1 00:00:00,000 --> 00:00:05,860 Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills 2 00:00:05,860 --> 00:00:11,260 to build their own research program, whether or not they have a mentor. 3 00:00:11,260 --> 00:00:17,340 As clinicians, we spend a decade or more as trainees learning to take care of patients. 4 00:00:17,340 --> 00:00:22,380 When we finally start our careers, we want to build research programs, but then we find 5 00:00:22,380 --> 00:00:27,780 that our years of clinical training did not adequately prepare us to lead our research 6 00:00:27,780 --> 00:00:29,200 program. 7 00:00:29,200 --> 00:00:35,480 Through no fault of our own, we struggle to find mentors, and when we can't, we quit. 8 00:00:35,480 --> 00:00:40,580 However, clinicians hold the keys to the greatest research breakthroughs. 9 00:00:40,580 --> 00:00:46,200 For this reason, the Clinician Researcher podcast exists to give academic clinicians 10 00:00:46,200 --> 00:00:51,800 the tools to build their own research program, whether or not they have a mentor. 11 00:00:51,800 --> 00:01:01,080 Now introducing your host, Toyosi Onwuemene. 12 00:01:01,080 --> 00:01:04,720 Hello everyone, and welcome to the Clinician Researcher podcast. 13 00:01:04,720 --> 00:01:09,160 I'm your host, Toyosi Onwuemene, and it's such a pleasure to be here with you today. 14 00:01:09,160 --> 00:01:13,000 I'm extremely excited about today's episode because we have a really thoughtful guest, 15 00:01:13,000 --> 00:01:18,280 Julia Xu, who is going to introduce herself shortly, but she's an outstanding clinician 16 00:01:18,280 --> 00:01:24,000 researcher who's really making waves in the field, and I want you to meet her. 17 00:01:24,000 --> 00:01:29,640 So without further ado, I'm going to say, Julia, welcome to the show. 18 00:01:29,640 --> 00:01:31,200 Thank you so much for having me. 19 00:01:31,200 --> 00:01:33,560 I'm really happy to be on the show. 20 00:01:33,560 --> 00:01:38,280 And just by way of introduction, I guess I'll just briefly say that I am currently an assistant 21 00:01:38,280 --> 00:01:44,240 professor at University of Pittsburgh in the Department of Medicine, Division of Hematology 22 00:01:44,240 --> 00:01:52,080 Oncology and Section of Benign Hematology, I see patients with benign hematological conditions, 23 00:01:52,080 --> 00:01:57,960 but mostly focusing on sickle cell disease and other hemoglobin disorders, and I'm adult 24 00:01:57,960 --> 00:02:01,360 internal medicine and global health trained as well. 25 00:02:01,360 --> 00:02:07,240 And then I also do clinical research, have a couple of clinical trials ongoing, and also 26 00:02:07,240 --> 00:02:08,820 have a small lab. 27 00:02:08,820 --> 00:02:13,560 So I think that's why I'm here to talk about both the clinical and the research portion 28 00:02:13,560 --> 00:02:14,560 of careers. 29 00:02:14,560 --> 00:02:15,560 Thank you, Julia. 30 00:02:15,560 --> 00:02:16,560 That's an awesome introduction. 31 00:02:16,560 --> 00:02:26,200 I chuckled when you said you have a small lab, because I feel like it, you know, I think 32 00:02:26,200 --> 00:02:27,200 it's important. 33 00:02:27,200 --> 00:02:30,560 I'm going to ask you to tell us how many years out you are from your fellowship, so how many 34 00:02:30,560 --> 00:02:35,760 years you are into this junior faculty career, and then ask you about, like, at what point 35 00:02:35,760 --> 00:02:39,440 did you decide, hey, I'm a clinician scientist, I'm a clinician researcher. 36 00:02:39,440 --> 00:02:44,120 At what point did you feel like you owned the position? 37 00:02:44,120 --> 00:02:49,940 Because you're a little early in your career, I feel, and have accomplished so much that 38 00:02:49,940 --> 00:02:53,660 I wonder if you can speak to that. 39 00:02:53,660 --> 00:02:57,280 Of course, and thank you, very kind words. 40 00:02:57,280 --> 00:03:03,600 So I am about a year and a half out from fellowship. 41 00:03:03,600 --> 00:03:11,120 So I did my hematology only fellowship at the National Institutes of Health at the NIH. 42 00:03:11,120 --> 00:03:18,760 I did a one year hematology fellowship followed by a couple of years of research, and then 43 00:03:18,760 --> 00:03:24,240 during my transition period stayed on a little bit longer to finish some research transition 44 00:03:24,240 --> 00:03:29,800 to University of Pittsburgh in October of 2021. 45 00:03:29,800 --> 00:03:36,560 And so I'm kind of in my second year of the faculty position and getting settled in, you 46 00:03:36,560 --> 00:03:41,160 know, getting studies off the ground, getting the lab finally set up. 47 00:03:41,160 --> 00:03:46,200 And so you're right, I am pretty early in my research career still. 48 00:03:46,200 --> 00:03:56,240 I would say I, gosh, owning is a hard concept, because sometimes I feel like I still don't 49 00:03:56,240 --> 00:03:57,240 own that identity. 50 00:03:57,240 --> 00:04:04,560 You know, there's always a lot of imposter syndrome and second guessing yourself in this 51 00:04:04,560 --> 00:04:06,720 career track. 52 00:04:06,720 --> 00:04:16,040 But I think I felt like a physician researcher when I was in residency at first, because 53 00:04:16,040 --> 00:04:22,340 I did a global health fellowship where I had a year to conduct independent research internationally 54 00:04:22,340 --> 00:04:24,180 in Thailand. 55 00:04:24,180 --> 00:04:31,640 And I think that that was kind of the first time that I was the PI of a project and I 56 00:04:31,640 --> 00:04:37,440 was, you know, managing an international grant and collaboration and, you know, could really 57 00:04:37,440 --> 00:04:44,080 say like, okay, I have taken charge of this research project and it is on me whether it 58 00:04:44,080 --> 00:04:45,680 was or dies. 59 00:04:45,680 --> 00:04:51,920 And then during my fellowship training, had the opportunity to lead a couple of early 60 00:04:51,920 --> 00:04:59,360 phase clinical trials and that really cemented my, I guess, confidence that I was able to 61 00:04:59,360 --> 00:05:07,000 assume more of a leadership position rather than someone who was carrying out research 62 00:05:07,000 --> 00:05:09,120 on behalf of a mentor. 63 00:05:09,120 --> 00:05:15,360 And so I think those experiences were probably the most formative, even though all of the 64 00:05:15,360 --> 00:05:20,420 research experiences I had up to that point had really built upon each other and kind 65 00:05:20,420 --> 00:05:25,200 of gave me a little bit more confidence step by step. 66 00:05:25,200 --> 00:05:27,560 Thank you for sharing that piece of your story. 67 00:05:27,560 --> 00:05:32,640 You know, it's funny, every time I hear your story, I think, wow, what an accomplished 68 00:05:32,640 --> 00:05:33,640 person. 69 00:05:33,640 --> 00:05:36,680 You've been doing so much for so long. 70 00:05:36,680 --> 00:05:41,880 It's interesting, you know, you talk about you leading a research program as a resident. 71 00:05:41,880 --> 00:05:42,880 Okay. 72 00:05:42,880 --> 00:05:47,000 So I'm going to pause and just say that most of the time that doesn't happen, right? 73 00:05:47,000 --> 00:05:51,280 Many clinicians going through training are participating in programs. 74 00:05:51,280 --> 00:05:55,400 They're not leading and you are not just leading in programs, you're leading a research program 75 00:05:55,400 --> 00:06:00,520 internationally and managing collaborations, which is such a great experience for you to 76 00:06:00,520 --> 00:06:01,520 have. 77 00:06:01,520 --> 00:06:07,600 I think many, many times there isn't really in our training and our clinical training, 78 00:06:07,600 --> 00:06:11,560 especially we have a little bit of research here and there, but opportunities to actually 79 00:06:11,560 --> 00:06:16,600 be in leadership of research don't necessarily happen commonly. 80 00:06:16,600 --> 00:06:22,000 So I do want to pause there and ask, what was the set of circumstances in your life 81 00:06:22,000 --> 00:06:26,040 that allowed you as a resident to lead this research program? 82 00:06:26,040 --> 00:06:27,840 How did that come to be? 83 00:06:27,840 --> 00:06:31,240 Yeah, I know that's a really good point. 84 00:06:31,240 --> 00:06:35,600 And I feel lucky in so many ways to have been put on this trajectory early. 85 00:06:35,600 --> 00:06:40,800 I think at the end of the day, you know, if you want to do research, I think getting into 86 00:06:40,800 --> 00:06:44,360 it early really lets you reap the rewards afterwards. 87 00:06:44,360 --> 00:06:49,400 And every little success begins further success in the academic career track. 88 00:06:49,400 --> 00:06:56,800 So I started off doing lab-based research in college, got a master's degree with a program. 89 00:06:56,800 --> 00:07:01,040 I was at University of Pennsylvania and there's a program called Vagilist Scholars Program, 90 00:07:01,040 --> 00:07:03,240 which allows you to sub-matriculate. 91 00:07:03,240 --> 00:07:10,640 And so it paid for two summers of full-time summer research and time during the year to 92 00:07:10,640 --> 00:07:14,120 work on your research and master's project. 93 00:07:14,120 --> 00:07:20,500 And so that gave me lab experience, you know, got me on my first co-author publication, 94 00:07:20,500 --> 00:07:24,760 but also made me realize that I didn't want to be just a basic scientist. 95 00:07:24,760 --> 00:07:28,000 I think I really missed the clinical side of things. 96 00:07:28,000 --> 00:07:30,920 I really liked translating discoveries. 97 00:07:30,920 --> 00:07:36,440 And even though I was fascinated by the lab work, I just didn't see myself as the PI of 98 00:07:36,440 --> 00:07:38,480 a large lab. 99 00:07:38,480 --> 00:07:44,280 And so I actually kind of used that experience to decide to go into medical school. 100 00:07:44,280 --> 00:07:48,720 And then during medical school, you know, I had some research experiences here and there. 101 00:07:48,720 --> 00:07:56,040 Like after my first year of med school, I went to Peru where I did some HIV research, 102 00:07:56,040 --> 00:07:58,120 but it didn't really pan out. 103 00:07:58,120 --> 00:08:02,200 You know, nothing came of the project and I ended up spending most of the time shadowing 104 00:08:02,200 --> 00:08:04,520 and exploring Peru, of course. 105 00:08:04,520 --> 00:08:09,880 And then, you know, I was really fascinated by the idea of global health and I love Spanish. 106 00:08:09,880 --> 00:08:15,400 It was kind of my, it was one of my majors in college and just a real passion. 107 00:08:15,400 --> 00:08:22,640 And so I sought to do more work in Latin America and I stumbled upon this wonderful opportunity 108 00:08:22,640 --> 00:08:26,120 to work with an amazing team of mentors. 109 00:08:26,120 --> 00:08:28,200 So I was in Steve's Vitality Lab. 110 00:08:28,200 --> 00:08:33,880 He's a transfusion medicine professor and he, you know, was a phenomenal mentor, got 111 00:08:33,880 --> 00:08:36,800 me interested in G6PD deficiency. 112 00:08:36,800 --> 00:08:42,800 I was kind of leaning towards hematology at the time, but, you know, hadn't decided on 113 00:08:42,800 --> 00:08:46,480 benign hematology, malignant hematology, you know, oncology. 114 00:08:46,480 --> 00:08:50,200 But, you know, got me really interested in hemoglobin disorders. 115 00:08:50,200 --> 00:08:54,480 I think it started my interest in sickle cell there as well. 116 00:08:54,480 --> 00:09:00,280 And then I had an opportunity to design this project as a, it was supposed to be a three 117 00:09:00,280 --> 00:09:04,240 month scholarly project, but the more we talked about it, the more we realized if I'm going 118 00:09:04,240 --> 00:09:09,160 to go, and this was in collaboration with a HIV clinic in the Dominican Republic. 119 00:09:09,160 --> 00:09:14,360 So it's like, if I'm going to go to the Dominican Republic and I only have three months to get 120 00:09:14,360 --> 00:09:18,800 a project off the ground, you know, best case scenario, I start it and then it never gets 121 00:09:18,800 --> 00:09:20,080 finished. 122 00:09:20,080 --> 00:09:25,960 And so after thinking about it a little more, I decided to apply for a Doris Duke Charitable 123 00:09:25,960 --> 00:09:33,200 Foundation Award for medical students to have a year of protected time doing research. 124 00:09:33,200 --> 00:09:40,060 So I used the scholarly project period to write my IRB, and then I spent that next year 125 00:09:40,060 --> 00:09:46,160 between third and fourth year of medical school going back and forth between the DR and New 126 00:09:46,160 --> 00:09:53,480 York implementing this project of G6PD deficiency screening and trying to identify risk factors 127 00:09:53,480 --> 00:09:59,680 that you can use in a low cost algorithm and resource poor settings to screen patients 128 00:09:59,680 --> 00:10:02,160 with G6PD deficiency. 129 00:10:02,160 --> 00:10:04,840 And it was a tremendous experience. 130 00:10:04,840 --> 00:10:10,200 You know, I loved, even though it was a mentored project, but I was the one on the ground kind 131 00:10:10,200 --> 00:10:12,360 of implementing the study, right? 132 00:10:12,360 --> 00:10:17,300 So in a way I got my first taste of leadership and, you know, the trials and tribulations 133 00:10:17,300 --> 00:10:24,200 of trying to see a project through identifying and overcoming barriers, getting people excited 134 00:10:24,200 --> 00:10:26,560 and engaged in the science. 135 00:10:26,560 --> 00:10:32,000 I had to figure out how to do all of that in Spanish, which was such a cool experience. 136 00:10:32,000 --> 00:10:39,560 And so that gave me my first taste of like, kind of leading a research project on the 137 00:10:39,560 --> 00:10:41,840 ground. 138 00:10:41,840 --> 00:10:46,720 And then when I came to Duke, you know, one of the reasons that I chose Duke was that 139 00:10:46,720 --> 00:10:54,320 there's this internal medicine global health residency program that's combined basically 140 00:10:54,320 --> 00:11:01,640 four years where you do your residency, but then you also do a master's in global health. 141 00:11:01,640 --> 00:11:07,120 And then you have a year on the ground where you're implementing your own projects and 142 00:11:07,120 --> 00:11:09,760 usually apply for some sort of grant. 143 00:11:09,760 --> 00:11:13,960 Like I applied for a Fogarty International Center fellowship. 144 00:11:13,960 --> 00:11:20,800 And so that gave me the opportunity not only to do research locally, you know, Marilyn 145 00:11:20,800 --> 00:11:22,160 Tellen, I love her. 146 00:11:22,160 --> 00:11:24,040 She's an incredible mentor. 147 00:11:24,040 --> 00:11:27,540 So she was my main mentor at Duke in sickle cell. 148 00:11:27,540 --> 00:11:32,440 And I kind of sought out working with her specifically in sickle cell. 149 00:11:32,440 --> 00:11:38,080 We did a really great database project together that, you know, she gave me a lot of independence 150 00:11:38,080 --> 00:11:41,680 to kind of help lead and direct as well. 151 00:11:41,680 --> 00:11:47,840 And then she supported me when I went abroad to do a project on balacemia. 152 00:11:47,840 --> 00:11:54,760 And I think in this situation, I was looking for something in sickle cell and global health, 153 00:11:54,760 --> 00:11:57,760 and there was just not the right project that fit. 154 00:11:57,760 --> 00:12:05,440 And so I ended up deciding to make the pivot to study something related, you know, hemoglobin 155 00:12:05,440 --> 00:12:12,360 disorders, but in kind of a different area of expertise in order to get the knowledge 156 00:12:12,360 --> 00:12:16,760 and training and experience of leading an independent study. 157 00:12:16,760 --> 00:12:23,600 And so I think that was one of my better decisions in life to, you know, not just stick with 158 00:12:23,600 --> 00:12:28,840 exactly my topic area, but to pursue something that gave me the skills I needed to then move 159 00:12:28,840 --> 00:12:30,200 on to the next step. 160 00:12:30,200 --> 00:12:32,280 And I think that was really helpful. 161 00:12:32,280 --> 00:12:37,840 When I then transitioned to fellowship, it could say, hey, I've led a couple of studies 162 00:12:37,840 --> 00:12:38,840 already. 163 00:12:38,840 --> 00:12:45,480 I know how to assemble a research team, how to oversee coordinators and interpreters, 164 00:12:45,480 --> 00:12:52,120 et cetera, and further extended my skill set by helping to run this clinical trial at the 165 00:12:52,120 --> 00:12:53,120 NIH. 166 00:12:53,120 --> 00:12:58,120 So a lot of baby steps along the way and a lot of lessons learned, I think. 167 00:12:58,120 --> 00:13:05,200 And I think at every step, I look for the opportunity that most gave me independence 168 00:13:05,200 --> 00:13:08,760 and the skill sets that I thought were useful for the future. 169 00:13:08,760 --> 00:13:11,160 That's super awesome. 170 00:13:11,160 --> 00:13:13,400 Thank you for sharing your story. 171 00:13:13,400 --> 00:13:18,920 And I see there, you know, you talk about, actually, you use the word luck at some point 172 00:13:18,920 --> 00:13:21,440 and you also talk about opportunity. 173 00:13:21,440 --> 00:13:26,240 But I do see you as someone who was always prepared to take on opportunities when they 174 00:13:26,240 --> 00:13:27,240 came. 175 00:13:27,240 --> 00:13:29,560 And I think you also talk about luck meets preparation. 176 00:13:29,560 --> 00:13:34,960 I feel like that's just such a great piece of your story where you've always had a great 177 00:13:34,960 --> 00:13:38,640 sense of what you want and you've always gone after it. 178 00:13:38,640 --> 00:13:42,800 And yes, you've had opportunities where you've had mentors who have allowed you to lead projects, 179 00:13:42,800 --> 00:13:48,360 but you really have seen yourself as a leader from the beginning and you've taken, you've 180 00:13:48,360 --> 00:13:52,760 pursued opportunities and you've also been prepared to take them and lead them as they 181 00:13:52,760 --> 00:13:55,160 come up, which I think is so incredible. 182 00:13:55,160 --> 00:13:59,880 I think so many people want to be there, you know, five years into faculty or 10 years 183 00:13:59,880 --> 00:14:03,640 into faculty, but you really started doing that super early. 184 00:14:03,640 --> 00:14:07,720 And I just want to say kudos to you for doing that. 185 00:14:07,720 --> 00:14:12,960 You know, I want to ask, is there, is there, because one of the things that I think you 186 00:14:12,960 --> 00:14:19,040 mentioned earlier is that if you are interested in the teachers start early and you have the 187 00:14:19,040 --> 00:14:23,320 opportunity to do that, I just wonder what was the earliest experience that made you 188 00:14:23,320 --> 00:14:27,080 decide I want to try this thing as a researcher, right? 189 00:14:27,080 --> 00:14:31,960 It just, I wonder what was the earliest experience that led you down this pathway? 190 00:14:31,960 --> 00:14:39,800 Yeah, I think the earliest experience was probably the project on G6PD inefficiency 191 00:14:39,800 --> 00:14:46,760 during medical school, you know, having the chance to really troubleshoot your own study. 192 00:14:46,760 --> 00:14:54,360 Like it's, it is frustrating to no end and also the biggest sense of accomplishment you 193 00:14:54,360 --> 00:15:01,000 can feel, you know, at the end of the year, realizing like, wow, I just overcome, you 194 00:15:01,000 --> 00:15:06,960 know, overcame so many hurdles and enrolled like 250 patients in this, you know, survey 195 00:15:06,960 --> 00:15:08,280 and genotype study. 196 00:15:08,280 --> 00:15:11,920 And I got all this data and a publication out of it. 197 00:15:11,920 --> 00:15:14,840 It's really exciting to be able to do that. 198 00:15:14,840 --> 00:15:21,080 I agree, I do think you have to be in the mindset of taking opportunities as they come 199 00:15:21,080 --> 00:15:28,200 along, being flexible, you know, things in research never go the way you imagine. 200 00:15:28,200 --> 00:15:34,160 So you just adapt and roll with the punches and you just have to persevere because I think 201 00:15:34,160 --> 00:15:42,720 if you, if you're waiting for someone to map out exactly how to do a research project and 202 00:15:42,720 --> 00:15:47,240 you know, help you along every time you face a hurdle, you'll just never get anywhere because 203 00:15:47,240 --> 00:15:49,600 everyone's busy with their own stuff. 204 00:15:49,600 --> 00:15:55,920 And so if you want to lead you, you really have to kind of take the ownership of, you 205 00:15:55,920 --> 00:16:02,000 know, whatever issues come up and just be tenacious and, you know, keep pushing regardless 206 00:16:02,000 --> 00:16:04,960 of how desperate the situation seems. 207 00:16:04,960 --> 00:16:10,000 And it's definitely seemed very desperate at times for me, but you know, in the end, 208 00:16:10,000 --> 00:16:12,120 it always seems to work out. 209 00:16:12,120 --> 00:16:17,800 So I think that was probably, you know, my first lesson in like what it truly means to 210 00:16:17,800 --> 00:16:22,160 engage in research and especially global health research, which comes with its own set of 211 00:16:22,160 --> 00:16:23,800 challenges. 212 00:16:23,800 --> 00:16:31,960 And then I think what convinced me to be like, to truly pursue the academic path and be a 213 00:16:31,960 --> 00:16:38,480 physician researcher or, you know, a physician scientist was my experience leading clinical 214 00:16:38,480 --> 00:16:44,000 trials at the NIH because I think that's when you get a real feel for like, okay, this is 215 00:16:44,000 --> 00:16:46,120 not a fellowship project. 216 00:16:46,120 --> 00:16:53,120 I'm not ticking off a box like this is real research that's going to impact patient care. 217 00:16:53,120 --> 00:16:58,400 And I can see how to, you know, move this forward into additional lines of research. 218 00:16:58,400 --> 00:17:04,120 And I think that's really exciting and starting to generate your own ideas about what you 219 00:17:04,120 --> 00:17:06,400 want to accomplish in the field. 220 00:17:06,400 --> 00:17:08,520 I love it. 221 00:17:08,520 --> 00:17:14,360 And you know, for those of you who are listening, Julia is smiling as she's talking about all 222 00:17:14,360 --> 00:17:17,020 these challenges that she's going through. 223 00:17:17,020 --> 00:17:22,320 And Julia, it makes me think, you know, sometimes it's not even about the end result. 224 00:17:22,320 --> 00:17:27,200 Oh, you accrued to an inoculation, so the study and you were able to get a publication. 225 00:17:27,200 --> 00:17:29,160 I mean, it's great that you have that. 226 00:17:29,160 --> 00:17:32,920 And that's the tangible piece that lets people know that she did something. 227 00:17:32,920 --> 00:17:37,320 But you know, as you're smiling, it makes me think that it's who you have to become 228 00:17:37,320 --> 00:17:38,520 to pull that off. 229 00:17:38,520 --> 00:17:43,440 That is so rewarding because the Julia that started the, you know, that started the project 230 00:17:43,440 --> 00:17:46,600 and the Julia that ended the project were two different Julias. 231 00:17:46,600 --> 00:17:52,000 It was a Julia who had pushed through obstacles, who had stayed tenacious and requested what 232 00:17:52,000 --> 00:17:54,680 she wanted and firmly pushed things forward. 233 00:17:54,680 --> 00:17:59,960 I mean, you were just, it was just the transformation that happened inside you that allowed you to 234 00:17:59,960 --> 00:18:03,080 that is your reward, your personal reward. 235 00:18:03,080 --> 00:18:07,840 Like the paper is great, but there's a personal reward and the reward in the transformation 236 00:18:07,840 --> 00:18:11,000 that happens that allows you at the end of that to say, well, what's next? 237 00:18:11,000 --> 00:18:12,560 What else can I do? 238 00:18:12,560 --> 00:18:17,760 And I see that in your story, there's almost like a sense of a graduated responsibility, 239 00:18:17,760 --> 00:18:20,760 so to speak, like a graduated, okay, I've done this project. 240 00:18:20,760 --> 00:18:22,360 Now I'm moving to the next project. 241 00:18:22,360 --> 00:18:24,900 And now I'm moving into this dynamic of it. 242 00:18:24,900 --> 00:18:28,120 Now I'm leading a clinical trial as a fellow. 243 00:18:28,120 --> 00:18:32,760 Many fellows don't do that, but you've had all these building blocks along the way that 244 00:18:32,760 --> 00:18:36,040 have allowed you to move forward into the next challenge and the next challenge and 245 00:18:36,040 --> 00:18:37,320 the next challenge after that. 246 00:18:37,320 --> 00:18:40,040 And I'm wondering how that lands for you. 247 00:18:40,040 --> 00:18:42,960 No, I completely agree with you. 248 00:18:42,960 --> 00:18:48,480 I mean, I think to jump, I think, you know, for instance, it's really intimidating to 249 00:18:48,480 --> 00:18:54,680 become junior faculty all of a sudden and not have been, you know, led your own studies 250 00:18:54,680 --> 00:18:59,280 previously and now suddenly all of the onus is on you, right? 251 00:18:59,280 --> 00:19:05,680 Like it's, it's one of those challenges and I still face it today, but I think I'm much 252 00:19:05,680 --> 00:19:10,200 more prepared because I had had those previous building blocks before. 253 00:19:10,200 --> 00:19:14,960 And I think I can say that for each step of my training, like I would not have been comfortable 254 00:19:14,960 --> 00:19:22,200 leading an international, you know, collaboration as a resident if I had not already gone through 255 00:19:22,200 --> 00:19:28,680 the many challenges of running an international study as a medical student. 256 00:19:28,680 --> 00:19:34,720 And you know, maybe I wouldn't have been as prepared for working in a different culture 257 00:19:34,720 --> 00:19:40,160 and you know, a different environment that I had to adapt to if I hadn't had the experience 258 00:19:40,160 --> 00:19:46,320 of trying to navigate and negotiate the culture in Peru, even, you know, when I didn't have 259 00:19:46,320 --> 00:19:51,080 a successful research project, but I still had to learn how to conduct myself in a new 260 00:19:51,080 --> 00:19:53,480 culture with new colleagues. 261 00:19:53,480 --> 00:19:57,880 And so I think every experience definitely helps you grow as a person. 262 00:19:57,880 --> 00:20:03,640 And it also just gives you confidence, you know, for yourself, but also when you're talking 263 00:20:03,640 --> 00:20:10,080 to other people, because for instance, I think, you know, mentors are also looking for individuals 264 00:20:10,080 --> 00:20:15,840 who are competent and inspired and, you know, really dedicated. 265 00:20:15,840 --> 00:20:20,760 And if you can show that through your previous work, you get more people interested in you 266 00:20:20,760 --> 00:20:25,320 and they're more willing to invest, they're more willing to trust and give you independence 267 00:20:25,320 --> 00:20:28,280 to kind of let you go on to the next step. 268 00:20:28,280 --> 00:20:33,320 Because if you've never shown initiative, they might not feel comfortable saying like, 269 00:20:33,320 --> 00:20:36,880 okay, why don't you take the initiative on this next project? 270 00:20:36,880 --> 00:20:42,480 So I think it really helps, you know, both ways kind of internally and then also in your 271 00:20:42,480 --> 00:20:48,200 interactions to be able to say like, yeah, I am ready for the next thing now. 272 00:20:48,200 --> 00:20:49,200 I love it. 273 00:20:49,200 --> 00:20:53,400 I love how you kind of highlight the fact that all along you were building a portfolio 274 00:20:53,400 --> 00:20:56,600 and you're like, this is, I can do this because I have done it. 275 00:20:56,600 --> 00:20:59,320 I've done it in this phase, I've done it in this place. 276 00:20:59,320 --> 00:21:00,920 And now I'm ready for the next step. 277 00:21:00,920 --> 00:21:04,080 I'm ready to be a leader of my own research program. 278 00:21:04,080 --> 00:21:09,120 And that leads me to think about how you really did as you were transitioning from fellows 279 00:21:09,120 --> 00:21:15,480 to faculty, you did need to negotiate resources to allow you to succeed in your career. 280 00:21:15,480 --> 00:21:20,600 And I wonder if you don't mind just sharing with us some of the thoughts that went into 281 00:21:20,600 --> 00:21:25,280 negotiating or getting ready to negotiate what was your first faculty job. 282 00:21:25,280 --> 00:21:26,280 Sure. 283 00:21:26,280 --> 00:21:31,880 And I have to say that was definitely one of the most stressful periods of my life today. 284 00:21:31,880 --> 00:21:36,960 I'm sure there will be more stressful ones down the road, but it's no one teaches you 285 00:21:36,960 --> 00:21:39,160 how to negotiate, right? 286 00:21:39,160 --> 00:21:44,880 And it's such a black box depending on, you know, what you're looking for and which institutions 287 00:21:44,880 --> 00:21:48,760 are hiring at which time, you know, what they're looking for. 288 00:21:48,760 --> 00:21:53,480 It's really hard to know what you're even allowed to ask for. 289 00:21:53,480 --> 00:21:56,600 So I relied on a lot of resources. 290 00:21:56,600 --> 00:22:04,240 I actually, you know, didn't, I didn't anticipate starting my job search as early as I did. 291 00:22:04,240 --> 00:22:08,920 I was going to stay on for a little bit longer, but you know, there were institutions that 292 00:22:08,920 --> 00:22:15,440 were interested in positions that were open and I ended up kind of just kickstarting the 293 00:22:15,440 --> 00:22:20,080 job search by talking to different people about my career interests. 294 00:22:20,080 --> 00:22:26,560 You know, not phrasing it as do you have a job for me, but more as I would love to get 295 00:22:26,560 --> 00:22:32,540 your advice as a leader in the sickle cell field to understand, you know, what my career 296 00:22:32,540 --> 00:22:37,800 trajectory might look like and what you think is important for me in the next stages, you 297 00:22:37,800 --> 00:22:38,800 know, my career. 298 00:22:38,800 --> 00:22:41,020 What's an IV looking for? 299 00:22:41,020 --> 00:22:47,640 And I got so much good advice that way and also a few job offers along the way. 300 00:22:47,640 --> 00:22:52,880 And so I think reaching out to different people, you know, experts in the field, people you 301 00:22:52,880 --> 00:22:55,560 admire is really important. 302 00:22:55,560 --> 00:23:02,240 As I talked to people, I got more, I began to shape the image of who I wanted to become 303 00:23:02,240 --> 00:23:04,200 as junior faculty. 304 00:23:04,200 --> 00:23:10,440 And I think that was really helpful in negotiations, being able to present a concrete image of, 305 00:23:10,440 --> 00:23:15,380 you know, this is what I intend to do as junior faculty. 306 00:23:15,380 --> 00:23:17,120 This is the space that I can occupy. 307 00:23:17,120 --> 00:23:19,680 This is what I can bring to the institution. 308 00:23:19,680 --> 00:23:23,440 I think plays really strongly when you're negotiating. 309 00:23:23,440 --> 00:23:28,400 And then all of the other pieces of negotiation, like, you know, it's important to negotiate 310 00:23:28,400 --> 00:23:29,640 salary. 311 00:23:29,640 --> 00:23:34,980 Everyone knows that, but more importantly, if you're trying to, you know, shoot for an 312 00:23:34,980 --> 00:23:43,560 academic career, the two things I think about are protected time and a startup package. 313 00:23:43,560 --> 00:23:47,620 Because if you don't have time and you don't have money to do the research, you're just 314 00:23:47,620 --> 00:23:50,000 never going to get the research off the ground. 315 00:23:50,000 --> 00:23:52,720 And you know, you're going to drown in clinical responsibilities. 316 00:23:52,720 --> 00:23:55,060 And it's happened to so many people. 317 00:23:55,060 --> 00:24:01,660 And so I kind of had to first decide what my one and, you know, number one and number 318 00:24:01,660 --> 00:24:04,120 two priorities were. 319 00:24:04,120 --> 00:24:08,760 And they were number one, protected time, and then the number two, you know, the resources 320 00:24:08,760 --> 00:24:11,400 that I got starting out. 321 00:24:11,400 --> 00:24:15,440 And so, you know, protected time, I think was pretty clear. 322 00:24:15,440 --> 00:24:22,420 Everyone I talked to said, you need at least 75% protected time to really be a strong physician 323 00:24:22,420 --> 00:24:23,420 scientist. 324 00:24:23,420 --> 00:24:25,680 That's the best place to start. 325 00:24:25,680 --> 00:24:30,560 Probably less than, you know, 20% clinical and you would lose your clinical footing. 326 00:24:30,560 --> 00:24:32,360 Like, you still need to see patients. 327 00:24:32,360 --> 00:24:39,520 But, you know, 75 to 80% is perfectly reasonable for a physician scientist with or without 328 00:24:39,520 --> 00:24:40,940 a lab. 329 00:24:40,940 --> 00:24:47,060 And then for startup and resources, I ended up just asking people who are going through 330 00:24:47,060 --> 00:24:54,080 the job process, maybe a year ahead of me, or even in my same year to, and it was very 331 00:24:54,080 --> 00:24:58,960 uncomfortable, but I would literally ask them if they would feel comfortable, you know, 332 00:24:58,960 --> 00:25:00,400 sharing their numbers with me. 333 00:25:00,400 --> 00:25:03,360 Like how much did you negotiate for? 334 00:25:03,360 --> 00:25:08,720 And from a basic science standpoint, like what's reasonable to negotiate for a lab? 335 00:25:08,720 --> 00:25:12,000 The number was way higher than I had ever expected. 336 00:25:12,000 --> 00:25:17,840 And then, you know, what do you negotiate when it comes to running a clinical trial 337 00:25:17,840 --> 00:25:20,200 for starting global studies? 338 00:25:20,200 --> 00:25:23,080 You know, what types of resources do you need? 339 00:25:23,080 --> 00:25:28,000 And with that, started putting together a budget of, you know, everything that I might 340 00:25:28,000 --> 00:25:32,200 potentially need to get my research program off the ground. 341 00:25:32,200 --> 00:25:34,760 And then, you know, ask different people. 342 00:25:34,760 --> 00:25:40,960 I asked you, I asked other people about, you know, what were kind of the key pieces of, 343 00:25:40,960 --> 00:25:46,440 for instance, personnel and support that you need and factor that into the budget as well, 344 00:25:46,440 --> 00:25:51,680 since, you know, salaries are usually the biggest money suck when you're talking about 345 00:25:51,680 --> 00:25:53,800 financing your own research. 346 00:25:53,800 --> 00:26:01,120 And so with all of that came, you know, came to a pretty comprehensive but impressive budget. 347 00:26:01,120 --> 00:26:07,000 And that is what I shared with the institutions that, you know, I negotiated with. 348 00:26:07,000 --> 00:26:11,640 And I think it was helpful for them to have a number to work with. 349 00:26:11,640 --> 00:26:17,480 And then also, it gave them a more concrete idea of, you know, what it was I was actually 350 00:26:17,480 --> 00:26:20,040 trying to accomplish in my first three years. 351 00:26:20,040 --> 00:26:28,320 And so I think that is, that's probably how I went about kind of getting ideas and kind 352 00:26:28,320 --> 00:26:30,320 of researching the process. 353 00:26:30,320 --> 00:26:34,600 And then I also took advantage of our, like, Office of Intramural Affairs. 354 00:26:34,600 --> 00:26:39,960 There was someone who you could actually talk to, to get advice on negotiation. 355 00:26:39,960 --> 00:26:47,440 So anytime I had an offer, or even just a phone conversation, I would, you know, run 356 00:26:47,440 --> 00:26:51,480 it by her and just get a sense like, did this go well? 357 00:26:51,480 --> 00:26:53,640 You know, what should I say here? 358 00:26:53,640 --> 00:26:54,960 Is this asking too much? 359 00:26:54,960 --> 00:26:56,360 Is this asking too little? 360 00:26:56,360 --> 00:27:00,000 It usually, the answer is you're asking too little. 361 00:27:00,000 --> 00:27:07,160 And she really helped me, you know, be bolder, because I think, especially as women in science, 362 00:27:07,160 --> 00:27:11,960 we don't tend to, we tend to ask for what we think is fair, not realizing that part 363 00:27:11,960 --> 00:27:17,760 of the negotiation is you need to ask for, you know, the maximum of what you need, and 364 00:27:17,760 --> 00:27:22,360 maybe a little more because you're never going to get that full ask. 365 00:27:22,360 --> 00:27:28,880 And so part of negotiation is being bold with your asks and knowing kind of the different 366 00:27:28,880 --> 00:27:31,400 components to ask for. 367 00:27:31,400 --> 00:27:36,880 So you know, just using all of these different resources, reading a couple of books about 368 00:27:36,880 --> 00:27:47,160 negotiation helped me expand the idea of like, what are the actual negotiables in these jobs? 369 00:27:47,160 --> 00:27:48,160 I love it. 370 00:27:48,160 --> 00:27:49,160 I love it. 371 00:27:49,160 --> 00:27:50,160 I see so much in that. 372 00:27:50,160 --> 00:27:53,600 So number one, you came prepared. 373 00:27:53,600 --> 00:28:01,760 You went and accessed resources, people, expertise, negotiation resources. 374 00:28:01,760 --> 00:28:03,520 You actually were so prepared. 375 00:28:03,520 --> 00:28:08,520 But see that as one preparation, which I think is so important to have any kind of successful 376 00:28:08,520 --> 00:28:09,520 negotiation. 377 00:28:09,520 --> 00:28:14,640 And then number two, I also see that you were looking when you didn't need to look. 378 00:28:14,640 --> 00:28:18,440 In a sense, you started early and you weren't desperate. 379 00:28:18,440 --> 00:28:20,360 You weren't like, I'm about to run out of money. 380 00:28:20,360 --> 00:28:26,360 I need a job, which really allows you to kind of take your time to think through the process 381 00:28:26,360 --> 00:28:30,840 and keep going back and forth in all the going back and forth that you needed. 382 00:28:30,840 --> 00:28:35,200 I also love that you made a budget and then you ask people what makes sense. 383 00:28:35,200 --> 00:28:36,200 Is this reasonable? 384 00:28:36,200 --> 00:28:37,960 And it's too little, it's too much. 385 00:28:37,960 --> 00:28:42,660 You didn't rely on yourself to be the source of all knowledge for moving forward. 386 00:28:42,660 --> 00:28:47,800 You really engaged all the resources that you had at your disposal. 387 00:28:47,800 --> 00:28:50,160 And then it sounds like you did it. 388 00:28:50,160 --> 00:28:55,520 You took bold steps and you up for things that I think made you feel uncomfortable. 389 00:28:55,520 --> 00:28:57,920 You said, this is what I need. 390 00:28:57,920 --> 00:29:04,580 And I think it's so powerful because you stand out to me as someone who's done things differently 391 00:29:04,580 --> 00:29:09,360 from many people who've come through clinical medicine where we're used to just getting 392 00:29:09,360 --> 00:29:14,160 what we get and we're used to just, you know, whatever you give me, thank you so much. 393 00:29:14,160 --> 00:29:15,640 But you really did something different. 394 00:29:15,640 --> 00:29:18,560 And you said, no, I want, I want to clarify what's needed. 395 00:29:18,560 --> 00:29:21,600 You asked, what do I need to be successful? 396 00:29:21,600 --> 00:29:22,800 You clarified that. 397 00:29:22,800 --> 00:29:26,440 And then you put together your own, this is what it looks, this is what I would need to 398 00:29:26,440 --> 00:29:27,440 be successful. 399 00:29:27,440 --> 00:29:29,040 And then you shared that with people. 400 00:29:29,040 --> 00:29:32,400 You knew from the beginning that you need the protected time. 401 00:29:32,400 --> 00:29:36,280 You knew you needed resources as far as setting up your own program. 402 00:29:36,280 --> 00:29:39,880 And you knew that because you went looking for information. 403 00:29:39,880 --> 00:29:43,840 And so I just want to pause and say to our listeners, if you are listening, I mean, Juliet's 404 00:29:43,840 --> 00:29:49,520 story is so awesome, but just it's so important to gather the information you need so that 405 00:29:49,520 --> 00:29:54,080 you can succeed in your negotiation so that you can set yourself up for success. 406 00:29:54,080 --> 00:29:59,880 You got to succeed in negotiation because it sets you up to succeed as a faculty person. 407 00:29:59,880 --> 00:30:03,080 And I think that's something that you really, really have done well, Juliet. 408 00:30:03,080 --> 00:30:05,840 And thank you for sharing that. 409 00:30:05,840 --> 00:30:06,840 Of course. 410 00:30:06,840 --> 00:30:07,840 Thank you. 411 00:30:07,840 --> 00:30:15,240 It's been a really great journey and definitely I've had a lot of moments along the way where 412 00:30:15,240 --> 00:30:17,360 I thought, can I really do this? 413 00:30:17,360 --> 00:30:19,160 Am I cut out for this? 414 00:30:19,160 --> 00:30:22,160 And am I really doing this in the right way? 415 00:30:22,160 --> 00:30:29,960 But I think, especially having peer mentors and mentors at different stages of their career 416 00:30:29,960 --> 00:30:36,880 to talk about these things with and get a sense of what are the tricks that I can use 417 00:30:36,880 --> 00:30:41,600 for getting to this next stage of my career has been really helpful. 418 00:30:41,600 --> 00:30:47,840 So I definitely encourage talking to as many people at any level of training as you can 419 00:30:47,840 --> 00:30:51,720 to kind of help you prepare for the academic journey. 420 00:30:51,720 --> 00:30:52,720 Absolutely. 421 00:30:52,720 --> 00:30:55,040 And you've really done that well. 422 00:30:55,040 --> 00:30:57,760 One of the things I want to point out that you did well is it's asking people at different 423 00:30:57,760 --> 00:30:59,760 institutions as well. 424 00:30:59,760 --> 00:31:04,600 And that's just so great to have such a rich perspective that's not just centered on one 425 00:31:04,600 --> 00:31:05,600 institution. 426 00:31:05,600 --> 00:31:06,600 This is the way we do things here. 427 00:31:06,600 --> 00:31:12,160 It's like, no, this is what makes sense across several institutions, which is really awesome. 428 00:31:12,160 --> 00:31:16,200 And that I think is a great segue into the next question, which is like, well, you know, 429 00:31:16,200 --> 00:31:17,800 you make this look so easy, Julia. 430 00:31:17,800 --> 00:31:22,720 It's like, wow, look at how much you've accomplished in such a little time. 431 00:31:22,720 --> 00:31:25,080 You as a resident were leading research projects. 432 00:31:25,080 --> 00:31:31,800 So was there any, I mean, what were the challenges, if any, that you faced along the way? 433 00:31:31,800 --> 00:31:32,800 Yeah. 434 00:31:32,800 --> 00:31:37,200 I know I definitely faced quite a few challenges. 435 00:31:37,200 --> 00:31:45,840 It was everything from not being able to get studies through the local IRBs, like the international 436 00:31:45,840 --> 00:31:52,040 IRBs, having things sit around for months, not knowing the right people or the right, 437 00:31:52,040 --> 00:31:56,640 I guess, phone calls to make to make things happen. 438 00:31:56,640 --> 00:32:01,040 Not having local buy-in and having to really generate that. 439 00:32:01,040 --> 00:32:06,120 And the Dominican Republic, I had to give talks and have frequent meetings with both 440 00:32:06,120 --> 00:32:12,560 the lab and the clinical team to explain why I thought this was an important clinical problem. 441 00:32:12,560 --> 00:32:20,160 And eventually after months, they got interested in the project and things went along swimmingly. 442 00:32:20,160 --> 00:32:25,120 But it was a lot of work trying to get local buy-in. 443 00:32:25,120 --> 00:32:31,880 And then there are all sorts of logistical, administrative barriers that you face. 444 00:32:31,880 --> 00:32:38,220 But I think one of the biggest things that I am still working on, and I think you probably 445 00:32:38,220 --> 00:32:44,240 work on for the rest of your life, is I guess the term is work-life integration. 446 00:32:44,240 --> 00:32:50,640 And along with that, I think integration of your clinical and your research role as well, 447 00:32:50,640 --> 00:32:53,560 I think is just very challenging. 448 00:32:53,560 --> 00:32:57,520 And I think it's an ever-moving target. 449 00:32:57,520 --> 00:33:03,040 And you probably never get it quite right, but you always move towards something that 450 00:33:03,040 --> 00:33:06,080 is tolerable and enjoyable, hopefully. 451 00:33:06,080 --> 00:33:13,520 But it's definitely something that's gotten more and more acute and important as I moved 452 00:33:13,520 --> 00:33:16,920 on to different phases of the academic career. 453 00:33:16,920 --> 00:33:22,380 As junior faculty now, really trying to make sure that I don't burn out because everyone 454 00:33:22,380 --> 00:33:26,000 keeps telling me, this is a marathon. 455 00:33:26,000 --> 00:33:29,840 Training might have felt like a sprint because you're always sprinting from one program to 456 00:33:29,840 --> 00:33:30,840 the next. 457 00:33:30,840 --> 00:33:37,560 I got to get this in so that I get accepted, so that I have a good match, et cetera. 458 00:33:37,560 --> 00:33:44,040 But once you get to being actual faculty, you don't have these little benchmarks to 459 00:33:44,040 --> 00:33:45,040 keep you going. 460 00:33:45,040 --> 00:33:49,720 You don't have something, a side post that tells you, oh, you've succeeded at this step. 461 00:33:49,720 --> 00:33:52,960 You can, here's the next step for you to move on to. 462 00:33:52,960 --> 00:33:59,760 It really is just this slow marathon that you have to keep up with, and you have to 463 00:33:59,760 --> 00:34:06,400 maintain your stamina and your interests, your passions, and your sanity. 464 00:34:06,400 --> 00:34:12,880 And so in order to do that, I think work-life integration is one of the most important things 465 00:34:12,880 --> 00:34:15,120 that I'm working on right now. 466 00:34:15,120 --> 00:34:20,040 And then wearing different hats as a clinician and a researcher, I'm constantly trying to 467 00:34:20,040 --> 00:34:27,360 decide should I work on my clinical inbox, answering patient calls, or should I be answering 468 00:34:27,360 --> 00:34:31,200 emails of my research study team, and I'm constantly flipping back and forth. 469 00:34:31,200 --> 00:34:37,400 And so that's something I haven't found a solution to, and it might just be a little 470 00:34:37,400 --> 00:34:42,480 bit of a flipping back and forth for the rest of your career. 471 00:34:42,480 --> 00:34:45,520 But I think it also keeps things interesting. 472 00:34:45,520 --> 00:34:52,240 I learned early on in my clinical training that when I was doing 100% research or 100% 473 00:34:52,240 --> 00:34:54,440 clinical, I just was not happy. 474 00:34:54,440 --> 00:34:57,600 I didn't feel fully fulfilled. 475 00:34:57,600 --> 00:35:03,720 And it's having the mix of both that really one inspires the other, and it really gives 476 00:35:03,720 --> 00:35:10,840 me that satisfaction of being a great provider, but also having a creative outlet and a way 477 00:35:10,840 --> 00:35:16,560 to make an impact that goes beyond just the patient sitting in front of me today. 478 00:35:16,560 --> 00:35:18,720 Wow. 479 00:35:18,720 --> 00:35:19,720 I love that. 480 00:35:19,720 --> 00:35:24,800 I think that you highlight something that's so important, is that the biggest obstacle 481 00:35:24,800 --> 00:35:32,160 or the biggest challenge is us, our capacity to integrate the things that are important. 482 00:35:32,160 --> 00:35:33,160 All of it is important. 483 00:35:33,160 --> 00:35:35,360 Your research is important. 484 00:35:35,360 --> 00:35:36,960 Your patients are important. 485 00:35:36,960 --> 00:35:38,680 The rest of your life is important. 486 00:35:38,680 --> 00:35:43,200 And how challenging it is to say, well, what is the priority in this moment? 487 00:35:43,200 --> 00:35:46,660 And what do I make sure I'm not neglecting in the moment as well? 488 00:35:46,660 --> 00:35:55,280 And so I think for our listeners, it's that as you get better, as you are able to clarify 489 00:35:55,280 --> 00:36:01,560 for yourself what is most important, it allows you to kind of recreate your environment or 490 00:36:01,560 --> 00:36:05,480 recreate your life, your experience to match those priorities. 491 00:36:05,480 --> 00:36:11,040 So that really, ultimately, along this journey, now that you stopped sprinting, and now that 492 00:36:11,040 --> 00:36:15,560 as a faculty member, you're now kind of looking at the long game. 493 00:36:15,560 --> 00:36:19,420 And to be honest, you've been doing that from the beginning, but now it's really a question 494 00:36:19,420 --> 00:36:20,920 of what do I want? 495 00:36:20,920 --> 00:36:21,920 How do I want to live? 496 00:36:21,920 --> 00:36:24,060 How do I want to lead this experience? 497 00:36:24,060 --> 00:36:25,440 And how do I make it all work? 498 00:36:25,440 --> 00:36:30,120 And it's so challenging because in a sense, it's about self mastery. 499 00:36:30,120 --> 00:36:31,440 And it's about other people. 500 00:36:31,440 --> 00:36:34,320 No longer are other people telling you what your goals should be. 501 00:36:34,320 --> 00:36:36,320 To some extent, they still do that. 502 00:36:36,320 --> 00:36:40,920 But really, you recognizing that they are not the ones with a yardstick of what success 503 00:36:40,920 --> 00:36:42,240 looks like. 504 00:36:42,240 --> 00:36:43,240 It's really you. 505 00:36:43,240 --> 00:36:49,080 Your measurement of success comes from your internal fulfillment and really feeling like 506 00:36:49,080 --> 00:36:51,640 you have things exactly where they need to be. 507 00:36:51,640 --> 00:36:56,240 And so I think it's a really important point in just how we're always kind of working on 508 00:36:56,240 --> 00:37:02,920 growing ourselves to become the kind of person who can lead the kind of careers that we want 509 00:37:02,920 --> 00:37:07,200 in that and the kind of fulfilling lives that we have in the process as well. 510 00:37:07,200 --> 00:37:08,200 Absolutely. 511 00:37:08,200 --> 00:37:10,120 You know, I completely agree. 512 00:37:10,120 --> 00:37:17,240 And I think one of the pitfalls of medical training is that we're kind of conditioned 513 00:37:17,240 --> 00:37:23,000 to externalize our self validation and our self worth. 514 00:37:23,000 --> 00:37:28,360 And it makes it really hard to listen to that inner voice say like, this is what I'm about. 515 00:37:28,360 --> 00:37:30,400 And this is why it's important to me. 516 00:37:30,400 --> 00:37:31,920 These are my values. 517 00:37:31,920 --> 00:37:38,200 We don't spend a lot of time thinking about it because we're just, you know, we were constantly 518 00:37:38,200 --> 00:37:43,480 being told this is what you need to do and this is who you need to be. 519 00:37:43,480 --> 00:37:48,060 And we're not really trained to think about, you know, those things for ourselves. 520 00:37:48,060 --> 00:37:54,760 And then it's a huge shock once you have that freedom to shape your own life and career. 521 00:37:54,760 --> 00:37:56,600 Absolutely. 522 00:37:56,600 --> 00:37:58,360 And it really, really is. 523 00:37:58,360 --> 00:38:03,360 It takes time and you've been practicing and continue to practice. 524 00:38:03,360 --> 00:38:04,680 It just, it's a lifelong. 525 00:38:04,680 --> 00:38:05,680 It's a lifelong journey. 526 00:38:05,680 --> 00:38:06,680 Absolutely. 527 00:38:06,680 --> 00:38:09,520 You know, Julia, it's been such a pleasure talking with you today. 528 00:38:09,520 --> 00:38:11,880 I mean, this conversation was so awesome. 529 00:38:11,880 --> 00:38:16,600 I want to say that I feel like our listeners are so fortunate to have this opportunity 530 00:38:16,600 --> 00:38:19,480 to listen to you, having you share your story. 531 00:38:19,480 --> 00:38:25,280 But I do feel like if there's one person out there saying, wow, Julia, can I do this? 532 00:38:25,280 --> 00:38:26,960 I've been in clinical training for 10 years. 533 00:38:26,960 --> 00:38:28,160 I haven't done what you've done. 534 00:38:28,160 --> 00:38:32,520 I didn't need a program as a medical student or as a resident. 535 00:38:32,520 --> 00:38:33,520 Is this for me? 536 00:38:33,520 --> 00:38:34,760 Can I be a clinician scientist? 537 00:38:34,760 --> 00:38:37,480 Can I also become a clinician researcher? 538 00:38:37,480 --> 00:38:39,960 What would you have to tell them? 539 00:38:39,960 --> 00:38:48,880 Well, I mean, I think probably the most important thing is to just get the experience and, you 540 00:38:48,880 --> 00:38:54,200 know, get out there and pursue some sort of research if you're thinking about it, you 541 00:38:54,200 --> 00:38:57,560 know, whether it's joining a lab or joining a clinical research project. 542 00:38:57,560 --> 00:39:04,040 I think until you start doing it, it's really hard to know, number one, is this something 543 00:39:04,040 --> 00:39:06,920 that you're interested in and passionate about? 544 00:39:06,920 --> 00:39:15,320 And number two, is it something that you, you know, have the patience and the, you know, 545 00:39:15,320 --> 00:39:16,960 perseverance to do? 546 00:39:16,960 --> 00:39:20,760 Because research is frustrating most of the time, right? 547 00:39:20,760 --> 00:39:24,640 Like it is not about big wins all the time. 548 00:39:24,640 --> 00:39:29,840 It's about taking advantage of or appreciating the little wins that you get along the way 549 00:39:29,840 --> 00:39:35,480 on a pretty challenging journey, but, you know, hopefully it's well worth it in the 550 00:39:35,480 --> 00:39:36,760 end. 551 00:39:36,760 --> 00:39:42,000 And so I think getting that experience and, you know, really deciding for yourself, is 552 00:39:42,000 --> 00:39:46,240 this something that I want to pursue would be the first step. 553 00:39:46,240 --> 00:39:51,480 And then after that, then you can ask yourself, you know, do I have the right setup, the right 554 00:39:51,480 --> 00:39:55,120 skills, the right training to do this? 555 00:39:55,120 --> 00:40:02,180 That might come in the form of talking to mentors or, you know, colleagues who are kind 556 00:40:02,180 --> 00:40:08,880 of doing research around your level, seeing what's actually needed to be successful at 557 00:40:08,880 --> 00:40:11,360 the next stages of your career. 558 00:40:11,360 --> 00:40:17,440 And realizing that with research, it's a long road where you're constantly acquiring 559 00:40:17,440 --> 00:40:21,400 new skills, and that's one of the big draws of research for me is that, you know, you're 560 00:40:21,400 --> 00:40:28,720 constantly learning and, you know, kind of evolving as a researcher. 561 00:40:28,720 --> 00:40:34,000 And so, you know, I don't think you should look at it and say like, oh, I'm never going 562 00:40:34,000 --> 00:40:37,640 to get there because I don't have X, Y, and Z skills. 563 00:40:37,640 --> 00:40:41,840 You look for the opportunity to pick up those skills. 564 00:40:41,840 --> 00:40:46,960 And maybe it takes a little bit longer, or maybe you happen to get all the skills in 565 00:40:46,960 --> 00:40:52,880 one project, but you just have to take it one step at a time and, you know, just keep 566 00:40:52,880 --> 00:40:57,160 building and knowing that it's kind of an incremental process to get to where you need 567 00:40:57,160 --> 00:40:58,160 to be. 568 00:40:58,160 --> 00:41:03,440 But I think really the first step is, you know, engaging and asking yourself, like, 569 00:41:03,440 --> 00:41:06,760 is this a path that I really want to pursue? 570 00:41:06,760 --> 00:41:09,600 And if so, go for it. 571 00:41:09,600 --> 00:41:10,600 I love it. 572 00:41:10,600 --> 00:41:12,000 I hear two things from what you said. 573 00:41:12,000 --> 00:41:15,880 Number one is stop waiting for someone to tell you, you can or can't. 574 00:41:15,880 --> 00:41:16,880 This is what you want to do. 575 00:41:16,880 --> 00:41:17,880 Go for it. 576 00:41:17,880 --> 00:41:18,880 Absolutely go for it. 577 00:41:18,880 --> 00:41:22,360 You've got to go for it as soon as you want, as soon as possible, because you want to know 578 00:41:22,360 --> 00:41:24,080 this is what you want to do. 579 00:41:24,080 --> 00:41:27,320 It's not glamorous. 580 00:41:27,320 --> 00:41:31,720 It's not, it's not like, you know, it's not the amazing thing that's always talked up 581 00:41:31,720 --> 00:41:32,720 to be. 582 00:41:32,720 --> 00:41:35,040 It's a lot of little battle every day. 583 00:41:35,040 --> 00:41:40,440 It's a lot of moving things forward incrementally, having conversations around whether it's 584 00:41:40,440 --> 00:41:42,320 work that needs to be done or not. 585 00:41:42,320 --> 00:41:44,960 So you want to know, is this the life you want? 586 00:41:44,960 --> 00:41:47,800 Is this something you're willing to fight for? 587 00:41:47,800 --> 00:41:50,400 Because it's a challenging journey, as you shared. 588 00:41:50,400 --> 00:41:51,560 It's not easy. 589 00:41:51,560 --> 00:41:55,120 And so if people are going to take this journey, they want to know that what they're doing 590 00:41:55,120 --> 00:42:00,680 is worth fighting for and that they're going to have the perseverance and the staying power 591 00:42:00,680 --> 00:42:03,760 to stay in the game because it's hard, it's challenging and there are other things to 592 00:42:03,760 --> 00:42:04,760 do. 593 00:42:04,760 --> 00:42:09,280 And so why stay and do something that you don't like and it's hard? 594 00:42:09,280 --> 00:42:12,040 So I really appreciate you sharing that perspective. 595 00:42:12,040 --> 00:42:14,520 And I just want to say thank you, Julia. 596 00:42:14,520 --> 00:42:16,920 It's just been such a great conversation. 597 00:42:16,920 --> 00:42:21,880 I learned a lot just listening to you and I know our listeners definitely have. 598 00:42:21,880 --> 00:42:25,960 So I just want to want to say thank you for coming on the show and thank you for just 599 00:42:25,960 --> 00:42:28,040 sharing your sage wisdom. 600 00:42:28,040 --> 00:42:29,660 Absolutely. 601 00:42:29,660 --> 00:42:30,660 This was such a pleasure. 602 00:42:30,660 --> 00:42:32,160 It was a great conversation. 603 00:42:32,160 --> 00:42:37,480 I really do hope that some of this advice and information can help your listeners. 604 00:42:37,480 --> 00:42:40,920 I think research is really rewarding. 605 00:42:40,920 --> 00:42:46,760 And if it's something like you said, if it's something that anyone has an inkling of an 606 00:42:46,760 --> 00:42:50,160 interest in, just go for it. 607 00:42:50,160 --> 00:42:56,440 It's waiting around for you to pick up and to run with it. 608 00:42:56,440 --> 00:42:57,440 Thank you, Julia. 609 00:42:57,440 --> 00:43:00,960 So everyone you heard, Julia, if you want to do it, you got to go for it. 610 00:43:00,960 --> 00:43:02,560 Don't wait for anyone to give you permission. 611 00:43:02,560 --> 00:43:04,920 You go figure out if this is what you want to do. 612 00:43:04,920 --> 00:43:07,840 So I want to say that Julia has shared with us so many awesome nuggets. 613 00:43:07,840 --> 00:43:12,560 If there is someone you know who needs to hear this, maybe a colleague or maybe even 614 00:43:12,560 --> 00:43:17,880 a mentee, if you're kind of a little further along, please share this episode with them 615 00:43:17,880 --> 00:43:23,720 and definitely make sure that Julia's wisdom gets shared with beyond more than just your 616 00:43:23,720 --> 00:43:29,200 immediate environment because this is so important for clinicians who are so capable, who are 617 00:43:29,200 --> 00:43:33,240 so able really to do whatever they want to do, whatever they set their hearts to do, 618 00:43:33,240 --> 00:43:36,160 to really figure out, hey, is this how I want to contribute in the world? 619 00:43:36,160 --> 00:43:38,920 And then to go for it and not to let anything stop them. 620 00:43:38,920 --> 00:43:43,240 And so I hope that you will definitely share this episode as widely as possible. 621 00:43:43,240 --> 00:43:44,880 And yeah, thank you for listening. 622 00:43:44,880 --> 00:43:51,560 We look forward again to the next time on the Clinician Researcher Podcast. 623 00:43:51,560 --> 00:43:57,760 Bye bye. 624 00:43:57,760 --> 00:44:03,120 Thanks for listening to this episode of the Clinician Researcher Podcast, where academic 625 00:44:03,120 --> 00:44:08,840 clinicians learn the skills to build their own research program, whether or not they 626 00:44:08,840 --> 00:44:09,920 have a mentor. 627 00:44:09,920 --> 00:44:16,040 If you found the information in this episode to be helpful, don't keep it all to yourself. 628 00:44:16,040 --> 00:44:17,760 Someone else needs to hear it. 629 00:44:17,760 --> 00:44:21,820 So take a minute right now and share it. 630 00:44:21,820 --> 00:44:27,280 As you share this episode, you become part of our mission to help launch a new generation 631 00:44:27,280 --> 00:44:33,520 of clinician researchers who make transformative discoveries that change the way we do health 632 00:44:33,520 --> 00:44:58,120 care in the most important person in history.