Scholarship at Night: Building a Successful Career as an Academic Nocturnist

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On this episode of the Academic Medicine Podcast, Jessica Chambers, MD, MPH, Alex Rittenberg, MD, and John George, MD, discuss the unique role of the nocturnist, or the night shift clinician, in academic medicine. They offer opportunities for pursuing scholarship related to night medicine and challenges to doing so as a nocturnist. And they emphasize the importance of collaborative, inclusive, and flexible professional development for building a successful academic career.

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A transcript is below.

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Transcript

Toni Gallo (00:03):

Welcome to the Academic Medicine Podcast. I’m Toni Gallo. On today’s episode, I’m joined by the authors of Glow in the Dark: Promotion Pathways for the Academic Nocturnist. Doctors Jessica Chambers, Alex Rittenberg, and John George, along with their co-authors, use their own experiences as nocturnists to discuss the challenges they and others who hold similar positions face in advancing in their careers, given how professional development opportunities are usually structured. In their article, they suggest how nocturnists can leverage their educational service, clinical care role, and health systems leadership experience to enhance their scholarly productivity and advance toward promotion. In our conversation today, we’ll talk about what makes the nocturnist role unique, the recommendations Jessica, Alex, John, and their co-authors have for fellow nocturnists looking to grow and develop, and how all clinician educators can benefit from a more flexible professional development system. So I want to thank you all for being on the podcast today, and I’d like to start with some introductions for our listeners.

John George (01:12):

Good morning, Toni. Thanks for hosting us. I’d like to introduce myself. My name is John George. I’m a clinical assistant professor at the University of Florida with our hospitalist division. I’ve been working for the last 10 years as a nocturnist. I kind of came straight out of residency into a nocturnist career. I’ve enjoyed it, and I’ve also been serving as our night director for the last five years.

Jessica Chambers (01:34):

Great intro, George. Hey, everyone. I’m Jessica Chambers. I am down at the University of Texas at Austin, where I am now the associate program director of internal medicine residency. This role pretty much came from the fact that I started as an academic nocturnist right when I graduated in 2019 and helped build up our night curriculum, how we assess and teach residents overnights, and just generally improve the quality of care and quality improvement projects overnight.

Alex Rittenberg (02:03):

Hi, everyone. I’m Alex Rittenberg. I am at this point PGY-10 academic nocturnist at Virginia Commonwealth University in Richmond. I am also the associate program director for inpatient medicine, the medical director of the house staff services. And thanks to both Jessica and John, as well as some other academic nocturnists, a recently minted associate professor of medicine. Toni, thank you so much for having us today.

Toni Gallo (02:27):

Congratulations. Maybe let’s set the stage for listeners. You all mentioned your own current roles, but what is the role of a nocturnist and what makes it unique from other positions in academic medicine?

Jessica Chambers (02:42):

Well, I think to make note of the elephant in the room, I do feel like maybe initially some people sign up to be night shift workers or nocturnists because by the end of residency, they’re just burnt out with the daily work, the daily metrics, the daily rounds, the daily discharges. At least that was the case for me. I really felt that becoming a nocturnist allowed me to get back to clinical medicine and really being at the bedside and worrying a little bit less about those day-to-day tasks. Because of that, I was really leaning into my clinical abilities, my clinical self, my clinical decision-making. I think at a time of day where there really wasn’t many other people around me to support me, I couldn’t get any stat echoes. There was no cardiologist I could call at least easily. So I was really learning and thinking on my feet and triaging in a way that I just didn’t as a daytime clinician.

(03:37):

All of those opportunities are really good in academic medicine for teaching, obviously junior learners and people from other departments. The three of us are internists and family med-trained docs, but we also interact with emergency medicine physicians and their residents and their advanced practice providers. So the breed at night is really a fun one as well. I think you’ll hear that talked about in general across nursing staff and the other people that work at night. I think there’s just so much unique about it to build a career on, and I feel really grateful I met my colleagues here through the Society of Hospital Medicine.

Alex Rittenberg (04:13):

I’ll echo what Jessica said. I don’t think many people expect to become nocturnists going into their clinical career, but I think you end up choosing in residency what excites you the most. And at least for me, that was essentially the work that we did as residents at night, and that translated into becoming a nocturnist. It’s very rewarding taking care of patients in internal medicine and family medicine, in medicine in general. And I think nights give you a unique opportunity to really focus on that, to take care of patients, both those coming in undifferentiated, those who experience clinical decompensation and you have to take care of them acutely. At least for me, you get to spend more time on nights sitting, talking with your patients. And I think one of the rewarding parts of being an academic nocturnist, to someone who works with learners at night, is that nights I got to do more education with my residents, which they found rewarding, which I find rewarding. And so it’s really kept me in this career for as long as it has.

John George (05:16):

I think I have to agree with both Jessica and Alex. So I did fall in love with the concept of a nocturnist during residency. I didn’t really know the position existed before residency, but it was during my night float rotations my first year as an intern that I realized that I really shined there. I’m naturally a night owl, I would say, so that does attract a certain population who like to be up at night. And I used to find that I would think the best at night, my mind would be the clearest at night compared to in the morning, it would take me a couple hours to really wake up and get into the swing of things.

(05:51):

But I think also the concept of this being as close to pure medicine, so you get to focus on either mostly … A lot of the work that we do is mostly admissions or crosscover issues. And if you think about it at the admission, you’re trying to make the decision on the patient, set the course for the next few days while you’re doing an undifferentiated workup. And then if you have a crosscover issue with somebody who may be acutely getting ill or acutely decompensating, so you had to take that moment to step back, reevaluate, take another broader look. So I think in that regard, we’re going back to pure medicine, why we went into the medical field and why we became generalists, internal medicine, family medicine, focusing on everything.

(06:34):

The other thing is we’re a smaller group of physicians, so there’s a lot more camaraderie. I feel like there’s a little bit more like a band of brothers. There’s a smaller group of us, so we always make sure to rely on each other. There may be one or two of us in the hospital. Sometimes larger groups, you can get up to five at night, but then we can bounce questions off of each other, but it’s a very smaller group and you get a little more close-knit.

(06:57):

I will also say there’s a little bit of a work-life advantage sometimes. My mom actually … I got some of the inspiration from my mom who worked as a night nurse for her whole career, so she was actually able to spend a little bit more time with us in the afternoons because of her work schedule, working nights. So that was part of the inspiration too. So I think a lot of things inspired us, the ability to focus on pure medicine, the camaraderie that exists at night, a little bit of that independence that comes with having to make decisions without all of the support that you may have during the daytime. And then sometimes work-life balance and seeing inspiration from other members around us.

Jessica Chambers (07:34):

That’s such a good point, John. And something I hear all the time from members of our … We have a gang of nocturnists or a cohort of nocturnists that are always in touch, including us three. And so many of them say it’s actually a really good time for raising a child that they’re able to be home at critical moments, especially tucking into bed or waking up in the morning. And I don’t personally have kids, but that’s something I hear a lot from my colleagues.

Toni Gallo (08:01):

So you’ve all mentioned academic careers, and a key part of that is thinking about scholarly productivity and promotion and advancement. In addition to … you’ve talked about the patient care aspect of nighttime medicine. How do you think about that in terms of scholarship and developing scholarly projects or work? How do you think the nocturnist role lends itself to scholarly work? Or what might be the barriers too that you face there?

Jessica Chambers (08:33):

I think nocturnists, because this was one of the very first pieces that we could find on this topic, if not the very first piece specifically on academic clinical nocturnist promotion advancement, you’re really seeing all the same problems that people have been studying in terms of education, quality improvement, hospital throughput, but from the lens of the night shift, and you have really unique insight into how the hospital operates at night, the gaps in care. And I know anyone listening to this podcast who’s done a night shift knows that sometimes problems occur and it’s like we just have to patch it up with duct tape and figure it out and keep going. That is a very common theme at night. And I think just being curious about any of those things, and if any of them particularly annoy or energize you or you’ve really find a way to make it better, trying to think how to make that into scholarship, whether it’s pure research or quality improvement or just an interesting case where a patient was impacted particularly by the nighttime hours care.

Alex Rittenberg (09:35):

And I think scholarship takes on a variety of forms. It’s not always large randomized controlled trials, which probably when you’re as busy as you are with being a nocturnist, you are not going to have the opportunity to participate in, but it can look like things like quality improvement, and look like education. All of these end up having their own areas where you are able to disseminate scholarly work at conferences, at the Society for Hospital Medicine, the Alliance for Academic Internal Medicine. There’s quality improvement conferences that are not my area of expertise, but I’m sure they exist as well. All of these lend themselves to being venues for presenting scholarly work. And because night medicine is kind of such a nascent career, there are opportunities that it’s novel, you’re able to get your ideas out there and actually create that communication around them.

Jessica Chambers (10:30):

And I have to put a plug in rolling off what Alex said for any kind of institute or academy for high value care, that’s a really important place to look if you really just don’t know where to start. Think about how many patients we keep up awake overnight with beeping and labs and unnecessary … What we have found for the average patient might be quite unnecessary contributing to longer hospital stays and of course delirium. There are myriad ways that you at your site know what is an actual way we could do to prevent this. And so you already have the topic and you just need to think of one way to do it within your own realm, and that’s its own scholarship and something, a niche that you’ll be known for going forward.

Alex Rittenberg (11:14):

Our associate program director for quality improvement is also a nocturnist stationed at the VA. And I believe the last … So every year our class of residents chooses a quality improvement project. And I think the last three years in a row, they’ve all been projects that have centered around night medicine.

Jessica Chambers (11:34):

That’s pretty incredible.

Alex Rittenberg (11:35):

That might be because he is a nocturnist, but two years ago, one of our quality improvement projects was changing the time that bedtime labs were drawn in an effort to reduce delirium to improve patient satisfaction. This ended up being presented by our chief resident for quality improvement and took first place, I believe, at the state ACP conference. So it’s these opportunities that lend themselves to scholarly activity when you are a nocturnist. These are the type of things that you can be thinking about, how can I improve this aspect of clinical care in the night medicine environment because it is understudied and there is value to improving it.

John George (12:13):

No, I have to agree. I think just our viewpoint that’s a little bit different from some of our colleagues that works days, so we get to see a lot of different things. And we also get to see patients just as they’re coming into the hospital. So sometimes we may be the first ones right after the ER to identify common cases. So we’ve done some projects, even some clinical trials that we’ve been involved with because we are the first to see patients. So our subspecialists will reach out to us and we will be involved with them because we’re actually the first ones enrolling patients into studies or identifying patients that will qualify for studies.

(12:47):

So we sometimes find ourselves even a little bit beyond QI into some of the clinical trials, but I do feel a lot of it is QI, what we’re going to see at bedside, what we’re going to see while we’re working on a shift. And it’s going to be small things that we sometimes overlook, but can make huge changes once we bring it up and study it. So it’s usually some of the small stuff that’s overlooked overnight that we will actually pick up on and that kind of leads to scholarly activity. And again, just like what Alex mentioned, night medicine is a very nascent field, so there’s a lot of things to be studied here, education scholarship, QI improvement, quite a bit.

Jessica Chambers (13:27):

I know it’s a little early to bring it up, but one of the really cool things John did is create a night writing group. So at his institution, him and his fellow nocturnists were thinking about how we’re temporally disaligned from our daytime colleagues. So it’s really hard to make those meetings or just things floating around like, “Hey, let’s get together and write together,” or all these workshops because we’re sleeping most of that time, AKA during business hours. And John created a night writers group, I think it was called Night Writers.

John George (14:00):

Yeah, it was like Night Writers. Yeah, W-R-I-T-E-R-S. Yeah. So yeah, we started this, it came up as an idea because we were thinking, how do we get involved in scholarly activity and how do we support each other? And we found out this is kind of a little bit of a force multiplier too if you think about it. Some of us like doing the research, some of us like doing the writing, some of us like doing different parts. So we were able to divide up the responsibilities and keep each other accountable with our meetings. We actually, we experimented with our timings of meetings like monthly meetings, biweekly meetings, and we kind of found the best was with a biweekly meeting, and we would meet up with …

(14:41):

A lot of the work we’ve done are more case reports. So just like what I mentioned, as you’re the first physician seeing a patient when they’re coming to the general medicine service, so you may be the first ones to identify very interesting presentations of clinical illnesses. So we do a lot of case reports and some of us like doing the research parts, some of us like doing the case writeup. And so that’s actually translated to quite a bit of publications. I think one year we did 12 plus poster presentations. And even this last year, we had done quite a bit of database-based research and we’re working on publishing those. And the good thing is since we work as a group and we’re able to divide up the responsibilities, it doesn’t become as overwhelming, and each one of us can bring an idea and then share it amongst each other. So even though we’re working, if you’re working independently, you would be only getting one project out, but since you’re working as a group, you can do multiple projects together.

Jessica Chambers (15:40):

What time of day were y’all meeting?

John George (15:42):

So we were actually meeting in the evenings. So we try to time a lot of our meetings in the evening. So just before we come into work, so like 5:00 PM is when we usually meet up. And so usually when we set up anything, we time it for 5:00 PM. So that way if you’re working, you can jump on a Zoom meeting and then get ready for work and head into work at 7:00. So that’s when we usually do it. And we usually do it on every other week just to keep the momentum. And we found that if we waited more than two weeks, you’d lose the momentum. But then if you went closer, then it became a little bit tiring, just a little exhausting to meet every week. But two weeks was what we decided on.

Alex Rittenberg (16:23):

I think that shows you the value and probably one of the biggest challenges for nocturnists, which is creating and fostering that community of nocturnist academic peers, especially because the clinical demands of this kind of subfield of hospital medicine are so demanding. Really going out of your way to establish that is extremely helpful if you’re seeking to pursue kind of academic work.

Toni Gallo (16:47):

How did you all meet up? You’re all at different institutions, you and your co-authors. Obviously, this is an example of a successful collaboration to produce scholarship. So I’m curious how you all got to know each other and how did the paper come about even?

Jessica Chambers (17:04):

I’ll give the little beginning because I’m actually the more recent interloper into this crew has been going on for a good six or seven years. One of our other co-authors, Kathleen Atlas up at Memorial Sloan Kettering, sort of pulled me in after I gave a national talk at another meeting about education at night and curriculum building at night. So a lot of this was cold emailing and pulling everyone into one sort of group chat and group cohort, and we started to meet up and bring research ideas together. And I was brought into a project John had been working on, which was a workshop for nocturnist career development. And I’ll let him tell you more about that.

John George (17:41):

Yeah, I think I do have to say thank you to Katie Atlas, who was kind of the spearhead for the nocturnist, the night medicine special interest group at SHM. That’s how I got involved. I was at SHM and I saw there was a special interest group for night medicine, so I attended the session, and that’s how I met Katie Atlas and joined the group. I also have to say thanks to our division chief, Dr. Nila Radhakrishnan, who kind of got me and Alex and Katie together with the idea of the workshop that we were going to do focused on nocturnists. And I think when we got together, we were floating around ideas of what to do. And I think we came up with nocturnist’s career development because that’s kind of a question that addresses a lot of struggles that nocturnists have, but also to provide answers and guidance and kind of inspiration with what we’ve done too.

(18:38):

And so we got together and we brainstormed ideas and we came up with the idea for the workshop, which was Glow in the Dark: Career Development for the Nocturnist. And we presented at SHM and it was very highly received. We ended up actually having a follow-up session also targeting a little bit more of leadership, like how to grow your nocturnist program. And then we got together and worked on this paper for the last couple of years. And I had to say thank you to Jessica, Alex for their support and also Jessica for helping spearhead the paper.

Alex Rittenberg (19:14):

Both of these kind of harken back to the idea of what is something that is understudied. And when you look at night medicine, so much of it is that even promotion is a topic. We don’t really have a concrete idea of what constitutes a successful academic career for a nocturnist. And to John’s credit coming up with this idea, that was something that we were able to both present on and then ultimately turn into this publication.

Toni Gallo (19:37):

So thinking about some of the work either you all have done together or just work that you and your colleagues have done, how do you think about whether it’s education, nighttime medicine education, or you’ve mentioned quality improvement. What are some of the kind of unique or special things that you think about, special considerations you have when you’re thinking about designing something specifically for a nighttime shift, when you’re thinking about different programs that might be helpful. Alex, you just mentioned there’s a lot that’s understudied. So what are the special considerations that you think about as you’re trying to figure out what could you be working on?

Jessica Chambers (20:18):

I have a background in neuroscience and circadian rhythms, so this has always been something of interest to me. And I think one thing that you need to consider as … you the self, the nocturnist, depending on your own circadian vulnerabilities or things that are going well for you, like John is purely a night owl. I’m actually not. I’m more of an early riser type of human being. So you have to accept that at some point you are functioning maybe less than 90% of your normal cognitive capacity that you would have on a well-rested brain. That means that the learners around you, as well as maybe even your patients and your peers are also able to receive information in a different way. I’ve noticed this not only with dedicated learning, so something this group has worked on quite a bit is how to integrate and teach in a less than 10 to 15-minute bite-sized didactic and make it relevant to what’s happening at the bedside right now.

(21:17):

I think that’s important because learners are just really unable from 2:00 to 3:00 AM, take in an hour didactic on endocarditis the way they may be able to maybe in the daytime. So the timing of your lectures, and although this is always important, they have to be relevant to the event going on at hand because that sort of memory that’s detached from the current ongoing life events is not as robust at night.

Alex Rittenberg (21:43):

I think looking at educational curriculum more broadly, it’s difficult to create a curriculum for night medicine, any curriculum across the UME, the GME spectrum needs to really have structure and bringing that into an environment that can inherently feel at times unstructured can be somewhat of a challenge. But much like anything else, nocturnists who want to build curricula for the night medicine rotation at their institution really should look at the core concepts that they want learners to build or to grow competency on to be successful overall internists. Very, very few learners are going to go become nocturnists for their overall career.

(22:25):

But for instance, let’s take one of the great successes I think of many night medicine rotations, which is growing a resident’s sense of autonomy. If a nocturnist wants to build curricula around night medicine, one learning objective of that rotation is going to be focusing on how to build that core physician skill of autonomy, nocturnists should be looking to translate it outside of a night medicine rotation. A nascent curriculum might look like a nocturnist, for example, reviewing clinical reasoning and a resident run rapid response, providing teaching based on the strengths and the opportunities for clinical growth. But a more structured curriculum might then look like incorporating sim training into a night rotation to augment this experience with relays core foundation, which is then going to be inherently translatable outside into other internal medicine rotations. To put it another way, a successful night medicine curriculum looks to instill the knowledge, the skills, the attitudes beyond the night environment into internal medicine overall.

John George (23:21):

I like what Alex had mentioned. We want to develop skills on a curriculum that focuses on things that will be applied outside. I think the clinical reasoning and the autonomy is very important in terms of developing a curriculum. And part of what drew me also into night medicine as a resident was that when you mentioned that, I thought back to my residency where usually it’s very relevant events, you’re learning information and tidbits that are relevant to your case. And there’s a lot of independent clinical reasoning. So if I have a question, I don’t have my attending readily available, what should I look up, what resources to look up? And then also building up skills too. There’s also a little bit of decision making on consults and reaching out to experts and making decisions on when it would be appropriate to consult overnight, which cases are urgent, which ones can wait till the morning, what things can I stabilize on my own when I’m working independently?

(24:19):

And this will actually translate to the daily rotation. Interestingly too, a lot of our residents who work with us overnight say that, we call this our night AOD rotation where they work with us overnight for one to two weeks doing admissions from the ER and doing cross cover. A lot of them will mention that this is the rotation where they grow the most. And I think it’s a lot and it’s a lot because of the learning reasoning on your own and autonomy.

Alex Rittenberg (24:46):

And I’ll add, if you do come up with a night curriculum post it on MedEdPORTAL and we will read it, I guarantee you the academic nocturnists will read it because we’re always looking to incorporate new ideas into our own rotations.

Jessica Chambers (25:00):

Definitely. And I like what John mentioned about expanding the offerings in terms of the realm of academic learners. We recently, or not even recently, maybe five or six years ago, instituted a medical student rotation just to do nights and do cross cover and admissions if they wish. But ours actually focuses more on triage and cross cover and really being the first call in supervised or fourth year medical students to prepare for intern year. And we’ve really got a lot of positive feedback on that as well, which is, I mean, to some degree, surprising. To me, having learners sign up to do night shifts on their fourth year of medical school is pretty wild to me. But when there’s benefit to it and they come away from it with a lot of autonomy, there seems to be some kind of benefit that they spread around to their peers.

Toni Gallo (25:48):

John, you mentioned that your writing group meets at 5:00 PM and in your paper, and you all have mentioned a couple of other ways, the idea of the usual times for professional development activities just don’t fit in with the schedule of a nocturnist. And so you recommend more flexible or asynchronous activities or opportunities that would fit in with your schedule. And I think that would serve a lot of people, not just people on a nighttime shift, whether you have other work or personal obligations during the day where maybe you can’t attend a workshop that’s at a certain time. And so I’m hoping we can talk about that of … a lot of your recommendations would really make professional development opportunities available and more inclusive for lots of clinician educators, not just nocturnists.

John George (26:40):

Yeah, so I do agree. Some of the things that we’ve implemented have been from outside of night medicine and some of them have been some things that we’ve come up on our own. A lot of the asynchronous work, I got some inspiration from my colleagues too, who are into a lot of medical informatics and technology. So they were the first ones to realize, okay, do we need to do a physical meeting? We can actually meet on Zoom or we can actually work on emails and keep a good thread going. So a lot of technology has helped support us here.

(27:12):

But going into the whole concept, our schedule, just like what you mentioned, does keep us away from certain meetings that occur during the daytime. I know we default to a lot of noon conferences or lunch conferences, but if you think about a nocturnist who’s possibly post-call, you’d be asleep at that time. Usually we’d get home at 8:00 and we have to make sure to get a good 6-8 hours of sleep before we come into work. So the timing of our meetings is very important. We’ve realized that if that 5:00 PM works out very well, and then also moving to virtual meetings has helped out. 5:00 PM actually is closer to something that’s more manageable for our day colleagues so we can actually get together. And then it’s not too early that we’re just waking up from a post-call day.

(28:03):

And so we’ve done both virtual and in-person meetings. We found that with in- person meetings, you had to factor in the time to get ready and come into work a little bit earlier. And sometimes the virtual meetings are easier and you can actually schedule them earlier to allow both a day and night physicians to work to be present.

(28:22):

And we’ve also done specific meetings for nocturnists. So we will do a specific night business meeting separate from our day business meetings so we can discuss some specifics that are unique to our night team. And then we also time them closer to 5:00 PM so that people are able to wake up and come for the meetings. And then it’s still not too late that we can have our admin and then our leadership be present for it. And the other things we’ve done is that a lot of meetings are common to the division, like our M&M conferences and some of our journal clubs, we’ve also timed them closer to 4:00 and 5:00 PM so that we can get input from the nocturnist, especially when we’re doing something like a M&M conference where we’re looking at QI and things like that could be improved. You want to have that viewpoint of the nocturnist. So we time those particularly for 5:00 PM.

Alex Rittenberg (29:16):

I think one key takeaway is the academic success of a nocturnist is really predicated on having effective hospital medicine leadership, that somebody who’s going to incorporate their nocturnists into the fold of the group is going to allow for nocturnists to actually have an academic career. I’m sure all of us can probably point to our division chief and say, “Hey, this person was willing to make us a part of the group, was make us willing to feel included,” which then allows us to establish those relationships, find mentorship, then pursue an educational career within hospital medicine.

John George (29:56):

I think that’s a very good point that you make. A lot of this would not be possible without the support of our leadership in our divisions.

Toni Gallo (30:03):

So to wrap up our conversation, I want to give each of you a chance. If you have anything else you want to leave listeners with, any other takeaways or key pieces of your paper that we haven’t talked about yet? Alex, we’ll start with you.

Alex Rittenberg (30:18):

I think just looking at future perspectives for nocturnists, we are still trying to break ground in terms of what is the right, call it work life, but really clinical academic balance for what makes a successful academic nocturnist career. And we still don’t know this yet. I’m hoping that perhaps in my lifetime that either us or some other new hotshot academic nocturnist is going to actually establish what makes that successful, to really establish that standard for how best to create an academic nocturnist career. All three of us are still working on this. This paper really is exploring this new idea, but I’m hoping that we’ll see that it gets established.

Jessica Chambers (31:03):

I think one thing that came to mind for me as we were talking and we were talking about leadership supporting nocturnists and honestly, a lot of the silent unseen work of academic nocturnists and everyone who works in the hospital at night, it made me reflect on the mentors who were not nocturnists that were willing to see my potential. I think there might be some perception that maybe a recent graduate that goes into nights or someone who does a lot of nights may be less interested in promotion or maybe more distanced from it. And I think those are exactly the people you need to guide and coach in their career. And I think starting with me as a new grad, fresh nocturnist and basically building a curriculum from the ground up, there was people on all sorts of shifts at all sorts of sites that believed that I was doing something new and innovative. And I didn’t understand that because I was so new to the field. I just thought it was obvious that we wanted to teach at night and take better care of patients at night. So those of you who are outside of nights and see people entering this field or maybe someone in your division that you don’t see very much at meetings, it definitely would be appreciated even just a reach out or trying to include them or connect them with other people who might have interest in that field.

John George (32:22):

I think I’ll echo both Alex and Jessica. I think a lot of our success has been made possible by our non-nocturnist colleagues and leaders who had served as mentors. And I think a lot of us did not realize how nascent a field this is and how much potential there is until our mentors had pointed it out to us. I had mentioned my mentor and my division leader, Dr. Nila Radhakrishnan who had kind of gotten us together, but she’s also the one who saw the fact that the nocturnist field is so nascent and getting us together would help us. So I do want to say thanks to a lot of our colleagues who are not nocturnists, but who see the potential in us and that see the potential in the field and who provide us mentorship and support because I think that’s what really helps to grow a nocturnist team and then help us succeed.

Jessica Chambers (33:16):

You’re right, John. It was Nila, who’s the senior author on this paper that right when the workshop concluded and we were all talking how it went, she came up to us and said, “You need to make a publication out of this.” And that was really the first time I had done that or thought about doing that. And that was pretty simple, but that was what I needed as someone new to publication and academic promotion.

Toni Gallo (33:38):

Well, I want to thank you all for being on the podcast today. I want to encourage our listeners, if you haven’t read the paper we’ve been talking about, you can find it in Academic Medicine on our website. And for those of you who are nocturnists, who are thinking about your own scholarly careers, submit your work to Academic Medicine and MedEdPORTAL. There’s lots of opportunities as we’ve talked about today. We’d love to see the work that you’re doing. So thanks everyone.

Jessica Chambers (34:04):

Thank you so much to Academic Medicine for seeing the value in this piece and helping us talk about it with the rest of the world.

Toni Gallo (34:11):

We appreciate you submitting it.

John George (34:12):

Thank you for hosting us.

Toni Gallo (34:14):

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