The number one shift you need to make as a clinician researcher

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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 am excited to be talking with you today on the Clinician Researcher podcast.

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And today I'm talking about the number one shift that you need to make to succeed in

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research that is the number one shift that you really do need to make to succeed in research.

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Now when I first applied for my first grant, it was actually in medical school.

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And the reason I applied for this grant is because my medical school had an option to

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take the third year and completely make it a scholarly third year.

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So our second year was actually our clinical year on the wards, and our third year was

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just dedicated to scholarly work.

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And the encouragement at the time was that people would go into labs and do research

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projects, but you did have the opportunity to get a second degree or there were different

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things you could do.

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But really it was really about scholarly research.

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And it was an opportunity for me to apply to a grant that would actually pay for part

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of my medical school.

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So I was going to get a grant that allowed me to do research and actually would fund

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me for the duration of my third year.

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And so that would be one year or less of student loan debt.

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So spoiler alert, I didn't get it.

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However, one of the things that that set up for me and I think about is how I always looked

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at research for me as a means to an end.

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I want free money, I will apply for a grant.

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But when I look back, it was always my MO throughout.

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So when I did research in undergrad, it was kind of with a view toward, okay, this will

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increase my chances of getting into med school.

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When I did research in residency and fellowship, there was always the sense of like, okay,

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what does this get me?

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And I do think it's the perspective of many of us in medicine, especially with regard

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to our physician training, because we do all this stuff from undergrad to get into med

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school.

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Now we do all this stuff in med school to get into residency.

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And if we do fellowship, we do all the stuff in residency that gets us into fellowship.

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So there's always this sense that we're exchanging the research we do for something.

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So if I do this, I get an opportunity to do more.

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And in a sense, research was like a transaction.

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And I recognized really as I traveled through my training and finally got to fellowship,

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and I was like, I actually really like research.

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Now there's no more transaction.

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Now it's not so much about, well, if you do research, you can get to the next level, because

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I was done.

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I was looking for a faculty job, and this time I wanted to do research for real.

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But one of the challenges of doing research as a transaction over time is that that actually

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became my MO.

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And so I had trained myself to be someone who did research so that I could get something

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at the end of it.

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And to be honest, it doesn't end as a faculty member.

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People are asking, well, how many manuscripts have you published, and how many grants have

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you submitted and earned?

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And there's so much about the stuff at the end that you can become confused and think

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about research as something you do to get something else.

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Like, if I can do research, I'll get the manuscript published.

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If I can do research, someone will give me money to be funded.

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And so today I'm talking about the number one shift you need to make to succeed in research.

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And before I tell you the number one shift, I want to talk about three reasons why people

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don't succeed in research.

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Three reasons.

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There are many reasons.

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I want to talk about three today.

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And the first one I want to talk about is that many times for us physicians, our training,

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our experience has been in that transactional nature of research as just something we do,

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the price we pay to get us to the next level.

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And so one of the reasons that people don't succeed is because that's the only way they

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see research.

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It's just the thing you do to get you to the next level.

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And the reality is that research is the vehicle that helps us answer questions.

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But research is an end in itself.

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The process of being able to answer questions that allows you to really make a difference

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is an end in itself.

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It's not a means to an end.

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It's not a means to promotion.

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It's not a means to more publications.

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Publications are the fruit of the research.

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You did work and now it's time to communicate that work.

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That's what a publication is.

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Publication is not a reward.

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It's like I did this research, now give me my reward.

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It's not the reward.

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It's just the fruit of having done the research.

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That means just you plant seeds of research, the fruits of publication arise because it

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doesn't really matter what you did if nobody knows about it.

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And so publication is really the means by which we say, hey, we did this work and we

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found this thing and we want to share it with an audience.

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And it's the same thing as giving talks.

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One of the metrics for promotion is if you are invited to give talks.

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Well, so people chase giving talks, but really in reality, talks are the fruit of the work

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you've been doing.

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You're talking about what you've been doing.

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And so I think it's important for people to stop seeing research as something they exchange

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for the next thing because then in a sense, you're just chasing the end result.

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And so the people who chase the end result will always have a different outcome from

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people who actually do research because there's a question that they want to answer that's

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really going to make a transformation in the lives of the patients they care for.

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And so number one reason for lack of success in research is really that many people are

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seeing research as something they do just to get the next thing.

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And you can succeed.

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Oh, people succeed widely.

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People do.

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They get all the things.

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They get all the trimmings.

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But at the end of the day, research is really a means really to move forward work that is

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meaningful to you that you enjoy when you do it.

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So the fact that you enjoy the research that you do just for the sole purpose of enjoyment

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is a sign that you see research as an end in itself.

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And ultimately, research produces things if you fully enjoy what you do, it's a good sign.

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If you're just kind of doing it just to get to the end, not a good sign.

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And that's one of the reasons why people don't succeed because you know what?

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It's hard.

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And rejection is like just part of the game.

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It's the name of the game.

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But if you love what you do enough so that you can overcome rejection, the chances are

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you're going to be doing it a long time.

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And the longer you do it, then you really start to see the benefits of compounding.

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And so people who are seeing research as a means to an end, they get to the place where

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it's like, you know what?

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This is not working.

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I quit.

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And so they're not really able to get the real benefits of the research because they

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quit too early.

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But when you enjoy what you're doing, you understand what greater purpose it serves.

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It really does allow you to enjoy the journey.

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And that is the real gift of doing research.

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It's the journey.

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It's because of who you become in the process of learning to ask and answer good questions.

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All right.

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Number two.

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Number two reason for lack of success in research is because many times as physicians we see

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ourselves as like a peripheral bit player in the research.

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A peripheral bit player, not as a leader of the research.

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And here's the challenge.

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Physician training is leadership training.

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Think about it.

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Let's think through residency.

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And you start out as the intern who's doing all the work and calling all the people and

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finding out about the patient and you're just doing.

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And then you move to be a resident and you're not just doing stuff.

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You're leading someone else to do it.

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You're now leading the intern or the interns.

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By the time you get to be a senior resident, you're really, really, really leading now.

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And so your whole life of training has been as a leader.

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And then you get to the place where you're like, OK, I want to do research.

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Many times I see people say, well, I just want to do a little bit of research.

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I just want to do a little bit.

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But the thing about doing a little bit of research is that, you know, are you trying

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to be a research technician or are you trying to be a research assistant?

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Because honestly, research technicians, research assistants, they do research too.

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But if you are coming to research as a clinician, it's because there's a clinical question that

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matters.

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There is a problem that you've identified in the clinical space that needs to be addressed.

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That's why you come to research.

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And so if there is something that is so important that needs to be addressed, well, who's going

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to lead it if not you?

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If you're just like, OK, I'll just, you know, I'll go with whoever else is doing this work.

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It's not likely that they have the exact same thoughts as you in terms of the direction

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that the research should go.

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Now, let's just, you know, OK, let's take a step back and say it's possible that, for

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example, I'm a hematologist and I care about TTP, thrombotic, thrombocytopenic purpura.

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Yes.

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If I gather with enough physicians, with enough hematologists who see patients with TTP, well,

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we probably will have similar questions that really bug us.

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And so we all come together and we can like figure out research questions that we want

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to answer.

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And you can be a peripheral bit player in that because there are other people who are

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kind of leading the same questions that you're interested in.

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I would argue that as a clinician who's leading research, your job is not to come together

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with everybody who already has the exact same interest as you and has the exact same questions

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they want to answer.

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Your job is to have the question and then find the person who has methodological expertise,

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so usually a PhD in my mind, maybe a biostatistician, and connect with them.

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And you have the clinical question and they come with the methodology and together the

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synergy is super awesome.

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So good.

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But that's you as a leader.

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It's you saying, I lead the clinical piece of this.

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I know what outcomes are relevant.

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I understand how to interpret the findings in light of the patients that I see.

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And so you come to research as the leader, as someone who has clinical experience, so

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that your leadership is a clinical leadership within the research realm.

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Because PhDs do research all the time and they're really good at it.

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But what they don't have is a clinical piece and that's what you have.

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You can interpret things in ways that they don't have the perspective to interpret it.

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And so they need partners in the research that they do.

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You need partners and they need partners.

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And what I see is a lot of clinicians thinking, well, you know, I'm a bit player, so why don't

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I just learn how to do all these assays and your job is not really to learn how to do

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assays.

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I mean, it's great that you know how to do it.

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Please learn it.

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But don't spend all your time learning all these techniques because your job is to learn

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it enough so you can lead other people to do it.

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But when you see yourself as a peripheral bit player, then you're not thinking, I'm the

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leader.

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You are the leader.

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You are the leader.

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And if you're not, it's like, well, how do you become the leader?

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And you do need to be the leader because the question you have is a question you have.

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Other people may not have that question.

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And if you don't lead it, who's going to do the work?

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And so the problem with being a peripheral bit player is that when the head person says,

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oh, you know what?

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I can't do this anymore, and the research stops.

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And if it's a question you really want to answer, then it's like, well, nobody's doing

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it anymore.

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I guess I don't want to answer that question anymore.

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And that can really derail you.

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And so if you don't see yourself as the person leading, then it's very hard to move research

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forward because it's dependent on the other leader.

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And if the other leader doesn't do it, if somebody decides to change direction, then,

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well, I guess the work is over.

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But I just want to encourage you to think about your research as a program that you

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lead because the questions you want to answer are questions that matter to you.

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If you're not leading it, then the chances are that that specific aspect of the research

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is not being done.

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OK, number three is that you see research as a part-time activity that can be done on

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the side.

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And so I will tell you that throughout my training, really, research wasn't something

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that was a focus of the training.

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Hello, I was getting clinical training, not research training.

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That because of that, research was kind of the thing we did on the side.

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If we published a paper as a resident, we were not writing that paper during the day.

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During the daytime, we were seeing patients.

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And if we were able to get time to actually work on that paper, we were doing it kind

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of at night and on the weekends or in our time off.

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And so that experience of doing research on the side then carries over to your career.

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And you think that your clinical work is the most important work you do, and research is

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just part-time activity.

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But in reality, research is a full-time job, and you can have more than one full-time job.

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Absolutely, you can.

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And in reality, when you think about even the big-time PIs, as we like to call them,

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who have multiple grants, they're kind of part-time actually on each grant.

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And what they do is they raise enough money, enough capital, called grant funding, to have

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other people do work for them.

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So in reality, part of what research funding does for you is it helps you leverage the

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time of other people.

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And so you can be a full-time researcher because you fund other full-time people to do it,

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right?

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But research is not a true part-time activity, especially not when you get started.

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And it's not really a thing that can be done on the side.

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People do it on the side.

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They totally do.

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However, if you're going to lead a research program, you're not just answering a question.

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You're raising and funding other people to do the work.

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I'm going to say that again.

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You're raising and funding other people to do the work.

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Any research you're doing by yourself that doesn't require anybody else to come alongside

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you is just not work that's going to be impactful.

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It's not.

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If you can do it by yourself with nobody else supporting you, it's not going to have impact.

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But the more you have people who are kind of part of the program doing the work, leading

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the work, the more you are able to bring in collaborators that add synergy to the work,

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the greater the impact that you can have.

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That doesn't happen if really you only do it on the side when you have time.

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And so research is not a part-time activity, and people who see it as something that's

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part-time don't tend to succeed because not much can come out of part-time activity where

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there's not significant investment.

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Now over time of years of part-time work maybe, but in general, if you're really going to

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make the transformation in research that you want to make, if you really want to see the

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impact of your work on the lives of patients, then research is something that's really done

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full-time.

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And whether it's your full-time or somebody's full-time that you're leveraging because you're

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funding them to do it, research is really full-time.

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So I talked about three things, three reasons for a lack of success in research.

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That's if you see research as a means to an end and not an end in itself, if you see yourself

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as a peripheral bit player in research and not as a leader of it, and three, if you see

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your research as a part-time activity that can be done on the side.

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Okay, so what is the number one thing that you need to succeed as a researcher?

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And I would say that the number one shift that we need to make from our clinical mindset

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is that we see ourselves as leaders of a research program that will solve an important problem.

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So the mindset shift you're making is that I am a leader of a research program, and this

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research program is working to solve an important clinical problem.

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And why is that shift important?

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Because many clinicians don't see themselves as leaders of research.

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Maybe they see their mentors as leaders, or they see their chairs as leaders, but they

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don't see themselves as leaders, and until you see yourself as the de facto leader, then

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it makes it very, very difficult to succeed.

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So there's the part of seeing yourself as a leader of a program of research, but then

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there's also the piece where you see yourself as solving an important problem.

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Research is what we do because there are problems that need to be solved, and we don't understand.

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We have questions we ask that help us to solve problems.

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We don't do research to get manuscripts.

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We don't do research to give talks.

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We don't do research to get promoted.

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Research leads to talks.

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It leads to manuscripts.

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It leads to getting promoted.

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But research is really about problems that need solving.

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And so when you see yourself as doing work to solve problems, you see yourself as the

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leader of a program that does work to solve problems.

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That's the critical shift you make that allows you to start to lead.

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And then you're not asking people, well, how do I live as a researcher?

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Tell me what to do.

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You really are like, well, if I'm leading this research program and this is the problem

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I want to solve, then these are the tools I need.

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These are the people I need access to.

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And it allows you to move from someone who's just a recipient of whatever people give them

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to someone who's like the director of their resource need.

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So it's like, thank you for all this wonderful stuff you want to give me to succeed in research,

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and here is what I need.

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Thank you for this wonderful package that allows me to have a biostatistician in my

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program, and I need grant writing help.

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And I need a program that teaches me to write proposals well.

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And I need support for X.

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Because once you're the leader, then you're not turfing responsibility to someone else.

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You are clear about what you need to achieve.

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Because of that, you can now argue or negotiate for the resources that you need.

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So that is the number one shift you need to make to see yourself as a leader of a program

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that will solve an important problem.

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And this shift doesn't come easily.

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I told you that if you had an experience like mine, research was just something you did,

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transactional.

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But many people actually maybe came to research, and they're like, wait, this is not about

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a transaction for me.

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This is about what I want to do.

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But in reality, our clinical programs don't support us doing that.

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Like it's a clinical training program.

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It's not a research training program.

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And many clinical programs actually have research built into it.

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But even then, it's not the component of the program.

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Not typically.

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It's a side thing.

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It's like, oh, you get three months of elective time.

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What to do?

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And so making this shift, once you come out from your training mindset to, I lead a research

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program, I'm going to solve an important problem, changes the way you see yourself, and it changes

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the way you act and you show up in the world.

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So this shift takes work.

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It does take work.

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And this is why we are hosting a master class on August 21st at 6 p.m. to help people negotiate

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their careers, to help people make the shifts that are necessary to lead as clinician researchers.

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And if you want more information, you can check out our podcast website, ClinicianResearcherPodcast.com,

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because it does take work to figure out exactly how you make the shift.

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It takes time.

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It takes intention.

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It takes effort.

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And so definitely reach out and be part of our upcoming cohort of clients who are learning

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to negotiate their careers so that they can succeed as clinician researchers.

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If this podcast episode has been helpful to you, please share it with someone else.

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Somebody else needs to hear this.

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Somebody else needs to be encouraged and to learn that, the things that you've learned

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today.

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So if this has been helpful to you, definitely share.

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All right.

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It's been a pleasure talking with you today.

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Definitely let us know how this episode was helpful to you.

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I'll see you again 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.