Making the most of your post-doctoral fellowship

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

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

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

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

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

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program.

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

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

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

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

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Now introducing your host, Toyosi Onwuemene.

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Welcome to today's episode.

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I'm your host, Toyosi Onwuemene, and it is such a pleasure to be speaking with you today.

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Today, I'm going to be talking about how fellows can succeed in their quest to become a clinician

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scientist.

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And, you know, to become a clinician scientist is hard, and to be honest, it is challenging.

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But we've been doing challenging things from the very beginning, and many times when the

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path is laid out for us, it seems less challenging.

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It's still challenging, but we know what we're doing, and so it feels less frustrating.

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And sometimes one of the challenges of doing this thing and trying to succeed as a clinician

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scientist is that the path is not so clear, and some people get great mentors, some people

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don't.

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And so how do we do that?

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How do we make the transition?

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How do we succeed so that we're able to move forward the research that we really want to

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move forward?

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And so that's one of the things I want to talk about, because when I was interviewing

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for jobs as a fellow transitioning to faculty, I wasn't really clear on what I wanted.

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People said, well, what kind of job are you looking for?

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I was like, well, I'm looking for 75% protected time for research.

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And they'd be like, well, so what kind of research do you want to do?

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And I'm like, well, maybe cancer associated thrombosis, hemostasis thrombosis.

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And I was not very specific.

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I didn't even recognize that that was an issue until now I'm in the one interviewing, I'm

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the one in the seat interviewing people as they come through.

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I'm the one in the driver's seat asking people, hey, why are you here?

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What do you want to do?

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How do you want to succeed?

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And although I'm not making the final hiring decisions, I can now see how it was problematic

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for me back then to say, hey, I want 75% protected time.

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And I couldn't clearly articulate what that 75% protected time would get me.

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So there are five things I want to talk to you about as far as how do you move forward

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in your fellowship in a way that allows you to set yourself up for success when you finally

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go for job interviews.

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And I'd like to actually stop here and let you know that one of the things I do is I

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help programs coach fellows so that they can be successful in that fellow to faculty transition.

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And it's really important if you can get it right early on, it makes your journey so much

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easier.

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And so if you're a fellow and you're like, well, I can't afford coaching because it's

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so expensive.

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Yes, it is.

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But sometimes what happens is that fellowship programs support their fellows so they can

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get the coaching to negotiate the right jobs that put them in the seat to really help enhance

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and guarantee their success.

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And you can always do that with the help of a coach guiding you.

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So if that's you, if you are interested, send me a DM, reach out to me on my website, coedcoach.com,

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and we can set up a time to talk and see if this relationship is a right fit for the both

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of us.

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Okay.

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So the first thing you want to do in succeeding in your quest to become a clinician researcher

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is to use your fellowship time strategically.

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Use your fellowship time strategically.

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What does that mean?

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Sometimes people are just kind of feeling their way around saying, well, I'm not sure

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what I want to do and maybe I'll do this or maybe I'll do that.

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We'll see how things go.

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And I want to tell you that whenever you have that feeling of not really being sure where

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you want to go, it is a sign that you have work to do.

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And I will tell you that in our training, there's a lot of disconnectedness that happens

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because of how much we work hard to disconnect ourselves from our feelings.

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We're delivering bad news.

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We try very hard to cut off all emotions so we don't cry, so we can be objective.

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We are sleepy, but we have an overnight shift.

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And so we suppress the urge to sleep, sometimes chemically, sometimes just by sheer force

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of will.

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We need to go to the bathroom, but we're in the middle of an OR case.

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And so we are suppressing the urge to go to the bathroom.

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We practice for so long how to disconnect ourselves from our feelings, from our emotions.

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And because of that, when we get to the point where we should be thinking very clearly about

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what we want for our careers, we're stuck, we're confused, we don't know.

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We're waiting for external forces to move us in the right direction.

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Maybe when I get on this rotation, I'll find a patient whose disease I fall in love with.

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It's not that that can't happen.

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It's that many times our inner voices, our inner compass is so suppressed that we can

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only recognize it when it slaps us in the face.

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We can only recognize what we want when it's right there in front of us.

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And that's why there's that sense that, well, if I encounter the right patient, if I'm just

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in the right mentor's presence, I'll know it.

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And yes, you might, but what if you don't get that mentor?

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What if you don't get that patient?

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What if you don't get around them?

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And then you're stuck.

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You're stuck not knowing what you want to do.

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And so anyway, so what I'm really saying is that, hey, it takes time, work, energy, and

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investment to figure out what you really want to do.

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And it is important upfront to clarify what that is.

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And a lot of that can happen with the help of a coach.

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It doesn't have to be a coach, but allowing yourself to have the time and the space to

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really get back in touch with the way you feel about things, with what you really want

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to do.

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What is your driving sense of purpose?

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It allows you to make a decision so that you can use your fellowship time strategically.

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You don't know what you want to do.

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You don't know what your experiences, what experiences in fellowship are going to move

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you forward.

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And what happens is that you kind of wander around, and at the end, when you finally have

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to make a decision, you literally just pick whatever you find and then move on.

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And so I just want to encourage you that if you are a fellow and you're not even sure

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what you want to do, talk with somebody, make time to really clarify what your desires,

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goals, wants are so that you can be very strategic about how your fellowship moves you forward.

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Don't accept a fellowship experience where you don't have clarity from the beginning

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about what you want to get out of your fellowship.

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So use your fellowship time strategically.

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The second thing you can do is to think carefully about the opportunities before you.

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That is to think carefully about the opportunities before you.

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What does that mean?

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In fellowship, there'll be so many opportunities.

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It feels overwhelming.

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There's this scientist you could work with, and there's this other project.

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There's so many of them.

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And sometimes it's tempting just to go with, in a sense, just guess and say, I'll just

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go with this one.

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I'll go with my gut.

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And going with your gut has probably served you a lot.

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So I don't discount its power to serve you again.

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But really, as you grow and as you really start to take ownership of your career, you

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stop going with your gut, and you start asking your gut to explain why it feels the way it

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does.

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And sometimes going with your gut is that you're so disconnected from how you feel.

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It's just literally you're looking for a rumbly in your belly to tell you, OK, this is what

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I want to do.

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And so what you really want to do is take a step back and say, well, how do I want to

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contribute?

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How do I want to be remembered?

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What do I really want to do?

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And then you say, what are the opportunities before me that helped me get there?

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And that's why number one is so important in clarifying what you want so that you can

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use your fellowship time strategically.

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Then it also allows you to analyze and evaluate all the opportunities before you to say, which

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opportunity gets me closest to my goal?

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All opportunities are not created alike.

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Several mentors don't get you to the same place.

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But when you have a clear sense of direction, you're able to say, this mentor can do this

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for me.

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I can learn these techniques in this mentor's lab, or this mentor already has access to

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this expertise that allows me to connect to my purpose, that allows me to connect to my

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why.

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And so understanding where you want to go allows you to assess the opportunities before

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you so you can pick the one that really helps you move forward.

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Number three is to have a plan for your unstructured research time.

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So what I find is that many fellows kind of just slug through the first year.

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It is such a hard year.

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And then at the end of it, they're recovering for three months and four months and five

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months and they're still recovering.

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But what is happening is that they have never been in the situation, not in the eight, nine,

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ten years of their training, where there's no clear plan for what they're supposed to

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do.

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And so many fellows have a hard time with that.

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Yes, they may show up to the lab in the morning and do all the activities, or they may show

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up to their research mentors' research program and do the things that are required of them.

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But where there's no experiment to be done or where they're waiting in between experiments,

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there isn't a clear sense of what to do with that unstructured time.

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And so if you're going to be successful in making the transition to become a clinician

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scientist, you're going to become a master at making unstructured time structured.

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Everybody needs structure.

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Everybody thrives with structure.

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Everybody does well with structure.

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Many times you create the structure you need.

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Some people are waiting for their fellowship programs to say, hey, from nine to two, this

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is what you do.

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And then from two to five, this is your schedule.

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It's really nice if your fellowship program provides that for you.

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But a time is coming when you're going to need to be the one creating structure for

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your structured time.

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Starting in fellowship is a great time to do it.

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Don't let unstructured time get away with you.

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Don't make believe that you are on an extended vacation doing research.

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Make sure you have the tools to create structure out of unstructured time.

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And again, I'm really partial to coaching in helping you get to where you need to be,

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get the coaching you need so that you can make the best use of your unstructured time.

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Perhaps you have a mentor who can help you do that.

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Whoever it is, get the help you need.

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Get the help you need.

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If you need me to help you, send me a DM.

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We'll talk about how to help you create structure.

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But get the help you need to create structure so that you can be successful in your time

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as a researcher during your fellowship.

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Number four is to apply for as many opportunities as you can.

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Rejection is tough and rejection is a part of the work we do.

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The reason rejection is a part of the work we do is because our work is unfolding, our

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work is evolving, and it's not perfect at the beginning.

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We're prototyping.

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With each failure, so to speak, with each failure is an opportunity to do things differently

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next time.

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Some people are lucky.

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They get it right the first time.

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They get the grant funded the first time.

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Most people are not.

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It takes two tries, three tries, four tries, five tries, and five tries iterating each

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time to bring something new, something different out of what existed in the past.

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Part of iterating, getting better each time you submit, getting more high quality feedback

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each time you submit is doing it again, and then doing it again, and then doing it again.

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Really applying for as many opportunities as makes sense for you is important because

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it not only advances your work in fellowship, but it also gives you opportunities as a faculty

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member because you get practice in the act of submitting and submitting again and submitting

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again, which really is what happens to as many people as are pursuing this path of becoming

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clinician scientists.

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Your work is going to be rejected.

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You may not align with the funder, or maybe there's a more meritorious application, or

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actually your application is equally meritorious, but the priorities of the funder support the

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other project.

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There are always going to be reasons why your work is rejected, but applying for as many

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opportunities as you can allows you to refine your work, allows you to improve over time,

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allows you to get over the pain of rejection.

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It takes time to recover and to get used to it.

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You get over it, and then you're like, okay, what's the next opportunity?

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What makes sense?

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It increases your chances that you get funded, increases your chances that you are able to

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say, I'm someone who's put forward an application that's been successful, and that always looks

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good when you go to interview, but it's also good for you because it helps you establish

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a pattern of moving forward in spite of rejection.

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And it doesn't have to be just about grants.

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You submit proposals for different things.

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You're putting forward a proposal for a new project, for a new education initiative.

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Applying for as many opportunities as you can gives you an opportunity to learn how

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to do it better each time, but it also gives you insight into where you don't go, where

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your work may not be as accepted.

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So there are many, many opportunities that come as a result of that.

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The fifth thing that fellows can do to succeed in their quest is to have a clear vision for

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their careers when they interview.

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So I have the opportunity now to interview so many people when they come our way and

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are looking for jobs at our institution, and I say, where do you see yourself in three

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years?

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And they can't answer that question.

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I mean, people fumble through, but it's very, very different when somebody says, in five

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years, I will be applying for a career development award because what I want to do is be established

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as a clinician investigator in sickle cell research.

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Wow, that's so clear.

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And it may not be true, and I'm not saying you should lie, but I'm saying that you will

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evolve over time.

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What you feel so sure about today may not be what you feel so sure about tomorrow, but

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you should have a clear plan and a clear goal.

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Because what it communicates to people is that you've really thought about it.

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You've been very thoughtful.

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You're not just kind of like waving your hands in the air and thinking, oh, how might this

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work?

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You have a clear plan for your future.

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And that means you're someone who thinks clearly.

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You're someone who takes action.

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You're someone who's decisive.

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And it helps you.

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It helps you because when you're saying, I want 75% protected time for my research, if

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that's what you want, you have a clear reason.

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You know what that will do for you.

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And you'll say, well, I've written this R01, I've written this grant, and I know it may

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be rejected the first or the second time around.

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And I know it's going to take time to really evolve it into the project I want it to be.

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And therefore, this protected time allows me to continue to refine my idea until it

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gets funded and I'm able to get my own independent funding.

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It makes it very clear.

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It makes it very clear that you have a sense of your direction.

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No one's going to have to give it to you.

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And that helps people have confidence in your ability to deliver or make use of the help

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that's given to you so that you can deliver.

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So those are five things that fellows can think about in their quest to become a clinician

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researcher.

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And I want to say that if this episode has been helpful to you, if you think it will

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be helpful to someone else, please share it with them.

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We also are asking you to please subscribe and share your feedback by rating the podcast.

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We want to hear from you.

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And we know that as you rate the podcast, we're hoping you'll give us a five star rating.

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It helps other people find us as well.

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All right.

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It's been a pleasure to talk with you today.

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I look forward to the next time.

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Thanks for listening to this episode of the Clinician Researcher Podcast, where academic

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clinicians learn the skills to build their own research program, whether or not they

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have a mentor.

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If you found the information in this episode to be helpful, don't keep it all to yourself.

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Someone else needs to hear it.

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So take a minute right now and share it.

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As you share this episode, you become part of our mission to help launch a new generation

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of clinician researchers who make transformative discoveries that change the way we do healthcare.