Transcript
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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills
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to build their own research program, whether or not they have a mentor.
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As clinicians, we spend a decade or more as trainees learning to take care of patients.
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When we finally start our careers, we want to build research programs, but then we find
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that our years of clinical training did not adequately prepare us to lead our research
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program.
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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.
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However, clinicians hold the keys to the greatest research breakthroughs.
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For this reason, the Clinician Researcher podcast exists to give academic clinicians
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the tools to build their own research program, whether or not they have a mentor.
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Now introducing your host, Toyosi Onwuemene.
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Welcome to the Clinician Researcher podcast.
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I'm your host Toyosi Onwuemene, and what an absolute pleasure it is to be talking with
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you today.
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Thank you so much for tuning in.
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I am talking today about how to receive feedback, especially when it feels like it's poison.
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Okay, that's an exceptionally long title.
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By the time I go to edit, I will decide on a better title.
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But right now what I'm talking about is feedback that makes you feel so awful, you feel like
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you could just explode.
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And I want to share this because I do know that in academic medicine there's a lot of
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rejection, whether it is that you're submitting manuscripts to be accepted for publication,
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or you're submitting grants, or you're making proposals.
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You've been met with probably more nos than you've been met with yeses.
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And so to some extent, academic medicine is a process of getting used to getting no without
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wilting under the pressure, right?
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There's so much rejection.
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And many times for any of us going through rejection, there's the feeling of isolation,
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and sometimes the feeling of shame and discouragement.
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And I just want to share that it is actually natural to experience rejection, and it is
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part of your journey.
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And very soon, actually, I will say there's no time you're ever celebrating a rejection
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for the most part, but over time, it ceases to have as much of a sting as it did the first
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time.
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That being said, I'd like to share a story that actually still feels a little bit stingy
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to me.
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I submitted a manuscript for acceptance.
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And actually, this was my first opinion piece, and I really was excited about writing it.
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I had so much fun writing it.
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I submitted this manuscript, and I was so excited to hear the feedback.
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Well, when the feedback came, it was horrendous.
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And when I'm saying horrendous, you know, if somebody tells you that, wow, your paper
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is puke?
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Yes, that's how it felt.
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Now, I'm not saying that's what the reviewer said.
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They certainly didn't say that.
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But when I read the feedback, that was the sense that I got that this paper was so bad,
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it should never have been written, right?
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And I will tell you that when I first read the feedback, I thought, what is this?
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I tell you, I read a lot of rejections.
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And I'm sure that I've never had a rejection where I'm like, thank you so much.
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This was so awesome.
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But this was one especially bad rejection where it almost felt as if the reviewer was
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going out of their way to rub my face in how bad my piece was.
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And I remember reading at the end of it and saying, okay, what do I take out of this?
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And I was struggling.
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I was struggling.
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Because really, what good feedback should do is move you forward.
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And every time you enter into a situation where feedback actually doesn't have a clear
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path forward, it's a sign that it's not really feedback.
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It's poison disguised as feedback.
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Why is that poison disguised as feedback?
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Because you know what?
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In life, there are so many of us that are so super successful.
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We have so many letters to our name, and we've got so much funding, and we've published trillions
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of articles and we're still hurting inside.
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And we're still just inadequate inside.
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Or we feel bad, or we don't feel like we like ourselves or the world.
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And so just because externally there are markers of success does not mean that people don't
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walk around with poison inside them.
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And here's the thing about poison when it lives inside people.
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And when I'm talking about poison, I'm talking about bitterness and anger and just all the
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ugly stuff that lives inside people, unforgiveness, it comes out and it hurts other people.
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You know how people talk about how a hurting person hurts others?
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Yes, that's exactly right.
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Because hey, if you're reading a manuscript, your job is to say, this is how it could be
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made better.
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And even if you think it sucks so bad, you can always find ways to say, this is how it
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could be made better.
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But in a way, insulting someone who's written something is not even a sign of being a bad
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reviewer.
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It's a sign that there's something wrong inside you that maybe you need to address.
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Anyway, that being said, this is not the story of this reviewer.
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It's a story of me.
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It's a story of how I received that feedback and what I do with it.
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What do I do with feedback, especially when it just doesn't feel like it's right?
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What do I do?
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Number one is to acknowledge that you have been wounded.
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Yes, acknowledge that you've been wounded.
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Now, no matter the feedback, if it's a rejection, it doesn't feel good.
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For some of us, we've had enough rejections where we're not as bothered.
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Sometimes actually you submit something, you're like, if this gets in, it'll be a miracle.
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And then when it comes back, reject it, you're like, yeah, I knew it was a long shot.
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But even when you knew it was a long shot, you knew it was going to be rejected and it
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still comes back rejected.
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You knew it was a long shot and it still comes back rejected.
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You still feel a little bit wounded.
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You do.
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You feel hurt because you wanted them to accept it.
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Even if secretly, even if you openly thought they wouldn't accept it, secretly you did.
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And you would have felt validated by the acceptance, but instead you got a rejection.
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And so I think the first step is just to acknowledge your wounding and say, you know what, that
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sucks.
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It hurts.
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It hurts because it does.
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And it's only human to feel bad at rejection.
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Like whoever wants to be rejected, nobody.
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And so if you're rejected, instead of just grinning and bearing it, acknowledge it.
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If you're someone who gets frustrated and nothing, the tears just come, let them fall.
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Give yourself time to mourn the loss of this particular experience.
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Give yourself time to get over the rejection.
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In reality, it hurts and it's okay to acknowledge the pain and to just mourn that pain or at
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least experience that pain for even a moment.
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But definitely allow yourself to experience the pain and acknowledge that the pain is
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present.
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Hey, this is disappointing.
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Say it to yourself.
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Hey, hey, this is disappointing.
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Okay, great.
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That's the first step.
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Acknowledge that you've been wounded in some way.
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Acknowledge that you've been hurt.
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The second thing we need to do is you need to pause.
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Now what am I saying?
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Am I saying pause and just live in that rejection for three months and say, oh my gosh, woe
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is me.
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I'll never submit another manuscript again.
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I'll never write another grant.
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In fact, I quit medicine.
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No, that's not what I'm talking about.
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Pausing is giving yourself distance between the first time you review the feedback and
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when you have a plan for what to do with the feedback.
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Okay.
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Pausing is to give yourself time to come up with a plan of action.
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Every rejected manuscript is an accepted manuscript waiting to happen.
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It's literally the acceptance is sitting there waiting for you, but only if you move forward.
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But you can't move forward until you have a plan.
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And to be honest, you don't move forward well when you're wounded and still reveling in
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your sorrow.
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Now, I don't want you to revel in sorrow for too long, but you do need to have a gap between
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the first reading and the final decision for a plan.
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And here's the thing.
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As soon as you've read it, your mind has processed it.
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And already you're working through a thinking of like, what do I do now?
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Hopefully you're not thinking, well, I quit.
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That's what.
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Hopefully you're thinking, okay, let me set it aside and then come up with a plan later.
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And the reason it's important to give yourself a gap between the first reading of it and
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when you finally want to come back to it is because your subconscious mind continues to
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work on the problem.
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Your subconscious mind accepts the fact that you've been rejected.
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And then it feels differently the next time you come to the piece of rejection or the
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feedback that you got.
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And so the third thing is to read it, go back and review it.
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Okay.
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So the first thing is that you've acknowledged that this hurt.
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The second thing is you've given yourself space between the first time you read it and
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later.
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And the third time is you come back to it.
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So here you are.
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The third point is that you come back to it.
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So here you are.
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You're finally reading it again.
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And what you'll notice if you've given yourself enough time between the first reading and
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now is that you come at it with a different perspective.
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At first, it actually was kind of like you, the shock of being rejected was so overwhelming
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that you didn't even really have time to think about what were all the benefits or what are
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all the merits of what was brought up in, in whatever the case was against accepting
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your manuscript or accepting your proposal.
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Right.
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And then when you come at it a second time, you come at it with a different perspective.
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There's less of the hurt, less of the sting and more of an objectivity, more of a, okay,
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let's see what feedback is useful here that I can use to move this work forward.
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And you know what, for better or for worse, there will always be feedback that you could
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use to move this work forward.
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Now in the particular rejection story I tell you, it did feel pretty scathing.
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It didn't really feel like there was real feedback there.
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You know, when you read something and you're like, you just really hate this paper, don't
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you?
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You hate it so much, you see no good in it.
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And that's fine.
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People are people.
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Sometimes that's the way it is.
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People are just like, this sucks so bad.
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And it, that's how they feel about it.
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And you can't argue how they feel about it.
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Now nothing sucks so bad that it cannot be salvaged, but I'm listening and I'm hearing
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people say, oh yeah, there are things that suck so bad, it cannot be salvaged.
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But one man's meat is another man's poison, which you think sucks so bad and cannot be
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salvaged.
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Nobody else can see the kernel of goodness that can be expanded to grow.
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Okay.
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I say all that to say that no matter how tremendous the feedback was, no matter how much the person
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actually didn't give you feedback, but went off on a diatribe about how you suck and everybody
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from your institution should stop writing manuscripts.
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Somewhere there, there is information.
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Okay.
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That's number four.
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Number four is gather the information.
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Okay.
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What do I mean?
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Number one, the feedback, if it was good feedback should really outline steps for improvement.
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Here is how this manuscript could be improved.
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And if you're a good reviewer and I hope you are, I'm not saying good or bad because that's
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never really useful, but if you're going to be a helpful reviewer, when you review, you
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need to point out places where improvements could be made.
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For example, you could say, hmm, the generic use of language reads like the use of a large
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language model like chat GPT.
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I would recommend that if such a model was used, it not be used for the revisions.
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Do you see?
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Very helpful.
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It's like, instead of saying, holy cow, did you use chat GPT?
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This is awful.
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You're saying, hmm, it reads like you may have used chat GPT to write this paper.
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Maybe you don't use it next time.
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Useful feedback.
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If you're a reviewer, please, please, please, instead of yelling or going off in a diatribe,
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showing what's really inside you, give feedback that's useful.
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Okay.
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So useful feedback helps you move forward.
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You can gather that information.
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That's pretty easy.
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The feedback that says step one, change the way you use these terms or the feedback that
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says step two, do this, do that.
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That's helpful.
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You can easily gather information.
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What about the feedback that is the diatribe?
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The feedback that is the, this sucks so bad, I can't believe you're still writing or that
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you're still alive, right?
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There is that feedback.
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Let's just be real.
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There is that feedback.
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What do you do with that?
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Take the information.
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And you're like, what information?
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The information that that's not where you want to go with your paper.
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You're like, what do you mean?
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There's the New England Journal of Medicine.
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I've always wanted to publish here.
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I am so glad that that's your childhood dream, but it's not the dream from this paper, clearly
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because this paper is not going to be looked at favorably by this particular community.
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And I know in academia, there's a lot of what's a high impact journal, what's the low impact
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journal and where should you try to get your work into and what should you not try to get
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your work into.
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That's a whole conversation for a different podcast.
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But at the bottom of your writing for peer review is that you do excellent work.
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You want feedback so that your excellent work can be presented in the best possible light
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and go out into the world and do good.
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That's at the bottom of all of it.
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For every manuscript, there is a home.
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Some homes look a little bit more appealing than others, but there is a home for every
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manuscript.
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And sometimes the information you take is that, wow, this manuscript could not scale
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the security of or could not get past the security of this particular journal.
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And you decide, do I take it to a journal with a less stringent security team or do
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I say, what will it take to scale the wall of this particular impregnable fortress of
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a journal?
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And it may be that that's what you want to do, but take the information and use it.
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If it's a scathing review, it may be that you say, well, I guess this journal is not
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for me.
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Or you might be like, okay, well, let's go knock on the door again and say, can you help
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me know how I can make this better?
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And sometimes you do that and you succeed.
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For example, I had a manuscript that I once submitted and it was a really interesting
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article idea to me, but I was also writing in an era that was outside of my expertise.
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And I think I recognized that and I thought, oh, I can write in this area.
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So I was writing kind of in hematology, but I was also writing in a genre that, oh gosh,
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what was it?
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It may have been medical decision-making, which it's hematology and I make medical decisions
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all the time, but people are very specific about their specific kind of expertise, a
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specific kind of language they used.
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Anyway, I got rejected.
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But what was interesting is that the journal said, you know what?
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We can't accept this manuscript in its current format.
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If you significantly revised it, maybe we could reconsider it.
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So they kind of opened a little bit of door and I was like, okay, well, let's go at it
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again.
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And we revised it, revised it, revised it.
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We sent it back.
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And they sent it back again.
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And I was like, you know what?
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Wow, this is a great case, but oh my gosh, your attempts are just, they're just, they're
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awful.
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Like, I mean, they didn't say it in that way.
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They were actually very, very helpful in just saying, this is how, if you were going to
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revise the paper, you would need to do this, but holy cow, that's a great undertaking.
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I'm not sure you're going to be able to do this.
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And so what we finally did was we went and we found somebody who had very specific expertise
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in this kind of writing.
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I know I'm calling it medical decision-making.
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I'm now blanking on what it actually was, but it's, anyway, the point I'm making is
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I got someone who was an expert in writing these kinds of papers and that I asked the
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editor.
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I said, Hey, we really think this is a great case and we think that people are going to
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learn from it, but we are not well versed in writing in this way.
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Who do you know who might work with us?
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I asked the editor that.
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And to be honest, the first time I sent a letter to the editor, I got no response.
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And then I went and looked at other people who had been associate editors or other people
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who had in some way, shape or form been associated with a journal.
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You could say I was stalking the journal.
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Maybe I was because I was like, no, this journal, this article is getting in here.
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And finally, finally they turn around and say, okay, I have nothing to do with this,
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but you should reach out to this person who frequently writes these kinds of articles.
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Great.
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And then they made the introduction.
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It was so awesome because now we had an expert in our field, in our, in our, in our court,
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right?
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In 2019.
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And that expert really helped us.
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It really, he really helped us shape the article.
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And when we finally submitted, we got another revision, but this time it was that this is
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a great article.
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Here's how you make it better.
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And so sometimes the information you receive is that, oh, wow, it sucks so bad.
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Well, how can I make it not suck so bad?
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And you go after that information and you don't stop until you get it.
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Or sometimes you say, you know what?
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I don't have time to be chasing or trying to knock down this wall.
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How about I just take it somewhere else that doesn't have a security system that's so,
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so intense, right?
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Information.
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You can use the information to your advantage.
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What you don't want to do is to be overwhelmed, but you do want to use the information to
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your advantage.
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And even when it's a scathing review, it is helpful information.
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And you have to ask yourself, what do you want to do about it?
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And that is the next thing.
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I think it's number five now.
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I'm not counting now, but not the number five is, is what is your plan?
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Like formulate a plan.
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Now, to be honest, formulate a plan should have been at the very beginning when you first
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submitted your manuscript.
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You should have had a list of three journals that you were going to submit to tier one,
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tier two, tier three.
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And as soon as you knew that tier one was rejecting your work, you would be like, oops,
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sucks for you tier one.
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You'll go to tier two.
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And then tier two is like, yeah, we hate this work too.
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You're like, sucks for you tier two.
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And then you go to tier three, right?
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That's kind of the pre-planning you do at the beginning of any, every manuscript.
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We don't always do that.
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And to be honest, in this particular manuscript I'm referencing, did not do that.
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So now I'm like, oh, I don't know where else I want to send it.
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I haven't really done this work.
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Well, whatever, no matter when you decide to have a plan, just have a plan and it's
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okay.
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And what is your plan?
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Your plan is, well, what am I going to do with this paper?
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Where do I want to send it to?
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How do I want to revise it?
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So it's meets that other audience's criteria.
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What do I want to do with this paper?
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Have a plan.
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And then of course, the last thing is execute on that plan.
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Execute on that plan.
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You know, and it seems a little bit obvious, but in reality, many of us stop at like number
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one, where we're just so wounded.
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We're like, you know what?
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Academia sucks.
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I am no good at it.
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I'm really horrible at writing.
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I don't know how to write grants.
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I just am not going to do this anymore.
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And I just want to say, please don't let that be you.
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Don't be the person who allows obstacles to throw them off course.
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Now here's the thing about obstacles.
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Obstacles are actually kind of clarifying because when an obstacle comes in front of
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you, you have to decide to do something about it, right?
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You're on your way.
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You're in motion.
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All of a sudden this big boulder drops out of the sky, narrowly misses you, lands in
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front of you, blocks the path.
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Okay.
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You have to do something about it.
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The question is, are you going to find a way through the boulder?
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Like are you going to try to blast it out of your way?
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Are you going to try to find a way over the boulder?
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Are you going to see if you can dig a tunnel and go under the boulder or are you going
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to walk away from the boulder?
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Are you going to say, you know what, this boulder?
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I know, but it's clarifying, but don't let an obstacle stop you because the question
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is should you be on this path?
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And it's really a question you ask before the obstacle comes because obstacles don't
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define you.
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They don't define where you're going.
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They don't define who you are.
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They clarify for you.
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Is this the path you actually want to be on?
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And if it is the path, then don't let the obstacle stop you.
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Let the obstacle be your jumping off point.
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So it's like, okay, well, here you are, big bad boulder in the middle of my path.
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How about I build a bridge or a ramp and ride a really fast motorcycle and use you to catapult
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to the next level?
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Absolutely could do that.
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But that's only if you have clarity that the path you're on is the path you want to be.
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Don't let obstacles make decisions for you.
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Don't let negative feedback make decisions for you.
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Make decisions for yourself.
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Make decisions regarding your purpose and why you want to do what you're doing.
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And if this is the field for you, one horrible feedback from one or two reviewers should
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not make you change off that path.
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So in summary, please don't quit.
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Don't quit because you got a horrible review.
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You know, unfortunately, there are many more where those came from and it's okay.
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The important thing is, are you doing work that matters to you?
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Are you doing work that resonates with you?
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Are you doing work that makes you proud of the work you do?
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And if the answer is no, then why are you doing this work?
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If you're like, well, I'm just looking because, you know, at my institution, they say we're
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supposed to submit manuscripts and I just want to, I just want to check the boxes.
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I want to say, please stop checking boxes.
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Life is just not, it's about so much more than just checking boxes.
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And I know you succeeded getting through med school and residency and fellowship by checking
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boxes.
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I know because I checked those boxes too.
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But there comes a point in life when we decide that checking boxes is not the way to live.
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And I'm thinking that's now.
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This is the moment.
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Like if you're listening to me, it's now.
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Because checking boxes, when there's a big obstacle that comes or a really huge rejection
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or a huge disappointment, then you find out that checking boxes doesn't satisfy and it's
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not enough to move you forward.
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So I want to encourage you that if for whatever reason you are a box checking person and there's
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no shame, I love box checking.
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I still think a good box checking gets me through my day.
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But I want you to think about how do you do your career differently?
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How do you do it differently?
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00:22:42,020 --> 00:22:44,760
How do you stop doing what everybody else says you should do?
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00:22:44,760 --> 00:22:50,280
How do you stop living like everybody else says you should live and begin to really live
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for your purpose, for something that resonates with the deepest core of who you are and that
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moves you to where you're supposed to be?
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If you don't know that, I invite you to come work with me as your coach.
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00:23:02,120 --> 00:23:07,600
So you'll see on Wemina, I am available on Instagram, most especially LinkedIn, also
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00:23:07,600 --> 00:23:08,600
on Facebook.
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00:23:08,600 --> 00:23:13,820
Reach out to me and let's set up a 30 minute conversation just to talk about what you need
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and how you're going to move forward in your academic career.
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00:23:16,200 --> 00:23:23,760
But if you're miserable in any way, if you are overwhelmed or tired or burned out, I
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00:23:23,760 --> 00:23:26,520
want to say it doesn't have to be that way.
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Don't accept it.
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Okay, so I'm going to summarize.
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First of all, you got it when you get bad feedback, something that's so horrible.
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Number one, you just got to acknowledge the hurt.
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You've got to acknowledge that you've been wounded.
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Number two, you've got to separate yourself.
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Just give yourself a gap between your first reading and your next reading.
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Number three, you do have to come back to it and give it another look and you'll find
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that you're seeing it with a new perspective.
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Number four, you want to draw out the information of this particular piece of feedback, no matter
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how bad it's giving you.
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Number five, you want to come up with a plan.
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Number six, you actually want to act on that plan.
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Number seven, you want to make sure that you know what to do with this obstacle and that
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it doesn't derail you or keep you from having the career that you were meant to have.
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All right, it's been a pleasure talking with you today.
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Thank you so much for paying attention.
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00:24:17,400 --> 00:24:21,200
Please, please, please, please share this episode with somebody else who's just been
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00:24:21,200 --> 00:24:24,040
rejected and needs this encouragement.
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00:24:24,040 --> 00:24:25,040
Thanks for listening.
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00:24:25,040 --> 00:24:35,720
I look forward to seeing you again next time on the Clinician Researcher Podcast.
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00:24:35,720 --> 00:24:41,080
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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are 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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00:24:55,680 --> 00:24:59,720
So take a minute right now and share it.
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00:24:59,720 --> 00:25:05,200
As you share this episode, you become part of our mission to help launch a new generation
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00:25:05,200 --> 00:25:18,080
of clinician researchers who make transformative discoveries that change the way we do healthcare.