Turn your passion into academic currency with Dr. Toma Omofoye

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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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And welcome to the Clinician Researcher podcast.

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

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I'm especially excited because I have a special guest, Dr. Toma Omofoye.

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Toma, welcome to the show.

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Thank you for having me.

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It's an honor.

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I'm thrilled to be here.

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The pleasure is ours.

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We're so excited to have you on our show.

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And I wonder if you could introduce yourself to the audience, especially with regard to

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your journey as a clinician scientist.

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Well, I'm an associate professor of radiology, and I work in a large academic medical center.

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I did my training at Duke Medical School and residency at Duke Medical School, so I had

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come from that sort of high academic output institution.

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However, when I started my first attending role, I was hired really as a community-based

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academic.

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So I was one of those registered who's actually reading studies out in the community, helping

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bring kind of high quality evidence-based care into community practice settings.

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And so in that role, it was really emphasized that I needed to focus on the clinical skills

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and less so focusing on any of the research or academic output kind of skills.

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Okay.

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Are you going to speak more about that?

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Speak to that a little bit more.

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Just here you are.

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You're hired as a full-time clinician, really, but in a community academic practice.

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So there is some expectation potentially, and there's a little bit of academics within,

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but you really are tasked with being clinical.

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How did you now make this transition to start doing research on that?

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Well, I think the first thing is that I had a hobby that I couldn't quite let go of.

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It really was a passion of mine to try to empower clinicians outside of the United States

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who are practicing in low-reforce settings to be the best clinicians they could be with

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the resources that they have available.

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And so the hobby that I had while I had this very clinical job was to create educational

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context for radiologists who are practicing in remote middle-income countries.

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What is really interesting in radiology is that when most of the world started expanding

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their frontiers and engaging in global health, radiology lags behind because a lot of our

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work is dependent on really expensive, really bulky technology that was really out of the

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reach of a lot of countries that were still developing socioeconomically.

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And so you saw this revolution, I think, like in internal medicine, you saw this HIV care

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led by partners and Paul Farmer.

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You saw these incredible roles in neonatal medicine.

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You saw all of this work on maternal, fetal medicine, maternal mortality outcomes, and

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radiology just really wasn't participating in the same way in global health because we

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really were hampered by not having the technology available on the ground there that we would

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want to use to improve outcomes.

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And I think for me, practicing in a place that is so well recognized, it was a lightbulb

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moment to realize that what was really providing excellent outcomes in our practice wasn't

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access to all of the super high-tech equipment.

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It was actually the ability to navigate that high-tech equipment or the entire spectrum

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of available equipment based on your expertise.

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It's still precision medicine, right?

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And that precision medicine could be about offering a patient the newest thing on the

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market or it could be about offering a patient something that's been around for a long time.

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It's cheap.

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It's really widely available, but it's actually going to answer their question in a way that

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does it quickly and definitively and minimizes their adverse effects.

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So realizing that even for us, having access to everything high-tech didn't mean we were

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using everything high-tech all the time.

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It just meant that we were using things well.

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And it made me, as somebody who is an immigrant, really aware of the potential that we made

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in places that didn't have all of the newest equipment to still provide a lot of really

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precise medicine to try to reduce breast cancer disparity globally.

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And so I started out just with making videos and placing them online.

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And thankfully, my department was very generous and they allowed me to use the department

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learning management software to create a website.

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And so each video had a pre-test and a post-test.

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And in talking with the collaborators, my friends, my colleagues who are working abroad,

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they would basically be the ones to dictate the topics they needed to hear about.

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And we could collaborate on what would be really the best answer to managing that disease

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state in a setting that was sort of a lower resource.

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And so it just kind of blew and blew and blew.

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And one thing led to another, and we found that one third of the residency programs in

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Singapore kind of signed up to use this as their adjunct, educational adjunct for their

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residents who are trying to learn breast radiology.

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And it was a game changer for them because prior to this, they would have to send their

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residents outside of the country, to the US or the UK, to get this kind of training.

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But again, getting that training in a resource-rich environment that doesn't really mimic what

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they may necessarily have at home.

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And so now providing this resource that was resource-adapted, it's available online, it

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was something that was being customized as we went, it ended up providing a lot of value

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to the teams that were using it.

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And so one thing led to another.

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I really, I mean, this gets more into the topic of the podcast here.

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I was really, really encouraged by department leaders, by department chair to publish it

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because I was spending so many nights and weekends doing this on my own time.

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And she said, it doesn't matter how much effort you put into it, it doesn't have the value

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unless it takes the shape of academic currency and academic currency as publications.

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And so if you cannot create a scholarly question around what you're doing, if you cannot create

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publication around what you're doing, you're not receiving the maximum benefit for the

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input that you are actually working on.

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Okay.

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I want to go back to the very beginning where you call it a hobby.

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And I just want to ask you about that because what I hear as you're talking about it just

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is that you had so much past that and it was kind of just a really strong pull to make

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a difference.

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And so I think a lot more than a hobby for sure, but I want you to speak to why you think

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of it as a hobby or if you would describe it differently.

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Yeah, I thought of it as a hobby because starting out as an attending, everyone's asking you

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to define your area of academic interest.

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What are you going to do?

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What are you going to do research in?

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And to me, it felt like the areas I would perform research in were different topics

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than this, right?

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It was what is that cutting edge of the field?

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What is the newest question that's being bandied about in our journal?

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And those to me felt like my areas of interest.

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Education and teaching is something that I've always done, right?

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So I was a peer learning leader doing tutoring in college.

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It was one of my first jobs.

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I had done all sorts of little teaching things as a resident and throughout my career.

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And education was something that I wanted just why I signed up to be this, you know,

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with an academic practice.

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But it didn't feel to me like I was approaching this in the way that you approach something

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where you have a hypothesis, that you have, you know, a very clear idea of what you're

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building and who your team is and what your outputs are going to be.

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I really was approaching this as something that allowed me to scratch the itch of wanting

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to teach because I just enjoyed that for its own sake.

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But I think in a broader sense, what this means is that we often have passion in academia

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that may not be the specific area of your interest, right?

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So my initial publications were another topic.

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But that little passion for teaching itself was something that I was going to care with

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me throughout my life.

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And today, even if I wasn't publishing on this topic now, even if it wasn't now a part

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of my official role, I would still be doing some teaching.

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I think that especially when you're an academic, you're probably an academic because you are

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a tinkerer.

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That's what I say.

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I think most academics are tinkers.

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You look at things and you think, how could this be a little bit better?

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You look at education and go, how could this be better?

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You look at research and go, how can I make this a little bit better?

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You look at all these questions that you're constantly trying to improve on yourself.

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And so if you are that kind of person, it's not that big of a leap to take that tinkering

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mindset and just put a scientific question around it and go ahead and plan for a publication

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around it.

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And even the process of peer review becomes more enjoyable to you because you get those

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revisions back from the editors and the reviewers and you go, I didn't see it that way.

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That's a topic for the next paper on this, right?

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It allows you to enter it with a sense of curiosity.

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And that's what academia, I think, really rewards is the people who want to play around

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with their hobbies.

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They want to play around with 3D printing.

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How could this change my practice?

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AI, that's cool.

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How did it change my practice?

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Those individuals who have that sort of curious growth mindset, that's really all it takes.

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It's not necessarily having a PhD to provide you all of the skills from the get go.

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It's having that curious mindset.

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Thank you.

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One thing that comes up for me is your, actually there are two things that come up.

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And I wonder if you can speak to them maybe at the same time or we can do them one at

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a time.

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But one thing is you did something that many people have not been able to successfully

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do.

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You turned something that you're really passionate about education into academic currency.

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Can you speak to how you did that?

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I think that where there's a will, there's a way.

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I would find it extremely hard to believe that somebody who can navigate high school

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and it's stress and college and medical school and residency that is such, you know, I mean,

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it's really the crescendo I think in terms of difficulty and responsibility and get to

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a situation like this now where you're doing something as part of your role, as part of

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your professional identity.

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And not be able to turn it into currency.

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In fact, I think that you get to this point and it's really about you believing that the

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goal is worthwhile.

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If you believe that the goal is worthwhile, I truly believe that we are creative enough.

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We are determined enough.

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We are stubborn enough to figure out the way to align what we're doing with the language

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that's necessary for currency.

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Of course, there's work that has to be done, but that work is done because the goal is

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worthwhile, right?

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Once it became important to me to put currency around this, then I sat there and did a literature

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review, right?

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Like I went into PubMed and Google Scholar and actually looked at what had been written

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and what angles had been taken.

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And I mean, everybody who's written on the topics of e-learning, people who have written

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on the topics of resource-adapted care, they all at the end of their manuscript will have

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some printings about next steps, which most of the time they didn't get to, right?

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And so you get to be the one that adds to the body of literature by incorporating some

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of those next steps into your work.

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And also you get to benefit from their hard work by not having to make all the mistakes

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yourself.

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You can kind of use some of the methods that they have used, of course, giving appropriate

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credit so that you're able to do your work efficiently.

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But I think the real key to being able to make that transition, especially with educational

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work and transitioning that into currency is believing that it's a worthwhile goal.

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And I think that it is.

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I think that it is because it does give you, number one, the credibility that what you're

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doing is evidence-based, that what you're doing is in fact something that does no harm

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because that's what peer review does, right?

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It allows people to look into your work and critique it and make sure that it is ethical.

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It is a buzz board.

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The IRB is looking at this.

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I think the ability to do, to create publications out of our work and research out of our work

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is also a way for us to establish ourselves as experts.

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There are hundreds and thousands of people who are doing e-learning programs.

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I am probably not even in the top 10 or top 100 or top 1,000 of the most hardworking or

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the smartest, right?

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But if you are, unfortunately, quiet about what you're doing, then it's a step you didn't

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do it at all.

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That's the unfortunate thing.

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And so you get to establish some expertise.

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And if you think about it this way, you're not becoming an expert for pride or ego.

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You're becoming an expert to help other people who are interested in doing similar work make

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fewer mistakes the next time around.

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You're becoming an expert so that people who are looking for the kind of problems, kind

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of solutions that you're solving can now access that through your work.

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So I think that that provides that.

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But I also say one important thing to think about is that time is limited.

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Time gets more limited, I feel like, every year.

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And so with academia, they want you to be visible to that.

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You're a clinician.

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You're an educator.

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You're a researcher.

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And so if you are able to kind of be synergistic in the way that you work, so your education,

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check that box, is also research.

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Check that box.

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You're actually sort of streamlining your workflow.

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And then things start to feed into each other.

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In my case, since my education and my research and my hobby were all kind of lining up, it's

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like, okay, this was also a way to refresh myself and be rejuvenated by my work, as opposed

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to feeling like I needed to engage in scientific projects that were very highbrow and serious.

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For the sake of highbrow and serious, even when I didn't love them, I could do something

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that I loved and get maximum benefit out of it on multiple fronts.

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So you talk about this kind of the energy that comes from doing this work, the ability

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to layer it on top of things you're already doing.

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And it makes me wonder, there are other projects you were doing before you really started taking

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the education and creating academic currency out of it.

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How did that shift the focus of your work?

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To what extent did you continue to do the other work?

242
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And what was the difference in energy in the work you were doing before compared to the

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work you now started to push forward?

244
00:17:36,920 --> 00:17:40,040
Yeah, I think that's a great question.

245
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When I started to do this, it was very slow.

246
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Even getting it published the first time was very difficult, right?

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There's just sort of multiple rejections and the editors couldn't quite, I mean, I'm talking

248
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death rejections, like you send it and within 30 minutes, they're like, nope, thank you.

249
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I didn't have a clear enough idea.

250
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They didn't have a clear enough idea.

251
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And so between the first death rejection and the second submission was actually a good

252
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six months.

253
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I restructured what I was doing, right?

254
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So it was very slow.

255
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It was a very slow ramp up.

256
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And so the other projects I was engaging in, I continued to kind of engage in them all

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along.

258
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And then I will say it's sort of nothing, nothing, nothing, and then everything all

259
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at once, right?

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It happened that the next submission came right after COVID when suddenly learning

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was the thing.

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It was very, you know, it was just, it was just the, I guess, the global mindset at that

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time.

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And then what happened with that is because it was something that globally was of interest,

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we now had, I now had editors that would reach out and say, would you review this paper,

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right?

267
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Or would you write an editorial or an invited article on this particular subtopic of the

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work that you're doing?

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And so initially it was very slow with this work and I could continue to engage with the

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other work that I was doing.

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But at the point where I decided to apply for grants, a foundational grant for this

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work, a foundation grant for this work, I knew that, I mean, just the grant writing

273
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process itself, right?

274
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Like I did not have a master's degree.

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I don't have a PhD.

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I've never done it before.

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The process of trying to write a grant, I had to slow down just about everything else

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that I was doing to learn this, right?

279
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And so everything else at that point actually, I would say I froze it.

280
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And I started to go very seriously to grant writing.

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Now when I submitted the first grant, which I did not get, and the second grant, which

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I did not get, and the third one, I think I got the third one.

283
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Maybe I didn't get the third one.

284
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Might have been the fourth one.

285
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But each of those, each of the comments that came back from all of those grants showed

286
00:19:59,520 --> 00:20:03,560
me where I had gaps in my research.

287
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So they gave me additional topics in this work that I could then explore to publish

288
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papers on to strengthen my next application, basically, which may be the hard way.

289
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I don't know.

290
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Maybe I should just have kept applying to more grants more frequently instead of trying

291
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to actually respond to what reviewers were saying.

292
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But it actually allowed me again to build that credibility as I went along.

293
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And so at that point, once I got to the point where now I'm applying for grants, I really

294
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did kind of stop the other things that I was doing.

295
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Once I got the first grant, and in the process of doing that, of course, you have collaborators

296
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that you've now built around you and mentors you've built around you locally at your institution

297
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and nationally and attached to the grant itself.

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It felt more like the work was more shared.

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And so it was now easier for me, I think, to start to pick back up some of the other

300
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topics that I had dropped.

301
00:21:00,680 --> 00:21:06,920
And I think that that's a decision each person makes is do you want to just be 100% in this

302
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particular field?

303
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Are you interested in still being the multi-faceted researcher?

304
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I think that depends for everyone.

305
00:21:15,240 --> 00:21:21,440
But I did become more selective about asking people, what is it that you would need from

306
00:21:21,440 --> 00:21:23,200
me on this project?

307
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And what is the timeline on this?

308
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So that I could be more careful about how I was able to distribute my time and what projects

309
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I was really going to truly be able to invest in and contribute to in a way that was beneficial

310
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for that team.

311
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Wow, I see a lot of kind of strategy, strategic investment and focus when it was time to do

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that.

313
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And then once there was a cadre of people involved and working collaboratively, you

314
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could let go of some of the heavy lifting to go back into some of the other work.

315
00:22:00,640 --> 00:22:05,800
So it sounds like kind of selective to zooming in and zooming out as needed.

316
00:22:05,800 --> 00:22:07,720
Yeah, I like that.

317
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Zooming in and zooming out.

318
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I like that.

319
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Absolutely.

320
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And I did this.

321
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I listened to a lot of podcasts and read a lot of books.

322
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In fact, most of the time I wasn't even reading books about academia or research.

323
00:22:22,680 --> 00:22:28,960
It was probably about strategy and maintaining different skill sets and strengths.

324
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Because there are strengths that I have and there are strengths that I don't have and

325
00:22:31,560 --> 00:22:36,040
learning how to find the right collaborators for it.

326
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There are teams on which, you know, they probably consider me a great co-author.

327
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And there are teams where I probably just did not bring value because the role that

328
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I was offered was not one that matched my strengths.

329
00:22:49,240 --> 00:22:55,320
And so that was a big part of it for me was if I have limited time, can I spend some time

330
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on strategy instead of just trying to spend all the hours on doing work, right?

331
00:23:00,720 --> 00:23:06,240
It's that whole mindset of are you just a worker being or are you also able to be the

332
00:23:06,240 --> 00:23:09,800
queen bee or are you also able to be the manager of your own work?

333
00:23:09,800 --> 00:23:15,760
It's not just about, and this happens, the busier you are, the more projects you have

334
00:23:15,760 --> 00:23:20,440
going on, but easier it is to just default to to-do list and just think, I just need

335
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to work, you know, 16 hours a day, 18 hours a day, just more work, just to check things

336
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off.

337
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But there's a lot of benefit I've learned in actually zooming out, like you say, and

338
00:23:32,480 --> 00:23:34,880
saying, do I need to do this at all?

339
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Or can I offer this team a different role that I could play that's going to match my

340
00:23:40,120 --> 00:23:41,120
strengths a little bit easier?

341
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It'll be faster for me and it'll be better for everyone involved.

342
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Are there things that I can just completely move to next year?

343
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Are there things that I can delegate?

344
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Are there things that are synergistic?

345
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Are there other collaborators I can invite into this work that will flip the load?

346
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And I think that was a huge, huge, huge factor in terms of not getting lost in the week.

347
00:24:03,400 --> 00:24:04,400
That's really powerful.

348
00:24:04,400 --> 00:24:08,040
One of the things I want to highlight that you mentioned right now and you actually talked

349
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about earlier is really the importance of strategy.

350
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Because as clinicians who are so busy clinically, and I think there's no clinician who doesn't

351
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understand how busy clinical work can be, for you to be able to do what you described

352
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early in layering, like this is my clinical work and I'm going to layer that on top of

353
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my academic work and layer that on top of a hobby I'm going to be doing anyway, is strategic

354
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use of your time.

355
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But then also thinking about how can I strategically bring people into this project so that I'm

356
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not doing all of the heavy lifting?

357
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And I think that's so critical in the sense that clinicians are not PhD scientists.

358
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And it's not that they cannot be.

359
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Given all the time in the world, we absolutely could be.

360
00:24:49,200 --> 00:24:53,380
But if we're coming to research a little bit later in the game, which most clinicians are,

361
00:24:53,380 --> 00:24:57,520
then we have to think strategically about how do we build it on top of and in spite

362
00:24:57,520 --> 00:24:59,760
of all the other things that we're doing?

363
00:24:59,760 --> 00:25:04,160
And I think you highlight how to do that really effectively.

364
00:25:04,160 --> 00:25:07,480
Well, thank you.

365
00:25:07,480 --> 00:25:11,040
I think it sounds so much cleaner in retrospect than it felt in the moment.

366
00:25:11,040 --> 00:25:12,040
It felt really messy.

367
00:25:12,040 --> 00:25:14,800
And you know what, that's worth saying.

368
00:25:14,800 --> 00:25:16,240
It felt messy.

369
00:25:16,240 --> 00:25:19,120
It felt like I was pulled in a million directions.

370
00:25:19,120 --> 00:25:23,040
And there's probably the people who were more strategic than I was who could have done it

371
00:25:23,040 --> 00:25:24,900
in a way that was more seamless.

372
00:25:24,900 --> 00:25:28,680
But I do encourage those for whom it does feel messy.

373
00:25:28,680 --> 00:25:32,400
That doesn't necessarily mean you're doing it wrong or that it won't be successful.

374
00:25:32,400 --> 00:25:38,720
If that adds with anything else, you're developing the skill sets that allow you to make each

375
00:25:38,720 --> 00:25:44,920
iteration better, more organized than the previous one.

376
00:25:44,920 --> 00:25:49,920
And one of the things I ended up learning were what are the tools that are available

377
00:25:49,920 --> 00:25:50,920
at my institution?

378
00:25:50,920 --> 00:25:52,960
And there were a lot of them.

379
00:25:52,960 --> 00:25:57,680
There is a grant writing office that will assist with reviewing your grants.

380
00:25:57,680 --> 00:26:02,920
Most of it is just editing, right, not necessarily scientific writing.

381
00:26:02,920 --> 00:26:07,440
But that was helpful because then I don't need to sit there and parse out whether this

382
00:26:07,440 --> 00:26:09,960
needs a comma or semicolon.

383
00:26:09,960 --> 00:26:10,960
We can leave that.

384
00:26:10,960 --> 00:26:14,120
We can just get to the meat of what needs to be discussed.

385
00:26:14,120 --> 00:26:20,080
So really figuring out what tools were available that I could harness was helpful.

386
00:26:20,080 --> 00:26:25,920
I reached out to people who had previously been awarded the grant that I was going after.

387
00:26:25,920 --> 00:26:30,760
And they were so kind and shared components of what they had written with me and mentored

388
00:26:30,760 --> 00:26:31,760
me through.

389
00:26:31,760 --> 00:26:35,480
And we became friends, right, because they were applying for other grants down the line

390
00:26:35,480 --> 00:26:39,560
or they were trying to work out a research question.

391
00:26:39,560 --> 00:26:41,600
And they would run that by me.

392
00:26:41,600 --> 00:26:47,120
And so it actually, again, becomes synergistic because it's an area of interest anyway.

393
00:26:47,120 --> 00:26:50,680
And so reaching out to those people, they become your friends, they become your collaborators.

394
00:26:50,680 --> 00:26:53,800
We've now collaborated together on other projects.

395
00:26:53,800 --> 00:26:57,360
Really thinking about what do I have in my toolkit?

396
00:26:57,360 --> 00:26:58,360
And that includes people.

397
00:26:58,360 --> 00:27:00,720
What people do I have in my toolkit?

398
00:27:00,720 --> 00:27:02,920
What resources are my institution?

399
00:27:02,920 --> 00:27:08,440
What resources do I have from the research training class that I took in medical school?

400
00:27:08,440 --> 00:27:09,940
What can I find from there?

401
00:27:09,940 --> 00:27:12,480
You have a lot more than you think.

402
00:27:12,480 --> 00:27:16,520
Tell me about mentors who supported you in this process.

403
00:27:16,520 --> 00:27:23,440
Well, that's a great question.

404
00:27:23,440 --> 00:27:31,800
I think that I had sponsors more than I had mentors, but I didn't realize it at the time.

405
00:27:31,800 --> 00:27:36,840
So I had a department chair who saw this vision from day one.

406
00:27:36,840 --> 00:27:40,280
And she just would talk to me about what did you do this weekend?

407
00:27:40,280 --> 00:27:44,840
I was recording videos and she would go, have you applied for that grant?

408
00:27:44,840 --> 00:27:45,840
Yeah.

409
00:27:45,840 --> 00:27:48,000
She just saw this vision from the beginning.

410
00:27:48,000 --> 00:27:50,800
And I think that that push was really important.

411
00:27:50,800 --> 00:27:54,600
I think when I now got to the point where I was applying for the grant, because I wanted

412
00:27:54,600 --> 00:28:01,360
to have more flexibility in my schedule, that's another reason to make the transition.

413
00:28:01,360 --> 00:28:04,380
If you do have grant funded work, typically that protects your time.

414
00:28:04,380 --> 00:28:07,520
You have more flexibility in your schedule.

415
00:28:07,520 --> 00:28:15,200
When I went to go do that, that's really when I realized, oh, she's a sponsor.

416
00:28:15,200 --> 00:28:16,200
She's not necessarily a mentor.

417
00:28:16,200 --> 00:28:21,160
She's not necessarily the person who's going to line edit the work that I'm doing.

418
00:28:21,160 --> 00:28:22,160
Just too busy.

419
00:28:22,160 --> 00:28:23,960
She's got too many things going on.

420
00:28:23,960 --> 00:28:30,880
But again, I think once you believe in the goal, which she did, it's such a motivator

421
00:28:30,880 --> 00:28:35,320
then to figure out all the things between here and there.

422
00:28:35,320 --> 00:28:43,720
I also had sponsors who were interested in the big picture of how can we get radiology

423
00:28:43,720 --> 00:28:46,360
more interested in global health, period.

424
00:28:46,360 --> 00:28:50,240
And so they weren't necessarily sold on what I was doing.

425
00:28:50,240 --> 00:28:52,120
They didn't know anything about what I was doing.

426
00:28:52,120 --> 00:28:55,840
But they overall had a belief that this was important.

427
00:28:55,840 --> 00:29:01,640
And their skill set around just what I would call bench research, more of the true clinical

428
00:29:01,640 --> 00:29:08,260
translational research, but in global health, allowed me to modify my work to have the kind

429
00:29:08,260 --> 00:29:13,600
of hypothesis that you actually need for a grant application, but you may not necessarily

430
00:29:13,600 --> 00:29:17,200
see in educational projects.

431
00:29:17,200 --> 00:29:18,480
And then I would take for mentors.

432
00:29:18,480 --> 00:29:20,040
Yeah, that was a big one.

433
00:29:20,040 --> 00:29:28,280
So those sponsors, there was the head of education for our division, heard of my work and said,

434
00:29:28,280 --> 00:29:32,080
I think we need to put a better research question around this.

435
00:29:32,080 --> 00:29:35,160
Let me introduce you to other people who are doing educational research.

436
00:29:35,160 --> 00:29:41,320
And so they helped connect me with the kind of mentors who had done similar things that

437
00:29:41,320 --> 00:29:42,740
then became my collaborators.

438
00:29:42,740 --> 00:29:46,520
So they then mentored me on different aspects of the project.

439
00:29:46,520 --> 00:29:53,080
One of the biggest things for me, specifically, because global health, is that some of my

440
00:29:53,080 --> 00:29:56,160
mentors are global experts.

441
00:29:56,160 --> 00:29:59,840
So I don't want to say local experts, but in-country experts, right?

442
00:29:59,840 --> 00:30:05,400
I consider them to be the experts that guide the work that I do.

443
00:30:05,400 --> 00:30:10,160
And often they are so busy clinically, they are extremely busy clinically.

444
00:30:10,160 --> 00:30:15,440
There's one radiologist per million people in sub-Saharan Africa, one radiologist per

445
00:30:15,440 --> 00:30:16,440
million.

446
00:30:16,440 --> 00:30:22,760
Some countries have zero specialty trained radiologists.

447
00:30:22,760 --> 00:30:28,280
So they are juggling the entire country in terms of clinical volume on their back, but

448
00:30:28,280 --> 00:30:31,120
they are experts in what they need.

449
00:30:31,120 --> 00:30:39,000
And so you are helping to be the arm that writes out and executes some of the projects

450
00:30:39,000 --> 00:30:41,840
that they think are going to be super impactful.

451
00:30:41,840 --> 00:30:46,800
And so they were extremely helpful as mentors, even though they could do the clinical science

452
00:30:46,800 --> 00:30:51,400
writing piece, they were extremely helpful as mentors in terms of defining the work that

453
00:30:51,400 --> 00:30:59,120
I was trying to do, making sure that it made sense and it had been critiqued and was likely

454
00:30:59,120 --> 00:31:00,640
to be successful.

455
00:31:00,640 --> 00:31:06,160
And then of course, in actually helping to make it successful when we launched.

456
00:31:06,160 --> 00:31:07,520
Thank you for that, Thoma.

457
00:31:07,520 --> 00:31:11,800
What I'm hearing is that you really pieced your mentoring together from as many people

458
00:31:11,800 --> 00:31:13,960
as possible.

459
00:31:13,960 --> 00:31:17,720
And I think it speaks to the experience of many clinicians who don't necessarily have

460
00:31:17,720 --> 00:31:19,620
the one mentor.

461
00:31:19,620 --> 00:31:23,080
And for what you're talking about, you're creating something new.

462
00:31:23,080 --> 00:31:25,680
And I think many clinicians are doing the same.

463
00:31:25,680 --> 00:31:27,480
They're not following a tried and true path.

464
00:31:27,480 --> 00:31:31,080
And when you're doing that, there's not one person who's going to rise to the floor as

465
00:31:31,080 --> 00:31:35,200
the expert that I'm going to go apprentice and they're doing apprenticeship in their

466
00:31:35,200 --> 00:31:36,200
lab.

467
00:31:36,200 --> 00:31:38,920
And they are taking what you need.

468
00:31:38,920 --> 00:31:41,080
So I want you to just speak about what does it take?

469
00:31:41,080 --> 00:31:45,720
What does it take to be the kind of person who knows what, who goes after what you want,

470
00:31:45,720 --> 00:31:47,360
who knows you have to know what you want, right?

471
00:31:47,360 --> 00:31:50,180
And then the person can go after it.

472
00:31:50,180 --> 00:31:54,160
And it takes, I think it's a special skill and strength to do that.

473
00:31:54,160 --> 00:31:58,640
And can you speak to how you develop those strengths to be able to figure out what you

474
00:31:58,640 --> 00:32:03,320
want and go after it in different people?

475
00:32:03,320 --> 00:32:07,640
All of those strengths, they all have terrible names, right?

476
00:32:07,640 --> 00:32:12,640
The strengths are things like stubbornness, you know?

477
00:32:12,640 --> 00:32:17,560
You know, it's probably, I guess we could say it's...

478
00:32:17,560 --> 00:32:22,960
We have to be careful not to be egotistical about the work that we do.

479
00:32:22,960 --> 00:32:30,120
But you do have to believe strongly enough that there is importance to the work.

480
00:32:30,120 --> 00:32:34,440
It doesn't have to be about me, but it's important for this work to get done.

481
00:32:34,440 --> 00:32:39,760
And it's important enough for me to bug somebody about it.

482
00:32:39,760 --> 00:32:45,560
It's important enough for the people who benefit from this work for me to be humble enough

483
00:32:45,560 --> 00:32:52,560
to open myself up to mentorship from all of these sources, right?

484
00:32:52,560 --> 00:32:56,720
Because these mentors are not necessarily friends, right?

485
00:32:56,720 --> 00:33:00,280
So you have to have that skill set of flexibility and adaptability.

486
00:33:00,280 --> 00:33:08,760
Like here, the pearls you're getting through whatever format they're being given to you,

487
00:33:08,760 --> 00:33:15,580
it's not a situation where you can build all of the depth of relationship maybe that would

488
00:33:15,580 --> 00:33:19,720
allow you to be coddled and get lenudged and all of that.

489
00:33:19,720 --> 00:33:24,600
You're working with people who have different expertise, they have different skill sets,

490
00:33:24,600 --> 00:33:25,600
they're busy.

491
00:33:25,600 --> 00:33:30,800
But being able to get pearls, being able to clearly define the questions you want answered

492
00:33:30,800 --> 00:33:33,200
by this individual is helpful.

493
00:33:33,200 --> 00:33:42,920
And so I think the communication with individuals could say, I'm doing this, I would love to

494
00:33:42,920 --> 00:33:46,560
collaborate with you, can you help me with this, right?

495
00:33:46,560 --> 00:33:48,680
It's really short emails, but very clear ads.

496
00:33:48,680 --> 00:33:52,340
And some people would just say no, some people would just respond with like a paper they

497
00:33:52,340 --> 00:33:56,080
had written and it's like, okay.

498
00:33:56,080 --> 00:34:02,880
But even though in the beginning of pursuing all of these people, it can be a little unclear

499
00:34:02,880 --> 00:34:09,000
as to how the relationship will take shape and how much benefit you'll get from it.

500
00:34:09,000 --> 00:34:14,680
What ends up happening is that you're pursuing, people love that, people love a winner, people

501
00:34:14,680 --> 00:34:16,320
love a winner.

502
00:34:16,320 --> 00:34:22,840
People also love to be acknowledged for their efforts because they've probably been emailed

503
00:34:22,840 --> 00:34:29,000
10 times in the last three months from all sorts of sources looking for help.

504
00:34:29,000 --> 00:34:33,080
And so you being the one who comes back to say, hey, I bugged you about this, but here's

505
00:34:33,080 --> 00:34:38,200
what I'm doing and I'm highlighting in the acknowledgement section of this paper and

506
00:34:38,200 --> 00:34:42,480
I may be applying for a grant later that I think we could collaborate on or I could have

507
00:34:42,480 --> 00:34:45,800
you as a co-walker on this paper if you want to work on this.

508
00:34:45,800 --> 00:34:49,920
It starts to show them the fruit of their labor and then they engage with you a little

509
00:34:49,920 --> 00:34:50,920
bit more.

510
00:34:50,920 --> 00:34:56,760
So I think there's a component of this that is having thick skin in terms of how the information

511
00:34:56,760 --> 00:35:03,760
is communicated to you, how those pearls come, how infrequently you may have contacts, how

512
00:35:03,760 --> 00:35:08,400
much gobbling you have to do to get their attention to begin with, how persistent you

513
00:35:08,400 --> 00:35:09,880
have to be around that.

514
00:35:09,880 --> 00:35:16,360
But you all, I think, come back to them with gratitude and humility and this understanding

515
00:35:16,360 --> 00:35:18,160
that this is going to be my life's path.

516
00:35:18,160 --> 00:35:22,400
And so if I'm doing this, this is the only paper that came out of this.

517
00:35:22,400 --> 00:35:25,320
Thank you for helping me get this far and this allows me to sleep a little better at

518
00:35:25,320 --> 00:35:26,320
night.

519
00:35:26,320 --> 00:35:30,440
So I think, I don't know if you could find the skills in there, but maybe you guys still

520
00:35:30,440 --> 00:35:33,560
have some skills in there that folks could use.

521
00:35:33,560 --> 00:35:41,920
I hear you talking about the importance of knowing what you want, the skill of being

522
00:35:41,920 --> 00:35:45,880
able to clearly define it for someone else so that they're very clear on what you want.

523
00:35:45,880 --> 00:35:50,040
And they can say yes or they can say no, but at least you're making it very explicit.

524
00:35:50,040 --> 00:35:55,720
And then I also hear you talk about tenacity and also you talk clearly about humility and

525
00:35:55,720 --> 00:36:00,200
coming back and letting people know how their help has advanced your work.

526
00:36:00,200 --> 00:36:02,880
And I think those are all really amazing things.

527
00:36:02,880 --> 00:36:04,800
I think that captures much of what you said.

528
00:36:04,800 --> 00:36:07,240
What do you think?

529
00:36:07,240 --> 00:36:08,320
I think you're absolutely right.

530
00:36:08,320 --> 00:36:12,600
I think you summarized that beautifully.

531
00:36:12,600 --> 00:36:17,200
So along the lines of all this amazing work you've been doing, big things are happening

532
00:36:17,200 --> 00:36:18,200
for you.

533
00:36:18,200 --> 00:36:24,120
What do you share with our audience where this work is going and how the big things

534
00:36:24,120 --> 00:36:25,120
that are coming out of it?

535
00:36:25,120 --> 00:36:26,120
I think that's all I can say.

536
00:36:26,120 --> 00:36:27,120
Yeah.

537
00:36:27,120 --> 00:36:28,120
Yeah.

538
00:36:28,120 --> 00:36:31,000
So a lot of big things that I really didn't anticipate.

539
00:36:31,000 --> 00:36:37,760
So once it was published, I had people reach out from Africa really interested in using

540
00:36:37,760 --> 00:36:42,480
the curriculum, modifying the e-learning curriculum for sub-Saharan Africa.

541
00:36:42,480 --> 00:36:49,120
And so we applied for a grant which was funded to modify this for sub-Saharan Africa.

542
00:36:49,120 --> 00:36:54,840
One of my collaborators actually also helped us to create more sustainability around this

543
00:36:54,840 --> 00:37:00,480
project in terms of doing not just the online learning, but what we call Project Echo, which

544
00:37:00,480 --> 00:37:06,680
is a telemedicine where people show monthly cases, which I mean, a community now that

545
00:37:06,680 --> 00:37:14,880
is so wide, we have people monthly who have joined from Zambia, Tanzania, Nigeria, Ghana,

546
00:37:14,880 --> 00:37:22,800
Uganda, Rwanda, I mean, just all over sub-Saharan Africa using components of this curriculum

547
00:37:22,800 --> 00:37:25,160
and this educational community.

548
00:37:25,160 --> 00:37:30,280
And then as part of this work, and again, I think the benefits of building credibility

549
00:37:30,280 --> 00:37:38,000
around this, as our institution itself decided to reframe its strategy for global health,

550
00:37:38,000 --> 00:37:42,240
and they were looking for experts in breast cancer, the fact that I had publications

551
00:37:42,240 --> 00:37:47,400
from this and I had a grant from this meant that I ended up getting an institutional role,

552
00:37:47,400 --> 00:37:56,000
a director of breast imaging for global oncology to help create curricula and seminars for

553
00:37:56,000 --> 00:37:58,840
different countries, Mozambique.

554
00:37:58,840 --> 00:38:02,000
We have projects throughout the Caribbean, even in the United States, so now leveraging

555
00:38:02,000 --> 00:38:04,720
institutional networks.

556
00:38:04,720 --> 00:38:08,480
And the institution also collaborates with the World Health Organization and Pan American

557
00:38:08,480 --> 00:38:12,680
Health Organization, which is the sub-regional office of the WHO for the Caribbean and Latin

558
00:38:12,680 --> 00:38:18,160
America and collaborates with the International Atomic Energy Agency.

559
00:38:18,160 --> 00:38:25,880
And so I get to kind of leverage the skill set and all the mistakes that I've made in

560
00:38:25,880 --> 00:38:32,600
trying to help these international agencies both create programs for the countries that

561
00:38:32,600 --> 00:38:37,120
they serve, but also better define the problems in those countries.

562
00:38:37,120 --> 00:38:43,000
Because I can say, here are all the roadblocks I've faced working in X, Y, and Z country,

563
00:38:43,000 --> 00:38:48,200
and that becomes something that helps to inform guidelines, right?

564
00:38:48,200 --> 00:38:50,920
And helps inform further processes going on.

565
00:38:50,920 --> 00:38:55,240
So I'm really not saying any of this has happened because I'm so brilliant.

566
00:38:55,240 --> 00:38:59,280
I'm really all, it's a combination of all the things, right?

567
00:38:59,280 --> 00:39:06,600
Certainly hard work, but also these collaborators who remembered that, hey, Tawna's doing something

568
00:39:06,600 --> 00:39:13,680
in Zambia, so let XYZ person know that she is someone who should be considered for this

569
00:39:13,680 --> 00:39:14,680
role, right?

570
00:39:14,680 --> 00:39:20,920
So it just, all of the things snowballed, all of those same frameworks I put in place.

571
00:39:20,920 --> 00:39:25,600
The fact that I was reading business books around strategy and while those business books

572
00:39:25,600 --> 00:39:29,880
also had leadership skills, and okay, now you have a team that you have to lead, right?

573
00:39:29,880 --> 00:39:36,920
I think all of the pieces that we put in place to do our work, as precursors that we are,

574
00:39:36,920 --> 00:39:42,880
we're able to go back and use all of those same pieces to implement the work and to find,

575
00:39:42,880 --> 00:39:46,320
I think, effectiveness in the work that we're doing.

576
00:39:46,320 --> 00:39:47,720
So it's been great.

577
00:39:47,720 --> 00:39:51,400
We applied for another foundation grant just earlier this year and that was funded.

578
00:39:51,400 --> 00:39:56,720
In fact, they overfunded, they offered to fund more than we would even ask for, which

579
00:39:56,720 --> 00:39:58,160
blew my mind.

580
00:39:58,160 --> 00:40:04,920
But I think all of this is a testament to perseverance and having the teams around you

581
00:40:04,920 --> 00:40:10,480
that may not be surrounded, you may not be surrounded by people doing similar or the

582
00:40:10,480 --> 00:40:13,960
exact same, like you pointed out, so I'm not surrounded by people doing the exact same

583
00:40:13,960 --> 00:40:15,640
thing that I'm doing.

584
00:40:15,640 --> 00:40:19,160
But I'm surrounded by people who are so brilliant.

585
00:40:19,160 --> 00:40:23,920
And the fact that they'll ask tough questions and they'll offer just tiny little pearls

586
00:40:23,920 --> 00:40:28,360
or just game changers and the humility to try to pick up on those pearls and try to

587
00:40:28,360 --> 00:40:34,160
act on them has made all the difference in my career and I'm very thankful.

588
00:40:34,160 --> 00:40:35,960
So beautifully summarized.

589
00:40:35,960 --> 00:40:40,600
Just you were doing all this work, you're not silent about it, you're making your work

590
00:40:40,600 --> 00:40:44,520
known, you're reaching out for collaborators so people know what you're doing.

591
00:40:44,520 --> 00:40:49,160
And when the time came to think about people who were doing this work, you came to mind

592
00:40:49,160 --> 00:40:53,600
because you had really put arms and legs around your work.

593
00:40:53,600 --> 00:40:56,480
You really had built currency out of it.

594
00:40:56,480 --> 00:41:01,920
Yeah, the currency, it turns out that's important.

595
00:41:01,920 --> 00:41:06,400
Well, I feel like you said so many amazing things.

596
00:41:06,400 --> 00:41:11,080
We're coming to the end of the show and I just wonder, is there anything that you feel

597
00:41:11,080 --> 00:41:15,000
has been left on the set that is important for the audience to know?

598
00:41:15,000 --> 00:41:19,320
Because many people are trying to make this transition, feeling that it's so hard, feeling

599
00:41:19,320 --> 00:41:24,000
that they're not supported and somehow you kind of have all of that in the back of your

600
00:41:24,000 --> 00:41:25,000
story.

601
00:41:25,000 --> 00:41:28,680
We didn't ask about your challenges, but I feel like many of your challenges came through.

602
00:41:28,680 --> 00:41:34,000
But I wonder for someone who feels like, wow, this is hard, what are some thoughts that

603
00:41:34,000 --> 00:41:38,760
you want to share in the closing?

604
00:41:38,760 --> 00:41:44,280
One thing I'll share for some people that relates to kind of imposter syndrome, I think

605
00:41:44,280 --> 00:41:51,240
when you're going into something new, as somebody who's been a perfectionist in most of the

606
00:41:51,240 --> 00:41:56,160
other areas of your life and you have exceeded expectations in most of the other areas of

607
00:41:56,160 --> 00:42:00,800
your life, going into something new can be extremely difficult because you're not good

608
00:42:00,800 --> 00:42:02,080
at it.

609
00:42:02,080 --> 00:42:07,080
And so you can spend a lot of time really beating yourself up.

610
00:42:07,080 --> 00:42:13,800
And what that does is just create more angst around the work beyond the challenges that

611
00:42:13,800 --> 00:42:14,800
you're having.

612
00:42:14,800 --> 00:42:18,040
There's like the external challenges and now you're creating internal challenges that

613
00:42:18,040 --> 00:42:21,560
make you want to procrastinate and not do the, I mean, it's just, it's this terrible

614
00:42:21,560 --> 00:42:22,640
cycle.

615
00:42:22,640 --> 00:42:30,640
I think that approaching this from a sense of gratitude was so wonderful for me.

616
00:42:30,640 --> 00:42:35,520
I came in feeling as if I was hired to be a community-based academic.

617
00:42:35,520 --> 00:42:39,840
I was hired to just work in the clinic.

618
00:42:39,840 --> 00:42:47,680
And the fact that I get to do any of this is above and beyond what I would have imagined.

619
00:42:47,680 --> 00:42:48,680
What a gift.

620
00:42:48,680 --> 00:42:50,160
I didn't earn any of this.

621
00:42:50,160 --> 00:42:53,400
I didn't go to get a PhD.

622
00:42:53,400 --> 00:42:57,640
I didn't do any of the things that you normally would do, but I'm getting to do this kind

623
00:42:57,640 --> 00:43:01,720
of work that some of the people who have the PhDs are doing.

624
00:43:01,720 --> 00:43:06,680
And so when I came into it with that mindset, it created a sense of humility.

625
00:43:06,680 --> 00:43:11,200
Yes, if I walk into a room and if you look, everybody there has a million titles and they're

626
00:43:11,200 --> 00:43:16,040
all MDPHC and they've got, you know, multi-millions of dollars in funding.

627
00:43:16,040 --> 00:43:18,960
I'm not walking in there thinking, whoa, it's me.

628
00:43:18,960 --> 00:43:21,200
Look how unqualified I am to be in this room.

629
00:43:21,200 --> 00:43:24,480
I walk into the room and I think, what a gift.

630
00:43:24,480 --> 00:43:28,900
I don't know how I got in this room with these people, but I'm going to use up every second

631
00:43:28,900 --> 00:43:29,900
of my time in here.

632
00:43:29,900 --> 00:43:32,200
I'm going to ask every question.

633
00:43:32,200 --> 00:43:34,000
I'm going to make every connection.

634
00:43:34,000 --> 00:43:35,560
I am taking notes.

635
00:43:35,560 --> 00:43:36,560
I am becoming friends.

636
00:43:36,560 --> 00:43:37,560
I'm following them on LinkedIn.

637
00:43:37,560 --> 00:43:39,320
I want to see their pathway.

638
00:43:39,320 --> 00:43:43,320
I just walked in with the sense that, no, I don't actually deserve to be in this room.

639
00:43:43,320 --> 00:43:46,960
I don't know how I got here, but you guys are, I mean, you're going to hear from me

640
00:43:46,960 --> 00:43:47,960
now.

641
00:43:47,960 --> 00:43:49,440
You know, now I'm in.

642
00:43:49,440 --> 00:43:53,680
And I think it also made it more fun so that it was collaborative.

643
00:43:53,680 --> 00:43:55,040
It wasn't competitive, right?

644
00:43:55,040 --> 00:43:58,640
I'm not in this room thinking, look at what they have versus what I have.

645
00:43:58,640 --> 00:44:00,920
It's like, look at what they have.

646
00:44:00,920 --> 00:44:02,840
We could do this together.

647
00:44:02,840 --> 00:44:09,160
And I think going in with that mindset is generous and it's a growth mindset that allows

648
00:44:09,160 --> 00:44:19,160
you, I think, to really get the full juice out of the work that you're doing.

649
00:44:19,160 --> 00:44:20,160
So beautifully said.

650
00:44:20,160 --> 00:44:22,640
And what a great way to end the show.

651
00:44:22,640 --> 00:44:25,440
I think it's coming at it with a sense of gratitude.

652
00:44:25,440 --> 00:44:28,000
It just changes our whole perspective.

653
00:44:28,000 --> 00:44:29,000
And so thank you.

654
00:44:29,000 --> 00:44:30,240
Thank you for sharing that.

655
00:44:30,240 --> 00:44:33,680
Well, everyone, you heard Dr. Thoma.

656
00:44:33,680 --> 00:44:40,480
It is hard, but it is not impossible with creativity, hard work, and really pursuing

657
00:44:40,480 --> 00:44:45,400
the right mentors and sponsors and collaborators so much of this is possible.

658
00:44:45,400 --> 00:44:51,200
Dr. Thoma, I want to say thank you so much for being on the show.

659
00:44:51,200 --> 00:44:52,480
Thank you so much for having me.

660
00:44:52,480 --> 00:44:55,040
I really appreciate the opportunity.

661
00:44:55,040 --> 00:44:56,960
It is our pleasure.

662
00:44:56,960 --> 00:44:59,160
All right, everyone.

663
00:44:59,160 --> 00:45:00,200
Thank you for listening.

664
00:45:00,200 --> 00:45:06,880
We look forward to having you again on the next episode of the Clinician Researcher Podcast.

665
00:45:06,880 --> 00:45:07,880
Wonderful.

666
00:45:07,880 --> 00:45:08,880
Hi.

667
00:45:08,880 --> 00:45:22,000
Thanks for listening to this episode of the Clinician Researcher Podcast, where academic

668
00:45:22,000 --> 00:45:27,320
clinicians learn the skills to build their own research program, whether or not they

669
00:45:27,320 --> 00:45:28,840
have a mentor.

670
00:45:28,840 --> 00:45:34,800
If you found the information in this episode to be helpful, don't keep it all to yourself.

671
00:45:34,800 --> 00:45:36,680
Someone else needs to hear it.

672
00:45:36,680 --> 00:45:40,720
So take a minute right now and share it.

673
00:45:40,720 --> 00:45:46,200
As you share this episode, you become part of our mission to help launch a new generation

674
00:45:46,200 --> 00:45:52,240
of clinician researchers who make transformative discoveries that change the way we do healthcare.