Author: Cameron Bosinski, MD, MS
The Daily Dose
Academic careers rarely follow a straight or predictable path. Successful physician-scientists often encounter rejected manuscripts, unsuccessful grant applications, unexpected changes in research direction, competing professional responsibilities, and difficult decisions about which opportunities to pursue.
A Scholars’ Day session at the 2026 IARS and SOCCA Annual Meeting brought together three accomplished academic anesthesiologists to discuss resilience, career development, overcommitment, and maintaining meaningful personal relationships while pursuing ambitious professional goals.
The central message was encouraging but realistic: people may be capable of doing almost anything, but no one can do everything simultaneously.
Turning Unexpected Results Into New Questions
Max Kelz, MD, PhD, described how his research career developed in directions he had not initially anticipated.
Although originally interested in neurology and psychiatry, he recognized that studying consciousness in animal models offered a more objectively measurable scientific question. It was easier to determine whether a mouse was conscious than whether it was happy, sad, or experiencing another complex emotional state.
A particularly important clinical experience involved a patient with narcolepsy who remained unconscious for more than six hours after anesthesia. Dr. Kelz initially questioned whether he had made a clinical mistake. He then began asking why the patient’s recovery had been so profoundly delayed.
This observation led him to investigate the orexin, or hypocretin, system involved in wakefulness and narcolepsy.
His early experiments did not show that mutations in this system changed anesthetic induction. Rather than viewing the negative finding as a failure, he asked a different question: Could emergence from anesthesia be a distinct neurologic process rather than simply the reverse of induction?
This question challenged prevailing assumptions about anesthesia. The resulting manuscript was rejected by several journals before eventually being accepted by one willing to consider research that questioned established thinking.
The experience demonstrated several important lessons:
• Unexpected findings can lead to more important questions.
• Negative results do not necessarily represent failed research.
• Scientific progress often requires challenging accepted beliefs.
• Manuscript rejection does not determine the value of an idea.
• Persistence is essential when pursuing unconventional research.
Reframing Ambiguity as Insight
Academic medicine frequently produces uncertain results. Experiments fail, hypotheses are disproven, and clinical observations do not always fit established explanations.
Resilient researchers do not ignore these problems. They examine them carefully and consider whether an apparent failure reveals a previously unrecognized scientific question.
Dr. Kelz’s career illustrates the importance of following observations rather than remaining rigidly attached to an original plan. An investigator may begin by studying one mechanism but ultimately make a greater contribution by recognizing that the initial question was incomplete.
The Importance of Personal Support
Dr. Kelz also emphasized the role of his wife, Rachel Kelz, MD, who is herself a physician-scientist.
Each has encouraged the other during professional setbacks. Their relationship also includes humor and humility, including reminders about who currently has the higher academic citation index.
Academic achievement is often described as an individual accomplishment, but careers are frequently sustained by spouses, families, mentors, colleagues, and friends who provide encouragement and perspective during difficult periods.
Doing Anything Does Not Mean Doing Everything
Julie Freed, MD, PhD, focused on the problem of overcommitment.
Academic physicians are frequently offered projects, leadership roles, committee appointments, speaking opportunities, research collaborations, and administrative responsibilities. Many of these opportunities are individually worthwhile, but accepting all of them is not sustainable.
A brief telephone call can unexpectedly become a major new responsibility. Some of these opportunities may advance a career, while others consume time without contributing meaningfully to long-term goals.
The critical question is not simply whether an opportunity is attractive. It is whether the opportunity aligns with the physician’s priorities and whether there is sufficient capacity to perform it well.
Evaluating New Opportunities
Before accepting a new role, physicians should consider:
• How much time the responsibility will actually require
• Whether it supports long-term career goals
• What existing responsibility may need to be reduced or abandoned
• Whether the opportunity provides meaningful professional growth
• Whether the work can be performed efficiently
• How it will affect family and personal responsibilities
• Whether the physician is accepting because of genuine interest or difficulty saying no
The true cost of an opportunity is not limited to the hours listed in a job description. It includes preparation, correspondence, travel, meetings, follow-up work, and the mental energy required to switch between responsibilities.
Becoming More Efficient
Dr. Freed explained that she remains very busy but has become more productive as she has gained experience.
Efficiency develops through:
• Recognizing which tasks require personal attention
• Delegating appropriate responsibilities
• Developing repeatable systems
• Becoming more selective about meetings
• Improving the ability to prioritize
• Learning how to complete familiar work with less effort
• Protecting focused periods for important projects
Greater efficiency can create additional capacity, but it should not automatically become a reason to accept every available opportunity.
The ability to work faster does not eliminate the need to establish boundaries.
Responsibilities Change Over Time
The attention given to research, clinical practice, leadership, marriage, parenting, and personal health may appropriately change during different periods of life.
Balance does not necessarily mean giving equal time to every category each day. It may mean deliberately shifting effort based on current needs.
At one stage, a grant deadline may require greater professional focus. At another, a family member may require more time and attention. The important point is that these shifts should be intentional rather than occurring entirely by accident.
Seeking Advice From Different Perspectives
Dr. Freed frequently seeks advice from her husband, who does not work in medicine. His different perspective helps her evaluate professional opportunities and the tradeoffs they may create.
She also maintains a relationship with a retired cardiologist who serves as a mentor. Because he has completed a long career, he can offer insight into which accomplishments ultimately provided lasting satisfaction.
Mentors at different career stages can answer different questions. A midcareer mentor may help an individual navigate current institutional challenges, while a retired mentor may provide perspective about what will still seem important decades later.
Saying Yes May Require Saying No Elsewhere
Taking on a new role sometimes requires leaving an existing one.
Dr. Freed acknowledged that she has had to cancel meetings, relinquish previous responsibilities, and intentionally reserve time for her family.
Saying no does not necessarily reflect a lack of ambition. It may be necessary to protect the quality of the commitments that matter most.
Time Management as Mental Management
Traditional discussions of productivity often focus on calendars, schedules, and task lists. Dr. Freed suggested that effective time management also involves training the mind to move between different contexts.
An academic physician may need to transition rapidly among:
• Clinical decision-making
• Scientific writing
• Administrative leadership
• Teaching and mentorship
• Parenting and family life
• Personal recovery and reflection
The difficulty is not only finding enough hours. It is learning how to focus fully on the responsibility currently requiring attention.
Following the Science
Miles Berger, MD, PhD, also described an unexpected change in research direction.
He originally planned to study the neurologic effects of abnormal serotonin in a mouse model but ultimately found himself studying pancreatic islet cells.
This experience taught him to remain flexible and follow the scientific evidence, even when it leads away from the original plan.
Investigators who become too attached to one technique, hypothesis.
Thank you to The Daily Dose and the International Anesthesia Research Society for allowing us to summarize this important session.