Anne Travis, MD, FACG, on Making A Career of Medical Writing
by Jill Gaidos, MD, FACG
Dr. Anne Travis & Dr. Jill Gaidos
I met Dr. Anne Travis when she was the Chair of the ACG Women in GI Committee and I was a committee member. In researching for my upcoming talk on Other Career Options for the ACG Bridging the Leadership Gap in GI conference, I reached out to Dr. Travis to find out more about her career at UpToDate.
Jill Gaidos (JG): I want to provide a little bit about your background. You completed GI fellowship and joined the faculty at Brigham and Women’s Hospital in 2006. Then, from 2008 to 2009, you served as the Associate Program Director of the GI Fellowship Program at Brigham and Women’s Hospital until 2009, when you joined the editorial staff at UpToDate as a deputy editor in GI and hepatology. How did you find out about that position and how did you transition into that role?
Anne Travis (AT): I found out about the position in the same way I think a lot of people do, through a recruiting letter. When UpToDate is looking for a new deputy editor in a particular specialty, one of the things we do is send out recruiting letters to let physicians in that specialty know that there is a position available. After I got the letter, I contacted UpToDate and they had me come in for an interview and to do a writing test. Even though I was excited about this new opportunity that allowed me to combine my love of medicine with my interest in writing, the transition was difficult; up until then, I was clinical full time, so going from spending all my time in the hospital to a position where I was in an office most of the time took a lot of adjustment. One of the things we do at UpToDate to help with the transition is assign every new editor two trainers. The trainers teach the deputy editor how to edit in the UpToDate style, how to determine what should be included in a topic, and how to work with our physician authors, who are experts in their areas. That training process takes about a year and it definitely helped with the transition. I was also fortunate to have been one of the last editors trained by Bud Rose, the creator of UpToDate.
JG: Then in 2014 you became the Co-Director of Editorial Quality at UpToDate, responsible for improving the quality of all the topics. What were your responsibilities in that role?
AT: At UpToDate we are always working on ways to improve our content, and I was a member of our quality group which focused on improving the quality of our topics. In 2014, I and Dr. Becky Conner, who is one of our hematology/oncology deputy editors, were named as co-directors for editorial quality. Our role was to further instill best practices for editing within the editorial group. We did things like giving lectures, reviewing other editors’ topics to help improve them, and encouraging the addition of things like more algorithms, to bring up the quality of the program overall.
JG: You were giving lectures to the team of editors?
AT: Yes. We have a group of about 50 physician deputy editors and the lectures were given to them. In addition to writing, I also like giving talks so that was a good fit for me.
JG: Do all of the deputy editors still have some clinical responsibilities? For example, does everyone do 20% clinical work and 80% time at UpToDate?
AT: That is definitely the most common set up. I can say that pretty much everyone starts out with some clinical time and editors typically maintain an academic appointment. Most editors are either 10% or 20% clinical. There are a few of us who, as we have taken on more roles within UpToDate, have moved to spending 100% of our time at UpToDate. I started out at 20% clinical, but eventually I decided to stop being clinically active and to give up my academic appointment, which was a hard decision to make.
JG: When you transitioned to be 20% clinical, how did you negotiate that change with Brigham and Women’s Hospital? Did that include cutting calls to 20% of your time or 20% inpatient time on consults?
AT: The way it works varies for different deputy editors, in terms of how they structure their time. Some people do their full 20% as inpatient consult service time, whereas others are fully outpatient. In my case, I went to my division chief and we talked about what would make the most sense for me. I was lucky that he was supportive of my move to UpToDate and he worked with me to find something that worked for both of us. In my case, I decided to focus on outpatient clinical care. Specifically, I focused on endoscopy.
JG: So, you would have one day of outpatient endoscopy?
AT: Exactly. But as I said, the approach to how you structure your clinical time is variable. I think most of the editors at UpToDate have worked out their clinical time in a way that works best for them. The other gastroenterology editors, for example, also spend time seeing outpatients in clinic.
JG: More recently, your position has evolved into overseeing the content on the new UpToDate Pathways (based on the individual subscription, these are available at: https://www.uptodate.com/contents/table-of-contents/pathways), which is an interactive clinical pathway to help guide management in various disorders and diseases. How have your responsibilities evolved in that new role?
AT: A few years ago, we started a program to create interactive algorithms. The idea behind them is to reduce variability in care by answering very specific clinical questions at the point-of-care. They are aimed largely at a primary care audience, but there are pathways aimed at specialists as well. I started out by helping develop the concept of what pathways were going to be included. I then worked with our software vendor to develop the authoring system that we would use to create these pathways. Once it became clear that these pathways were something that we definitely wanted to continue developing, I started overseeing a small team of deputy editors responsible for creating the content for the clinical pathways. Right now, my focus is on overseeing the editorial work on the pathways, thinking about new ways the pathways could be used, and identifying other resources we could bring in and incorporate into the pathways to make them more useful for clinicians.
JG: You mentioned that you are not focusing on GI at this point as you are overseeing all of the pathways.
AT: Yes, my focus is on overseeing pathway creation, which includes creating pathways myself. Lately my main focus has been on pathways that address the treatment of diabetes. I am one of just three editors who are working on creating the pathways, so we all have to sort of stretch and work outside of our specialties. However, if there are any GI pathways that we are working on, I definitely take those. In addition, I do continue to maintain several UpToDate topics on upper gastrointestinal bleeding, so I do still get to do some editing.
JG: I saw that you got a Master of Science degree in Epidemiology in 2006. Was that during your fellowship training?
AT: Yes, I did that as part of my fellowship training. The Master of Science has been incredibly helpful because one of the things that we do at UpToDate is review the medical literature and decide what studies we should include. It’s really helpful to have the background in epidemiology, in particular, to be able to read studies, understand the methods used, and decide which ones I want to include, or which ones may have significant flaws.
JG: What is your typical work day like?
AT: Even though I’m in an office, I’ve continued to come in early like I did at the hospital. I usually get to work at about 6:30 and spend some time catching up on emails and that kind of thing. Then my day is a mix between directly working on pathways, overseeing my editorial team, working with our software team to help improve our authoring system for creating the pathways and attending meetings. The meetings include things like strategizing future directions that we might want to take pathways in, taking part in talks with leaders at healthcare systems to look for opportunities to work together to get pathways into the hands of clinicians directly from within their workflow, talking about new projects, and working with our sales and marketing teams. What is nice is that I have a lot of flexibility in how I structure my time, as do the other editors. While I’m someone who likes to work 6:30 to 3:30, there is one editor who starts her day at 4:00 a.m. so she can be home early to pick up her kids, whereas other editors come in at 9:00 or 10:00 and work into the early evening.
JG: If other people were interested in pursuing medical writing as either a part of their regular schedule or as a side job, what would be some recommendations that you would have?
AT: I would start by saying that I have absolutely adored my time as a medical editor and working on developing clinical decision support tools. I would say that if you’re interested in this kind of work, you should have a strong background in writing and really enjoy doing it because that is where the bulk of your time will go. You don’t have to have formal training in writing, but you definitely want to be someone who is comfortable writing a lot. Full-time positions like those of a deputy editor are relatively uncommon, so if you are interested in something like a deputy editor position, I would keep an eye out for job postings at places like UpToDate. There are also many other ways to get involved with medical writing, including writing for textbooks, serving on the editorial boards of journals, and writing review articles. The fact that I had written some book chapters prior to starting at UpToDate definitely helped when it came time for me to do my writing test. Also, it reinforced for me that writing was something I wanted to devote a lot of time to. Places like UpToDate often have job listings on their website, so you can check in to see if there are positions available. If you happen to know someone in the field, that is another potential source of information about opportunities. Also, keep an eye out for the recruiting letters.
“I would say that if you’re interested in this kind of work, you should have a strong background in writing and really enjoy doing it because that is where the bulk of your time will go. You don’t have to have formal training in writing, but you definitely want to be someone who is comfortable writing a lot.”
JG: Right! One of the perceptions about this type of job, or at least when you were a deputy editor, is that you could do this job from home or from anywhere. But it sounds like you are predominantly office-based.
AT: Yes, there are some other medical content companies that do have people working from home, but UpToDate requires that all editors work onsite. We really want a collaborative environment where people are working together, so we think it’s important to have all the deputy editors actually working out of the same office. You do, however, have the option to work from home one day a week once you are out of training, if you want to. I think it’s really important that we are together as an editorial group because we collaborate a lot. It is common that, if I am working on a topic that overlaps with another specialty, I will need to work closely with editors in that specialty. For example, if I am working on a topic dealing with the diagnosis of pancreatic cancer, I will work closely with one of the oncology editors. In addition to facilitating working together, another reason that it is helpful for us all to work together in the same office is for the ongoing education we get. As I mentioned before, as co-director of editorial quality, I gave lectures on editing to the group. I don’t think it would be quite as effective if we were spread out. Having said that, there is some flexibility. We have had a couple people who spent a year in another country, and they were able to work remotely during that time.
JG: That makes sense. What is the starting salary for a deputy editor? And is it based on your previous clinical experience?
AT: The typical starting salaries vary. They are generally based on a typical salary for someone within a given specialty.
JG: OK. So, they try and match what you made as a physician in clinical practice?
AT: Exactly. UpToDate tries to be competitive so that you’re not taking a salary hit when you make the switch.
JG: Do you know of any other medical writing opportunities other than UpToDate? I’m sure UpToDate is probably very competitive.
AT: The other major company providing information for clinicians at the point-of-care that I know of is EBSCO, which produces DynaMed. I’m sure there are other companies as well, but UpToDate and DynaMed are the two I am most familiar with.
JG: Great. Thank you. That is all very helpful. Thank you so much for your time.