Advocating for your authentic self with Dr. Julia Warren

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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

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to build their own research program, whether or not they have a mentor.

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As clinicians, we spend a decade or more as trainees learning to take care of patients.

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When we finally start our careers, we want to build research programs, but then we find

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that our years of clinical training did not adequately prepare us to lead our research

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program.

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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

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However, clinicians hold the keys to the greatest research breakthroughs.

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For this reason, the Clinician Researcher podcast exists to give academic clinicians

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the tools to build their own research program, whether or not they have a mentor.

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Now introducing your host, Toyosi Onwuemene.

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Welcome to the Clinician Researcher podcast.

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I'm your host Toyosi Onwuemene, and I'm excited to be on the show today because I have a very,

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very, very, very, did I say very special guest, Dr. Julia Warren, and I'm just excited to

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have her on the show.

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Julia, welcome to the show.

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Thank you so much for having me.

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It's great to be here.

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I'm going to ask, if you don't mind, introduce yourself to the audience, especially with

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regard to your role as a clinician scientist.

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Yeah, so I'm Julia Warren.

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I'm an assistant professor here at the University of Pennsylvania, Perelman School of Medicine,

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and I'm also an attending hematologist at the Children's Hospital of Philadelphia, where

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I see patients in the Comprehensive Bone Marrow Failure Program, and also have my research

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laboratory.

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My research lab focuses on how we make blood cells, also known as hematopoiesis.

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I love it.

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You know, Julia, one of the things you didn't mention is how accomplished you are.

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Uh-oh.

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You know, everybody seems to miss that, and maybe because we're kind of on the journey

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to believing that we're accomplished at all.

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I love that you said that, yes.

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All right, so I want you to tell me about how you came to recognize and accept, or maybe

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you're still on the journey to accepting, your role as a clinician scientist.

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What was a defining point in your career where you said, oh, I am?

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I love that question so much because I think when you do training that's so dichotomous,

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okay, this is your MD time, this is your PhD time, and ne'er the twain shall meet, when

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they're, you know, so separate feeling, at some point they do come together.

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I think for me, I had a moment in my intern year at St. Louis Children's Hospital.

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It's a pediatric intern, and there was a child with RSV outside my wheelhouse, so you know,

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what I've come to have expertise in, and we only give kind of prophylactic treatment for

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RSV to some infants and not to others, but other children, really small children, can

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really suffer from RSV infection.

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So I went back to PubMed, and I looked up what is happening in this space, this space

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that I know nothing about, what's happening in the RSV space, is there an immunization

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that's really going to be able to be accessible to all children?

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Is this a reality?

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What are the barriers to this?

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And then we had to give journal clubs.

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A lot of times the journal club morning reports were more clinically focused, and I thought,

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forget this.

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I'm putting up a crystal structure, I'm putting up a ribbon diagram, I'm giving some history

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about why we haven't gotten there yet, what's being done to get there now.

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And even though it wasn't pipetting and it wasn't being in the lab, it was really one

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of the first moments where I thought, I'm using that part of my brain to think about

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patients that are right in front of me, and I'm so excited that very soon that's what

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I get to do just all the time.

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I love it.

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Julia, it was almost like you were in rebellion in that moment.

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I did have to say, bear with me, it's a ribbon diagram, but it's going to be okay.

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That's really awesome.

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That's really awesome because I think you're correct.

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What a false dichotomy.

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We are one person, and to say that this is a time when you're a clinician and this is

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the time when you're a scientist is not real, and how amazing for you to just own that in

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your intern year and to say, I'm not doing this anymore, I'm going all in.

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That's so awesome.

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Now, let me ask about what was the internal struggle to get to that moment?

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Because it sounds like you hesitated.

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It wasn't something you did automatically.

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To get to the moment of saying, I'm a physician, I'm a scientist, I am both.

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Yeah, it's right, not a straight road to get there for sure.

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And we were just in a training where someone was talking about how you talk in a space

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where you might feel like this is a space where I'm the outsider.

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And so when you're doing your training, I really think you have those moments as, you

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know, for me doing MD, PhD combined training, sometimes I'd be in my med school classes

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and I'd think, wow, all my colleagues, they are just so good at sitting down and memorizing

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and they were really great pre-meds.

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And, you know, I was never that kind of a student.

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I wanted to do the pathway.

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I want to think about it.

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I thought memorization was a waste of time.

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And then during my PhD, you know, it was almost that you wanted to be taken seriously among

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your PhD colleagues.

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You didn't want other PhD students saying, oh, well, you're in this special program and

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they kind of make things easier for you.

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You know, they kind of help you get through your PhD and we got to go it on our own.

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I wanted to be, I'm the same.

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My PhD is the same.

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You know, I'm working just as hard.

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I'm trying just as hard.

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So let me just not talk about the fact that I'm an MD, PhD student.

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When we try to put that MD part of me, bury it away, you know, maybe a great moment is

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if somebody doesn't even realize that I'm in an MD, PhD student, I'm just one of them.

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And then you go back to, you know, your medical training and you, again, you don't want to

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be the outsider.

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You don't remember what a normal potassium is, right?

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All your other medical students just went straight through and they're so knowledgeable

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and they're really on top of their game and you're kind of scrambling to get caught up.

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So you almost don't want to talk about, oh, I took a break for four years.

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You want to say, how can it get as good as all these other students around me as quickly

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as possible?

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So yeah, I think it really took until that moment where it was, I don't have to hide

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that I'm a physician and I want to be a gosh darn good physician.

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And I'm a scientist.

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Like, I can't turn that part of my brain off.

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I'm bringing it here to the hospital every day.

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So I love it.

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You speak to one challenge that I think people face in different spheres of life.

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It's like you're in the PhD space and you're feeling like an outsider, but you're also

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in the MD space and feeling like an outsider.

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So it's almost like you have to create your own space where you're just your whole person

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right there.

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And I wonder, you know, you're bringing it all together into one space because both spaces,

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at least individually, seem to reject you.

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That's hard.

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I wonder how you manage that.

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And I also wonder, where did you find those spaces that were more welcoming to your dichotomous

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personality, so to speak?

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Yeah, how I'm managing it or kind of working through it, I'd say it's probably still a

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work in progress.

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It is one incredibly refreshing thing about working with children, especially with teenagers,

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is they can smell it when you're not being your authentic self.

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They can just tell us, you know, the teenagers, if you show up, and if I would try to talk

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to a teenager about sports, they're going to know right away.

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I'm faking it.

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I don't know.

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I have no idea.

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To me, it's all sports ball.

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I can't tell you.

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And so I want to relate to my patients, but I'm going to find something else that we can

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relate about that is not whatever team is playing a sport right now because I truly

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have no idea about it.

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And it's that I know that sounds like a funny example, but really working with teenagers,

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actually, I think really helps you to embrace who you are and present your authentic self

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because they just do not tolerate it otherwise.

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They're not going to respect you.

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They're not going to want to listen to you when you tell them they have to take medications

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that make them feel sick, that they have to go through testing, that they have to go through

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inpatient admissions, they have to call you with fevers, you know, all these things.

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So I think that really is something that continues to help me remember to show up as my authentic

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self.

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And then as far as spaces, places that really promote you being who you are as a physician

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scientist, in a way, I think it's almost a numbers game having a lot of physicians, scientists

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around and having physician scientists who are doing really serious science and are incredible

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scientists first and foremost, but who you then work with clinically and you think you

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are an incredible clinician, you are an amazing doctor, you're top of this game too.

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And I think that being surrounded by that and just the sheer numbers of that at the

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institutions I've been at really, really helps.

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I really, really appreciate what you said about the thing about authenticity.

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And I love that you shared this about the teenagers.

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Yes, I think it's perfect.

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Because when you were talking about kind of beating these two spaces in one space, you

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kind of have to adjust to fit in and the other space you have to as well.

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So it's almost like this feeling like you're always pretending to be someone that you're

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not.

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And I think if you want to speak to this whole thing, I think about imposter syndrome, there's

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a sense that you're just not who you're supposed to be or you're not in the right place.

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And what you share about the teenagers helping you to be your authentic self, I wonder if

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that's not part of that, trying to like recognizing that you can only be yourself successfully,

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trying to be someone else is very hard and probably something we should abandon.

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Absolutely.

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Do you want to speak some more to that?

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Well, and that pressure to feel that, you know, are you doing what you're doing?

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That pressure to feel, are you being who you're supposed to be right now?

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Are you enough physician?

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Are you enough scientists?

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Are you enough of both combined?

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Are you combining them well?

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Or what is your ratio of how things are going?

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It's a lot of pressure.

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And I do think that sometimes as women, we have a more critical lens on ourselves.

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And maybe that does come from, you know, we get criticized more, just to be honest, and

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I don't know that it's fully internal or there are some external components to it too.

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And so I really think for me, there's moments where that comes, that cup feels a little

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emptier and you got to fill that cup back up.

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And so being somewhere where you can say to yourself, look, here's a talk by this incredible

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physician, scientist woman.

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We just had somebody visiting, if I can name drop her, Ashley Steed from Washington University,

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just have so much immense respect for her and for the work she does and for the clinician

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she is and the scientist she is and kind of the person, she's like a wonderful person

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too.

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And so she was coming to give a talk here at campus and I just thought, well, this is

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not in my research domain at all.

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But if my cup is feeling a little empty, I'm going to go fill that cup back up.

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I'm going to go hear from another female physician scientist who is out there hustling and making

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it work and crushing it and doing a great job.

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And so I think having the opportunity to, you know, just kind of tank back up and say,

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okay, great.

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Yes.

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I'm going to go fill some number of years ahead of me, if you will, in our prescribed

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trajectory who is just making it all work and just doing a fabulous job.

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I love it.

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I love what you talk about, the concept of filling your own tank, right?

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I think that many times we abdicate that responsibility to someone else and they don't even do a good

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job of it.

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And so for you to say, this is what I need and I'm going to go do that and you fill your

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own tank and at the end you feel satisfied and fulfilled because you did that.

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You took that step for yourself.

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And I just wonder how many of us do that enough and whether we're encouraged to do that.

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Because you speak about community and the power of community and being surrounded by

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people who are doing what you want to do.

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But even within that community, there are gaps.

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You're going out and finding what you need and filling your own cup, which allows you

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to keep being successful.

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Yeah, and so much of the time, the programming that we get offered, especially as female

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physician scientists, is how to have a work-life balance.

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I think it's just this theme that it's very important, but it's almost that we get told

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more that this is important for us.

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It's not important for everybody.

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It's really important for women.

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We have to figure out how to have work-life balance.

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We have to figure out how to be satisfied with our work time and our family time.

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And we've got to figure out that balance.

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And here's a seminar on how to accomplish that.

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And really, we have to figure out how to be great physicians and we have to figure out

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how to be great scientists.

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And that's a universal problem that a physician scientist has.

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And I don't think we all get equally pressured to also have a nice life, figure all of that

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out.

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So yeah, for me, I just want to see other women out there crushing it.

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And there's a lot of great examples around me.

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That's awesome.

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And you are a great example yourself.

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Thank you.

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All right.

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I want to...

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I know you taught you a lot of things that I feel like we should talk about, but we're

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going to talk about it.

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Actually, maybe this is a good time though.

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How do we keep women...

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How do we keep trainees in general, but especially women committed to the physician scientist

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pathway?

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One of the things you allude to is that this is hard.

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And even when you're surrounded by communities of people who are doing this, there's still

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times when you're feeling low and you need more and you need encouragement along the

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way.

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And you alluded to the fact that it is different for people who identify as women compared

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to men in the academy.

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Can you speak to how we can support people better at the trainee phase and even as faculty?

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Yes.

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I think that first we have to recognize that this pathway of trying to have two jobs at

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the same time is difficult and anybody doing it knows that.

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And I think that outside of really living in it, really living that moment where you

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are writing a grant and getting a page at the same time and you have to make a decision,

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is this an urgent page?

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Do I need to call somebody back?

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Oops, it's too late.

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My brain's already clinical.

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How to do those two things at exactly the same time.

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I think first we just have to start with the recognition that it's very hard.

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And with that recognition can then come sort of extra support.

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And for me, I had these funny moments along my training pathway where I sort of fell into

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some opportunities to get support that, okay, well, I could say fell into it or I could

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say earned it, whatever.

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You know, these moments in my training path where I was presented with opportunities that

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I seized, let's say it that way.

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I love that.

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Okay, yes.

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And you know, one of them, honest to God, it sounds so small, but very early in my postdoctoral

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training I got to work with a technician.

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And I don't know that I would be sitting here talking to you right now if I didn't have

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that opportunity.

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But yes, it was me training another person.

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And yes, that person had their own long-term goals and why they had come to the lab.

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But for me, what it allowed me to do was I had a patient relapsing and I wanted to go

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talk to them about their treatment plan and my work didn't have to stop.

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Or I didn't have to be there.

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I was there until midnight plenty of times, but it didn't mean, oh, now I'm going to have

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to be here until midnight because I can't even start my experiment until 5 p.m.

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It really meant, okay, well, here's somebody who I've invested a lot of time training.

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I've gotten that experience of training and mentoring someone.

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And also, this is a person who it's very reasonable to turn to and say, let's come up with a plan

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for what your afternoon is going to look like.

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I need to make a small adjustment because of an emergency that's happening for the other

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part of my job.

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And that was huge.

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It was great to be able to train someone.

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It was great to have that experience of mentorship.

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And it was hugely helpful for the type of clinical work I was doing to be able at an

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earlier stage than I think a lot of people get the opportunity to do to walk away from

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the lab at random times to do my second job.

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And right, I think that was a really great thing to help keep me on this path.

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But it's so uncommon.

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And it really is so variable from lab to lab.

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And we pay technicians so little that I don't think it would be, okay, that's its own problem.

287
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But in academics, that's its own problem.

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But I don't know that it would be some massively huge investment to say, okay, what kind of

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clinical work are our fellows doing as they're trying to get postdoctoral serious scholarly

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research done?

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What would it take to say, hey, host laboratory, mentor laboratory?

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We're going to provide half an FTE worth of salary for a technician if you're willing

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to dedicate at least that half FTE to this fellow.

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And at some point, I actually just asked for that.

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I thought I'm going to put my big girl pants on and say, hey, my leadership in my division,

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I really need this.

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I'm really realizing I need this support, this pair of hands in the lab to help me extend

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the work that I can get done during the day.

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Will you pay for that?

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And my leadership said, yes.

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And I was very grateful.

302
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I was very surprised.

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I was very grateful.

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But that is not institutionalized.

305
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And I really think it ought to be thinking how can we say, here's a person who's really

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proven through their commitment to this pathway that they want to be a physician scientist.

307
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What can we do to help them get there rather than have these barriers that come with having

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two jobs?

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So I think that's kind of small potatoes cash that could really go a long way to keeping

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people in the pipeline in that critical fellowship period.

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Because I do think you can get through an MD, PhD program, or you can get through an

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MD where you're doing heavy focus on research and you have research opportunities in your

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residency training period too.

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And it's really that fellowship time, I think, where you see all your residency friends who

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didn't do fellowship training are out in the world making money and doing some version

316
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of nine to five, probably more than that, but some nine to five-ish kind of a job with

317
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more regular hours, benefits, all those good things.

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And you're still slogging away as a fellow in the lab and doing your clinical stuff.

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And the end is not in sight yet in the sense of you've got to work towards getting an early

320
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career award.

321
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You've got to get a K. You've got to get all these things under your belt.

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And then your fellowship colleagues finish and maybe they take a clinical job and you

323
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see, okay, well, not that their life is easy by any means, but their life now, they're

324
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doing what they want to do.

325
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They've already gotten there and they're already sort of, they're seeing patients, they're

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contributing to that incredibly important aspect of patient care.

327
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And I'm still working towards my goals.

328
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And if we make that period of time easier, I think more people will say on the pathway.

329
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And then of course, it's another funding thing is just, we need more support for these early

330
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career awards.

331
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And having a K award is so critical.

332
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And the K funding lines at some agency are not what they need to be.

333
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I really want to commend the NHLBI if I can.

334
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They made a K99R00 pilot program that's specific for physician scientists.

335
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And I think recognizing this problem at that transition from fellowship to instructor stage,

336
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they said, listen, we're going to do a look back and we're going to judge you, your competitiveness

337
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for this award based on time that you've have done research in the past, for example, if

338
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you did a PhD and your commitment to this pathway.

339
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And we know that it's really hard in two years of fellowship to already have some big, huge

340
00:21:25,140 --> 00:21:31,000
first author paper that is in Cell Nature Science or whatever other top journal in your

341
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field, but we really want to support people staying in this pathway.

342
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And so they've piloted this program for specifically for physician scientists.

343
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And I think we need more opportunities like that at other NIH agencies.

344
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You have crystallized a problem just, I mean, just perfectly.

345
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I think one thing that is not always obvious to trainees on the journey is that for the

346
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most part, so for you, you did an MBA PhD.

347
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So there's PhD training in the background of that, but nowhere near as much research

348
00:22:07,820 --> 00:22:10,740
training as your PhD only colleagues.

349
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And then when you look at the MDs where there's barely really any research training in any

350
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of that, there may have been time in the lab or time doing research, but not really research

351
00:22:18,220 --> 00:22:20,540
training for research leadership.

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And so here we are in the clinical space where we go from intern to being a resident to being

353
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a senior resident in those three or four years of our residency training.

354
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And there's never the expectation that one person is taking care of the patient by themselves.

355
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But then you get to the place of research and then it's like, well, you're on your

356
00:22:38,180 --> 00:22:39,180
own.

357
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I hope you can do all the experiments and still be a physician.

358
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Good luck.

359
00:22:43,140 --> 00:22:44,140
And it's not really realistic.

360
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And I think it's you alluding to something that I feel like the business world knows

361
00:22:48,100 --> 00:22:49,100
well.

362
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It's like, I mean, it sounds bad to say leveraging other people's time, but it really is the

363
00:22:52,940 --> 00:22:54,260
way it is.

364
00:22:54,260 --> 00:22:58,740
It's that what is the benefit of the physician who spends a lot of time pipetting where they

365
00:22:58,740 --> 00:23:04,100
could easily teach someone else to do that and really now enter into the thought leadership

366
00:23:04,100 --> 00:23:05,460
of leading the research program?

367
00:23:05,460 --> 00:23:06,460
That's really what's about.

368
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It's not about doing.

369
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It's about leading the doing.

370
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It's about thinking about the direction of doing.

371
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And I think it is a missed opportunity to support people in that from the beginning,

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00:23:16,820 --> 00:23:22,100
to almost wait for people to finally either succeed or fall flat on their faces and then

373
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judge them to be not capable, but really how do we resource people so that they can succeed

374
00:23:27,740 --> 00:23:29,780
if that's what they want to do?

375
00:23:29,780 --> 00:23:32,140
And I do think that's a big gap.

376
00:23:32,140 --> 00:23:36,620
And I love your story of negotiating what you need, and I'm big on negotiation.

377
00:23:36,620 --> 00:23:41,580
I think we should ask for everything we want and then some.

378
00:23:41,580 --> 00:23:42,580
But it's like, why?

379
00:23:42,580 --> 00:23:46,480
Why did you have to ask for something that you should have gotten from the very beginning?

380
00:23:46,480 --> 00:23:48,300
Why isn't that baked in?

381
00:23:48,300 --> 00:23:51,960
And so there's opportunity for institutions to get up and really support people.

382
00:23:51,960 --> 00:23:56,420
If you want people to succeed in this endeavor, resource them to succeed.

383
00:23:56,420 --> 00:23:58,780
And our part is we're moving forward.

384
00:23:58,780 --> 00:24:02,700
It's like, well, if we don't have what we need, we should ask for it.

385
00:24:02,700 --> 00:24:03,700
Ask for it.

386
00:24:03,700 --> 00:24:06,860
And it's not always easy, but it's definitely, I think there's opportunity on both sides.

387
00:24:06,860 --> 00:24:09,420
I don't know if you want to speak more about that.

388
00:24:09,420 --> 00:24:15,820
This is such an interesting challenge because I really see as somebody who did a PhD and

389
00:24:15,820 --> 00:24:19,060
my PhD looked like the PhD of my PhD colleagues.

390
00:24:19,060 --> 00:24:20,060
It was not any easier.

391
00:24:20,060 --> 00:24:21,660
It wasn't any different.

392
00:24:21,660 --> 00:24:26,160
I got to get some of my classes out of the way during med school time.

393
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But then I spent just as much time in the lab as my colleagues did.

394
00:24:31,700 --> 00:24:36,620
And so that was hugely, it was a hugely useful experience because I got to think through

395
00:24:36,620 --> 00:24:37,900
how do you design an experiment?

396
00:24:37,900 --> 00:24:39,020
How do you ask a question?

397
00:24:39,020 --> 00:24:43,820
How you design the experiments to answer the hypothesis that you've come up with?

398
00:24:43,820 --> 00:24:47,760
How are you going to make something out of proving your hypothesis right and wrong?

399
00:24:47,760 --> 00:24:53,100
How do you stand up in front of people and communicate your science effectively and write

400
00:24:53,100 --> 00:24:54,100
a grant?

401
00:24:54,100 --> 00:24:57,780
You know, so many things that you get the opportunity to learn in that phase.

402
00:24:57,780 --> 00:25:03,200
And I think especially when you get to your postdoc training that's happening during a

403
00:25:03,200 --> 00:25:09,160
clinical fellowship, it's hard if you've never had those experiences.

404
00:25:09,160 --> 00:25:11,780
You want to bake that in, right?

405
00:25:11,780 --> 00:25:15,140
Those are incredibly rich experiences that you need to bake in.

406
00:25:15,140 --> 00:25:20,300
But you also have to become the leader of a lab where experiments are being done.

407
00:25:20,300 --> 00:25:22,900
So you need to know how to do the experiments.

408
00:25:22,900 --> 00:25:28,440
But do you need to do those experiments yourself personally as the only person for years in

409
00:25:28,440 --> 00:25:30,060
a row?

410
00:25:30,060 --> 00:25:35,140
Does that have to be the system or can it be, okay, I'm putting my hands on this right

411
00:25:35,140 --> 00:25:38,140
now and I'm learning it and I'm mastering it.

412
00:25:38,140 --> 00:25:42,380
And then I will teach somebody how to do it and I will move on so that when that person

413
00:25:42,380 --> 00:25:44,860
has questions, I understand how this works.

414
00:25:44,860 --> 00:25:46,500
I understand the ins and outs of this.

415
00:25:46,500 --> 00:25:49,940
When I'm the lab leader, I can direct the questions.

416
00:25:49,940 --> 00:25:51,740
I can think about the science.

417
00:25:51,740 --> 00:25:52,740
I can do this.

418
00:25:52,740 --> 00:25:58,560
But I can also, you know, know how to point someone in the right direction experimentally

419
00:25:58,560 --> 00:26:06,180
or I can hire a lab manager or a staff scientist who I can feel confident knows how to direct

420
00:26:06,180 --> 00:26:10,380
people and those things experimentally because I'm comfortable with it.

421
00:26:10,380 --> 00:26:15,460
And that is it's almost that those two things are, you know, at odds with each other that

422
00:26:15,460 --> 00:26:22,100
you want someone to really become a good experimentalist in that way and be able to, you know, lead

423
00:26:22,100 --> 00:26:23,100
their people.

424
00:26:23,100 --> 00:26:27,180
But you want them to also be using the part of their brain where they can critically think

425
00:26:27,180 --> 00:26:31,020
about big questions, how to answer them.

426
00:26:31,020 --> 00:26:36,160
And if somebody has not had PhD training, you're asking a lot out of somebody in a very

427
00:26:36,160 --> 00:26:43,540
small period of time before you then have them have access to institutional or, you

428
00:26:43,540 --> 00:26:50,740
know, national fellowship awards to help support their additional time to foster that experience

429
00:26:50,740 --> 00:26:58,140
and then throw in the mix that so many institutions are moving towards models where they want

430
00:26:58,140 --> 00:27:04,020
to de-invest from big pieces of equipment, complex pieces of equipment, lots of labs,

431
00:27:04,020 --> 00:27:09,540
having lots of pieces of equipment by themselves to things happening in core facilities.

432
00:27:09,540 --> 00:27:16,840
That makes a lot of sense to me from the business world of why ask a hundred labs to be replicating

433
00:27:16,840 --> 00:27:25,060
the same infrastructure and the same, you know, every PI or every fellow or every, you

434
00:27:25,060 --> 00:27:30,260
know, lab manager takes a new person who comes into the lab and that person has to, you know,

435
00:27:30,260 --> 00:27:35,860
learn this over and over and develop from zero to expertise in, you know, some technical

436
00:27:35,860 --> 00:27:36,860
pipetting thing.

437
00:27:36,860 --> 00:27:41,080
Why don't we just put that expertise into a core group of people with a core set of

438
00:27:41,080 --> 00:27:44,520
instruments that are highly well maintained or highly trained people and we'll get the

439
00:27:44,520 --> 00:27:46,360
work done faster.

440
00:27:46,360 --> 00:27:51,100
And so I think that's great and it makes a lot of sense.

441
00:27:51,100 --> 00:27:56,940
But it also could, I see why people feel some concern about them saying, okay, well, welcome

442
00:27:56,940 --> 00:27:57,940
to the lab.

443
00:27:57,940 --> 00:27:58,940
Here's a technician.

444
00:27:58,940 --> 00:28:03,440
We're going to send most of your stuff to a core facility and three to four years from

445
00:28:03,440 --> 00:28:04,980
now you can run your own group.

446
00:28:04,980 --> 00:28:07,740
You're going to know exactly how to get everything done.

447
00:28:07,740 --> 00:28:13,560
And that's a simplification of, that's a simplification, but I think there are some people who worry

448
00:28:13,560 --> 00:28:17,800
is that what this end of somebody's training is going to look like and are they really

449
00:28:17,800 --> 00:28:21,960
going to be ready to do all the things you have to do as a lab leader, as a physician

450
00:28:21,960 --> 00:28:27,140
scientist where, you know, you can truly think about the science, think about the questions

451
00:28:27,140 --> 00:28:32,200
and know how to answer the questions and be critical of the data that people are walking

452
00:28:32,200 --> 00:28:33,920
into your office with.

453
00:28:33,920 --> 00:28:38,840
And I don't know how, I don't know what the right answer is, but I definitely see where

454
00:28:38,840 --> 00:28:40,720
there's some tension there.

455
00:28:40,720 --> 00:28:41,720
Absolutely.

456
00:28:41,720 --> 00:28:43,540
It's a lot of, it's complex.

457
00:28:43,540 --> 00:28:47,600
It's that you are as a clinician scientist, really an emerging leader.

458
00:28:47,600 --> 00:28:49,320
That's who you are.

459
00:28:49,320 --> 00:28:55,000
And part of that leadership is getting your hands dirty and learning how to do it, is

460
00:28:55,000 --> 00:28:57,800
getting your hands dirty and learning how to do it so that you can support other people

461
00:28:57,800 --> 00:28:58,960
to do it.

462
00:28:58,960 --> 00:29:03,680
But if a lot of that getting your hands dirty is that the opportunity is not available,

463
00:29:03,680 --> 00:29:06,200
it's being siphoned away to another group.

464
00:29:06,200 --> 00:29:10,280
How do you do that and still become an effective leader that you need to be?

465
00:29:10,280 --> 00:29:15,160
And are we raising people who are disconnected from being able to do the good science?

466
00:29:15,160 --> 00:29:16,160
Like you're right.

467
00:29:16,160 --> 00:29:21,360
If all the data is being generated outside, do I have the training to be able to analyze

468
00:29:21,360 --> 00:29:23,240
the data and say, do I accept this?

469
00:29:23,240 --> 00:29:24,240
Is this real?

470
00:29:24,240 --> 00:29:25,240
Is this credible?

471
00:29:25,240 --> 00:29:26,240
Is this authentic?

472
00:29:26,240 --> 00:29:27,560
Is this quality data?

473
00:29:27,560 --> 00:29:29,120
And those are challenges.

474
00:29:29,120 --> 00:29:32,800
I'm not sure that the answers are readily apparent.

475
00:29:32,800 --> 00:29:34,360
I agree.

476
00:29:34,360 --> 00:29:35,360
Yeah.

477
00:29:35,360 --> 00:29:41,040
I wonder though, it's like looking forward into the future, if you could have a blank

478
00:29:41,040 --> 00:29:49,880
check and fix like one thing, major thing in this clinician scientist training pathway

479
00:29:49,880 --> 00:29:54,880
and faculty development pathway, what would that be and why would that be the thing you

480
00:29:54,880 --> 00:29:58,600
choose?

481
00:29:58,600 --> 00:30:06,960
If I could get one thing to fix, I could fix one thing.

482
00:30:06,960 --> 00:30:09,800
That is such a tough question because we've got to fix a few.

483
00:30:09,800 --> 00:30:12,960
If you want to cluster them, that's okay.

484
00:30:12,960 --> 00:30:15,840
No, I mean, not to be redundant.

485
00:30:15,840 --> 00:30:17,820
We just need more funding.

486
00:30:17,820 --> 00:30:25,720
We just need, we need people to know, look, I think back to my time being a post-doc during

487
00:30:25,720 --> 00:30:30,160
the pandemic, I was getting up at 3.30 in the morning so that I could get to the lab

488
00:30:30,160 --> 00:30:33,920
by four for my shift because I had to be out of my bay by noon.

489
00:30:33,920 --> 00:30:36,000
Right at the beginning, I wanted to get the work done.

490
00:30:36,000 --> 00:30:38,880
I didn't want to not get the work done.

491
00:30:38,880 --> 00:30:39,880
Yeah.

492
00:30:39,880 --> 00:30:45,400
I mean, when you have somebody who's got the dedication, who's got that commitment to this

493
00:30:45,400 --> 00:30:52,000
pathway or you have somebody who's just coming with all this skill and all this intelligence

494
00:30:52,000 --> 00:30:56,120
who wants to know what does it mean to be a scientist and this is their first opportunity

495
00:30:56,120 --> 00:31:04,840
to do it and the road in front of them is, okay, well, come work incredibly hard, have

496
00:31:04,840 --> 00:31:09,920
two jobs, have all the challenges that go along with being both a physician and a scientist,

497
00:31:09,920 --> 00:31:13,080
I don't know rewards, but all the challenges that go along with that.

498
00:31:13,080 --> 00:31:18,200
And at the end of the day, you might have done enough.

499
00:31:18,200 --> 00:31:26,920
You might be able to access this funding mechanism that's just so critical and you might have

500
00:31:26,920 --> 00:31:32,760
done all the things you need to be able to get an early career award from the NIH and

501
00:31:32,760 --> 00:31:38,920
that's the gold shining light and the pay line is whatever it is, 10%.

502
00:31:38,920 --> 00:31:45,600
So asking somebody to stay committed to that pathway when they feel that, well, maybe I

503
00:31:45,600 --> 00:31:51,760
have a one in 10 or maybe a one in five chance of getting this award, that's a stepping stone

504
00:31:51,760 --> 00:31:52,920
in and of itself.

505
00:31:52,920 --> 00:32:00,320
That's not the guarantee that I'm not going to get scooped and instead of having a nice

506
00:32:00,320 --> 00:32:06,800
cell nature science or my field blood in some high impact publication that I need to have

507
00:32:06,800 --> 00:32:13,880
in order to be marketable to an academic institution, all these things have to line up.

508
00:32:13,880 --> 00:32:24,000
You almost have to be both intelligent, motivated, a great leader and lucky and making that happen

509
00:32:24,000 --> 00:32:29,760
really requires a lot of working hours every day, every week, every traditional working

510
00:32:29,760 --> 00:32:33,740
day and maybe some non-traditional working days as well.

511
00:32:33,740 --> 00:32:38,360
So good luck on your journey and we'll see you at the end in a few years and hopefully

512
00:32:38,360 --> 00:32:43,680
you've done enough to get this career award that you need and we just have to fund more

513
00:32:43,680 --> 00:32:46,960
of those.

514
00:32:46,960 --> 00:32:52,760
We just have to make it so that the path doesn't seem so improbable that you would spend all

515
00:32:52,760 --> 00:33:00,080
this extra time and effort relative to people who choose a path where they have, and I hate

516
00:33:00,080 --> 00:33:04,360
to say just one job because it's not that being a clinician is easy or being a scientist

517
00:33:04,360 --> 00:33:11,040
is easy, but that you are really being asked to do so much to have two jobs at one time

518
00:33:11,040 --> 00:33:18,160
and the end of the road is kind of can seem like a very improbable chance for success

519
00:33:18,160 --> 00:33:20,640
and it really I think comes down to money.

520
00:33:20,640 --> 00:33:25,480
We've just got to fund more of those early career fellowship awards.

521
00:33:25,480 --> 00:33:31,320
I really commend programs like Burroughs Welcome, Doris Duke, who are really recognizing that

522
00:33:31,320 --> 00:33:37,120
there are gaps that the NIH with the constraints that it has of not being able to come up with

523
00:33:37,120 --> 00:33:42,480
its own budget that with those constraints there are gaps that need to be filled and

524
00:33:42,480 --> 00:33:47,400
are trying to step up and to fill those gaps for exactly this time in physician scientist

525
00:33:47,400 --> 00:33:48,400
careers.

526
00:33:48,400 --> 00:33:50,640
Thank you, Julia.

527
00:33:50,640 --> 00:33:54,640
I think that this is like a call to the billionaires out there.

528
00:33:54,640 --> 00:34:00,680
This is why we need funding and we need more support for physician scientists.

529
00:34:00,680 --> 00:34:01,680
It's important.

530
00:34:01,680 --> 00:34:04,400
It's the only way healthcare advances and it's hard.

531
00:34:04,400 --> 00:34:06,040
It is very, very hard.

532
00:34:06,040 --> 00:34:08,960
And as you say, it's almost like it's like good luck.

533
00:34:08,960 --> 00:34:10,920
We hope we see you on the other side.

534
00:34:10,920 --> 00:34:11,920
Yeah, exactly.

535
00:34:11,920 --> 00:34:15,920
And there's a cry about how there's such a shortage of physician scientists and it's

536
00:34:15,920 --> 00:34:17,560
like, well, of course there's a shortage.

537
00:34:17,560 --> 00:34:19,400
It's very difficult.

538
00:34:19,400 --> 00:34:21,080
It's hard to make it through.

539
00:34:21,080 --> 00:34:24,360
And so then that begs the question, Julia, how come you're still here?

540
00:34:24,360 --> 00:34:25,520
This is such a hard journey.

541
00:34:25,520 --> 00:34:26,560
It's been hard so far.

542
00:34:26,560 --> 00:34:28,720
The road ahead still seems hard.

543
00:34:28,720 --> 00:34:30,280
How is it that you're still here?

544
00:34:30,280 --> 00:34:32,280
What is keeping you in the game?

545
00:34:32,280 --> 00:34:37,400
Yeah, that's a great question.

546
00:34:37,400 --> 00:34:43,320
And you know, for me, it's what keeps me in the game is why we are here as physician

547
00:34:43,320 --> 00:34:44,320
scientists.

548
00:34:44,320 --> 00:34:49,320
I get to come to the lab in the morning and think, okay, there's questions I want to answer,

549
00:34:49,320 --> 00:34:51,680
that part of my brain that I love using.

550
00:34:51,680 --> 00:34:53,400
I love coming to the lab.

551
00:34:53,400 --> 00:34:54,520
I love mentoring people.

552
00:34:54,520 --> 00:35:02,080
I love thinking about questions that need answering and coming to love grant writing

553
00:35:02,080 --> 00:35:06,560
and all that entails, but really to synthesize your thoughts and say, am I on the right track?

554
00:35:06,560 --> 00:35:08,880
Am I answering questions correctly?

555
00:35:08,880 --> 00:35:12,400
What a fun way to spend your day.

556
00:35:12,400 --> 00:35:16,040
Young people coming through the lab who are never been in the lab before and want to know

557
00:35:16,040 --> 00:35:17,680
what doing science is all about.

558
00:35:17,680 --> 00:35:19,660
It's so satisfying.

559
00:35:19,660 --> 00:35:27,080
And then I just walk down the hall and I see children who I can help and I can help them

560
00:35:27,080 --> 00:35:29,380
right there in that moment.

561
00:35:29,380 --> 00:35:33,540
And I can look at the problems they're having and saying, is there something I can be doing

562
00:35:33,540 --> 00:35:36,420
back in the lab to help you with this problem?

563
00:35:36,420 --> 00:35:43,140
So I think about a patient who unfortunately passed away, who had a invasive fungal infection

564
00:35:43,140 --> 00:35:48,040
after having a really long period of not having any neutrophils.

565
00:35:48,040 --> 00:35:54,700
And it was so heartbreaking for so many reasons, but primarily because I think we could have

566
00:35:54,700 --> 00:35:57,880
cured that child of their cancer.

567
00:35:57,880 --> 00:36:04,180
And to me, that moment where we need more, we need to offer these children more.

568
00:36:04,180 --> 00:36:05,880
We need to offer these families more.

569
00:36:05,880 --> 00:36:10,960
We need to be able to look somebody with a new cancer diagnosis in the eye and say, you're

570
00:36:10,960 --> 00:36:13,820
going to be at risk for infections, but don't worry, we got this.

571
00:36:13,820 --> 00:36:15,400
We're actually going to fix that problem.

572
00:36:15,400 --> 00:36:20,840
So let's focus on beating the cancer as aggressively as we possibly can.

573
00:36:20,840 --> 00:36:24,840
And I care for patients too, who just their whole life they can't make neutrophils.

574
00:36:24,840 --> 00:36:30,460
And the incredible impact on their quality of life, having this fear from the time that

575
00:36:30,460 --> 00:36:35,020
your child is born that at any moment they could have a life threatening infection.

576
00:36:35,020 --> 00:36:38,420
I mean, we just have to do more for these patients.

577
00:36:38,420 --> 00:36:39,820
We just have to.

578
00:36:39,820 --> 00:36:47,540
And being poised to contribute to the care of those kids and their families is really

579
00:36:47,540 --> 00:36:49,420
a special privilege.

580
00:36:49,420 --> 00:36:52,980
And I can't right now imagine doing anything else.

581
00:36:52,980 --> 00:36:59,460
Though, I know many people take different trajectories in their long careers, so stay

582
00:36:59,460 --> 00:37:00,460
tuned.

583
00:37:00,460 --> 00:37:05,940
But for right now, it's really feels like a privilege to have this job.

584
00:37:05,940 --> 00:37:12,820
Absolutely, and I love you light up as you're talking about this path and it's hard, but

585
00:37:12,820 --> 00:37:18,740
you're having fun and you can see the impact in what you have the potential to do.

586
00:37:18,740 --> 00:37:21,140
And so it's really awesome and it's interesting.

587
00:37:21,140 --> 00:37:25,660
It's like, yeah, this is hard, but it's like the struggle.

588
00:37:25,660 --> 00:37:28,740
It's hard to picture being without it for sure.

589
00:37:28,740 --> 00:37:34,420
All right, so we are coming to the end of the show and I wanted to ask you if there

590
00:37:34,420 --> 00:37:40,220
is someone who is a clinician early, early, early on in their career and they're struggling

591
00:37:40,220 --> 00:37:43,140
and they're like, I'm not even sure this is worth it anymore.

592
00:37:43,140 --> 00:37:45,660
How would you encourage them?

593
00:37:45,660 --> 00:37:50,740
Yes, right.

594
00:37:50,740 --> 00:37:55,860
Because yes, how would I encourage them?

595
00:37:55,860 --> 00:37:58,700
Because it is really a hard pathway.

596
00:37:58,700 --> 00:38:05,980
And there is that desire to not just tell people, well, the only right way forward is

597
00:38:05,980 --> 00:38:08,060
to be just like me.

598
00:38:08,060 --> 00:38:13,220
The only way that you will be a success at the end of the day is if you're doing exactly

599
00:38:13,220 --> 00:38:17,620
what I'm doing, because that shouldn't be true.

600
00:38:17,620 --> 00:38:22,580
And if somebody is really struggling, for me, I think it's a good opportunity to reflect

601
00:38:22,580 --> 00:38:25,780
and to say, well, why did you come to the lab in the first place?

602
00:38:25,780 --> 00:38:27,960
What brought you to the lab?

603
00:38:27,960 --> 00:38:34,060
What did you want to get out of your time coming to do a research project?

604
00:38:34,060 --> 00:38:38,940
And for some people, I've heard them say things like, well, I never got a chance to do research

605
00:38:38,940 --> 00:38:42,540
before and I just wanted to know what it's like.

606
00:38:42,540 --> 00:38:47,860
And the more time I spend here, the more I really just wish I was in the clinic.

607
00:38:47,860 --> 00:38:56,720
Maybe that's a person who shouldn't keep pushing themselves down a path that they really are

608
00:38:56,720 --> 00:38:59,740
just feeling a pull away from.

609
00:38:59,740 --> 00:39:07,260
And the road ahead would be, I think, for that person, a very difficult road.

610
00:39:07,260 --> 00:39:14,340
But if somebody says something more like, well, I really wanted to be able to think

611
00:39:14,340 --> 00:39:18,220
about problems that are impacting these patients that I care for.

612
00:39:18,220 --> 00:39:22,460
And I think somehow my project is not moving forward or I've moved far away from that or

613
00:39:22,460 --> 00:39:26,020
I got into the lab and I thought I was going to work on one thing and instead I'm working

614
00:39:26,020 --> 00:39:31,460
on another, sit down and almost write a mini grant for yourself.

615
00:39:31,460 --> 00:39:33,220
What do you want to do?

616
00:39:33,220 --> 00:39:35,300
What did you want to get out of this?

617
00:39:35,300 --> 00:39:37,780
What were your aims coming to the lab?

618
00:39:37,780 --> 00:39:42,140
And is there a way that you can now address those questions?

619
00:39:42,140 --> 00:39:48,260
How can I help my patient who has sickle cell disease, who has alloreactive antibodies,

620
00:39:48,260 --> 00:39:51,260
and we don't have good transfusion options for them?

621
00:39:51,260 --> 00:39:55,400
If that's what's keeping you up at night and you've gotten away from that questionnaire,

622
00:39:55,400 --> 00:40:00,220
you're not moving forward towards that question, sit back down and say, how can I get back

623
00:40:00,220 --> 00:40:01,220
to that?

624
00:40:01,220 --> 00:40:05,300
I've built almost certainly, if you've been in the lab for one or two years already, you

625
00:40:05,300 --> 00:40:06,860
have built skills.

626
00:40:06,860 --> 00:40:12,420
And if you feel like those skills aren't taking you where you want to be, I really wish young

627
00:40:12,420 --> 00:40:16,920
people could hear that the people training you want to know.

628
00:40:16,920 --> 00:40:21,360
They want to hear from you that you're having these doubts.

629
00:40:21,360 --> 00:40:26,620
They don't want you to go to apply for your K, for example, and put together something

630
00:40:26,620 --> 00:40:32,860
that you don't even feel proud of, or you felt like it was fighting tooth and nail just

631
00:40:32,860 --> 00:40:37,300
to get it written because you're not passionate about what you're working on right now.

632
00:40:37,300 --> 00:40:41,220
People training you want to hear from you if you're having these struggles and be able

633
00:40:41,220 --> 00:40:46,140
to say, okay, let me move you to a different project, or okay, let's, you feel like you

634
00:40:46,140 --> 00:40:48,860
haven't had a success yet.

635
00:40:48,860 --> 00:40:51,540
What is this one thing that just needs to be completed?

636
00:40:51,540 --> 00:40:54,820
Let's get it done because this is up and running and working in the lab.

637
00:40:54,820 --> 00:40:57,940
And let's just have you put your hands on this to get some rejuvenation for a month

638
00:40:57,940 --> 00:41:00,380
or two, and then we'll come back to this.

639
00:41:00,380 --> 00:41:05,300
And I think a lot of people don't advocate for themselves in that way because they think

640
00:41:05,300 --> 00:41:11,380
they might come off as, I don't know what, as weak or uninterested or somebody it's not

641
00:41:11,380 --> 00:41:12,820
worth investing time in.

642
00:41:12,820 --> 00:41:18,340
And if somebody's accepted you into their lab, put you maybe on a T training grant and

643
00:41:18,340 --> 00:41:22,660
supporting your career development, sat through scholarly oversight committee meetings with

644
00:41:22,660 --> 00:41:24,380
you, like they're invested.

645
00:41:24,380 --> 00:41:26,660
They want you to succeed.

646
00:41:26,660 --> 00:41:32,060
So speak up if that's where the mode you're at, not, I just wish I was in the clinic,

647
00:41:32,060 --> 00:41:36,060
but if your mode is more, I'm feeling stuck, I'm feeling I'm spinning my wheels.

648
00:41:36,060 --> 00:41:38,540
I feel like I haven't gotten the experience I want to get.

649
00:41:38,540 --> 00:41:43,660
Say something and I think say it as early as you can because you really don't want to

650
00:41:43,660 --> 00:41:49,060
be in a three year fellowship at the end of year two in the lab, you know, at the end

651
00:41:49,060 --> 00:41:55,020
of your fellowship asking for instructor time when you're not even sure if you want it.

652
00:41:55,020 --> 00:41:57,540
Wow.

653
00:41:57,540 --> 00:41:59,420
That's a lot to unpack in that answer.

654
00:41:59,420 --> 00:42:04,300
I don't even know where to start, but I love what you talk about.

655
00:42:04,300 --> 00:42:07,420
I think what you're saying is you got to do what you love.

656
00:42:07,420 --> 00:42:10,100
And I know people say that it's almost like a cliche.

657
00:42:10,100 --> 00:42:11,840
This is hard work.

658
00:42:11,840 --> 00:42:15,780
And if you're going to work so hard, please do something you actually care about.

659
00:42:15,780 --> 00:42:20,940
Don't do something that drains you because it's too hard to invest time and energy in

660
00:42:20,940 --> 00:42:23,280
something you don't even care about.

661
00:42:23,280 --> 00:42:27,700
And I appreciate what you talk about the importance of self advocacy because sometimes there's

662
00:42:27,700 --> 00:42:30,700
this sense of like, well, I don't want my mentor to be upset with me, but it's like,

663
00:42:30,700 --> 00:42:32,480
look, this is not your mentor's journey.

664
00:42:32,480 --> 00:42:33,480
This is your journey.

665
00:42:33,480 --> 00:42:36,740
And years from now, your mentor is going to be out of your picture.

666
00:42:36,740 --> 00:42:37,980
And what are you going to be doing?

667
00:42:37,980 --> 00:42:41,340
Are you going to be that person who's so successfully miserable?

668
00:42:41,340 --> 00:42:43,100
And that's not worth that struggle.

669
00:42:43,100 --> 00:42:46,500
And actually you may not even end up being successfully miserable because you just might

670
00:42:46,500 --> 00:42:48,860
not even get that you're so miserable.

671
00:42:48,860 --> 00:42:51,020
But I do appreciate that.

672
00:42:51,020 --> 00:42:52,020
It's almost cliche.

673
00:42:52,020 --> 00:42:53,900
It's like, do what you love, but it's real.

674
00:42:53,900 --> 00:42:58,940
It's like, don't do things you hate because it's just too hard to sustain a career that

675
00:42:58,940 --> 00:42:59,940
way.

676
00:42:59,940 --> 00:43:00,940
It's impossible actually.

677
00:43:00,940 --> 00:43:07,780
Well, and having an Eliza that you can't troubleshoot is very different than I don't like research.

678
00:43:07,780 --> 00:43:13,340
But when you're been on call because you also have a clinical job and you haven't slept

679
00:43:13,340 --> 00:43:18,900
for some period of time, and maybe you also have family obligations and you're going into

680
00:43:18,900 --> 00:43:22,820
the lab and you're just thinking one more day that I have to get this thing to work

681
00:43:22,820 --> 00:43:23,820
that isn't working.

682
00:43:23,820 --> 00:43:26,620
And I don't even know what I'm doing with my life.

683
00:43:26,620 --> 00:43:31,980
And my colleague is doing a chart review in their pajamas at home and having a great time,

684
00:43:31,980 --> 00:43:37,740
but really, I mean, and that's important work too, but it's, yeah, I think it's very

685
00:43:37,740 --> 00:43:41,580
easy to get discouraged and to stay discouraged for two years.

686
00:43:41,580 --> 00:43:42,820
And then your fellowship's up.

687
00:43:42,820 --> 00:43:48,220
And then all of a sudden it's, well, you told us you wanted to do lab.

688
00:43:48,220 --> 00:43:52,940
You never told us that you were struggling.

689
00:43:52,940 --> 00:43:57,340
And we didn't sort of move things around or come to an understanding of maybe we need

690
00:43:57,340 --> 00:43:58,720
to shift your focus.

691
00:43:58,720 --> 00:44:00,820
Maybe you do want to do more clinical activity.

692
00:44:00,820 --> 00:44:05,860
And now you're not marketable from a lab standpoint and you're not marketable at an academic

693
00:44:05,860 --> 00:44:09,820
institution that's going to expect hardcore clinical work to have come out of a fellow.

694
00:44:09,820 --> 00:44:13,700
And so nobody has been coming into a clinical position.

695
00:44:13,700 --> 00:44:16,420
They're going to expect that you've done hardcore clinical work during your fellowship.

696
00:44:16,420 --> 00:44:20,300
So nobody's helped by not speaking up.

697
00:44:20,300 --> 00:44:25,060
And yeah, I think really, I almost wish that in fellowship you got a chance to rotate in

698
00:44:25,060 --> 00:44:29,420
a lab that you almost got like graduate students do.

699
00:44:29,420 --> 00:44:33,920
The expectation that you're going to spend six weeks somewhere, six weeks somewhere else

700
00:44:33,920 --> 00:44:38,320
and six weeks in a third place, and you're going to see what's the right fit for you.

701
00:44:38,320 --> 00:44:41,220
Because we, you know, we ask people to commit to mentors.

702
00:44:41,220 --> 00:44:42,220
They don't know them at all.

703
00:44:42,220 --> 00:44:44,180
They don't know the lab environment.

704
00:44:44,180 --> 00:44:46,260
And this is the beginning of the rest of their career.

705
00:44:46,260 --> 00:44:51,420
Now you're in a field that you're going to be in that field for at least, you know, for

706
00:44:51,420 --> 00:44:53,860
the foreseeable future.

707
00:44:53,860 --> 00:44:57,500
And I think that's an interesting that we just ask people to sort of jump in.

708
00:44:57,500 --> 00:45:06,380
Yes, so to our audience, if you are feeling miserable on your trajectory, you need an

709
00:45:06,380 --> 00:45:10,020
intervention and you can't give it to yourself.

710
00:45:10,020 --> 00:45:15,620
You can engage your mentor or find someone outside of your mentorship circle, but please

711
00:45:15,620 --> 00:45:17,900
don't try to do it alone.

712
00:45:17,900 --> 00:45:18,900
And build that.

713
00:45:18,900 --> 00:45:20,140
I wish I could come up.

714
00:45:20,140 --> 00:45:23,860
Maybe you know the name of this kind of map that you make.

715
00:45:23,860 --> 00:45:27,820
It's not a mentorship map because mentor is one word, but who are the people you're going

716
00:45:27,820 --> 00:45:30,980
to need different things from to support you on this?

717
00:45:30,980 --> 00:45:33,620
You know, you need a research mentor.

718
00:45:33,620 --> 00:45:35,820
You need a clinical mentor.

719
00:45:35,820 --> 00:45:41,140
You need a mentor to help you with the life part of doing this job.

720
00:45:41,140 --> 00:45:43,700
You need peers for peer support.

721
00:45:43,700 --> 00:45:50,180
You need a sponsor that is often, if it's also your research mentor, isn't that so great?

722
00:45:50,180 --> 00:45:53,780
It probably ought not to just be your research mentor.

723
00:45:53,780 --> 00:45:54,780
You need a sponsor.

724
00:45:54,780 --> 00:45:56,820
You need someone who's going to open doors for you.

725
00:45:56,820 --> 00:45:58,340
And you need role models.

726
00:45:58,340 --> 00:46:02,300
You know, these are different people who are going to give you these different things and

727
00:46:02,300 --> 00:46:05,000
you have to build that team for yourself.

728
00:46:05,000 --> 00:46:09,580
And there are these diagrams you can download online if you're a visual person where you

729
00:46:09,580 --> 00:46:11,860
then just fill the names in.

730
00:46:11,860 --> 00:46:17,100
Really sit with it and ask, who is in each of these buckets is my person?

731
00:46:17,100 --> 00:46:21,060
And in this moment, I'm having these feelings of doubt, you know, disconcertment.

732
00:46:21,060 --> 00:46:24,020
I'm not sure if I'm doing the right thing with my life.

733
00:46:24,020 --> 00:46:26,740
Which of these people can I go talk to about this?

734
00:46:26,740 --> 00:46:30,340
And maybe I start with one person and move to a different one.

735
00:46:30,340 --> 00:46:34,940
Maybe I, you know, meet with a peer first who's a few years ahead of me who might have

736
00:46:34,940 --> 00:46:36,420
had these same moments.

737
00:46:36,420 --> 00:46:40,240
Maybe I just bounce ideas off of them and then I go to my research mentor.

738
00:46:40,240 --> 00:46:44,340
Or I, you know, I go to my sponsor and I say, do you think I have what it takes?

739
00:46:44,340 --> 00:46:45,900
You're someone who's been my champion.

740
00:46:45,900 --> 00:46:50,940
You know, do you think I'm a person you see continue to be able to champion in the future?

741
00:46:50,940 --> 00:46:52,700
What do I need to accomplish now?

742
00:46:52,700 --> 00:46:54,620
And how do I get to accomplishing that?

743
00:46:54,620 --> 00:46:59,180
So yeah, sit down and make a map for yourself and then reach out to those people.

744
00:46:59,180 --> 00:47:00,180
Absolutely.

745
00:47:00,180 --> 00:47:02,060
You speak to the importance of mentoring networks.

746
00:47:02,060 --> 00:47:04,900
I mean, it's like one person cannot be all of it for you.

747
00:47:04,900 --> 00:47:05,900
It's not even possible.

748
00:47:05,900 --> 00:47:06,900
Don't do it.

749
00:47:06,900 --> 00:47:08,620
Don't, don't try to make it fit.

750
00:47:08,620 --> 00:47:11,500
But yeah, no, that's, this has been so awesome, Julia.

751
00:47:11,500 --> 00:47:13,380
I mean, just so much wisdom.

752
00:47:13,380 --> 00:47:17,180
I feel like we need to do like a part two because there's so much that could still be

753
00:47:17,180 --> 00:47:18,180
said.

754
00:47:18,180 --> 00:47:21,300
And I just just shared so much wisdom and I just want to thank you.

755
00:47:21,300 --> 00:47:22,660
Thank you for being on the show.

756
00:47:22,660 --> 00:47:23,660
Of course.

757
00:47:23,660 --> 00:47:24,660
Thank you so much for inviting me.

758
00:47:24,660 --> 00:47:25,660
All right, everyone.

759
00:47:25,660 --> 00:47:26,660
You've heard Julia.

760
00:47:26,660 --> 00:47:29,500
You've got to share this episode with someone else.

761
00:47:29,500 --> 00:47:33,060
Someone is struggling and they need advice and they need to think a little bit more broadly

762
00:47:33,060 --> 00:47:35,020
about that mentoring networks.

763
00:47:35,020 --> 00:47:37,700
Think about that one person and forward this episode to them.

764
00:47:37,700 --> 00:47:38,860
All right, everyone.

765
00:47:38,860 --> 00:47:48,820
It's been a pleasure to talk to you again the next time.

766
00:47:48,820 --> 00:47:54,180
Thanks for listening to this episode of the Clinician Researcher podcast, where academic

767
00:47:54,180 --> 00:47:59,620
clinicians learn the skills to build their own research program, whether or not they

768
00:47:59,620 --> 00:48:00,980
have a mentor.

769
00:48:00,980 --> 00:48:07,060
If you found the information in this episode to be helpful, don't keep it all to yourself.

770
00:48:07,060 --> 00:48:08,820
Someone else needs to hear it.

771
00:48:08,820 --> 00:48:12,860
So take a minute right now and share it.

772
00:48:12,860 --> 00:48:18,340
As you share this episode, you become part of our mission to help launch a new generation

773
00:48:18,340 --> 00:48:24,100
of clinician researchers who make transformative discoveries that change the way we do health

774
00:48:24,100 --> 00:48:25,100
care.

775
00:48:25,100 --> 00:48:51,340
All right, thanks for tuning in.