Journey to research excellence with Dr. Julia Xu

1
00:00:00,000 --> 00:00:05,860
Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

2
00:00:05,860 --> 00:00:11,260
to build their own research program, whether or not they have a mentor.

3
00:00:11,260 --> 00:00:17,340
As clinicians, we spend a decade or more as trainees learning to take care of patients.

4
00:00:17,340 --> 00:00:22,380
When we finally start our careers, we want to build research programs, but then we find

5
00:00:22,380 --> 00:00:27,780
that our years of clinical training did not adequately prepare us to lead our research

6
00:00:27,780 --> 00:00:29,200
program.

7
00:00:29,200 --> 00:00:35,480
Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

8
00:00:35,480 --> 00:00:40,580
However, clinicians hold the keys to the greatest research breakthroughs.

9
00:00:40,580 --> 00:00:46,200
For this reason, the Clinician Researcher podcast exists to give academic clinicians

10
00:00:46,200 --> 00:00:51,800
the tools to build their own research program, whether or not they have a mentor.

11
00:00:51,800 --> 00:01:01,080
Now introducing your host, Toyosi Onwuemene.

12
00:01:01,080 --> 00:01:04,720
Hello everyone, and welcome to the Clinician Researcher podcast.

13
00:01:04,720 --> 00:01:09,160
I'm your host, Toyosi Onwuemene, and it's such a pleasure to be here with you today.

14
00:01:09,160 --> 00:01:13,000
I'm extremely excited about today's episode because we have a really thoughtful guest,

15
00:01:13,000 --> 00:01:18,280
Julia Xu, who is going to introduce herself shortly, but she's an outstanding clinician

16
00:01:18,280 --> 00:01:24,000
researcher who's really making waves in the field, and I want you to meet her.

17
00:01:24,000 --> 00:01:29,640
So without further ado, I'm going to say, Julia, welcome to the show.

18
00:01:29,640 --> 00:01:31,200
Thank you so much for having me.

19
00:01:31,200 --> 00:01:33,560
I'm really happy to be on the show.

20
00:01:33,560 --> 00:01:38,280
And just by way of introduction, I guess I'll just briefly say that I am currently an assistant

21
00:01:38,280 --> 00:01:44,240
professor at University of Pittsburgh in the Department of Medicine, Division of Hematology

22
00:01:44,240 --> 00:01:52,080
Oncology and Section of Benign Hematology, I see patients with benign hematological conditions,

23
00:01:52,080 --> 00:01:57,960
but mostly focusing on sickle cell disease and other hemoglobin disorders, and I'm adult

24
00:01:57,960 --> 00:02:01,360
internal medicine and global health trained as well.

25
00:02:01,360 --> 00:02:07,240
And then I also do clinical research, have a couple of clinical trials ongoing, and also

26
00:02:07,240 --> 00:02:08,820
have a small lab.

27
00:02:08,820 --> 00:02:13,560
So I think that's why I'm here to talk about both the clinical and the research portion

28
00:02:13,560 --> 00:02:14,560
of careers.

29
00:02:14,560 --> 00:02:15,560
Thank you, Julia.

30
00:02:15,560 --> 00:02:16,560
That's an awesome introduction.

31
00:02:16,560 --> 00:02:26,200
I chuckled when you said you have a small lab, because I feel like it, you know, I think

32
00:02:26,200 --> 00:02:27,200
it's important.

33
00:02:27,200 --> 00:02:30,560
I'm going to ask you to tell us how many years out you are from your fellowship, so how many

34
00:02:30,560 --> 00:02:35,760
years you are into this junior faculty career, and then ask you about, like, at what point

35
00:02:35,760 --> 00:02:39,440
did you decide, hey, I'm a clinician scientist, I'm a clinician researcher.

36
00:02:39,440 --> 00:02:44,120
At what point did you feel like you owned the position?

37
00:02:44,120 --> 00:02:49,940
Because you're a little early in your career, I feel, and have accomplished so much that

38
00:02:49,940 --> 00:02:53,660
I wonder if you can speak to that.

39
00:02:53,660 --> 00:02:57,280
Of course, and thank you, very kind words.

40
00:02:57,280 --> 00:03:03,600
So I am about a year and a half out from fellowship.

41
00:03:03,600 --> 00:03:11,120
So I did my hematology only fellowship at the National Institutes of Health at the NIH.

42
00:03:11,120 --> 00:03:18,760
I did a one year hematology fellowship followed by a couple of years of research, and then

43
00:03:18,760 --> 00:03:24,240
during my transition period stayed on a little bit longer to finish some research transition

44
00:03:24,240 --> 00:03:29,800
to University of Pittsburgh in October of 2021.

45
00:03:29,800 --> 00:03:36,560
And so I'm kind of in my second year of the faculty position and getting settled in, you

46
00:03:36,560 --> 00:03:41,160
know, getting studies off the ground, getting the lab finally set up.

47
00:03:41,160 --> 00:03:46,200
And so you're right, I am pretty early in my research career still.

48
00:03:46,200 --> 00:03:56,240
I would say I, gosh, owning is a hard concept, because sometimes I feel like I still don't

49
00:03:56,240 --> 00:03:57,240
own that identity.

50
00:03:57,240 --> 00:04:04,560
You know, there's always a lot of imposter syndrome and second guessing yourself in this

51
00:04:04,560 --> 00:04:06,720
career track.

52
00:04:06,720 --> 00:04:16,040
But I think I felt like a physician researcher when I was in residency at first, because

53
00:04:16,040 --> 00:04:22,340
I did a global health fellowship where I had a year to conduct independent research internationally

54
00:04:22,340 --> 00:04:24,180
in Thailand.

55
00:04:24,180 --> 00:04:31,640
And I think that that was kind of the first time that I was the PI of a project and I

56
00:04:31,640 --> 00:04:37,440
was, you know, managing an international grant and collaboration and, you know, could really

57
00:04:37,440 --> 00:04:44,080
say like, okay, I have taken charge of this research project and it is on me whether it

58
00:04:44,080 --> 00:04:45,680
was or dies.

59
00:04:45,680 --> 00:04:51,920
And then during my fellowship training, had the opportunity to lead a couple of early

60
00:04:51,920 --> 00:04:59,360
phase clinical trials and that really cemented my, I guess, confidence that I was able to

61
00:04:59,360 --> 00:05:07,000
assume more of a leadership position rather than someone who was carrying out research

62
00:05:07,000 --> 00:05:09,120
on behalf of a mentor.

63
00:05:09,120 --> 00:05:15,360
And so I think those experiences were probably the most formative, even though all of the

64
00:05:15,360 --> 00:05:20,420
research experiences I had up to that point had really built upon each other and kind

65
00:05:20,420 --> 00:05:25,200
of gave me a little bit more confidence step by step.

66
00:05:25,200 --> 00:05:27,560
Thank you for sharing that piece of your story.

67
00:05:27,560 --> 00:05:32,640
You know, it's funny, every time I hear your story, I think, wow, what an accomplished

68
00:05:32,640 --> 00:05:33,640
person.

69
00:05:33,640 --> 00:05:36,680
You've been doing so much for so long.

70
00:05:36,680 --> 00:05:41,880
It's interesting, you know, you talk about you leading a research program as a resident.

71
00:05:41,880 --> 00:05:42,880
Okay.

72
00:05:42,880 --> 00:05:47,000
So I'm going to pause and just say that most of the time that doesn't happen, right?

73
00:05:47,000 --> 00:05:51,280
Many clinicians going through training are participating in programs.

74
00:05:51,280 --> 00:05:55,400
They're not leading and you are not just leading in programs, you're leading a research program

75
00:05:55,400 --> 00:06:00,520
internationally and managing collaborations, which is such a great experience for you to

76
00:06:00,520 --> 00:06:01,520
have.

77
00:06:01,520 --> 00:06:07,600
I think many, many times there isn't really in our training and our clinical training,

78
00:06:07,600 --> 00:06:11,560
especially we have a little bit of research here and there, but opportunities to actually

79
00:06:11,560 --> 00:06:16,600
be in leadership of research don't necessarily happen commonly.

80
00:06:16,600 --> 00:06:22,000
So I do want to pause there and ask, what was the set of circumstances in your life

81
00:06:22,000 --> 00:06:26,040
that allowed you as a resident to lead this research program?

82
00:06:26,040 --> 00:06:27,840
How did that come to be?

83
00:06:27,840 --> 00:06:31,240
Yeah, I know that's a really good point.

84
00:06:31,240 --> 00:06:35,600
And I feel lucky in so many ways to have been put on this trajectory early.

85
00:06:35,600 --> 00:06:40,800
I think at the end of the day, you know, if you want to do research, I think getting into

86
00:06:40,800 --> 00:06:44,360
it early really lets you reap the rewards afterwards.

87
00:06:44,360 --> 00:06:49,400
And every little success begins further success in the academic career track.

88
00:06:49,400 --> 00:06:56,800
So I started off doing lab-based research in college, got a master's degree with a program.

89
00:06:56,800 --> 00:07:01,040
I was at University of Pennsylvania and there's a program called Vagilist Scholars Program,

90
00:07:01,040 --> 00:07:03,240
which allows you to sub-matriculate.

91
00:07:03,240 --> 00:07:10,640
And so it paid for two summers of full-time summer research and time during the year to

92
00:07:10,640 --> 00:07:14,120
work on your research and master's project.

93
00:07:14,120 --> 00:07:20,500
And so that gave me lab experience, you know, got me on my first co-author publication,

94
00:07:20,500 --> 00:07:24,760
but also made me realize that I didn't want to be just a basic scientist.

95
00:07:24,760 --> 00:07:28,000
I think I really missed the clinical side of things.

96
00:07:28,000 --> 00:07:30,920
I really liked translating discoveries.

97
00:07:30,920 --> 00:07:36,440
And even though I was fascinated by the lab work, I just didn't see myself as the PI of

98
00:07:36,440 --> 00:07:38,480
a large lab.

99
00:07:38,480 --> 00:07:44,280
And so I actually kind of used that experience to decide to go into medical school.

100
00:07:44,280 --> 00:07:48,720
And then during medical school, you know, I had some research experiences here and there.

101
00:07:48,720 --> 00:07:56,040
Like after my first year of med school, I went to Peru where I did some HIV research,

102
00:07:56,040 --> 00:07:58,120
but it didn't really pan out.

103
00:07:58,120 --> 00:08:02,200
You know, nothing came of the project and I ended up spending most of the time shadowing

104
00:08:02,200 --> 00:08:04,520
and exploring Peru, of course.

105
00:08:04,520 --> 00:08:09,880
And then, you know, I was really fascinated by the idea of global health and I love Spanish.

106
00:08:09,880 --> 00:08:15,400
It was kind of my, it was one of my majors in college and just a real passion.

107
00:08:15,400 --> 00:08:22,640
And so I sought to do more work in Latin America and I stumbled upon this wonderful opportunity

108
00:08:22,640 --> 00:08:26,120
to work with an amazing team of mentors.

109
00:08:26,120 --> 00:08:28,200
So I was in Steve's Vitality Lab.

110
00:08:28,200 --> 00:08:33,880
He's a transfusion medicine professor and he, you know, was a phenomenal mentor, got

111
00:08:33,880 --> 00:08:36,800
me interested in G6PD deficiency.

112
00:08:36,800 --> 00:08:42,800
I was kind of leaning towards hematology at the time, but, you know, hadn't decided on

113
00:08:42,800 --> 00:08:46,480
benign hematology, malignant hematology, you know, oncology.

114
00:08:46,480 --> 00:08:50,200
But, you know, got me really interested in hemoglobin disorders.

115
00:08:50,200 --> 00:08:54,480
I think it started my interest in sickle cell there as well.

116
00:08:54,480 --> 00:09:00,280
And then I had an opportunity to design this project as a, it was supposed to be a three

117
00:09:00,280 --> 00:09:04,240
month scholarly project, but the more we talked about it, the more we realized if I'm going

118
00:09:04,240 --> 00:09:09,160
to go, and this was in collaboration with a HIV clinic in the Dominican Republic.

119
00:09:09,160 --> 00:09:14,360
So it's like, if I'm going to go to the Dominican Republic and I only have three months to get

120
00:09:14,360 --> 00:09:18,800
a project off the ground, you know, best case scenario, I start it and then it never gets

121
00:09:18,800 --> 00:09:20,080
finished.

122
00:09:20,080 --> 00:09:25,960
And so after thinking about it a little more, I decided to apply for a Doris Duke Charitable

123
00:09:25,960 --> 00:09:33,200
Foundation Award for medical students to have a year of protected time doing research.

124
00:09:33,200 --> 00:09:40,060
So I used the scholarly project period to write my IRB, and then I spent that next year

125
00:09:40,060 --> 00:09:46,160
between third and fourth year of medical school going back and forth between the DR and New

126
00:09:46,160 --> 00:09:53,480
York implementing this project of G6PD deficiency screening and trying to identify risk factors

127
00:09:53,480 --> 00:09:59,680
that you can use in a low cost algorithm and resource poor settings to screen patients

128
00:09:59,680 --> 00:10:02,160
with G6PD deficiency.

129
00:10:02,160 --> 00:10:04,840
And it was a tremendous experience.

130
00:10:04,840 --> 00:10:10,200
You know, I loved, even though it was a mentored project, but I was the one on the ground kind

131
00:10:10,200 --> 00:10:12,360
of implementing the study, right?

132
00:10:12,360 --> 00:10:17,300
So in a way I got my first taste of leadership and, you know, the trials and tribulations

133
00:10:17,300 --> 00:10:24,200
of trying to see a project through identifying and overcoming barriers, getting people excited

134
00:10:24,200 --> 00:10:26,560
and engaged in the science.

135
00:10:26,560 --> 00:10:32,000
I had to figure out how to do all of that in Spanish, which was such a cool experience.

136
00:10:32,000 --> 00:10:39,560
And so that gave me my first taste of like, kind of leading a research project on the

137
00:10:39,560 --> 00:10:41,840
ground.

138
00:10:41,840 --> 00:10:46,720
And then when I came to Duke, you know, one of the reasons that I chose Duke was that

139
00:10:46,720 --> 00:10:54,320
there's this internal medicine global health residency program that's combined basically

140
00:10:54,320 --> 00:11:01,640
four years where you do your residency, but then you also do a master's in global health.

141
00:11:01,640 --> 00:11:07,120
And then you have a year on the ground where you're implementing your own projects and

142
00:11:07,120 --> 00:11:09,760
usually apply for some sort of grant.

143
00:11:09,760 --> 00:11:13,960
Like I applied for a Fogarty International Center fellowship.

144
00:11:13,960 --> 00:11:20,800
And so that gave me the opportunity not only to do research locally, you know, Marilyn

145
00:11:20,800 --> 00:11:22,160
Tellen, I love her.

146
00:11:22,160 --> 00:11:24,040
She's an incredible mentor.

147
00:11:24,040 --> 00:11:27,540
So she was my main mentor at Duke in sickle cell.

148
00:11:27,540 --> 00:11:32,440
And I kind of sought out working with her specifically in sickle cell.

149
00:11:32,440 --> 00:11:38,080
We did a really great database project together that, you know, she gave me a lot of independence

150
00:11:38,080 --> 00:11:41,680
to kind of help lead and direct as well.

151
00:11:41,680 --> 00:11:47,840
And then she supported me when I went abroad to do a project on balacemia.

152
00:11:47,840 --> 00:11:54,760
And I think in this situation, I was looking for something in sickle cell and global health,

153
00:11:54,760 --> 00:11:57,760
and there was just not the right project that fit.

154
00:11:57,760 --> 00:12:05,440
And so I ended up deciding to make the pivot to study something related, you know, hemoglobin

155
00:12:05,440 --> 00:12:12,360
disorders, but in kind of a different area of expertise in order to get the knowledge

156
00:12:12,360 --> 00:12:16,760
and training and experience of leading an independent study.

157
00:12:16,760 --> 00:12:23,600
And so I think that was one of my better decisions in life to, you know, not just stick with

158
00:12:23,600 --> 00:12:28,840
exactly my topic area, but to pursue something that gave me the skills I needed to then move

159
00:12:28,840 --> 00:12:30,200
on to the next step.

160
00:12:30,200 --> 00:12:32,280
And I think that was really helpful.

161
00:12:32,280 --> 00:12:37,840
When I then transitioned to fellowship, it could say, hey, I've led a couple of studies

162
00:12:37,840 --> 00:12:38,840
already.

163
00:12:38,840 --> 00:12:45,480
I know how to assemble a research team, how to oversee coordinators and interpreters,

164
00:12:45,480 --> 00:12:52,120
et cetera, and further extended my skill set by helping to run this clinical trial at the

165
00:12:52,120 --> 00:12:53,120
NIH.

166
00:12:53,120 --> 00:12:58,120
So a lot of baby steps along the way and a lot of lessons learned, I think.

167
00:12:58,120 --> 00:13:05,200
And I think at every step, I look for the opportunity that most gave me independence

168
00:13:05,200 --> 00:13:08,760
and the skill sets that I thought were useful for the future.

169
00:13:08,760 --> 00:13:11,160
That's super awesome.

170
00:13:11,160 --> 00:13:13,400
Thank you for sharing your story.

171
00:13:13,400 --> 00:13:18,920
And I see there, you know, you talk about, actually, you use the word luck at some point

172
00:13:18,920 --> 00:13:21,440
and you also talk about opportunity.

173
00:13:21,440 --> 00:13:26,240
But I do see you as someone who was always prepared to take on opportunities when they

174
00:13:26,240 --> 00:13:27,240
came.

175
00:13:27,240 --> 00:13:29,560
And I think you also talk about luck meets preparation.

176
00:13:29,560 --> 00:13:34,960
I feel like that's just such a great piece of your story where you've always had a great

177
00:13:34,960 --> 00:13:38,640
sense of what you want and you've always gone after it.

178
00:13:38,640 --> 00:13:42,800
And yes, you've had opportunities where you've had mentors who have allowed you to lead projects,

179
00:13:42,800 --> 00:13:48,360
but you really have seen yourself as a leader from the beginning and you've taken, you've

180
00:13:48,360 --> 00:13:52,760
pursued opportunities and you've also been prepared to take them and lead them as they

181
00:13:52,760 --> 00:13:55,160
come up, which I think is so incredible.

182
00:13:55,160 --> 00:13:59,880
I think so many people want to be there, you know, five years into faculty or 10 years

183
00:13:59,880 --> 00:14:03,640
into faculty, but you really started doing that super early.

184
00:14:03,640 --> 00:14:07,720
And I just want to say kudos to you for doing that.

185
00:14:07,720 --> 00:14:12,960
You know, I want to ask, is there, is there, because one of the things that I think you

186
00:14:12,960 --> 00:14:19,040
mentioned earlier is that if you are interested in the teachers start early and you have the

187
00:14:19,040 --> 00:14:23,320
opportunity to do that, I just wonder what was the earliest experience that made you

188
00:14:23,320 --> 00:14:27,080
decide I want to try this thing as a researcher, right?

189
00:14:27,080 --> 00:14:31,960
It just, I wonder what was the earliest experience that led you down this pathway?

190
00:14:31,960 --> 00:14:39,800
Yeah, I think the earliest experience was probably the project on G6PD inefficiency

191
00:14:39,800 --> 00:14:46,760
during medical school, you know, having the chance to really troubleshoot your own study.

192
00:14:46,760 --> 00:14:54,360
Like it's, it is frustrating to no end and also the biggest sense of accomplishment you

193
00:14:54,360 --> 00:15:01,000
can feel, you know, at the end of the year, realizing like, wow, I just overcome, you

194
00:15:01,000 --> 00:15:06,960
know, overcame so many hurdles and enrolled like 250 patients in this, you know, survey

195
00:15:06,960 --> 00:15:08,280
and genotype study.

196
00:15:08,280 --> 00:15:11,920
And I got all this data and a publication out of it.

197
00:15:11,920 --> 00:15:14,840
It's really exciting to be able to do that.

198
00:15:14,840 --> 00:15:21,080
I agree, I do think you have to be in the mindset of taking opportunities as they come

199
00:15:21,080 --> 00:15:28,200
along, being flexible, you know, things in research never go the way you imagine.

200
00:15:28,200 --> 00:15:34,160
So you just adapt and roll with the punches and you just have to persevere because I think

201
00:15:34,160 --> 00:15:42,720
if you, if you're waiting for someone to map out exactly how to do a research project and

202
00:15:42,720 --> 00:15:47,240
you know, help you along every time you face a hurdle, you'll just never get anywhere because

203
00:15:47,240 --> 00:15:49,600
everyone's busy with their own stuff.

204
00:15:49,600 --> 00:15:55,920
And so if you want to lead you, you really have to kind of take the ownership of, you

205
00:15:55,920 --> 00:16:02,000
know, whatever issues come up and just be tenacious and, you know, keep pushing regardless

206
00:16:02,000 --> 00:16:04,960
of how desperate the situation seems.

207
00:16:04,960 --> 00:16:10,000
And it's definitely seemed very desperate at times for me, but you know, in the end,

208
00:16:10,000 --> 00:16:12,120
it always seems to work out.

209
00:16:12,120 --> 00:16:17,800
So I think that was probably, you know, my first lesson in like what it truly means to

210
00:16:17,800 --> 00:16:22,160
engage in research and especially global health research, which comes with its own set of

211
00:16:22,160 --> 00:16:23,800
challenges.

212
00:16:23,800 --> 00:16:31,960
And then I think what convinced me to be like, to truly pursue the academic path and be a

213
00:16:31,960 --> 00:16:38,480
physician researcher or, you know, a physician scientist was my experience leading clinical

214
00:16:38,480 --> 00:16:44,000
trials at the NIH because I think that's when you get a real feel for like, okay, this is

215
00:16:44,000 --> 00:16:46,120
not a fellowship project.

216
00:16:46,120 --> 00:16:53,120
I'm not ticking off a box like this is real research that's going to impact patient care.

217
00:16:53,120 --> 00:16:58,400
And I can see how to, you know, move this forward into additional lines of research.

218
00:16:58,400 --> 00:17:04,120
And I think that's really exciting and starting to generate your own ideas about what you

219
00:17:04,120 --> 00:17:06,400
want to accomplish in the field.

220
00:17:06,400 --> 00:17:08,520
I love it.

221
00:17:08,520 --> 00:17:14,360
And you know, for those of you who are listening, Julia is smiling as she's talking about all

222
00:17:14,360 --> 00:17:17,020
these challenges that she's going through.

223
00:17:17,020 --> 00:17:22,320
And Julia, it makes me think, you know, sometimes it's not even about the end result.

224
00:17:22,320 --> 00:17:27,200
Oh, you accrued to an inoculation, so the study and you were able to get a publication.

225
00:17:27,200 --> 00:17:29,160
I mean, it's great that you have that.

226
00:17:29,160 --> 00:17:32,920
And that's the tangible piece that lets people know that she did something.

227
00:17:32,920 --> 00:17:37,320
But you know, as you're smiling, it makes me think that it's who you have to become

228
00:17:37,320 --> 00:17:38,520
to pull that off.

229
00:17:38,520 --> 00:17:43,440
That is so rewarding because the Julia that started the, you know, that started the project

230
00:17:43,440 --> 00:17:46,600
and the Julia that ended the project were two different Julias.

231
00:17:46,600 --> 00:17:52,000
It was a Julia who had pushed through obstacles, who had stayed tenacious and requested what

232
00:17:52,000 --> 00:17:54,680
she wanted and firmly pushed things forward.

233
00:17:54,680 --> 00:17:59,960
I mean, you were just, it was just the transformation that happened inside you that allowed you to

234
00:17:59,960 --> 00:18:03,080
that is your reward, your personal reward.

235
00:18:03,080 --> 00:18:07,840
Like the paper is great, but there's a personal reward and the reward in the transformation

236
00:18:07,840 --> 00:18:11,000
that happens that allows you at the end of that to say, well, what's next?

237
00:18:11,000 --> 00:18:12,560
What else can I do?

238
00:18:12,560 --> 00:18:17,760
And I see that in your story, there's almost like a sense of a graduated responsibility,

239
00:18:17,760 --> 00:18:20,760
so to speak, like a graduated, okay, I've done this project.

240
00:18:20,760 --> 00:18:22,360
Now I'm moving to the next project.

241
00:18:22,360 --> 00:18:24,900
And now I'm moving into this dynamic of it.

242
00:18:24,900 --> 00:18:28,120
Now I'm leading a clinical trial as a fellow.

243
00:18:28,120 --> 00:18:32,760
Many fellows don't do that, but you've had all these building blocks along the way that

244
00:18:32,760 --> 00:18:36,040
have allowed you to move forward into the next challenge and the next challenge and

245
00:18:36,040 --> 00:18:37,320
the next challenge after that.

246
00:18:37,320 --> 00:18:40,040
And I'm wondering how that lands for you.

247
00:18:40,040 --> 00:18:42,960
No, I completely agree with you.

248
00:18:42,960 --> 00:18:48,480
I mean, I think to jump, I think, you know, for instance, it's really intimidating to

249
00:18:48,480 --> 00:18:54,680
become junior faculty all of a sudden and not have been, you know, led your own studies

250
00:18:54,680 --> 00:18:59,280
previously and now suddenly all of the onus is on you, right?

251
00:18:59,280 --> 00:19:05,680
Like it's, it's one of those challenges and I still face it today, but I think I'm much

252
00:19:05,680 --> 00:19:10,200
more prepared because I had had those previous building blocks before.

253
00:19:10,200 --> 00:19:14,960
And I think I can say that for each step of my training, like I would not have been comfortable

254
00:19:14,960 --> 00:19:22,200
leading an international, you know, collaboration as a resident if I had not already gone through

255
00:19:22,200 --> 00:19:28,680
the many challenges of running an international study as a medical student.

256
00:19:28,680 --> 00:19:34,720
And you know, maybe I wouldn't have been as prepared for working in a different culture

257
00:19:34,720 --> 00:19:40,160
and you know, a different environment that I had to adapt to if I hadn't had the experience

258
00:19:40,160 --> 00:19:46,320
of trying to navigate and negotiate the culture in Peru, even, you know, when I didn't have

259
00:19:46,320 --> 00:19:51,080
a successful research project, but I still had to learn how to conduct myself in a new

260
00:19:51,080 --> 00:19:53,480
culture with new colleagues.

261
00:19:53,480 --> 00:19:57,880
And so I think every experience definitely helps you grow as a person.

262
00:19:57,880 --> 00:20:03,640
And it also just gives you confidence, you know, for yourself, but also when you're talking

263
00:20:03,640 --> 00:20:10,080
to other people, because for instance, I think, you know, mentors are also looking for individuals

264
00:20:10,080 --> 00:20:15,840
who are competent and inspired and, you know, really dedicated.

265
00:20:15,840 --> 00:20:20,760
And if you can show that through your previous work, you get more people interested in you

266
00:20:20,760 --> 00:20:25,320
and they're more willing to invest, they're more willing to trust and give you independence

267
00:20:25,320 --> 00:20:28,280
to kind of let you go on to the next step.

268
00:20:28,280 --> 00:20:33,320
Because if you've never shown initiative, they might not feel comfortable saying like,

269
00:20:33,320 --> 00:20:36,880
okay, why don't you take the initiative on this next project?

270
00:20:36,880 --> 00:20:42,480
So I think it really helps, you know, both ways kind of internally and then also in your

271
00:20:42,480 --> 00:20:48,200
interactions to be able to say like, yeah, I am ready for the next thing now.

272
00:20:48,200 --> 00:20:49,200
I love it.

273
00:20:49,200 --> 00:20:53,400
I love how you kind of highlight the fact that all along you were building a portfolio

274
00:20:53,400 --> 00:20:56,600
and you're like, this is, I can do this because I have done it.

275
00:20:56,600 --> 00:20:59,320
I've done it in this phase, I've done it in this place.

276
00:20:59,320 --> 00:21:00,920
And now I'm ready for the next step.

277
00:21:00,920 --> 00:21:04,080
I'm ready to be a leader of my own research program.

278
00:21:04,080 --> 00:21:09,120
And that leads me to think about how you really did as you were transitioning from fellows

279
00:21:09,120 --> 00:21:15,480
to faculty, you did need to negotiate resources to allow you to succeed in your career.

280
00:21:15,480 --> 00:21:20,600
And I wonder if you don't mind just sharing with us some of the thoughts that went into

281
00:21:20,600 --> 00:21:25,280
negotiating or getting ready to negotiate what was your first faculty job.

282
00:21:25,280 --> 00:21:26,280
Sure.

283
00:21:26,280 --> 00:21:31,880
And I have to say that was definitely one of the most stressful periods of my life today.

284
00:21:31,880 --> 00:21:36,960
I'm sure there will be more stressful ones down the road, but it's no one teaches you

285
00:21:36,960 --> 00:21:39,160
how to negotiate, right?

286
00:21:39,160 --> 00:21:44,880
And it's such a black box depending on, you know, what you're looking for and which institutions

287
00:21:44,880 --> 00:21:48,760
are hiring at which time, you know, what they're looking for.

288
00:21:48,760 --> 00:21:53,480
It's really hard to know what you're even allowed to ask for.

289
00:21:53,480 --> 00:21:56,600
So I relied on a lot of resources.

290
00:21:56,600 --> 00:22:04,240
I actually, you know, didn't, I didn't anticipate starting my job search as early as I did.

291
00:22:04,240 --> 00:22:08,920
I was going to stay on for a little bit longer, but you know, there were institutions that

292
00:22:08,920 --> 00:22:15,440
were interested in positions that were open and I ended up kind of just kickstarting the

293
00:22:15,440 --> 00:22:20,080
job search by talking to different people about my career interests.

294
00:22:20,080 --> 00:22:26,560
You know, not phrasing it as do you have a job for me, but more as I would love to get

295
00:22:26,560 --> 00:22:32,540
your advice as a leader in the sickle cell field to understand, you know, what my career

296
00:22:32,540 --> 00:22:37,800
trajectory might look like and what you think is important for me in the next stages, you

297
00:22:37,800 --> 00:22:38,800
know, my career.

298
00:22:38,800 --> 00:22:41,020
What's an IV looking for?

299
00:22:41,020 --> 00:22:47,640
And I got so much good advice that way and also a few job offers along the way.

300
00:22:47,640 --> 00:22:52,880
And so I think reaching out to different people, you know, experts in the field, people you

301
00:22:52,880 --> 00:22:55,560
admire is really important.

302
00:22:55,560 --> 00:23:02,240
As I talked to people, I got more, I began to shape the image of who I wanted to become

303
00:23:02,240 --> 00:23:04,200
as junior faculty.

304
00:23:04,200 --> 00:23:10,440
And I think that was really helpful in negotiations, being able to present a concrete image of,

305
00:23:10,440 --> 00:23:15,380
you know, this is what I intend to do as junior faculty.

306
00:23:15,380 --> 00:23:17,120
This is the space that I can occupy.

307
00:23:17,120 --> 00:23:19,680
This is what I can bring to the institution.

308
00:23:19,680 --> 00:23:23,440
I think plays really strongly when you're negotiating.

309
00:23:23,440 --> 00:23:28,400
And then all of the other pieces of negotiation, like, you know, it's important to negotiate

310
00:23:28,400 --> 00:23:29,640
salary.

311
00:23:29,640 --> 00:23:34,980
Everyone knows that, but more importantly, if you're trying to, you know, shoot for an

312
00:23:34,980 --> 00:23:43,560
academic career, the two things I think about are protected time and a startup package.

313
00:23:43,560 --> 00:23:47,620
Because if you don't have time and you don't have money to do the research, you're just

314
00:23:47,620 --> 00:23:50,000
never going to get the research off the ground.

315
00:23:50,000 --> 00:23:52,720
And you know, you're going to drown in clinical responsibilities.

316
00:23:52,720 --> 00:23:55,060
And it's happened to so many people.

317
00:23:55,060 --> 00:24:01,660
And so I kind of had to first decide what my one and, you know, number one and number

318
00:24:01,660 --> 00:24:04,120
two priorities were.

319
00:24:04,120 --> 00:24:08,760
And they were number one, protected time, and then the number two, you know, the resources

320
00:24:08,760 --> 00:24:11,400
that I got starting out.

321
00:24:11,400 --> 00:24:15,440
And so, you know, protected time, I think was pretty clear.

322
00:24:15,440 --> 00:24:22,420
Everyone I talked to said, you need at least 75% protected time to really be a strong physician

323
00:24:22,420 --> 00:24:23,420
scientist.

324
00:24:23,420 --> 00:24:25,680
That's the best place to start.

325
00:24:25,680 --> 00:24:30,560
Probably less than, you know, 20% clinical and you would lose your clinical footing.

326
00:24:30,560 --> 00:24:32,360
Like, you still need to see patients.

327
00:24:32,360 --> 00:24:39,520
But, you know, 75 to 80% is perfectly reasonable for a physician scientist with or without

328
00:24:39,520 --> 00:24:40,940
a lab.

329
00:24:40,940 --> 00:24:47,060
And then for startup and resources, I ended up just asking people who are going through

330
00:24:47,060 --> 00:24:54,080
the job process, maybe a year ahead of me, or even in my same year to, and it was very

331
00:24:54,080 --> 00:24:58,960
uncomfortable, but I would literally ask them if they would feel comfortable, you know,

332
00:24:58,960 --> 00:25:00,400
sharing their numbers with me.

333
00:25:00,400 --> 00:25:03,360
Like how much did you negotiate for?

334
00:25:03,360 --> 00:25:08,720
And from a basic science standpoint, like what's reasonable to negotiate for a lab?

335
00:25:08,720 --> 00:25:12,000
The number was way higher than I had ever expected.

336
00:25:12,000 --> 00:25:17,840
And then, you know, what do you negotiate when it comes to running a clinical trial

337
00:25:17,840 --> 00:25:20,200
for starting global studies?

338
00:25:20,200 --> 00:25:23,080
You know, what types of resources do you need?

339
00:25:23,080 --> 00:25:28,000
And with that, started putting together a budget of, you know, everything that I might

340
00:25:28,000 --> 00:25:32,200
potentially need to get my research program off the ground.

341
00:25:32,200 --> 00:25:34,760
And then, you know, ask different people.

342
00:25:34,760 --> 00:25:40,960
I asked you, I asked other people about, you know, what were kind of the key pieces of,

343
00:25:40,960 --> 00:25:46,440
for instance, personnel and support that you need and factor that into the budget as well,

344
00:25:46,440 --> 00:25:51,680
since, you know, salaries are usually the biggest money suck when you're talking about

345
00:25:51,680 --> 00:25:53,800
financing your own research.

346
00:25:53,800 --> 00:26:01,120
And so with all of that came, you know, came to a pretty comprehensive but impressive budget.

347
00:26:01,120 --> 00:26:07,000
And that is what I shared with the institutions that, you know, I negotiated with.

348
00:26:07,000 --> 00:26:11,640
And I think it was helpful for them to have a number to work with.

349
00:26:11,640 --> 00:26:17,480
And then also, it gave them a more concrete idea of, you know, what it was I was actually

350
00:26:17,480 --> 00:26:20,040
trying to accomplish in my first three years.

351
00:26:20,040 --> 00:26:28,320
And so I think that is, that's probably how I went about kind of getting ideas and kind

352
00:26:28,320 --> 00:26:30,320
of researching the process.

353
00:26:30,320 --> 00:26:34,600
And then I also took advantage of our, like, Office of Intramural Affairs.

354
00:26:34,600 --> 00:26:39,960
There was someone who you could actually talk to, to get advice on negotiation.

355
00:26:39,960 --> 00:26:47,440
So anytime I had an offer, or even just a phone conversation, I would, you know, run

356
00:26:47,440 --> 00:26:51,480
it by her and just get a sense like, did this go well?

357
00:26:51,480 --> 00:26:53,640
You know, what should I say here?

358
00:26:53,640 --> 00:26:54,960
Is this asking too much?

359
00:26:54,960 --> 00:26:56,360
Is this asking too little?

360
00:26:56,360 --> 00:27:00,000
It usually, the answer is you're asking too little.

361
00:27:00,000 --> 00:27:07,160
And she really helped me, you know, be bolder, because I think, especially as women in science,

362
00:27:07,160 --> 00:27:11,960
we don't tend to, we tend to ask for what we think is fair, not realizing that part

363
00:27:11,960 --> 00:27:17,760
of the negotiation is you need to ask for, you know, the maximum of what you need, and

364
00:27:17,760 --> 00:27:22,360
maybe a little more because you're never going to get that full ask.

365
00:27:22,360 --> 00:27:28,880
And so part of negotiation is being bold with your asks and knowing kind of the different

366
00:27:28,880 --> 00:27:31,400
components to ask for.

367
00:27:31,400 --> 00:27:36,880
So you know, just using all of these different resources, reading a couple of books about

368
00:27:36,880 --> 00:27:47,160
negotiation helped me expand the idea of like, what are the actual negotiables in these jobs?

369
00:27:47,160 --> 00:27:48,160
I love it.

370
00:27:48,160 --> 00:27:49,160
I love it.

371
00:27:49,160 --> 00:27:50,160
I see so much in that.

372
00:27:50,160 --> 00:27:53,600
So number one, you came prepared.

373
00:27:53,600 --> 00:28:01,760
You went and accessed resources, people, expertise, negotiation resources.

374
00:28:01,760 --> 00:28:03,520
You actually were so prepared.

375
00:28:03,520 --> 00:28:08,520
But see that as one preparation, which I think is so important to have any kind of successful

376
00:28:08,520 --> 00:28:09,520
negotiation.

377
00:28:09,520 --> 00:28:14,640
And then number two, I also see that you were looking when you didn't need to look.

378
00:28:14,640 --> 00:28:18,440
In a sense, you started early and you weren't desperate.

379
00:28:18,440 --> 00:28:20,360
You weren't like, I'm about to run out of money.

380
00:28:20,360 --> 00:28:26,360
I need a job, which really allows you to kind of take your time to think through the process

381
00:28:26,360 --> 00:28:30,840
and keep going back and forth in all the going back and forth that you needed.

382
00:28:30,840 --> 00:28:35,200
I also love that you made a budget and then you ask people what makes sense.

383
00:28:35,200 --> 00:28:36,200
Is this reasonable?

384
00:28:36,200 --> 00:28:37,960
And it's too little, it's too much.

385
00:28:37,960 --> 00:28:42,660
You didn't rely on yourself to be the source of all knowledge for moving forward.

386
00:28:42,660 --> 00:28:47,800
You really engaged all the resources that you had at your disposal.

387
00:28:47,800 --> 00:28:50,160
And then it sounds like you did it.

388
00:28:50,160 --> 00:28:55,520
You took bold steps and you up for things that I think made you feel uncomfortable.

389
00:28:55,520 --> 00:28:57,920
You said, this is what I need.

390
00:28:57,920 --> 00:29:04,580
And I think it's so powerful because you stand out to me as someone who's done things differently

391
00:29:04,580 --> 00:29:09,360
from many people who've come through clinical medicine where we're used to just getting

392
00:29:09,360 --> 00:29:14,160
what we get and we're used to just, you know, whatever you give me, thank you so much.

393
00:29:14,160 --> 00:29:15,640
But you really did something different.

394
00:29:15,640 --> 00:29:18,560
And you said, no, I want, I want to clarify what's needed.

395
00:29:18,560 --> 00:29:21,600
You asked, what do I need to be successful?

396
00:29:21,600 --> 00:29:22,800
You clarified that.

397
00:29:22,800 --> 00:29:26,440
And then you put together your own, this is what it looks, this is what I would need to

398
00:29:26,440 --> 00:29:27,440
be successful.

399
00:29:27,440 --> 00:29:29,040
And then you shared that with people.

400
00:29:29,040 --> 00:29:32,400
You knew from the beginning that you need the protected time.

401
00:29:32,400 --> 00:29:36,280
You knew you needed resources as far as setting up your own program.

402
00:29:36,280 --> 00:29:39,880
And you knew that because you went looking for information.

403
00:29:39,880 --> 00:29:43,840
And so I just want to pause and say to our listeners, if you are listening, I mean, Juliet's

404
00:29:43,840 --> 00:29:49,520
story is so awesome, but just it's so important to gather the information you need so that

405
00:29:49,520 --> 00:29:54,080
you can succeed in your negotiation so that you can set yourself up for success.

406
00:29:54,080 --> 00:29:59,880
You got to succeed in negotiation because it sets you up to succeed as a faculty person.

407
00:29:59,880 --> 00:30:03,080
And I think that's something that you really, really have done well, Juliet.

408
00:30:03,080 --> 00:30:05,840
And thank you for sharing that.

409
00:30:05,840 --> 00:30:06,840
Of course.

410
00:30:06,840 --> 00:30:07,840
Thank you.

411
00:30:07,840 --> 00:30:15,240
It's been a really great journey and definitely I've had a lot of moments along the way where

412
00:30:15,240 --> 00:30:17,360
I thought, can I really do this?

413
00:30:17,360 --> 00:30:19,160
Am I cut out for this?

414
00:30:19,160 --> 00:30:22,160
And am I really doing this in the right way?

415
00:30:22,160 --> 00:30:29,960
But I think, especially having peer mentors and mentors at different stages of their career

416
00:30:29,960 --> 00:30:36,880
to talk about these things with and get a sense of what are the tricks that I can use

417
00:30:36,880 --> 00:30:41,600
for getting to this next stage of my career has been really helpful.

418
00:30:41,600 --> 00:30:47,840
So I definitely encourage talking to as many people at any level of training as you can

419
00:30:47,840 --> 00:30:51,720
to kind of help you prepare for the academic journey.

420
00:30:51,720 --> 00:30:52,720
Absolutely.

421
00:30:52,720 --> 00:30:55,040
And you've really done that well.

422
00:30:55,040 --> 00:30:57,760
One of the things I want to point out that you did well is it's asking people at different

423
00:30:57,760 --> 00:30:59,760
institutions as well.

424
00:30:59,760 --> 00:31:04,600
And that's just so great to have such a rich perspective that's not just centered on one

425
00:31:04,600 --> 00:31:05,600
institution.

426
00:31:05,600 --> 00:31:06,600
This is the way we do things here.

427
00:31:06,600 --> 00:31:12,160
It's like, no, this is what makes sense across several institutions, which is really awesome.

428
00:31:12,160 --> 00:31:16,200
And that I think is a great segue into the next question, which is like, well, you know,

429
00:31:16,200 --> 00:31:17,800
you make this look so easy, Julia.

430
00:31:17,800 --> 00:31:22,720
It's like, wow, look at how much you've accomplished in such a little time.

431
00:31:22,720 --> 00:31:25,080
You as a resident were leading research projects.

432
00:31:25,080 --> 00:31:31,800
So was there any, I mean, what were the challenges, if any, that you faced along the way?

433
00:31:31,800 --> 00:31:32,800
Yeah.

434
00:31:32,800 --> 00:31:37,200
I know I definitely faced quite a few challenges.

435
00:31:37,200 --> 00:31:45,840
It was everything from not being able to get studies through the local IRBs, like the international

436
00:31:45,840 --> 00:31:52,040
IRBs, having things sit around for months, not knowing the right people or the right,

437
00:31:52,040 --> 00:31:56,640
I guess, phone calls to make to make things happen.

438
00:31:56,640 --> 00:32:01,040
Not having local buy-in and having to really generate that.

439
00:32:01,040 --> 00:32:06,120
And the Dominican Republic, I had to give talks and have frequent meetings with both

440
00:32:06,120 --> 00:32:12,560
the lab and the clinical team to explain why I thought this was an important clinical problem.

441
00:32:12,560 --> 00:32:20,160
And eventually after months, they got interested in the project and things went along swimmingly.

442
00:32:20,160 --> 00:32:25,120
But it was a lot of work trying to get local buy-in.

443
00:32:25,120 --> 00:32:31,880
And then there are all sorts of logistical, administrative barriers that you face.

444
00:32:31,880 --> 00:32:38,220
But I think one of the biggest things that I am still working on, and I think you probably

445
00:32:38,220 --> 00:32:44,240
work on for the rest of your life, is I guess the term is work-life integration.

446
00:32:44,240 --> 00:32:50,640
And along with that, I think integration of your clinical and your research role as well,

447
00:32:50,640 --> 00:32:53,560
I think is just very challenging.

448
00:32:53,560 --> 00:32:57,520
And I think it's an ever-moving target.

449
00:32:57,520 --> 00:33:03,040
And you probably never get it quite right, but you always move towards something that

450
00:33:03,040 --> 00:33:06,080
is tolerable and enjoyable, hopefully.

451
00:33:06,080 --> 00:33:13,520
But it's definitely something that's gotten more and more acute and important as I moved

452
00:33:13,520 --> 00:33:16,920
on to different phases of the academic career.

453
00:33:16,920 --> 00:33:22,380
As junior faculty now, really trying to make sure that I don't burn out because everyone

454
00:33:22,380 --> 00:33:26,000
keeps telling me, this is a marathon.

455
00:33:26,000 --> 00:33:29,840
Training might have felt like a sprint because you're always sprinting from one program to

456
00:33:29,840 --> 00:33:30,840
the next.

457
00:33:30,840 --> 00:33:37,560
I got to get this in so that I get accepted, so that I have a good match, et cetera.

458
00:33:37,560 --> 00:33:44,040
But once you get to being actual faculty, you don't have these little benchmarks to

459
00:33:44,040 --> 00:33:45,040
keep you going.

460
00:33:45,040 --> 00:33:49,720
You don't have something, a side post that tells you, oh, you've succeeded at this step.

461
00:33:49,720 --> 00:33:52,960
You can, here's the next step for you to move on to.

462
00:33:52,960 --> 00:33:59,760
It really is just this slow marathon that you have to keep up with, and you have to

463
00:33:59,760 --> 00:34:06,400
maintain your stamina and your interests, your passions, and your sanity.

464
00:34:06,400 --> 00:34:12,880
And so in order to do that, I think work-life integration is one of the most important things

465
00:34:12,880 --> 00:34:15,120
that I'm working on right now.

466
00:34:15,120 --> 00:34:20,040
And then wearing different hats as a clinician and a researcher, I'm constantly trying to

467
00:34:20,040 --> 00:34:27,360
decide should I work on my clinical inbox, answering patient calls, or should I be answering

468
00:34:27,360 --> 00:34:31,200
emails of my research study team, and I'm constantly flipping back and forth.

469
00:34:31,200 --> 00:34:37,400
And so that's something I haven't found a solution to, and it might just be a little

470
00:34:37,400 --> 00:34:42,480
bit of a flipping back and forth for the rest of your career.

471
00:34:42,480 --> 00:34:45,520
But I think it also keeps things interesting.

472
00:34:45,520 --> 00:34:52,240
I learned early on in my clinical training that when I was doing 100% research or 100%

473
00:34:52,240 --> 00:34:54,440
clinical, I just was not happy.

474
00:34:54,440 --> 00:34:57,600
I didn't feel fully fulfilled.

475
00:34:57,600 --> 00:35:03,720
And it's having the mix of both that really one inspires the other, and it really gives

476
00:35:03,720 --> 00:35:10,840
me that satisfaction of being a great provider, but also having a creative outlet and a way

477
00:35:10,840 --> 00:35:16,560
to make an impact that goes beyond just the patient sitting in front of me today.

478
00:35:16,560 --> 00:35:18,720
Wow.

479
00:35:18,720 --> 00:35:19,720
I love that.

480
00:35:19,720 --> 00:35:24,800
I think that you highlight something that's so important, is that the biggest obstacle

481
00:35:24,800 --> 00:35:32,160
or the biggest challenge is us, our capacity to integrate the things that are important.

482
00:35:32,160 --> 00:35:33,160
All of it is important.

483
00:35:33,160 --> 00:35:35,360
Your research is important.

484
00:35:35,360 --> 00:35:36,960
Your patients are important.

485
00:35:36,960 --> 00:35:38,680
The rest of your life is important.

486
00:35:38,680 --> 00:35:43,200
And how challenging it is to say, well, what is the priority in this moment?

487
00:35:43,200 --> 00:35:46,660
And what do I make sure I'm not neglecting in the moment as well?

488
00:35:46,660 --> 00:35:55,280
And so I think for our listeners, it's that as you get better, as you are able to clarify

489
00:35:55,280 --> 00:36:01,560
for yourself what is most important, it allows you to kind of recreate your environment or

490
00:36:01,560 --> 00:36:05,480
recreate your life, your experience to match those priorities.

491
00:36:05,480 --> 00:36:11,040
So that really, ultimately, along this journey, now that you stopped sprinting, and now that

492
00:36:11,040 --> 00:36:15,560
as a faculty member, you're now kind of looking at the long game.

493
00:36:15,560 --> 00:36:19,420
And to be honest, you've been doing that from the beginning, but now it's really a question

494
00:36:19,420 --> 00:36:20,920
of what do I want?

495
00:36:20,920 --> 00:36:21,920
How do I want to live?

496
00:36:21,920 --> 00:36:24,060
How do I want to lead this experience?

497
00:36:24,060 --> 00:36:25,440
And how do I make it all work?

498
00:36:25,440 --> 00:36:30,120
And it's so challenging because in a sense, it's about self mastery.

499
00:36:30,120 --> 00:36:31,440
And it's about other people.

500
00:36:31,440 --> 00:36:34,320
No longer are other people telling you what your goals should be.

501
00:36:34,320 --> 00:36:36,320
To some extent, they still do that.

502
00:36:36,320 --> 00:36:40,920
But really, you recognizing that they are not the ones with a yardstick of what success

503
00:36:40,920 --> 00:36:42,240
looks like.

504
00:36:42,240 --> 00:36:43,240
It's really you.

505
00:36:43,240 --> 00:36:49,080
Your measurement of success comes from your internal fulfillment and really feeling like

506
00:36:49,080 --> 00:36:51,640
you have things exactly where they need to be.

507
00:36:51,640 --> 00:36:56,240
And so I think it's a really important point in just how we're always kind of working on

508
00:36:56,240 --> 00:37:02,920
growing ourselves to become the kind of person who can lead the kind of careers that we want

509
00:37:02,920 --> 00:37:07,200
in that and the kind of fulfilling lives that we have in the process as well.

510
00:37:07,200 --> 00:37:08,200
Absolutely.

511
00:37:08,200 --> 00:37:10,120
You know, I completely agree.

512
00:37:10,120 --> 00:37:17,240
And I think one of the pitfalls of medical training is that we're kind of conditioned

513
00:37:17,240 --> 00:37:23,000
to externalize our self validation and our self worth.

514
00:37:23,000 --> 00:37:28,360
And it makes it really hard to listen to that inner voice say like, this is what I'm about.

515
00:37:28,360 --> 00:37:30,400
And this is why it's important to me.

516
00:37:30,400 --> 00:37:31,920
These are my values.

517
00:37:31,920 --> 00:37:38,200
We don't spend a lot of time thinking about it because we're just, you know, we were constantly

518
00:37:38,200 --> 00:37:43,480
being told this is what you need to do and this is who you need to be.

519
00:37:43,480 --> 00:37:48,060
And we're not really trained to think about, you know, those things for ourselves.

520
00:37:48,060 --> 00:37:54,760
And then it's a huge shock once you have that freedom to shape your own life and career.

521
00:37:54,760 --> 00:37:56,600
Absolutely.

522
00:37:56,600 --> 00:37:58,360
And it really, really is.

523
00:37:58,360 --> 00:38:03,360
It takes time and you've been practicing and continue to practice.

524
00:38:03,360 --> 00:38:04,680
It just, it's a lifelong.

525
00:38:04,680 --> 00:38:05,680
It's a lifelong journey.

526
00:38:05,680 --> 00:38:06,680
Absolutely.

527
00:38:06,680 --> 00:38:09,520
You know, Julia, it's been such a pleasure talking with you today.

528
00:38:09,520 --> 00:38:11,880
I mean, this conversation was so awesome.

529
00:38:11,880 --> 00:38:16,600
I want to say that I feel like our listeners are so fortunate to have this opportunity

530
00:38:16,600 --> 00:38:19,480
to listen to you, having you share your story.

531
00:38:19,480 --> 00:38:25,280
But I do feel like if there's one person out there saying, wow, Julia, can I do this?

532
00:38:25,280 --> 00:38:26,960
I've been in clinical training for 10 years.

533
00:38:26,960 --> 00:38:28,160
I haven't done what you've done.

534
00:38:28,160 --> 00:38:32,520
I didn't need a program as a medical student or as a resident.

535
00:38:32,520 --> 00:38:33,520
Is this for me?

536
00:38:33,520 --> 00:38:34,760
Can I be a clinician scientist?

537
00:38:34,760 --> 00:38:37,480
Can I also become a clinician researcher?

538
00:38:37,480 --> 00:38:39,960
What would you have to tell them?

539
00:38:39,960 --> 00:38:48,880
Well, I mean, I think probably the most important thing is to just get the experience and, you

540
00:38:48,880 --> 00:38:54,200
know, get out there and pursue some sort of research if you're thinking about it, you

541
00:38:54,200 --> 00:38:57,560
know, whether it's joining a lab or joining a clinical research project.

542
00:38:57,560 --> 00:39:04,040
I think until you start doing it, it's really hard to know, number one, is this something

543
00:39:04,040 --> 00:39:06,920
that you're interested in and passionate about?

544
00:39:06,920 --> 00:39:15,320
And number two, is it something that you, you know, have the patience and the, you know,

545
00:39:15,320 --> 00:39:16,960
perseverance to do?

546
00:39:16,960 --> 00:39:20,760
Because research is frustrating most of the time, right?

547
00:39:20,760 --> 00:39:24,640
Like it is not about big wins all the time.

548
00:39:24,640 --> 00:39:29,840
It's about taking advantage of or appreciating the little wins that you get along the way

549
00:39:29,840 --> 00:39:35,480
on a pretty challenging journey, but, you know, hopefully it's well worth it in the

550
00:39:35,480 --> 00:39:36,760
end.

551
00:39:36,760 --> 00:39:42,000
And so I think getting that experience and, you know, really deciding for yourself, is

552
00:39:42,000 --> 00:39:46,240
this something that I want to pursue would be the first step.

553
00:39:46,240 --> 00:39:51,480
And then after that, then you can ask yourself, you know, do I have the right setup, the right

554
00:39:51,480 --> 00:39:55,120
skills, the right training to do this?

555
00:39:55,120 --> 00:40:02,180
That might come in the form of talking to mentors or, you know, colleagues who are kind

556
00:40:02,180 --> 00:40:08,880
of doing research around your level, seeing what's actually needed to be successful at

557
00:40:08,880 --> 00:40:11,360
the next stages of your career.

558
00:40:11,360 --> 00:40:17,440
And realizing that with research, it's a long road where you're constantly acquiring

559
00:40:17,440 --> 00:40:21,400
new skills, and that's one of the big draws of research for me is that, you know, you're

560
00:40:21,400 --> 00:40:28,720
constantly learning and, you know, kind of evolving as a researcher.

561
00:40:28,720 --> 00:40:34,000
And so, you know, I don't think you should look at it and say like, oh, I'm never going

562
00:40:34,000 --> 00:40:37,640
to get there because I don't have X, Y, and Z skills.

563
00:40:37,640 --> 00:40:41,840
You look for the opportunity to pick up those skills.

564
00:40:41,840 --> 00:40:46,960
And maybe it takes a little bit longer, or maybe you happen to get all the skills in

565
00:40:46,960 --> 00:40:52,880
one project, but you just have to take it one step at a time and, you know, just keep

566
00:40:52,880 --> 00:40:57,160
building and knowing that it's kind of an incremental process to get to where you need

567
00:40:57,160 --> 00:40:58,160
to be.

568
00:40:58,160 --> 00:41:03,440
But I think really the first step is, you know, engaging and asking yourself, like,

569
00:41:03,440 --> 00:41:06,760
is this a path that I really want to pursue?

570
00:41:06,760 --> 00:41:09,600
And if so, go for it.

571
00:41:09,600 --> 00:41:10,600
I love it.

572
00:41:10,600 --> 00:41:12,000
I hear two things from what you said.

573
00:41:12,000 --> 00:41:15,880
Number one is stop waiting for someone to tell you, you can or can't.

574
00:41:15,880 --> 00:41:16,880
This is what you want to do.

575
00:41:16,880 --> 00:41:17,880
Go for it.

576
00:41:17,880 --> 00:41:18,880
Absolutely go for it.

577
00:41:18,880 --> 00:41:22,360
You've got to go for it as soon as you want, as soon as possible, because you want to know

578
00:41:22,360 --> 00:41:24,080
this is what you want to do.

579
00:41:24,080 --> 00:41:27,320
It's not glamorous.

580
00:41:27,320 --> 00:41:31,720
It's not, it's not like, you know, it's not the amazing thing that's always talked up

581
00:41:31,720 --> 00:41:32,720
to be.

582
00:41:32,720 --> 00:41:35,040
It's a lot of little battle every day.

583
00:41:35,040 --> 00:41:40,440
It's a lot of moving things forward incrementally, having conversations around whether it's

584
00:41:40,440 --> 00:41:42,320
work that needs to be done or not.

585
00:41:42,320 --> 00:41:44,960
So you want to know, is this the life you want?

586
00:41:44,960 --> 00:41:47,800
Is this something you're willing to fight for?

587
00:41:47,800 --> 00:41:50,400
Because it's a challenging journey, as you shared.

588
00:41:50,400 --> 00:41:51,560
It's not easy.

589
00:41:51,560 --> 00:41:55,120
And so if people are going to take this journey, they want to know that what they're doing

590
00:41:55,120 --> 00:42:00,680
is worth fighting for and that they're going to have the perseverance and the staying power

591
00:42:00,680 --> 00:42:03,760
to stay in the game because it's hard, it's challenging and there are other things to

592
00:42:03,760 --> 00:42:04,760
do.

593
00:42:04,760 --> 00:42:09,280
And so why stay and do something that you don't like and it's hard?

594
00:42:09,280 --> 00:42:12,040
So I really appreciate you sharing that perspective.

595
00:42:12,040 --> 00:42:14,520
And I just want to say thank you, Julia.

596
00:42:14,520 --> 00:42:16,920
It's just been such a great conversation.

597
00:42:16,920 --> 00:42:21,880
I learned a lot just listening to you and I know our listeners definitely have.

598
00:42:21,880 --> 00:42:25,960
So I just want to want to say thank you for coming on the show and thank you for just

599
00:42:25,960 --> 00:42:28,040
sharing your sage wisdom.

600
00:42:28,040 --> 00:42:29,660
Absolutely.

601
00:42:29,660 --> 00:42:30,660
This was such a pleasure.

602
00:42:30,660 --> 00:42:32,160
It was a great conversation.

603
00:42:32,160 --> 00:42:37,480
I really do hope that some of this advice and information can help your listeners.

604
00:42:37,480 --> 00:42:40,920
I think research is really rewarding.

605
00:42:40,920 --> 00:42:46,760
And if it's something like you said, if it's something that anyone has an inkling of an

606
00:42:46,760 --> 00:42:50,160
interest in, just go for it.

607
00:42:50,160 --> 00:42:56,440
It's waiting around for you to pick up and to run with it.

608
00:42:56,440 --> 00:42:57,440
Thank you, Julia.

609
00:42:57,440 --> 00:43:00,960
So everyone you heard, Julia, if you want to do it, you got to go for it.

610
00:43:00,960 --> 00:43:02,560
Don't wait for anyone to give you permission.

611
00:43:02,560 --> 00:43:04,920
You go figure out if this is what you want to do.

612
00:43:04,920 --> 00:43:07,840
So I want to say that Julia has shared with us so many awesome nuggets.

613
00:43:07,840 --> 00:43:12,560
If there is someone you know who needs to hear this, maybe a colleague or maybe even

614
00:43:12,560 --> 00:43:17,880
a mentee, if you're kind of a little further along, please share this episode with them

615
00:43:17,880 --> 00:43:23,720
and definitely make sure that Julia's wisdom gets shared with beyond more than just your

616
00:43:23,720 --> 00:43:29,200
immediate environment because this is so important for clinicians who are so capable, who are

617
00:43:29,200 --> 00:43:33,240
so able really to do whatever they want to do, whatever they set their hearts to do,

618
00:43:33,240 --> 00:43:36,160
to really figure out, hey, is this how I want to contribute in the world?

619
00:43:36,160 --> 00:43:38,920
And then to go for it and not to let anything stop them.

620
00:43:38,920 --> 00:43:43,240
And so I hope that you will definitely share this episode as widely as possible.

621
00:43:43,240 --> 00:43:44,880
And yeah, thank you for listening.

622
00:43:44,880 --> 00:43:51,560
We look forward again to the next time on the Clinician Researcher Podcast.

623
00:43:51,560 --> 00:43:57,760
Bye bye.

624
00:43:57,760 --> 00:44:03,120
Thanks for listening to this episode of the Clinician Researcher Podcast, where academic

625
00:44:03,120 --> 00:44:08,840
clinicians learn the skills to build their own research program, whether or not they

626
00:44:08,840 --> 00:44:09,920
have a mentor.

627
00:44:09,920 --> 00:44:16,040
If you found the information in this episode to be helpful, don't keep it all to yourself.

628
00:44:16,040 --> 00:44:17,760
Someone else needs to hear it.

629
00:44:17,760 --> 00:44:21,820
So take a minute right now and share it.

630
00:44:21,820 --> 00:44:27,280
As you share this episode, you become part of our mission to help launch a new generation

631
00:44:27,280 --> 00:44:33,520
of clinician researchers who make transformative discoveries that change the way we do health

632
00:44:33,520 --> 00:44:58,120
care in the most important person in history.