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

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

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

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

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

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program.

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

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

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

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

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Now introducing your host, Toyosi Onwuemene.

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Welcome to today's episode of the Clinician Researcher podcast.

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

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So today we're going to be talking about how to keep going in the face of rejection.

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Ugh, rejection.

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Yes, we're going to be talking about how to keep going in the face of rejection.

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And one thing I want to invite you to do is if you are interested, please sign up on our

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website for more information about our coaching programs.

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That is ClinicianResearcherpodcast.com.

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Academic Negotiation Academy will be enrolling its next cohort soon.

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Sign up to get on the wait list at ClinicianResearcherpodcast.com.

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All right.

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I am talking today about how to keep going in the face of rejection.

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And you know, I will tell you that no one prepared me for the rejection that was coming

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in academic medicine.

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And there is a ton of rejection.

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Oh my goodness, so much rejection.

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You get rejected in your grant submission to get rejected in your manuscript submissions.

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There's a lot of rejection.

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And many times that can feel very personal.

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And it's hard to separate yourself from all that rejection.

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So when I recently submitted a grant, I was so pumped about this grant.

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I mean, it was maybe one of the best applications I had ever written.

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We had time.

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I had submitted this application as an MPI application.

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So I had another PI who was equally invested.

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And it was just such a wonderful writing collaboration.

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The best grant I've ever written, just considering all the energy and just it was good.

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It was good grant.

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It was good.

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And so I was so sure that this grant would be funded.

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I was so sure.

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Like, no, grants are not to be funded the first time.

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It was like, this one's going to be.

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And even if it's not funded, it's going to score really, really well.

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And so imagine my surprise.

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And really, I was shocked when it came back as not discussed.

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Shock, shock.

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I mean, I don't know.

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You have enough grants that are not discussed.

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You're not really shocked, shocked anymore.

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It's like, oh, that happened again.

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But I was surprised at this one.

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And it did kind of it was like a sucker punch to the stomach.

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This one took me a little bit to think about to think about going back and looking at it.

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And actually, when you first find out that the grant is not discussed, you don't necessarily

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have the opportunity to go find out what the summary statements are.

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So it takes a couple of weeks.

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Anyway, it took a couple of weeks.

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And by then, you already know that the grant is not going to be funded.

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So by the time the summary statement comes, to some extent, you're prepared.

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But even then, you're still not prepared because you're like, I don't want to look at this.

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But I did look at it.

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And I will tell you, it is the first time I read a summary statement.

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And at the end of it, I was like, oh, OK, is that what you need?

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OK, bring it on.

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This is going to be good.

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It was just an opportunity.

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And at the end of it, I think why I was so pumped by reading that summary statement is

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that we wrote a grant we really wanted to do.

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We wrote a grant we were super excited about.

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And it was such a wonderful writing experience.

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And so to read the summary statement and realize that, you know what?

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This project is still pretty awesome.

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And these are the things that are recommended to get the project to funding.

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OK, we can do that.

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And it's just the sense of the value of the work is such that it's not going to stop.

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We're going to find a way to move it forward.

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We are going to find a way to move it forward because we are committed to the work, because

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the work is important and it needs to see the light of day.

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And it's just such a wonderful place to be, I think, from just the perspective of what

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are you writing that ignites your fire?

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What are you writing about that keeps you going?

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And I think that's probably what I'm talking about today is how do you keep going in the

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face of rejection and what are some of the ways that you can think about rejection and

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how do you rejection proof your experience?

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So I'm not saying I'm taking away rejections.

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I'm saying how do you take those rejections and make them into more than just rejection?

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So today I'm talking about four things to think about in fortifying yourself against

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rejection.

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So number one is start with a project.

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So there's a book by Simon Sinek that says start with why.

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And if I wasn't saying start with a project, I would say start with why.

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Many times when we are coming to our careers as clinician researchers, we are kind of starting

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off on the project that was handed to us.

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And there's value in that because, again, we are thinking about research training.

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It takes time to do research training.

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And over the course of PhD training, people start from where they were just contributing

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to a project to where they're actually taking pieces of projects and creating their own

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projects out of that to where they are actually leading their own projects.

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And so when you think about clinicians doing research, in a way, you're trying to fast

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track and accelerate the process.

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So you don't necessarily start out with your own project.

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You're looking to see is there a mentor who's already working on a project and I can get

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skills that I need.

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So there's definitely the elements of that.

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But as you start to think about leading your own research program, and I would argue that

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when you are a fellow making that transition, to really start thinking about what do I care

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about?

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What do I really, really care about?

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And to focus on getting involved in projects you really, really care about that you see

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yourself continue projects that really energize you.

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And it's important because there are two pieces I think about in making and doing the training

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or in making the transition from clinician to researcher to leader of a program is number

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one, you do need to learn how to do you need to learn techniques, but you learn how to

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do not so that you keep doing, but so that you are able to supervise people who do because

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as a clinician, you are a leader and your job ultimately is not to continue to do things

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for yourself.

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Your job ultimately is to lead people to do the work of your research program.

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And so it's important, I think, to separate the doing of the research from the leading

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of the research.

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So there are two components to the training.

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Number one is the doing.

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Number two is the leading of the doers because your job and actually maybe I would argue

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that you're leading the doers and ultimately you lead thinkers as well.

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Your value to your research program leadership is your thought, is the way you think.

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This is how we can take this huge complex problem and boil it down into a research question

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that can be answered.

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And these are the set of experiments that allow us to answer the question, or these

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are the set of analyses that allow us to answer the question.

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And then you get your team to do the analyses to answer the question, or to do the experiments

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that answer the question.

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Your thought leadership is so key.

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And so when you are thinking about your experiences for training, think about how do I get the

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thought leadership?

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How do I get the thought patterns that allow me to do this well?

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And so you think about your projects in terms of what skill is this bringing me?

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Is it giving me the skill to do, which is fine, but ultimately the goal is not to get

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good at doing, your goal is to get good at leading the people who do.

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And you get good at leading the people who do things by being able to think well.

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And so yes, sometimes it's like, well, but I have to teach the people who do things.

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I would say that think about how do you structure your research programs such that you're working

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with people who already know how to do these things.

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And sometimes that is about collaborations as well.

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Who already has the infrastructure to do what you want to do?

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And how can you collaborate with them so that your group can focus on what their area of

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expertise is, and you're not necessarily investing all the time trying to learn new techniques

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each time.

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Anyway, so there are nuances depending on the field of research that you're in.

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But you do want to really love what you do.

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You want to be invested in the patient population.

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You want to know that this work leads to something meaningful to you.

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And for different people, that means different things.

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So for me, I'm not a basic scientist.

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I don't work in a wet lab.

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I lead a research team that includes biostatisticians and data analysts.

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And we do different work from someone who say at them at the bench.

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So maybe taking an example from the bench and thinking about, OK, maybe this person

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is doing receptor signaling and this work is so important to them.

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And they're like, this receptor signaling work that I'm doing is going to really help

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us solve problems in patients who have a certain type of cancer.

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And that's their why.

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It's like this cancer needs to be cured.

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Receptor signaling research allows me to do that.

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And it allows me to contribute in this way.

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And so for that reason, the research project that they're doing is not about receptors.

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It's not about signaling.

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It's about the patient at the end that's going to benefit from what is coming out of this

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work.

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And that's great.

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I wouldn't resonate with that.

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I resonate with how do we answer clinical questions using big data so that we can have

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insights to help many more patients?

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I want to be a little bit closer to the patient's population.

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And for that reason, the population of patients in whom I am asking questions is so important.

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And so you want to make sure that you actually enjoy what you do or that the why is so clear

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to you because you know that the work you're doing will be done whether people pay you

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to do it or not.

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You want to do this work.

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In fact, if you could, you would pay to do the work.

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And for that reason, you want to make sure that you're doing work that matters so that

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when rejection comes, you keep it in perspective.

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It's like, okay, it's one rejection, but this work is so important, it still needs to move

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forward.

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And you don't let rejection stop you from doing the work.

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What happens when you do work that you don't care about or work that other people have

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asked you to do and you've kind of taken on as your own is that the moment rejection comes,

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you're like, you know what?

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This sucks.

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I quit.

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I'm done with this.

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And so, you know, when it's work that you value, it's a patient population you absolutely

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want to contribute to no matter what, you don't let the rejection stop you in your tracks.

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You think about a different way to deal with it.

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And so anyway, it starts with why.

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It starts with really thinking about the reason for which you're doing the research.

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Number two is to reframe the way you think about rejection.

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Now, when you say rejection, it just sounds so bad, but what if we thought about rejection

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as the failure of a prototype?

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We've created a prototype and we've put it out there into the world and someone said,

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I don't like this prototype.

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Now, all the work that you have put into this prototype is still valuable.

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All the experience you had in creating this prototype is still valuable.

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You haven't lost any of it.

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But what you're going to do is take the prototype, keep the stuff in the prototype that makes

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sense and then create the next prototype.

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And so when you have something that is rejected, it's rejected right now in its current format,

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but how can it be recreated so that it becomes something greater?

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For example, you just submitted a grant that was rejected and if you're lucky, if you're

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submitting to NIH, you get a summary statement that tells you these are all the things that

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we think could be improved about your grant.

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Now you never are starting from scratch when you resubmit the grant because there's a lot

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of it that's already written and a lot of components that don't necessarily need to

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change and then there are components that are going to change.

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And even if you're doing an overhaul, there's still a starting point.

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You're not starting from a blank page.

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And so at the end, if we reframe the way we think about rejection, instead as well, well,

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this thing was not acceptable in its current format to somebody else.

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You can think about who else might accept it in its current format.

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So is there a different audience that might like it?

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Or you can think about how do we reformat this thing so that it is now acceptable to

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the people that we're sending it to?

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And so what you find is over time, rejection of one thing allows you to recreate it in

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a way that's now acceptable the second time around.

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And so rejection really is a personal thing, or we can make it personal, but really it's

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just the prototype was rejected.

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This thing that you created was rejected.

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How can you recreate it so that it's now acceptable to the people that you're putting out there

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to?

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So it's either the funders or it's the reviewers on behalf of the funders or the reviewers

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on behalf of the journal.

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But let's rethink the way we think about rejection.

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So it's not personal.

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It's not being rejected me, but it's really clearly, okay, they didn't like this prototype.

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What do we do about it?

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And that's why number three is really thinking about creating multiple prototypes.

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So it's like, okay, if you're creating something, you know that the very, very first version

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is usually not the best version.

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It's very rare that you create something that's the final version.

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I have submitted many manuscripts in my lifetime.

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Goodness, I feel like that number is at least close to 100.

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I mean, I haven't had 100 published, not right now, not at the time of this recording, but

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I've submitted a lot.

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And sometimes it's resubmitting the same thing across, you know, in different versions across

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different platforms.

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But ultimately, the first thing is usually not the first thing that's accepted.

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I've had one, yes, that's what I was saying.

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I was trying to say that I've submitted many things and I've only ever had one manuscript

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that was accepted the first time.

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And that was a complete shock.

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I was like, what?

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And in reality, it wasn't the first draft that we submitted.

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I mean, this is work that we've been doing for a long time.

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We were proud of our work, but we also expected that the reviewers would come back with things

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that we needed to change.

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So we were surprised it was accepted the first time.

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That rarely happens.

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But each time you submit, it's one version, right?

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And it's not even the version you started with.

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And if you get rejection, then you recreate and you resubmit.

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So ultimately, you're creating multiple prototypes of the same product.

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And each time you create a subsequent prototype, the prototype actually gets better.

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And if you think about it, let's think about the iPhone, for example, as an example of

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a phone.

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This is not a promotion.

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But if you go back to the very first iPhone and we still have the very first iPhone, I

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mean, it was really cool for its time.

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But multiple prototypes have been created such that the prototype that's currently available

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is infinitely better than the prototype that first started.

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And so over time, prototyping helps you get better.

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So in a sense, rejection is about forward failure, if you allow it to be.

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If you allow the rejection to give you information that creates the next prototype, it allows

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you to just realize that what you're doing is prototyping.

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In your career as a clinician researcher, you're creating multiple prototypes.

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And usually, each prototype, each subsequent prototype, is better than the last prototype.

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And what's interesting is that you already know as you're creating a prototype how you

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can make it better.

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So let's say we submit a manuscript and we get reviews.

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Then the reviewers give us information about how the prototype could be made better.

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And we could agree with that, but we could disagree with that.

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But we have information.

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And so we take that information and we create the next prototype.

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And so think of rejection as failing forward because what you're doing is enhancing their

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prototype, is making the prototype better.

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And it really helps you create a better product.

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And I will say that I don't know a review that has not really enhanced my product.

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And I think a lot right now, I'm thinking about manuscripts where the reviewers were

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like, well, what if you did this?

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And what if you did that?

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And at first, we roll our eyes.

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We're like, this is ridiculous.

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When we come back, we're like, hmm, yeah, we can see how that might enhance the work.

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And when we respond, we get to respond in our own way.

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So we're not like, well, it's rare.

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It does happen.

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Sometimes reviewers will say, write this instead.

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But we get to use the information we see from the reviewers to create something that's so

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much better, to create something that's so much better.

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And so there's an opportunity to really continue to prototype in our work.

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And that helps us not think of it as a rejection, but really an opportunity to create a better

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prototype.

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And then number four is to have a plan.

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Okay, rejection is coming.

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If you didn't know that, I've just announced it to you.

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If you haven't experienced it yet, congratulations.

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Your first rejection is coming.

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And what are you going to do when it comes?

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Are you prepared?

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So how do you prepare for rejection?

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Well, you have a plan.

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When you go to submit something, if you're submitting a manuscript, for example, have

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a list of journals that you're submitting to.

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This is tier one of the journals we still want to submit to.

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This is tier two that we want to submit to.

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This is tier three.

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And if the journal doesn't get into one, then we're going to go with two.

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If it doesn't get into two, we're going to go with three.

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If it doesn't get into three, we're going to go with four.

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Start with a plan.

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And so there's already a plan of action when the manuscript is not accepted.

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You're not sitting down thinking, oh, what do we do now?

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Oh, my goodness, we didn't expect this rejection.

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Oh, no, we are stuck.

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You have a plan.

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You're like, oh, we didn't think this would happen, but we made a plan that we would go

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to manuscript two, tier two.

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And let's go ahead now revamp and resubmit to tier two journal.

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When you have a plan, it allows you not to get overwhelmed by the rejection because in

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a way you've kind of planned for it and you can execute on the plan.

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How about a grant rejection?

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Well, I hope that you're not basing your entire career on this one grant that you're submitting.

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I hope that you have taken this grant and thought about how you're going to repurpose

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it.

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But let's say you have a grant and it's like, oh, my gosh, this is the most amazing grant

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I've ever submitted.

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And you've got to have a plan for if that grant is not accepted, if that proposal is

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not funded, what's next?

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You can take the summary statements, you know, revise the proposal, where are you going to

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resubmit to?

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And it may be that you say, nope, this is the last time we're submitting this to this

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particular funder.

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And if it's rejected, then we're going to change the focus of the proposal so that it

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can match, it can better align with this other funder.

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And then we're going to go to this other funder.

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But you have a plan in place.

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And so it allows you to get away from the rejection that just paralyzes you for weeks

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and weeks or months and months.

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And you're like, whatever happened to that project?

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You're like, ah, we got rejected.

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But when you have a plan and after you've picked yourself up from the floor, you're

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like, OK, what did we say we were going to do if this rejection came?

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You have a plan.

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So for this particular grant I talked about, you know, we already had a plan to resubmit

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if it wasn't funded the first time.

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And we're in the process of talking about what does responding to the summary statement

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look like?

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What do we want to change?

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What do we want to keep?

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What ways do we enhance the project so that when it goes in the next time, it actually

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is fundable?

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So when you have a plan, it does allow you to fortify yourself against rejection.

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I think one thing that it's important to mention is have a support group.

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Have a group of people that you can come to and say, ah, this was rejected and I feel

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so awful about it and I'm so mad.

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I want to quit forever so they can help you put things in perspective.

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This journey is not a journey that you should go at alone.

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You should have accountability and you should have support as well.

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And sometimes your mentor is not the person to help you work through your feelings, your

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emotions about rejection because they are probably so far ahead they don't even think

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much about rejection.

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They're like, and get over it, but you can't get over it, not right away.

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You need people to come around you and say, you worked so hard and that was such a good

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paper and it's going to get published.

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Don't worry about it.

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You need a group of people to just enhance you.

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So if you're looking for a group, if you're looking for accountability, you can get that

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in our coaching programs, sign up at clinicianresearcherpodcast.com to get more information.

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If this podcast episode has been helpful to you, please leave us a review and help other

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00:22:56,820 --> 00:22:58,820
people to find us as well.

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And better still, forward this to just one clinician researcher who needs to be encouraged

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in the face of rejection.

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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 look forward to the next time.

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

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

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have a mentor.

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

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Someone else needs to hear it.

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So take a minute right now and share it.

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

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