nothing to do with clinical medicine. So each chapter is different and each chapter is interesting, but the chapters together are a compendium and that's your career and that's your life. So don't get too hung up about one chapter because it's just a chapter. Think about it also in the context of the entire book from cover to cover. Also there are many ways to be successful. I remember this hallway conversation about a decade ago with one of my senior colleagues and we were talking about another colleague at another institution that was a friend of both of ours. And he was like, well, you know, so-and-so, he could have been more successful. And I said, wait a minute. You know, success is defined individually and success means different things to different people. I totally disagree. I think in the context of what he's wanted to achieve, he's been incredibly successful and it's not the number of papers, which was what this other person was hung up on. For some people, that's success. For others, that's not their yardstick. So there are many ways to be successful and what matters is what's successful to you. So what does success mean to you? That is my checklist for you for where to start with your self-exploration in brand building. So let's talk about you. Why did you pick medicine? Why did you pick GI, hepatology, nutrition? Main reason I picked GI was actually because of that punch in the face and one person who really had a big impact on me and you'll see her picture towards the end of my talk. What do you see yourself doing in the short term but also in the long term and what major changes do you foresee in your future? Maybe you have a big life event coming up that might have some impact and what major changes do you see even farther out and what can you see yourself not doing? You need to be really honest with yourself because they are going to be people who either incented or even with best intentions are going to sort of try to push you in certain directions. But if those directions aren't you, be honest with yourself so that you don't disappoint yourself because you're the person who owns yourself and you need to be happy with the decisions that you make for yourself and that also impact your loved ones. Again, what are your best talents? What are you less talented at? You wish you could be successful in the realm of science but you've been in the lab and that didn't really work out. I tried the lab, I tried really hard but I just, the science, I could do it but I wasn't talented at it and there was a difference. I had to be honest with myself about that and being honest, I've ended up being happy as a clinician. What do you enjoy the most and the least? I think there's a real need to be honest with oneself and food for thought here. There's a difference between considering the opinions of others and making your own decisions and being pushed by others into making decisions about what they want you to be. Be very, very careful about that. Be honest because while sort of kowtowing might help in the short term, in the long run I'm going to opine that it probably isn't going to make you as happy. So leave room for serendipity and if I have a little time at the end of the scripted talk then I'll give you a little more insight into what was going on with me. I show you this picture at the bottom because that one represents recent serendipity to me. So that's my colleague and friend Vinay Chandra Shekhar. He's working with Stephanie, one of our nurses and this was when Aliana Beaufille was our advanced fellow a couple of years ago. To our great fortune she agreed to stay with us and join our faculty. She's originally from Puerto Rico and about a year ago in one of her visits back to her parents she met someone special and it worked out and it was all of a sudden. She just moved back. She's getting married. She loved being on our faculty and working with us but other life circumstances changed the realities for her and so you need to leave room for serendipity. It's important. There are lots of things to consider. It's a career but it's also a life. Got to know what a brand is to understand how to build one. There's a brand. It's a really strong one and it's changed over the years too. I remember yesterday we were saying it was the endoscopy club. Well it's a lot more than a club now. Here are the 10 most valuable brands in the world last year and I'll bet there isn't a person in the room who doesn't know what each of those brands is or what at least one thing that each of those companies makes. And you probably have opinions about those companies, positive and negative with many of them and I'll bet if I asked each of you, you would say different things about many of these companies and some may be positive, some may be negative or some in the middle. And a product isn't just some tangible thing. You're a product. You're a product of your upbringing, the work that you've done, the people that you've met and been influenced by, the places you've lived, et cetera, et cetera. There is Pratik Sharma, he's the president of ASGE and he's an academic physician and to some of you he may be the barracks guru, to others of you, you think of him as the society president or for me he was one of my committee chairs when I was a committee member on membership. He has many different brands or hats that he wears. Mother Teresa, she had a brand. She was the ultimate caregiver to people in need. There's my great friend, Iko Hirano, who passed away a few weeks ago. Half the EOE papers that you saw earlier this morning that Bill talked about were Iko's studies and papers. And to most people, Dr. Hirano is Mr. EOE. But to me, he was my competitive running partner, somebody that I bounced my personal life off of and to lots of other people, he was their mentor. He mentored so many people in academic medicine, many different brands. So I could go on and on. You know who many of these people are. There's Shohei Otani, a great baseball player who is an incredibly versatile guy on the field. There's Chaka Khan. Many of you might think of her as a singer for Rufus, but she's also, you can't name the number of songs where somebody hired her to belt out a scream like nobody else could. And she's from Chicago too. Dwight Yoakam, is he just a country singer or somebody who's been in a few movies or is he the dude that made country cool again? That's who he is to me. Dr. Dre, you think of him as a musician and a producer or do you think of him as a businessman? He's an incredibly successful business person. Tina Turner, she had at least two careers. My mom is 90 and she used to go to Ike and Tina concerts. The music then was different from when she was a star when I was a college student. Music was totally different, but a star nonetheless. And here's one of my big heroes. Some think of him as Mr. Toyota, the Toyota quality plan, if you will. That's Edwards Deming, who's a Midwesterner who really brought quality control onto the map. And when he couldn't sell that idea to US industry, he went and educated industry folks in post-war Japan, which led to Japan being a quality leader in so many industries. So many people are also brands and have different brands. And I ask you, what's going to be your brand? Your brand should be about who you aspire to be. That shouldn't be inspire, but you will inspire people. Who you want or how you want other people to consider and view you, what you're willing to do to achieve both of those things, and today, tomorrow, and also the next day. So a brand can mean different things, but here are some definitions that I found compelling. To marketing professionals, a brand's a product or a business that has a distinct identity in the perception of consumers. So the brand is created through elements of design, packaging, and advertising that as a whole distinguish the product from competitors. So how do we distinguish you from other gastroenterologists? The product then contributes to brand equity, your value in the view of others, and reflects on the company that produces it, your institution, or the society that you're a part of, or your specialty. And a successfully executed brand provides enormous value to a company, your practice, or your institution, giving it a competitive edge over others in the same industry. A brand is a particular entity or identity or image regarded as an asset. So this is something that you build on through your career. It's a public image, a reputation, or identity conceived of as something to be marketed or promoted. So an easily distinguishable product, service, or concept for easy communication and marketing. I just showed you a bunch of brand images, and all sorts of things probably immediately came to your mind. When somebody says your name in five or 10 years, what are they going to think? What's going to be their first thought? Well, you're going to build that. And how do you build it? You need to decide what you want to build expertise in that distinguishes you from others. You want to determine what you want to be known for, which may not necessarily be what exactly your mentor wants you to be known for. Decide what you want your focus to be, what separates you from others in your field. What distinguishes you? What do you want to distinguish you in your own eyes and the eyes of others? And those others may be colleagues, patients, and others. What do you want people to think of when they see your name or your image? You're going to need to think locally, say within your own practice or institution, but also outside of your institution, because you're going to be a physician to whom other physicians refer. Think regionally, globally, even outside your core field. You may be actually developing new techniques with physicians and other specialties. You may be developing new technologies with corporations and vendors that do that, for example, pharma companies, et cetera. You're going to want to think short-term and long-term, and you need to do both at the same time. And then sustain, refresh, or reset. Your career is going to go for several decades, and sometimes you just need to reset or rejuvenate to keep it fun and interesting. So this is David Aker, and David Aker was a professor at Berkeley in marketing. And he had this thing called the Aker Model, and it's outlined in that book if you have an interest in brand building. That book has sat on the shelf in our house for a long time. My wife's a professional marketer. And he simplifies his Aker Model of brand strategy as brand equity, a need to develop a brand identity, and then talks about brand identity and what that is. And brand equity includes brand awareness, loyalty, and its associations. And the need to develop a brand identity centers around a unique set of brand associations representing what the brand stands for. And I'll show you graphically what that means in a second. And offers customers an aspiring brand image. And finally, the brand identity could be the brand as a product or as an organization, or in this setting, as a person and as a symbol. So take a look at this, because I found this to be a nice, simple way to think about building a brand. And yeah, these are tangible products, but you can, you're smart. You can easily extrapolate this to building yourself as a brand. So here, we're looking at Nike as an example. And at the bottom, what is that company? It's Performance Athletic Equipment. What does it have? It has technological superiority, product variety, and stylish design. What does it do? It improves performance through these characteristics that it possesses. And what it does intangibly is the exhilaration of athletic excellence. And it has an enduring promise, which is to help you achieve your personal best. Think about extrapolating that to your career as a physician with a particular identity. How about Folgers Coffee? Yuck. Okay. But you get the point. So what is it? It's ground coffee. That's all it is, right? It's ground coffee. But what it has is mountain-grown taste and aroma. What it does is it simply wakes me up. But what it does intangibly is that it brightens my day, and its enduring promise is to maximize your potential every day. Okay? You can put Starbucks on there if you want to. But you get the point, right? This is breaking up where does that brand identity come from, and how do you strategize building a brand? How do you strategize it when you build your own brand? It truly is worth thinking about because you want to distinguish yourself from others. So I've put a few other comparos on here. I won't enumerate them. The How is Canada Different from the U.S. is something I thought about because I chose to do my interventional fellowship on that side of the border for a number of reasons, including wanting the opportunity to see another healthcare system, and what the differences were in efficiency. But there are distinguishing characteristics of you, and you want to leverage those. So there are gonna be similarities, but there are differences, and you want to leverage those differences. And how do you build your brand? You need to understand what makes you, you. Who do you want to be? How do you want to be seen? We talked about these things. Of course, you need to work hard. You need to cultivate, curate, and continue to refine your skills, abilities, and your talent, and each of those is different. There are resources for you to leverage that you should consider. Your education, of course, and your training, and you're going to continue to retrain because we're in a highly technology-driven subspecialty. There are certifications that you have obtained, continue to obtain, and will need to recertify in order to demonstrate that you're staying current. Mentorship, mentorship, mentorship, as Doug mentioned earlier today. Writing and publishing, speaking and teaching, mentoring others, that becomes part of your brand identity, too. Networking, and not just networking, but keeping in touch with people that you meet to keep those relationships not just alive, but growing. And of course, in this day and age, let's not forget about social media, but be careful. And same with industry relations, be careful. Because both of those things have the potential to strongly, positively help you build your brand identity, but they also have the risk of driving your brand identity into an identity that you may not intend, choose, or desire. Let's talk a bit about building your career, advancing your career. So what's a job? Here are some different definitions, dictionary definitions of a job, and they basically relate to work, a specific piece of work, or an occupation. And that's not what this talk is about. We're talking about a career, not a job. So what makes a career a career? Well, I've given you a lot of definitions here. And the take-home, really, from all of this is that it is not just a job, it's a life work. That's really what, you don't hop from job to job. You're building a career and getting better and better, or changing it up and keeping it interesting because it's gonna last through your working life, and maybe even after that. I know a lot of physicians who work late into their life and then retire, but continue to give of themselves in what ways they still can that continue to be relevant for them. I can't think of a better definition of a career than someone like that. And again, it all boils back down to who are you? What brings you happiness and joy? Who do you have to think about besides yourself? How much of yourself do you actually have to be able to invest in your career versus the other responsibilities in your life? We talked about time management. What limitations exist? How much risk can you afford to take? And that may change at different points in your life and your career. And what sacrifices can you afford to make? What's a career and who cares about you? Not who cares, but who cares about you? Be true to yourself. Care about yourself enough to be true to yourself and honest to yourself about what really interests you and makes you happy because I could keep saying this over and over again, you're gonna wanna be happy for a long, long time. This will help you to be more successful and you'll actually be so happy that you'll want to contribute to the success of lots of other people along the way. And that will lead to the durability of your happiness. But be willing to listen to what others have to opine and offer because one size doesn't fit all and that's a good thing. And you know what? We all change different chapters in the book. And if what you're doing or where you're working no longer makes you happy and you see a better opportunity, be an opportunist. Have the guts to get out of your chair and walk out the door because really you're the most important to you. So don't feel stuck. You're never stuck. As a physician, there's never gonna not be a physician shortage or a gastroenterologist shortage in our lifetime, I don't think. It's not like there aren't other places to go. You just have to look. And then if there's something that looks like it's more fun for the next 10 years or whatever, you need to have the guts to do that for yourself because you're worth it. Rejuvenate your career, reinvent yourself to the benefit of others who you're gonna end up helping along the way because you're happier and more productive and more successful. Your patients, your family too. All right. Some of this has been talked about and you know how academic careers work. And so in the interest of time, I'm not gonna enumerate. But as you can see in these pictures, there's different ways to be academic. You can do different types of research and have different types of research-related careers. And you can do this in education and training. And also these days in leadership and administration. So there are many different ways to be academically successful, thank goodness, these days. It's not only how many papers you write or whether you do basic science. There are different environments, there are different people surrounding you, case complexity, team management. All sorts of things might attract you to an academic environment. You just wanna be around a bunch of smart people that are doing some new things? That's a good enough reason to be in an academic environment if that's what you want. Dr. Adler talked about how important mentorship is and that's true in your training, but it's also true in the academic world once you become an attending. In fact, early in your attending years, I would argue that choosing a mentor well can be the most important, most impactful thing that you can do. And that second line there, I look back at my own career to pull this one out of the hat. A resourced one can help even more. I'm not just talking about money, but I'm talking about opportunity. So a couple of examples. One, when I was a GI fellow, I spent a mildly successful year in the lab and my lab mentor was a PhD scientist who was very nice and he was doing some great work, but he was poorly resourced. He didn't have much in the way of grant funding yet. And so I was largely used as a lab tech for much of the time and I think my career suffered as a result of that. And I was begging, borrowing, and stealing resources from other labs half the time to try to get the things done that I was assigned to do. So resources matter. And later in my career, my senior mentor was someone who was only a couple of years older than me. And so he was too busy building his own career to be able to give opportunities to me. And I felt that I was basically competing and had to find another opportunity early on in order to grow. So just wanna say, pick your mentor carefully and you really need to do some homework to see whether they're gonna have opportunities and resources to offer you, because you need those to grow. Or maybe you should find another one. And you can have more than one mentor in your career and you should, internal and external. In one of my stations, I didn't have a senior mentor, so I got all my senior mentorship extramurally and they were a great help to me. Different institutions are different in terms of what they require for your promotion. Some are very scripted. For example, at my institution, you can't even clear your own department to submit for a promotion unless you have X number of peer reviewed articles, period. That's the first cut. At other institutions, they have multiple tracks. And so it really kind of depends and you should do your homework early to find out what boxes you have to check in order to climb the ladder. And at some institutions, there is a freshness expiration date. If you don't apply for these things within a certain duration, then you're gonna lose your opportunity for advancement. Some institutions will give you credit for citizenship, education, things that you do extramurally for societies, talks that you give, all sorts of things other than peer reviewed article count, grantsmanship, but other institutions are very old school on that. Know upfront what you need to get promoted and I've given you a list there. Can you have a research career and private practice? These days you actually can, but as was described to you yesterday, a lot of that is going to be enrolling patients in clinical trials in pharma or in device development. But yes, you can have a hybrid career, but there are limitations. And remember that there are academic careers these days and things outside of science and outside of education in academic institution, hospital leadership and other types of administrative leadership positions. So choose your track carefully and choose a strong mentor, hopefully one that's resourced well. These are the things that you need to do if you're gonna be a clinician educator. Look for true altruism. The altruism of the brand that you receive as a trainee is not the same after you graduate. As was discussed earlier today, once you are able to be competitive, you can be seen as a competitor. So the altruism may diminish with individuals who perceive you as a threat. That's not gonna be a healthy mentor-mentee relationship and you probably ought to either look for other mentors to mentor you as well, or if that's your primary mentor, you maybe need to think about switching sooner than later. You need altruism to continue for you to be successful. These are a checklist I've provided for you if you're going in the investigator or the scientist track. These are some of my mentors and the main reason I show you these pictures is twofold. The man at the upper left is Nat Zoper. He's not a gastroenterologist, he's actually a surgeon. And he influenced my career because he got me into third space endoscopy back when it was notes. He offered me an opportunity to expand my career outside the lumen of the gut. And at the same time, he offered me an appointment in the Department of Surgery, so he became my other boss. Next to him, to the right of him, is Greg Haber, who is my GI endoscopy mentor and was my attending in my advanced fellowship. But the person I owe it to most in GI is Miriam Vishny, who's in private practice in Cleveland, who was a first year GI fellow when I was an intern and got punched in the face and landed into the GI service against my will. And she was just so enthusiastic and was like, wow, you're a great intern. You're doing a really great job here. You can hold my beeper while I go to clinic. But she knew what buttons to push. She was super enthusiastic. She loved GI so much that she infected me with GI and I ended up doing exactly what I said I hated. Al Baker's a hepatologist, not a luminal endoscopist, but he gave me opportunities when I started my career at Northwestern in transplant endoscopy and I've never lost that love. Unfortunately, we lost him a couple of years ago. Adam Slivka was my attending when I was a GI fellow in my three year fellowship and he infected me with an interest in pancreas and biliary endoscopy. Norm Marcon at the bottom there was my other interventional endoscopy attending. He was awarded the Order of Canada for great things that he did to promote interventional endoscopy over the years. John Petrini fostered my interest in ASGE and helped me build my career in the society. Alan Bookman is a nutritionist who gave me opportunities to delve into enteral nutrition as an interest in GI endoscopy. Bob Carey was my dean in medical school when I was a student leader in med school. He offered to help me write the very first paper I wrote on medical education and Steve Edmundowitz who served as my external extramural mentor when I had no senior mentorship when I was trying to build a program at Northwestern here in Chicago. So my take home message is your career is your life's work. It ain't a job and that's not what we're talking about. Plan it as a lifetime pursuit. Start to create your brand through self-exploration and be honest with yourself above all else and then build your brand based on your true fashion, keeping in mind limitations that are going to be important in your life. Cultivate your brand by differentiating yourself and then curate that brand from there forward throughout your career, keeping it fresh. Understand the pathway of your academic career early and know what check boxes you need to check to advance it based on the requirements of your institution. Pick strong mentors who truly care about you from the bottom of their heart and stay focused and plan well but leave room for that punch in the face which may actually land you in the best place you could ever be. Thank you very much. Thank you.

career development

systematic planning

unexpected opportunities

brand building

mentors

self-exploration

career growth

authenticity