Transcript
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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 today's episode of the Clinician Researcher podcast.
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It's a pleasure to be talking with you today.
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Thank you so much for tuning in.
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I'm excited to be talking today about fear, fear in academia, and the importance of banishing
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fear.
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Specifically, I'm talking about not being afraid of what you do not know, do not be
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afraid of what you don't know.
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The reason this episode comes is because of a recent conversation I had with a young person,
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early career, and this person is still a trainee.
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I remember we were talking about a paper that this person's writing, and this is their first
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paper, and I forgot that.
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You know when you've done a lot of writing or you've published a lot of manuscripts,
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at least relatively speaking for me, and I forget what it is like to write that first
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manuscript, how hard it is, and how little time we have to dedicate to that manuscript
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because dedicating time to writing is not what we do.
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I forgot that.
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And I remember I was saying, great, so this is where you are right now, what I need is
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a title page and I need an outline.
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And then I paused and I was like, oh, wait a minute.
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Someone hasn't done this before.
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And not in a bad way, not in a judgmental way, but as a reminder to myself that wait
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a minute, if someone hasn't done this before, you can't have an expectation that they know
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what to do, and my job is to step in and to give them resources to be able to move forward.
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And I think it's so important that I was able to acknowledge that, especially because I
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think in that moment, this person was feeling like, well, I should know.
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I mean, clearly I've come very far in my education and in my training and how can I say I haven't
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done this before?
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And so they didn't want to ask me questions because they were expecting that they should
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know the way we behave in medicine where we're like, well, we don't know, but we're going
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to go study about it when you'll find out.
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And then we're going to come back and know.
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I just want to say that that's not healthy.
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The whole idea that you should go to a corner and find out all the answers before you come
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out.
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To be honest, there isn't even time for that.
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We need help and we need help now.
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And we need people to help us cut short the time.
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So all the time we invest in going to look stuff up, we need to cut it short by just
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asking questions.
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And so that fear, the fear of being judged, the fear of shame, the fear of not knowing
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and being exposed for not knowing overwhelms so much of what we do and keeps us focused
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on what we already know and keeps us hiding and running away from the things we do not
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know.
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So I want to talk about why we or the strategies that we need to help us really grow and expand.
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One of the things I talk about quite often is that clinical training is not research
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training.
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It absolutely is not research training.
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And I don't care if you had two whole years of fellowship time, nobody has two years,
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maybe you had 18 months of fellowship time to do research, that's still not really sufficient
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research training time.
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PhD researchers get at least six years just in the course of doing their PhD.
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And okay, so they'll say, okay, it was not exactly six years, but just the bottom line
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is not the number of years.
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It's that those who get training to do research get a lot of years invested in research.
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And after they do their first degree, I mean, they get their PhD, then they also do more,
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and then they do more, and then they do some more.
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And so it takes a long time to learn to do research well.
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And if you're a clinician who's done all the things, you've gone through your clinical
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training, even if you've done your fellowship and you had time to do research and fellowship,
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you still don't have near enough research training.
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And this is not a ding against MDs or those who are only clinically trained.
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It's just saying, hey, you don't have the skillset and that's okay.
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What you're going to do is grow the skillset, but you can't be ashamed of not knowing what
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you were not taught.
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And you cannot live in fear that someone's going to expose you for not knowing because
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you're not supposed to know and it's okay.
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So I want to talk about seven things specifically that can hold you back from growing in the
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way you're supposed to grow as a scientist, as a researcher, especially when you don't
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have the strong foundation of training that someone else's your counterpart might have.
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The first thing I want to share is that you have to banish shame.
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And I don't want to say you have to, should, or these terms that might suggest that you
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must do something.
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I'm saying that if you're going to succeed, shame cannot be part of your picture, not
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at all.
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See, the thing about shame is that shame is a trick.
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Shame is a trick to keep you from growing and expanding in the way you should.
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It's a trick.
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How can you grow if you're ashamed of what you don't know?
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How can you ask questions when you're ashamed that someone's going to figure out that you
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don't know?
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But in reality, you don't know.
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And it's okay that you don't know.
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It's okay.
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But shame is a trick because we're ashamed that someone's going to find out that we don't
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know, meanwhile, they kind of already know that we don't know, or maybe they don't, but
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we don't know.
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And so we're hiding something that's true, but is nothing to be ashamed of because the
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fact that we don't know opens up a door of opportunity for us to know.
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And it gives the person before us an opportunity to help educate us if they choose.
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And in medicine, there is a lot of judgment.
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So sometimes instead of educating us, people may actually say things that are hurtful.
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And that's happened too.
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But it does give them an opportunity to say, oh, you don't know, let me help you learn.
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And I would venture to say that many people around you have that heart, have that desire
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to help you.
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Once they figure out you don't know, they do want to help.
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But most of the time, we're so busy being ashamed of what we don't know.
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We don't give people opportunity to help us.
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And that is why shame is a trick.
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Shame tells you that you are protecting your self image.
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Meanwhile, it's holding you back from getting the help that you need.
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And so I want to encourage you for whatever reason you're like, well, I'm not very good
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at writing any scripts.
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I don't even know how to write a grant.
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Don't be ashamed of that.
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Of course, you don't know.
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You weren't taught.
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It wasn't part of your training.
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No, you don't know how to write a grant.
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That's okay.
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And you can be like, well, my mentor tried to show me.
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No.
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It takes years to learn to know how to be a good grant writer.
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It takes time to get really good.
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And yes, you may have written one or two grants in fellowship.
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That's not near enough experience to get really good.
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Look, this is not you.
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It's not your fault.
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You're not a bad person.
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You're not obtuse.
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You're not dense.
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You are somebody who really wants to learn and you have not had opportunity.
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Here's the other thing.
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You're a great learner.
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You are great at learning, getting good at skills.
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You're great at that, if given the opportunity.
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And so don't be ashamed of what you don't know.
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You just don't know and it's okay.
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Imagine a kid who's trying to learn to walk and we're yelling at them saying, I can't
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believe you can't even walk.
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What's wrong with you?
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We don't do that.
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We don't do that.
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We encourage them.
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And we say, hey, good job.
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We encourage them.
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If they're crying and we're like, hey, kid, it's okay.
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Let's do this again.
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And so it is so important that we do not allow shame to keep us from growing and expanding
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in the way that we need to.
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The second thing I want to share is that it's time to remove judgment.
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And I'm not just talking about judgment of others.
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I'm talking very specifically about judgment of yourself.
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It is time to stop judging yourself.
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We look down on ourselves and we're like, I can't believe I don't know how to write
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a paper.
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I can't believe I don't know how to write a grant.
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I can't believe I can't finish this on time.
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I can't believe I can't make the deadline.
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And it's like, no, it's not expected that you start writing grants today and you know
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that, wow, this seemingly small application actually has 25 pages to it.
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It's not expected that you would know if you've never done it before.
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And every time you look at yourself in judgment, you shrink under the weight of that judgment.
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So it's not just others that judge you that causes you to shrink.
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It's you judging yourself that keeps you from thriving in creativity.
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Encouragement helps you do better.
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And there is no greater space for that encouragement than you.
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And sometimes you're looking at your mentor to encourage you and they may or may not.
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But we don't need to wait for the mentor to encourage us.
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We don't need to wait for somebody else to encourage us.
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We are the ones to encourage ourselves to stop being self-deprecating, to stop calling
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ourselves abusive names, to stop saying, oh, if only I knew better.
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It's just not helpful.
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It's not helpful.
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Criticism doesn't help anybody grow and criticizing yourself is a problem because it doesn't give
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you room to thrive.
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And so one of the most important things you're going to do if you're going to succeed as
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someone who has not done this before, who's not written papers, who's not written grants,
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who has not submitted proposals before, figured out what proposals to submit, is to remove
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judgment from yourself and to just accept what is.
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Like, oh, okay, I haven't done this before.
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I'm going to need to do this for the first time without judgment, without criticism,
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without harshness.
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I'm just talking about not judging ourselves.
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But I'm also talking about not judging others.
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And this is something that, oh my goodness, was so hard for me to learn because I would
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look around at the people around me and I would say, you should have helped me.
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You should have known I didn't know this.
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You should have given me more of your time.
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And honestly, nobody owes me anything.
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Anything I receive from everybody, from anybody around me, mentor, division director, dean,
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all of it is a gift.
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And if they don't give it to me, they don't have to give me any gifts.
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But if they do, I am grateful.
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And if they don't, I don't judge them for it.
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And the reason we have to let go of judging others is because, to be honest, judging others
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is a sign of how harshly we judge ourselves.
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Yep.
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And if we would let go of judging ourselves, then we would let go of judging others as
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well.
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And so I want to invite you to stop judging yourself first.
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But I also invite you to practice not judging others as well, no matter how badly they
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behave.
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Take whatever they give you as information.
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Use it to make your next best decision.
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Okay, this mentor tends to yell a lot.
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Okay.
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All right.
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Don't be angry.
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Don't be mad.
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Just decide, are you going to stick around for it?
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Are you going to find yourself a new mentor?
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How are you going to work yourself out of the situation?
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Just use it as information.
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But remove judgment from your experience.
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It doesn't help you.
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The energy of judgment doesn't allow you to move forward in the way you want.
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It actually inhibits your learning.
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So remove judgment if you're going to advance in the space of your academic growth as a
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researcher.
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The third thing I want to share is that in as much as you're no longer judging yourself
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or others, don't accept others' judgment of you.
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Okay, it's medicine.
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There's so much judgment everywhere.
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We judge each other so badly.
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But in reality, anybody can say anything and if you don't receive it as such, then it didn't
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happen.
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If somebody looks at you and they sneer and you don't accept it as a sneer, then it just
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it's like it didn't happen.
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If somebody says something that's a judgment against you and you don't receive it as a
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judgment, it's as if it didn't happen.
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And so don't accept judgment from other people.
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Let's say you've never written a manuscript and you write one and it's not a great draft.
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You don't even know how bad the draft is, but you wrote the draft and you're like, oh
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great, well, here's a draft.
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And you present it to someone who's mentoring you in this area and they say, this is terrible.
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Don't accept the judgment.
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Say, okay, it looks like this could be better.
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Don't accept the judgment.
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Don't accept the shame that comes with the judgment.
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Don't accept the feelings that come with the judgment.
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Just say, oh, okay, well, I thought it was good, but I guess not.
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Okay.
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Don't accept the judgment.
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Don't accept those negative feelings that make you feel like I will never do this again.
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Why I will never put my foot forward in this way anymore.
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Don't do that.
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Don't accept the judgment.
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People have judgments and for better or for worse, maybe they're trying to help us improve
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in medicine, we haven't always learned how to encourage people.
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But no matter how people come at you, if it feels like they're saying something bad about
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your work, don't accept it.
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And here's the flip side of that though.
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It's easy to say, don't accept the bad judgment, but don't accept the good judgment either.
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Don't let someone look at the very first manuscript you've ever written and tell you, this is
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fantastic.
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Don't accept that either.
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And what do I mean by not accepting that?
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Don't just say, oh, okay, great.
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And pat yourself on the back and feel good.
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Say, oh, okay, what's great about it, right?
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And by not accepting judgment, what you're asking for is unbiased feedback.
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You're like, no, no, no, don't tell me it's great.
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Don't tell me it's terrible.
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Tell me how to make it better.
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Tell me how to improve it.
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If it's already great, as you're saying it is, well, tell me what's already good about
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it.
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So I know what to do again.
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Because you're not here for praise.
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You're not here for criticism.
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You're here to grow.
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That's it.
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You're here to grow.
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And what helps you grow?
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Feedback that is actionable.
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End of the story.
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Terrible.
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That's feedback that's not actionable, not useful.
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Don't accept it.
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Amazing.
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That's feedback that's not actionable.
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Don't accept it.
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And by don't accept it, I'm not just saying just block it out of your ears and say, la,
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la, la, la, la, la, la, la, la, la, la.
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I can't hear you.
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Don't do that.
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But ask questions.
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Don't settle for what they told you.
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Like, OK, I hear that you don't like it.
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What is it about it that you don't like?
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Or I hear that you think this is really amazing.
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Tell me what it is about it that could make it better.
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Right?
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You're asking for feedback that's actionable.
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It's the only way you grow.
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Don't take any of it personally.
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But don't accept what they give you without pushing back and saying, I can see that this
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paper is annoying.
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I can see that.
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Tell me how I can actionably, reasonably improve it.
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Push back and let people give you feedback that's actionable.
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And if you are in a situation or in a mentoring relationship where your mentor cannot give
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you feedback that's actionable, that is not a mentoring relationship that you want to
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continue in, no matter how amazing that mentor is on paper.
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Any mentor that cannot give you feedback that's actionable, that allows you to grow, is not
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a mentor for you.
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They may be great and give other people actionable feedback, but if they can't give you actionable
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feedback that you can grow, they are not the mentor for you.
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So do not accept the judgment of others, whether good judgment or bad judgment.
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The fourth thing I want you to share is that it is so important for you to prioritize learning.
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And this is why we do the work of removing the shame and the judgment associated with
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this whole process, because we're here to learn.
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We're already really good clinically.
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We spent 10 years doing the clinical stuff.
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We're good at that.
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What we're not good at is writing papers over and over and over again, shepherding them
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through the manuscript publication process.
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We're not that great at writing grants.
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And that's okay.
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We are getting better, but we're not the best yet.
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So we prioritize learning.
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We prioritize learning, and that's why we remove all the stuff that keeps us from learning
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so that we can learn, so that we can improve.
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We're not improving to impress other people.
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We're not.
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We're improving so we can grow.
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We're improving so we can grow and start to stand independently by ourselves to do this
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work.
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So we don't need to come every day to the office to say, mentor of mine, please edit
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my work.
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Right?
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So that we can do it on our own and get to the place where we can actually teach others
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so that they can do the same as well.
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So we can reproduce the skills we have in others.
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So prioritizing learning is so important, and that's why we reject the shame that keeps
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us from asking the questions that allow us to grow.
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We reject the judgment that keeps us from getting feedback that's actionable.
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We reject judging ourselves so that we can thrive so that we can prioritize learning.
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At the end of the day, this is about our growth.
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We're already good at other things, but if we just stayed at what we were good at, then
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we would just be one-sided.
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But we want to expand.
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We want to have skills that we didn't have before.
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We want to be able to write in a way that's compelling.
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We want to be able to sell our science for better or for worse.
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We want to be able to write a six-page research strategy and get a couple of hundreds of thousands
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of dollars.
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We want to be able to do that well, and therefore we embrace the opportunities to learn.
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The fifth thing we want to do in order for us to learn is to ask questions.
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Okay.
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So I think the whole process of being pimped in medical school and pimping when you became
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maybe the senior resident is that asking questions seems to be a bad thing.
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It's like, oh, what is she thinking?
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What is she thinking?
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What's the right answer?
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What if I don't have the right answer in the stress that comes out of asking questions
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sometimes?
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But I want us to step away from the stress of asking questions that comes with our spaces
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in the clinical space and go back to when we asked questions when we were kids.
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Remember that time when we didn't even know we were annoying our parents and we asked,
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why is the sky blue?
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But why?
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And we keep asking.
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We're not asking to be annoying.
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We're asking because we really want to know.
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We have no idea.
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We have no clue, but we want to know.
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We are curious people.
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We want to know.
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And I want to invite you back to that beautiful space of just asking questions and just asking.
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Say, I just want to know.
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I don't know.
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Why is it that we have to write the title page in this way?
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Ask questions.
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00:20:55,900 --> 00:20:58,020
Now, here's the thing about asking questions.
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There are going to be some people who love your questions, who welcome them, and who
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answer them all the time.
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They are the people who are going to say, okay, this is a great question.
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You should read this paper that's going to answer three or four of the questions you
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have right now, and then let's talk about it next time.
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And that's okay.
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You're also going to get to the people who are like, don't ask me any more questions.
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And that's okay too, because in the way they respond to your question asking, they're giving
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you information.
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They're saying, I am not the kind of person you can ask questions of.
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I'm not someone who can help you grow and learn.
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Or they're saying, I just don't have bandwidth to help you grow in this way.
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Go to someone else.
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They're giving you information.
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But for you, your job is not to tiptoe around people who may not want to answer your questions.
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Your job is to ask and to find the people who are so excited when you ask.
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You think about those teachers in early kindergarten, I hope you remember, who were so excited about
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your love for learning.
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They just loved how much you wanted to learn.
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Those are the people you look for.
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And if you're not finding them in your immediate environment, you've got to go further to find
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them.
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00:22:08,300 --> 00:22:13,900
But your questions are beautiful, because they represent someone who wants to know more.
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00:22:13,900 --> 00:22:19,180
And people who are excited to teach learners want questions like the ones you have.
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00:22:19,180 --> 00:22:27,540
And I just want to invite you to not take any curmudgeonly answers, any curmudgeonly
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people around you, and to find the people who want to answer your questions so that
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you can keep on asking.
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00:22:35,980 --> 00:22:38,760
The sixth thing I want to invite you to do is to push for more.
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00:22:38,760 --> 00:22:41,460
Don't accept what you already know.
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00:22:41,460 --> 00:22:46,700
Sometimes I come across clinicians who say, you know what, I'm already a good clinician.
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00:22:46,700 --> 00:22:47,940
I don't need all this.
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00:22:47,940 --> 00:22:55,180
And it's like, yeah, you are a good clinician, but you want more out of your experience.
410
00:22:55,180 --> 00:22:57,660
Don't settle for what you've been given.
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00:22:57,660 --> 00:22:58,660
Push for more.
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00:22:58,660 --> 00:23:02,820
No, you don't know how to write manuscripts really well, but you want to learn because
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of how it helps you develop as a writer.
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00:23:05,520 --> 00:23:06,520
Push for more.
415
00:23:06,520 --> 00:23:10,700
No, you don't need to spend all this time asking for grant funding.
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00:23:10,700 --> 00:23:13,140
You just want to be able to settle your salary and go home.
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00:23:13,140 --> 00:23:18,180
But there's a reason why you want to do more than what you're already doing because what
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00:23:18,180 --> 00:23:24,360
you're doing right now does not satisfy that longing and the desire in you for more.
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00:23:24,360 --> 00:23:26,100
Push for more.
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00:23:26,100 --> 00:23:27,980
Please don't settle.
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00:23:27,980 --> 00:23:32,920
You can never be happy or fulfilled if you settle.
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You settle for less than your best, settle for less than your potential.
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00:23:36,780 --> 00:23:40,300
And I'm not even saying everybody has to be a scientist.
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I'm not even saying that, but I'm saying if it is in your heart to do research, if it's
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in your heart to write papers, to publish, to be a scholarly person, even when you meet
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00:23:51,340 --> 00:23:54,820
opposition, you should push for more.
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00:23:54,820 --> 00:24:01,700
And the reason you push for more is that your highest self depends on you actualizing your
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full potential.
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And pushing for more allows you to do that.
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00:24:06,900 --> 00:24:08,940
And that brings me to number seven.
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As you're pushing for more, it's going to be uncomfortable for you, maybe for other
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people as well, but mostly for you.
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And it's going to be okay to sit with discomfort.
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That's going to be okay.
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00:24:21,460 --> 00:24:22,460
It's going to be hard.
436
00:24:22,460 --> 00:24:24,980
It's going to be important for you to do that.
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00:24:24,980 --> 00:24:29,860
You're going to ask a question and someone's going to look at you like, wait a minute,
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00:24:29,860 --> 00:24:38,100
anybody, anybody with head, I don't even know what expression I'm trying to say.
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00:24:38,100 --> 00:24:39,820
You know, like anybody should know that.
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00:24:39,820 --> 00:24:41,540
How come you don't know that?
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00:24:41,540 --> 00:24:43,340
Like a first year PhD student would know that.
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00:24:43,340 --> 00:24:46,660
How come you don't know that, doctor?
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00:24:46,660 --> 00:24:49,060
Just sit with the discomfort of, well, I don't know.
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00:24:49,060 --> 00:24:52,220
And I'm asking you, what do you want to do about it?
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00:24:52,220 --> 00:24:57,260
And I'm not saying that you should do it with attitude or ugliness in any way, but just
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recognize that sometimes people are not used to people who are open and honest about what
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they don't know, especially in medicine.
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00:25:04,860 --> 00:25:06,540
We're always hiding what we don't know.
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00:25:06,540 --> 00:25:14,100
And so when you say, I don't know how to do this, and then you pause and it looks uncomfortable.
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00:25:14,100 --> 00:25:18,580
You give the other person the opportunity to say, well, who will I be in this, in this
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moment?
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Am I going to be ugly and, and, and berate you?
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And maybe they will sit with that.
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They're going to be many uncomfortable moments, but they're going to be important and defining
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moments.
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When you learn to sit with discomfort, you learn to expand who you are.
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You learn to expand your tolerance.
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00:25:40,240 --> 00:25:42,060
You learn to be more.
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I invite you to sit with discomfort, especially as you're pushing for more.
460
00:25:48,860 --> 00:25:52,820
And so those are the seven things that I wanted to share with you today.
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00:25:52,820 --> 00:25:54,020
Number one is to banish shame.
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00:25:54,020 --> 00:25:56,100
Number two is to remove judgment.
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00:25:56,100 --> 00:26:00,740
Number three is not to accept the judgment of others, whether good judgment or bad judgment.
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Number four is to prioritize learning.
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Number five is to ask questions.
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00:26:04,740 --> 00:26:06,780
Number six is to push for more.
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And number seven is to learn to sit with discomfort.
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00:26:11,180 --> 00:26:16,300
I hope that you will consider these things on your quest on learning to grow as a scientist.
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00:26:16,300 --> 00:26:19,980
You didn't have the training, not the extensive training that you could have.
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And it's okay.
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00:26:20,980 --> 00:26:21,980
That's in the past.
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What you're doing is you're getting the skills today.
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And I want to invite you to do everything you can to grow and expand the someone who's
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learning in this space, even if you didn't have the training or the experience that you
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should have had by now, but don't judge yourself.
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00:26:37,380 --> 00:26:39,180
Don't judge others.
477
00:26:39,180 --> 00:26:44,780
And if you need someone to help you walk through as you're learning to stop automatically judging
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00:26:44,780 --> 00:26:47,620
things, I'd be happy to be there for you as your coach.
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00:26:47,620 --> 00:26:53,780
But I encourage you to think differently about your experience and to enjoy this journey
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because the journey is the gift.
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All right.
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It's been a pleasure talking with you today.
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I look forward to talking with you again next time on the clinician researcher podcast.
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Thanks for listening to this episode of the clinician researcher podcast where academic
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clinicians learn the skills to build their own research program, whether or not they
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have a mentor.
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If you found the information in this episode to be helpful, don't keep it all to yourself.
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Someone else needs to hear it.
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So take a minute right now and share it.
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As you share this episode, you become part of our mission to help launch a new generation
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of clinician researchers who make transformative discoveries that change the way we do healthcare.