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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Hey everyone, welcome to the Clinician Researcher podcast.
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I'm your host, Toyosi Onwuemene, and it is a pleasure to be here talking with you today
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on our inaugural podcast episode.
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I want to share with you the story of how the Clinician Researcher podcast came to be
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and what to expect in the coming months of the podcast.
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So first I'll tell you that about 10 years ago, I was looking for jobs as a new faculty,
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and I had one thing on my mind.
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I wanted to succeed in research.
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I really, really, really wanted to lead a research program, and I was shocked to find
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that as I went from program to program, people said, well, you know, you really want to lead
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research, but you're not really prepared.
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You're not really qualified to lead research.
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You don't have funding.
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You don't have experience getting funding, and you don't even have the publication records
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to show that you can do this.
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And so, no, but you can take a clinical job.
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And I went around from place to place and finally found a program that was like, well,
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you know, you really don't have the things that we would expect in someone who is going
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to succeed as a clinician scientist, but here's a clinical job and we'll support you if you
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can make this funding happen or if you can make the publication record better.
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And I took the job, and over the course of a 10-year period, I made the transition from
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clinician to researcher.
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And in the course of that 10 years, one of the things I learned is that, wow, clinicians
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get 10 years or more of clinical training.
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Nowhere in that does anyone really prepare clinicians to lead research, yet clinicians
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should lead research programs.
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Clinicians are the right people to lead research programs, but because they get no research
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training, they're actually the wrong people to lead research programs.
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Yet many clinicians want to lead research.
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And so the Clinician Researcher podcast exists to help clinicians learn to lead research
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programs.
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So why is it called Clinician Researcher?
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Why not Clinician Scientist or Physician Scientist or, you know, one of those names that physicians
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are called when they're leading research as well.
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That's because I'm talking to the clinician, the person who sees patients, and I'm talking
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to the person who's becoming a researcher.
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Now you can do research and the person who does research is typically called a scientist.
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But I'm really just talking about the two sides of the coin.
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One is the clinician, the other is the researcher.
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And my goal in this podcast is to get the clinician to become the research leader.
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So that's the goal of the Clinician Researcher podcast.
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On today's inaugural episode, I want to talk to you about three reasons why clinicians
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should lead research programs.
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And then I want to talk to you about the skills that clinicians need to make the transition
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from clinicians to researchers.
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I'm only going to talk about seven.
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There are so many more.
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I want to paint the picture of why it's important first for clinicians to really think beyond
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their clinical training into acquiring the skills necessary to lead research programs.
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And I want to talk to you about the skills you should be thinking about developing in
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the course of your research experience.
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So the first thing I want to talk about is why clinicians should be research leaders.
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So the first reason is that clinicians make breakthrough observations.
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Now if you've been in clinic or if you've been in the hospital taking care of patients,
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you're probably impressed by the amount of things that we can do to help patients do
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better.
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But you also know that there are gaps.
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You know that that medication that's hailed as the breakthrough medication of the year
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doesn't help everybody.
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You've seen a patient who didn't respond at all.
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And you know that questions remain unanswered in the care of the patient.
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You've also seen patients in whom all of science would say that this patient should not succeed,
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this patient should not make it, this patient should not live in the midst of this crazy
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situation.
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And you've seen those patients thrive.
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And you're asking the question, well, how?
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How did this patient make it and why?
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So clinicians are making the kinds of observations that lead to research breakthroughs.
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I mean, throughout history, any major research breakthrough came because somebody made an
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observation.
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And over the years, many of these observations were made by physicians as they were taking
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care of their patient.
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And so clinicians should be leading research because they're making the kinds of observations
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that really can make a difference in the research questions that we have.
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But here's the rub, clinicians don't have the research training.
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And so it is very hard for clinicians to come from, oh, I've made this observation to, I've
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now turned this observation into an answerable question where we're going to be able to use
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the answer to help millions of patients down the road.
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The transition is difficult.
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And that's why the Clinician Researcher podcast exists.
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Or maybe clinicians don't even have time.
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They're like, yeah, I made the observation.
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Now I got to see the next patient.
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I don't have time to think about that.
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And clinicians are so busy.
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There really isn't time to take those observations and make them into actionable research breakthroughs.
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And so part of the Clinician Researcher podcast mission is to help clinicians think about
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how do I create the space to be the researcher I want to be, to lead the research programs
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that I want to lead.
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And I want to encourage as many clinicians as possible to do that because clinicians
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make the breakthrough observations that lead to breakthrough discoveries.
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The second reason why I think clinicians should lead research programs is because clinicians
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care about improving patients' lives.
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Now many people care about patients.
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Patient families care about patients.
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Patients care about patients.
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But in terms of sacrificing to meet the needs of a patient, I can't think of a group more
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amazing than physicians.
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I can't think of a group of people who are willing to struggle to whittle down their
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weeks to 80 hours.
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I'm trying my best to keep it under 80.
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And I don't know any other group that really works that much to serve the needs of people
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that are not family members.
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And so clinicians really care about patients.
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They suppress the need for sleep.
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We suppress the need to eat.
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We suppress so many needs.
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We suppress a whole decade.
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Some of us invested our 20s to be able to learn to care for patients well.
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And so if clinicians are so dedicated to the care of patients, wow, what a group to lead
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research.
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What a group because their research breakthroughs are not motivated by financial gain alone,
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not motivated by fame and notoriety.
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It's really motivated by the care of the patient.
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And so if you are really looking for anybody to lead a research program that's actually
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going to make a difference, you should look to clinicians.
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That's why clinicians need the skills to be able to make those research breakthroughs.
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The third reason I think that clinicians should lead research is because they know what outcomes
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are meaningful to patients.
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Clinicians are always there with patients asking, how are you doing?
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How are you tolerating this medication?
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Are the side effects tolerable?
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These are the questions we're asking our patients every day.
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And so when we're looking to see what outcomes are meaningful to patients, we have those
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answers.
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But many times we're not there.
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We're not there when people are making these decisions about what outcomes are going to
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be studied.
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And that's why it's important that clinicians are there at the table when research is being
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done and in fact not just being at the table, but actually leading their own research programs
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so that they can become better contributors when they are at the table.
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And so clinicians should lead research programs because they know what outcomes are important
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to patients.
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Okay, those are just three reasons why clinicians should lead research.
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Now what are the skills that clinicians are missing?
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Why aren't there more clinicians leading research breakthroughs?
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Well, because it takes skill.
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So clinicians spend 10 years or more learning to do clinical care.
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And that's so important because clinical care is so important and it takes a long time to
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learn the skills for clinical care.
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But guess what's not happening while clinicians are learning to do patient care and not learning
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the skills to do research.
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And it does take time and it does take effort to become skilled in doing research.
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Just ask your PhD colleagues, ask them how many years they spent getting their PhD and
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what they were doing for most of that PhD training.
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They weren't taking care of patients.
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They were learning to do research.
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They were learning to acquire skills and research.
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And for many PhDs, they end their PhD program and then they say, hey, I want to do a postdoc.
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And some people even do two postdocs.
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Wow, some people do three or more postdocs.
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And what are they doing?
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They're honing research skills so that they can do better in research.
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And so you look at a PhD trajectory and people are easily spending 10 or more years just
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focused on research.
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So why do clinicians think that they're going to come from their 10 years of clinical training
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with two or three research electives in the midst of that training and then succeed wildly
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in research?
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Where our PhD colleagues finish all their postdocs and then say, well, now I'm ready
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for a career development award.
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And for that reason, I just want to highlight seven research skills that clinicians should
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consider acquiring in their quest to lead research programs.
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Skill number one is asking research questions.
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Now, you see a patient in front of you and you're like, how can I help patients like
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this do better?
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And that's great.
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It's a really, really great desire.
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We want to help the patients do better.
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Perhaps the patient has diabetes and you're like, I want this patient to control their
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diabetes.
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And that's a great question.
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But how do you take it into a question that's small enough to answer in a way that's actionable?
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So is a patient not doing better because they are not able to get access to medication?
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Is a patient not doing better because they have access to medication, but perhaps they
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can't tolerate it?
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Is a patient not doing better because yeah, they can tolerate the medication, but they
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can't absorb the medication?
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Or is a patient not doing better because they can absorb the medication, but somehow they
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have a genetic polymorphism that renders them resistant to the medication?
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Or is it that they are not resistant to the medication, but they're not able to break
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the medication down into the metabolites that allow the medication to take effect?
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Which question are you asking?
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And so part of the skill of taking something huge and complex, boiling it down into its
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minuscule components, and then creating a research question that you can actually answer,
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that takes skill.
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It takes years to develop and hone that skill.
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And many clinicians don't have that.
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For that reason, this is one of the skills, asking research questions that clinicians
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have the opportunity to develop and to hone.
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The second skill is to create writing structure.
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Create the structure that helps you write consistently and regularly.
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Now if you are a research scientist, one of your primary goals is communicating your research.
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So if a researcher went to their lab and did a research project, and it was never communicated
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to anybody, was the research project ever done?
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Was the research ever done if nobody got to hear about it?
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And the answer is no.
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It's as if it wasn't done because nobody heard about it.
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So whenever you sign up to become a research scientist, you sign up to become a science
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communicator because you got to communicate your science.
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You got to communicate your science to funders who will give you money to support your research
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program.
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You got to communicate your science to the public so that they can take action on your
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research findings.
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You got to communicate your research to your peers so that they can help you look at the
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blind spots that you missed in the quest to complete your research.
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And so communication is so important.
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And you know what?
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It's not part of our clinical training.
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Yes, we learn to write notes and we write a lot of notes.
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Writing notes is not the same as communicating science.
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And having the structure that allows you to write consistently so that you consistently
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communicate your science, that is a skill that has to be learned.
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It's not just about writing.
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It's about the process of writing and it's about the process of writing consistently.
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And that's a skill that every research scientist should have so that they can communicate their
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science well.
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The third skill is writing research manuscripts.
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So you've done a lot of writing, a lot of writing through college.
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Oh, you sure did a lot of writing in medical school and in residency and in fellowship.
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You've been writing all your life.
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But writing research manuscripts is a different beast.
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It's a different skill level because you're writing for a scientific audience.
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You're not just writing about the patient.
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And so yes, we get a lot of training.
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Many of us are mentored to do case reports.
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But when we talk about actually communicating a project that has been done, that does take
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skill.
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And so writing research manuscripts is a skill that clinicians have an opportunity to gain
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in their quest to become research scientists.
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So what does that entail?
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Well, it entails being able to communicate in a way that people who are outside your
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field can understand.
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Have you ever read a research paper and at the end of that your head hurt because you're
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like, oh my gosh, that was so dense?
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Yes, it takes skill to write where people clearly at the end have received what you
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intended to communicate.
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And that is a skill that takes time to develop.
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So clinicians need skill in writing research manuscripts.
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The fourth skill I want to talk about is shepherding your research manuscript through the publication
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process.
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OK, the publication process is crazy.
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There are millions of journals available.
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OK, maybe not millions, thousands of journals available for you to submit your manuscript
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to.
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Which one are you going to choose?
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And who's your audience?
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And which journal actually cares about what you're writing?
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Which journal is going to reject you right away or keep your paper for three to four
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months and then reject you?
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And do you have time for three to four months of rejection as far as the science that you're
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trying to communicate?
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Those are the kinds of things that nobody teaches you, but you do need to learn.
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How do you shepherd a manuscript through the publication pipeline?
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How do you decide which manuscript to go for?
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Which manuscript not to go for?
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Is impact factor needed or do you just need to get the manuscript out there?
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Someone's got to teach you these skills.
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And it's not a skill that's easily learned.
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It really does take time to develop.
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And you may meet a lot of scientists who just easily churn out the publications and it looks
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so easy, but it really does take time to develop that skill.
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Shepherding research manuscripts through the publication pipeline, getting it from manuscript
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draft to submitted and published manuscript is a skill that can be learned.
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And clinicians have the skills to learn it, but they do need to recognize that it's a
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skill that is needed.
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How about developing research proposals?
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So to take a research idea, turn it into a research proposal, find the right funder,
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submit it according to their specifications, take the feedback when it's rejected and turn
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it into another proposal.
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Whoa, that takes time.
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It takes time to figure out and guess what?
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Not part of your clinical training.
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And for that reason, there needs to be space and time to learn to develop research proposals
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because, you know what?
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Guess who's also competing for the same funding that you are?
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PhDs who've been spending a lot of time learning to develop research proposals.
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And so I want to make sure that clinicians are aware that it really does take time and
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energy and investment to learn how to do it well.
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And if it was not part of your clinical training, or if you just spent maybe a month or two
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learning to do that, there is opportunity to learn to really, really grow that skill.
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Another skill that clinicians should consider is grant getting strategy.
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So you have your research proposal, oh my goodness, your idea is going to just cure
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humanity of all of their ills and can you get the funding to move that idea forward?
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And so how do you decide how much you need to get that idea forward?
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How much do you need?
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What is the team you need to fund?
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To what extent do you need to fund your own time to do this work?
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Who is the funder who is most aligned with your interests?
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Do they support you in the way that's needed so they cover your time, but they don't cover
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the time of the person who's going to help you do the work?
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What is the strategy for getting you the funding that you need to move your program forward?
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That takes time to figure out.
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It's not something that's intuitive.
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And so many times I see clinicians who are fresh out of residency or fresh out of fellowship
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submitting grants and getting frustrated that they're not getting any grants.
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Because it takes time to develop the skill that allows people to even look at your grant
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in a way that says, okay, I think this can be funded.
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I think this makes sense.
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I believe this can be done.
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And it's not easy.
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It's not straightforward.
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It's not part of our clinical training.
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So that's one of the skills that's important for clinicians to acquire.
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Okay.
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The seventh skill I want to talk about is building and leading research teams.
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Now, if you're going to do anything of significance, you can't do it by yourself.
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And if you can't do it by yourself, then you need to call other people to come alongside
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you to do the work.
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But how do you build the research teams that allow you to do the work?
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How do you lead the research teams that allow you to do the work?
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How do you lead so that you're not so immersed in the power plays on the struggles that come
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from teams getting together and the research is not getting done?
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It takes skill to learn how to hire people.
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It takes skill to learn how to work with people.
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It takes skill to learn how to lead people in the vision that you have for your research
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program.
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And guess what?
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That's not part of clinical training.
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That being said, clinicians have the capacity to learn all of these skills, given time and
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investment every clinician can acquire and teach these skills.
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But the skills, first of all, need to be acquired.
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For many clinicians, you have mentors, kudos to you.
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But there's at least 60 to 80% of clinicians who don't have the mentoring support to be
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able to lead the research program of their dreams.
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And that's why the Clinician Researcher podcast exists, to give clinicians the resources and
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the tools that they need to succeed as researchers.
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So what can you expect over the next several months of the podcast?
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I'm going to be bringing you interviews from clinicians who are succeeding as research
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scientists.
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I'm going to be bringing you interviews from collaborators who work with clinicians to
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bring their research programs to life.
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I'm going to be interviewing people who lead programs that help clinicians turn into research
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scientists.
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I'm going to be bringing you as many resources as possible to help you succeed on this journey
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as a clinician researcher or really as a physician scientist.
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Whatever name that you want to take for yourself, I'm okay.
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But really it's a Clinician Researcher podcast because we want to turn clinicians into researchers
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who lead.
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At the end of this journey is leadership.
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And why leadership?
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Why not just say, hey, I'm okay to participate in research?
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Yes, you can participate in research.
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Research technicians participate in research.
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But if you have an idea for how to transform patient care, I'm going to submit to you that
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if you don't do this work, somebody else might not do it because nobody else cares about
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it as much as you do.
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And if you care about a research question that you think will actually change patient
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lives, then you've got to be the person to lead it.
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And you need the tools to lead it.
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And I hope the Clinician Researcher podcast will help you acquire some of those tools.
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So if this podcast episode has been helpful to you, I want you to share it with just one
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other clinician.
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Just one clinician.
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Say, hey, you should listen to this.
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You should listen to this podcast.
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And if you want other people to find us, please subscribe.
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Give us a five-star rating so that we can also be found by other clinicians who need
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the resources to build the research programs of their dreams.
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It's been a pleasure talking with you today.
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Thank you for listening.
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I'm your host, Tiesien Lumina, and I look forward to talking with you again the next
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time.
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Thanks for listening to this episode of the Clinician Researcher podcast, where academic
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clinicians learn the skills to build their own research program, whether or not they
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have a mentor.
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If you found the information in this episode to be helpful, don't keep it all to yourself.
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Someone else needs to hear it.
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So take a minute right now and share it.
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As you share this episode, you become part of our mission to help launch a new generation
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of clinician researchers who make transformative discoveries that change the way we do healthcare.