Going against the status quo is hard but you should do it anyway

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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 Toyosi Onwuemene, and it is an absolute pleasure to be talking with you today.

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Thank you so much for tuning in.

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Today I want to talk about going against the status quo, why it is so hard, and why you

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should do it anyway.

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I'm talking about going against the status quo, why it's hard, and why you should do

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it anyway.

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I am reminded of when I first started my faculty career, gosh, about 11 years ago now or more,

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and I came to my faculty position knowing that I wanted to do research, but not necessarily

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having had the background to succeed as a researcher.

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I thought my clinical training was enough to allow me to succeed as a researcher, and

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I didn't realize there was so much more that was needed.

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I didn't realize that there were skills I was missing.

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I didn't realize I needed training.

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When I said, this is what I want to do, and people to some extent either didn't take me

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seriously or didn't believe that I could, I found myself doing what I didn't want to

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do.

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I came to do research, even then my research aspirations were not very specific.

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It was very vague, which is fine.

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There are different stages, and sometimes you know your call to something even if you

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don't know what the details of it are.

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I knew I wanted to lead research.

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I knew I wanted to be in research, but I didn't know exactly what it was.

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Part of my confusion was that the research I had started didn't necessarily have space

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in the new place that I was in.

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Another area that I wanted to get into was closed off to me, at least so I was told or

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so I thought.

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But there was a lot I didn't know.

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There was a lot of knowledge that I was lacking.

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In reality, clinicians work to take care of patients.

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That's what we do.

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Our training is about taking care of patients.

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When you say, I want to step outside of our training, my training, and I want to do something

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different, you're going against the status quo.

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Yeah, there may be other people who are doing it.

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But the prevailing number of physicians who go into research is few relative to those

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who go into clinical care.

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Clinical care is the default for clinicians.

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It's not being a physician scientist.

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If you're going to go against the grain and do your thing as a leader of a research program,

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you're going to understand that it's going to be hard.

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It's hard exactly because you are starting a course that's not the default course, but

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it's also important because it is the way that you establish yourself and fulfill your

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purpose.

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The reason you're not satisfied with only being a clinician, not to say that that's

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an only, but the reason you're not satisfied with doing that alone is because you feel

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like there is more.

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If you're going to answer that call, if you're going to pay attention to the yearnings that

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you have inside you, you're going to want to step outside the box and do something different.

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That is challenging.

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I tell people who are trying to make the transition into research that, hey, this is a hard path.

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It's not supposed to be easy.

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Easy is going with the flow, jumping on the bandwagon, letting the current carry you.

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That's easy.

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Now, swimming against the current?

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Yeah, that's hard.

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That's hard.

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It's hard because you're going against the flow.

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It's not hard because it has to be hard.

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It's just hard because the very nature of the thing you've chosen to do is difficult.

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You're swimming against the current.

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You're going to have to exert more energy.

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You're going to have to grow muscles.

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You're going to have to be strong.

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You're going to have to have stamina because every time you take a break, the current carries

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you in the opposite direction.

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So I'm talking about the status quo, why it's hard, going against it is hard, and why you

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should still do it anyway.

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Okay.

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The first thing to recognize is that social pressure and conformity will always push you

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towards doing what is accepted, what everybody else is doing.

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Again, if you wanted to do what everybody else was doing, you would already be doing

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it and you'd be satisfied.

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You'd be like, this is the life, exactly what I want to do.

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This is just it for me.

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And it's okay if that's it for you.

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But if you're listening to me, it's probably because there's more.

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You know that there is more.

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You know that whatever it is that you're doing right now is not enough.

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And it's not because you're a discontent, you're malcontent or you're discontented in

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any way.

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It's just because you want to grow.

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You want to reach for a different way of making an impact or making an impact to a larger

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population of people in a way that's different from your training.

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And you feel it, you feel the difference, you want to do something different.

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But everybody around you, or at least many of the people that you see around you, are

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going one way.

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And so there is pressure to conform to doing what everybody else is doing, even when you

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feel as if you should be doing something different.

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And I'm not saying that you should resist the pressure or you should conform to the

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pressure.

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I'm just saying the very fact that you're choosing to do something that everybody else

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is not doing puts pressure on you.

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And it's a natural pressure of just socialization.

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We want to go with the crowd.

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We want to do what everybody else is doing because it's easier that way.

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And the moment you're trying to do something different, you start to put yourself in a

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place of isolation because people don't resonate with what you're doing.

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They don't understand it.

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Sometimes they just have no idea why you're doing what you're doing.

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What do you mean you're not going to spend four days a week seeing patients?

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What are you going to be doing?

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What do you mean you're spending only 25% of your time in clinical care?

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What do you do?

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Are you even working?

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And people don't understand.

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And they don't understand not because they're not considered or kind, it's just because

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they don't have a frame of reference for what you're doing.

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Yeah, they have a general sense of research, but it's like, yeah, but why do you have to

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take time off to do research?

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Why does it have to be your daytime job?

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Why can't you just do it on the side?

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There is pressure to conform.

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And you can make, actually, you can make three choices, but there's really two.

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There are really two choices.

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One choice is to just go with the crowd and just say, you know what, this is what everybody

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else is doing here.

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Let's just go with the flow.

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Or you can say, this is really what I want to do.

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I know it's not something you understand.

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I'm going to do it anyway, even though it's hard.

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The third option, which is not really an option, it's the middle option of lukewarmness or

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like, you know, being sitting on the fence, like, well, you know, I'm not really going

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to do this and I'm not going to really do that.

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I'm just going to stay in the middle.

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And that may be the worst thing that you can do.

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You might as well just go with the flow or go against the flow, but sitting in the middle

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thing, you accomplish nothing.

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So that's why I say it's only really two choices.

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You're either going to go with what you want to do, push towards your goal, or you can

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just capitulate and just do what everybody else is doing.

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But there is social pressure to conform.

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You feel it, you know about it, you've experienced it since you were on the playground in kindergarten,

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and it's real.

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And if you're going to push forward to leading a research program as a clinician, then you

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got to recognize that you're going to face some social pressure and you have to be ready

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to decide what you're going to do, whether you're going to conform or whether you're

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going to push forward into the thing that you know you're supposed to be doing.

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Okay.

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The second thing is that there is a risk of repercussion.

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And it's an interesting thing that we don't think about.

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When I say I want to lead research and I now want research to be my daytime job, it means

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I'm not doing as much clinical care.

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And there are people who feel like they're doing a lot of clinical care and have the

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burden of clinical care on them.

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And then they look around and say, wait a minute, who is this person who says they're

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doing research and they're not fully carrying the brunt of the clinical load with us?

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What's going on?

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And so people don't like that.

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And there is a risk of repercussions.

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There are people who are not going to like you.

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There are people who don't understand and they don't want to understand and they don't

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see why.

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And you have to say you're doing research as part of your daytime job and not like fully

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being on board with all things in the clinical space and vice versa.

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Every time you say, I'm going to do something different, it means you're not doing the thing

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everybody else around you is doing.

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And there are repercussions for that.

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There are people who are not happy about it.

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There are people who'll solitize you sometimes.

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There are people who'll get in your way.

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And it's not personal.

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Just the way of people.

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It's what happens when somebody who's part of a social circle goes a different way.

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There's isolation and there are real repercussions for going in a different direction.

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And so yes, there is a risk of repercussion.

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So what do you do about it?

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Well, one thing you have to recognize is if you want change in your life, it's hard to

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stay around the people who are not executing that change and expect something to be different

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or expect it to be easy.

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It's not going to be easy.

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But one thing you can do is change your environment or change your community.

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If you are surrounded by people who don't support you to succeed in a certain way that

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you want to succeed, then what would happen if you planted yourself in a place where there

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are people who want you to succeed in that way?

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Now it doesn't have to mean moving institutions, at least not right away, but it does mean

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finding a community of like-minded people who want to grow and stretch in exactly that

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direction and who recognize the value of the direction in which you want to grow in.

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For example, I have a weekly peer coaching community that I'm part of.

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And these are faculty from different institutions across the country in different disciplines.

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No one in my group is a medicine, but they all are into research, into publishing, into

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writing grants.

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And so we hold each other accountable every week for moving forward academically or in

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a scholarly way, the way we say we want to.

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We're making the goals.

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And so they hold us accountable to the goals we say we want to achieve.

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And it's a beautiful space.

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It's not the space of my everyday work, but it's a community that I gather with once a

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week that reinforces the choices that I've made.

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Yes, there's isolation from people who are in my immediate circle who don't really understand

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what it is I'm doing.

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But in joining your group of like-minded people, they create a community that helps me grow.

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So there is risk of repercussion, and you've got to be intentional about finding community

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that supports you in the way you need support.

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Number three is the fear of uncertainty, fear of uncertainty.

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So you don't know if it's going to work.

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You're putting in all this effort.

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You're working towards getting all this grant funding.

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You're working towards manuscripts.

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You have no idea that at the end of the day, it's absolutely going to pay off.

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Actually, maybe I'll take a step back and say, you know it's going to pay off.

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You're just not sure exactly how and when.

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And you feel the real pressure of people saying, well, when is this going to work?

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When are you going to get this grant?

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When is this going to happen?

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And you feel the real pressure of time running out on you.

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Like, oh, you have three years to make this work or you're bust.

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And so there's real fear that you're not going to make it, that you're not going to make

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the transition, that you're not going to be funded, that you're not going to get manuscripts

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published.

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There is real fear.

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Because you're going the way that's not tried and tested.

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And it may not even just be in going towards research as a clinician.

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It may even be in the topic of research or the choice of research.

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You're not doing what everybody else is doing.

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You're choosing to blaze a new trail.

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And it might not work.

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And I want to say that fear of uncertainty shouldn't stop you.

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Because yes, it might not work.

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And that is part of the journey, part of the beauty of the journey.

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The thing is, the moment you say, I'm going to change and go in a different direction,

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you've already declared yourself as someone who is willing to innovate and pivot and flex

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and move as needed to accomplish what's needed.

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You've already won.

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Because what you've done is you've chosen a path that makes you a certain kind of person

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that is able to weather storms and be flexible.

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That is the gift that you have for making a choice of going against the grain, of going

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against the stethoscope.

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That's what you have.

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And so yes, it may not work.

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But that is not the thing.

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The thing is that you're the kind of person who can laugh in the face of uncertainty because

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you know that the substrate that's being created can flex in a different direction.

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Yes, the line of research that you've chosen may not work.

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And you're going to be okay because you're going to figure out a new line of research

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that takes the skills you already had in one line of research and makes it work.

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You are that kind of person.

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And so no, you may not know what the future brings.

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But what you're very clear about, what you should be clear about, is the fact that you're

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growing into somebody who can face an uncertain future, face it head on, and succeed.

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That is a skill that is amazing, incredible, and absolutely worth celebrating.

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Number four challenge of going against the grain is that because there is no built-in

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infrastructure for someone like you who's doing something different, there may not be

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resources for you.

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There might not be support.

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You know I will argue that there are always resources.

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The challenge is not the resources because we always talk about limited resources, limited

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resources.

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No, the challenge is not the limitation of the resources.

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The challenge is the limitation of the person who is guarding the resources and whether

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they choose to release resources or not.

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And so we have the challenge not of limited resources, but of people who may not believe

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in the dream enough to release resources.

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Like, I don't even believe in that.

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What is that?

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What is the limit?

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So you may feel a lack of support, and support is important.

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And if people don't want to give it to you, how can you negotiate for it?

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And if you're having difficulty negotiating, where do you go with that support already

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exists?

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Where do you go with the resources already are?

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And so maybe in your clinical space, people are not very supportive of clinicians doing

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research.

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They need more support for clinicians doing clinical work.

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Where at your institution are there people who are doing the kind of research you want

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to do?

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They may not be in the clinical space.

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They may not be in the clinical space, but they're already doing the research.

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They're already advancing the work, and that's a space that you should go explore.

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In that space, there are resources to do research because people are already doing it.

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And if they're doing it, it means that there's infrastructure that supports them in some

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way.

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And it may be that they created the infrastructure, but the key is that it exists.

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Wherever you see people succeeding, there is an infrastructure of support to help them

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succeed.

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And if you can't access support in your own immediate neighborhood, where can you go to

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find the support that you need?

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Maybe it's that you attend workshops at other institutions across the country.

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Now we're in the day where there's so many virtual opportunities, so you don't have to

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feel stuck.

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But there may not be support, and yet, and yet, you still have the opportunity to find

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a space where you can be supported.

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Number five is that you may experience resistance.

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I laugh because isn't that what I've been talking about the whole time, resistance?

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Well, the kind of resistance I'm talking about specifically right now is resistance from

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those who should support you.

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For example, maybe it's your division leadership.

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Maybe it's your department leadership.

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Maybe it's your dean.

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And they're like, what is this?

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I mean, they say they support you, but then they don't give you the resources that support

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you.

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So to some extent, you feel the resistance, or they say they support you, and then you

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feel as if they might be undermining you.

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You feel the resistance, and if you feel resistance, it's real.

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I just want to just acknowledge that the resistance you feel is real.

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Because the challenge is sometimes we don't acknowledge that it's real, and then we're

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spending so much time in two minds trying to say, well, are they resisting me, or am

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I just imagining it?

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I just want to say, just throw it out.

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Just say, it is a real resistance.

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You're not imagining it, and move forward.

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What does that help you do?

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It helps you take away all the time that you're investing in spending that energy trying to

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figure out whether you're making it up or not.

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There's this term called gaslighting that I think is apt, where I want to say when people

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are gaslighting you, sometimes it's not personal.

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And sometimes they're not trying necessarily to deny your reality.

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It's that they have no clarity about your reality.

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For example, someone who wants you to succeed as a researcher, they came from an era 30

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years ago where there was a lot of support, and they forget what it's like right now for

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the person who's starting out with a very busy clinical load and little support and

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not having the infrastructure to do research.

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They forget.

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And so when you say, wait, I'm not supported to do this, they're like, what do you mean?

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What are you talking about?

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There's all this support.

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There's all this funding, but you're not seeing it.

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So there is resistance and sometimes from spaces in which you hoped that there would

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be support.

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And so I want you to acknowledge that there's a resistance and then build a plan, build

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a plan to move forward despite the resistance.

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Oh, wouldn't it be lovely if everybody came on board and they wanted to support you so

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much and everybody was lined up just to support you.

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It would be so beautiful.

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And it's not that way.

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You still have to move forward.

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And here's the thing about resistance.

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It builds muscle.

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It builds character.

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It helps you grow in ways that you can't even imagine.

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So I encourage you to not let the resistance stop you, but to recognize that it's a sign.

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It's a sign that you're going in the right direction, in the direction you need to go

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in because you're swimming against the current when you can feel the resistance of the current

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to your motion.

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Number six is mindset.

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And the fact that it's hard for your mindset to change.

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So the challenge is not the mindset of the people around you.

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That's not the problem.

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You can't control that.

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So it's not the problem.

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Anything you can't control is not the problem.

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The thing you can control is your problem and you should focus on it.

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And that's your mindset.

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Okay.

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So other people may not believe this is what you should do, but other people are not the

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ones who are going to make the effort to make it possible.

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You are.

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And so what do you need to do to make your experience different?

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What do you need to do to succeed in the way you want to?

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That is a choice you have to make.

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These are decisions you have to make.

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Nobody can make them for you.

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People can say, we're not going to support you.

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We don't believe in what you're doing, but how do you support yourself?

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Even when it's hard, even when you feel the resistance, even when you feel isolated, even

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when it feels like everything is against you, how do you move forward?

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And it really takes you having the right mindset that's geared towards succeeding in the thing

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that you want to succeed in because you've chosen it.

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I want to succeed as a researcher.

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I do.

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And it's hard and I'm still going to do what it takes.

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And it's really you growing and being resilient and recognizing that your dream is worth fighting

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for.

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Yeah, it takes building community.

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It takes reading.

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It takes studying.

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It takes acquiring knowledge that helps you do what you want to do.

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But it's really you exercising your power to believe, I know I can do this.

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So then I go forth and I do it.

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And so it's your mindset that's the most challenging that you have to overcome.

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You've also come from the background of really being mostly a clinician full time.

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Now you're saying you want to lead a research program?

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Okay.

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Are you willing to think differently about what it means to now be a scientist leading

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a research program?

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Are you willing to change your habits?

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Are you willing to think about doing things differently?

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Are you willing to make the mindset change necessary to achieve the goal that you say

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you want to achieve?

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And finally, number seven is that there is the potential for failure.

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Success is not guaranteed.

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But here's the thing about success.

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It depends on how you define it.

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I say that the success of working to lead a research program is a success of changing

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who you are.

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It's a success of expanding your belief system.

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It's a success of reaching for something you've not done before.

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00:23:40,060 --> 00:23:45,020
Sometimes people count success as number of publications, number of grants funded, and

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00:23:45,020 --> 00:23:49,660
yeah, that's one set of metrics or different sets of metrics.

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00:23:49,660 --> 00:23:52,260
But the real journey at the end is you.

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00:23:52,260 --> 00:23:58,140
I mean, the real gift is the journey and the gift at the end of the journey is you.

404
00:23:58,140 --> 00:23:59,140
Who will you become?

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00:23:59,140 --> 00:24:04,700
It's the person you have to become to be the kind of person who proposes big audacious

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00:24:04,700 --> 00:24:08,700
things and asks people to put their money down and fund it.

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That is the gift.

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00:24:10,740 --> 00:24:14,780
The gift of someone who looks at the literature and says, this is a gap and I'm going to fill

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00:24:14,780 --> 00:24:15,780
it.

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00:24:15,780 --> 00:24:17,300
That is your gift.

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The gift of someone who says, this is a challenging problem and I'm going to tackle it.

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That is the gift.

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00:24:23,780 --> 00:24:30,420
The gift of courage, the gift of perseverance, the gift of tenaciousness, because it doesn't

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just help you in your life as a research scientist, in your life as a clinician researcher.

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00:24:37,980 --> 00:24:45,180
It helps you in all of life because it takes boldness and courage to live life well and

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to live life to the fullest.

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00:24:47,860 --> 00:24:49,900
So yeah, there's a chance of failure.

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You may not make the number of grants you need to make.

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00:24:52,260 --> 00:24:56,820
You may not be able to cover that effort for a period of time.

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00:24:56,820 --> 00:25:03,460
That's not true failure unless you quit and then you lock it in.

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00:25:03,460 --> 00:25:10,620
But the more you keep moving forward, the more success is guaranteed, especially because

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00:25:10,620 --> 00:25:12,940
success is not a number of publications.

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00:25:12,940 --> 00:25:14,180
It's not a number of grants.

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00:25:14,180 --> 00:25:17,540
It's not dollars funded.

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00:25:17,540 --> 00:25:24,060
Success is the you you become in the process of pushing forward to an impossible.

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I want to invite you to go against the grain today.

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I do.

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Think about it.

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00:25:28,580 --> 00:25:33,260
This week, as you go forward, what are you going to do that's going to push against the

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00:25:33,260 --> 00:25:36,260
status quo?

431
00:25:36,260 --> 00:25:42,340
And what will it take for you to stand firm in pushing against the status quo?

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00:25:42,340 --> 00:25:43,340
What do you need?

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00:25:43,340 --> 00:25:46,460
I want you to think about that.

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00:25:46,460 --> 00:25:50,740
I want you to take a step, take a step against the grain this week.

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00:25:50,740 --> 00:25:56,340
Take a step against the grain towards your dream, towards your goal, because it absolutely

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00:25:56,340 --> 00:25:57,340
is worth it.

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00:25:57,340 --> 00:25:59,740
So I'm going to recap those seven things.

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00:25:59,740 --> 00:26:04,420
If you choose to go against the grain, you're going to experience social pressure to conform.

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00:26:04,420 --> 00:26:07,340
You are probably going to experience repercussions.

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00:26:07,340 --> 00:26:08,980
There's the risk of that.

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00:26:08,980 --> 00:26:10,740
You'll experience fear of uncertainty.

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00:26:10,740 --> 00:26:13,300
You may not get the resources you want.

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00:26:13,300 --> 00:26:17,860
You may get resistance from those who are around you, the stakeholders and the status

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00:26:17,860 --> 00:26:19,140
quo.

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00:26:19,140 --> 00:26:24,420
You may struggle with your own ingrained mindset that you need to overcome.

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00:26:24,420 --> 00:26:30,980
And there is the potential for failing as people define failure, but it absolutely is

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00:26:30,980 --> 00:26:37,740
worth it because your dream and your desire to succeed absolutely is worth it.

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00:26:37,740 --> 00:26:39,580
It has been a pleasure talking with you today.

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00:26:39,580 --> 00:26:43,660
I invite you to share this episode with somebody else who needs to hear it.

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00:26:43,660 --> 00:26:45,460
Thank you so much for tuning in.

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00:26:45,460 --> 00:26:50,260
I look forward to speaking with you again next time on the Clinician Researcher podcast.

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00:26:50,260 --> 00:26:51,260
Thank you for tuning in.

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00:26:51,260 --> 00:27:03,500
Thanks for listening to this episode of the Clinician Researcher podcast, where academic

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00:27:03,500 --> 00:27:08,860
clinicians learn the skills to build their own research program, whether or not they

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00:27:08,860 --> 00:27:10,300
have a mentor.

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00:27:10,300 --> 00:27:16,420
If you found the information in this episode to be helpful, don't keep it all to yourself.

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00:27:16,420 --> 00:27:18,140
Someone else needs to hear it.

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00:27:18,140 --> 00:27:22,200
So take a minute right now and share it.

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00:27:22,200 --> 00:27:27,660
As you share this episode, you become part of our mission to help launch a new generation

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00:27:27,660 --> 00:27:48,700
of clinician researchers who make transformative discoveries that change the way we do healthcare.