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

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

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

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

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

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program.

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

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

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

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

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Now introducing your host, Toyosi Onwuemene.

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Welcome to the Clinician Researcher podcast.

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

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Thank you for listening.

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I am in the process of talking about five keys to 2024, and yes, we are a couple of

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weeks in.

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And even if you feel like your 2024 is already set and you don't need keys anymore for 2024,

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these will help you for your life as well.

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And today we're talking about action.

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Oh, you know action is so important.

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In fact, as clinicians, we don't need to be told that action is important.

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We only ever take an action.

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We're always, always taking action.

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But one of the stories I share about my action taking is that I'm a massive action taker,

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and sometimes I take action in the wrong direction.

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For example, when I started out in research, I started out in a project in cardiac transplant

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rejection, and there was nothing wrong with the project.

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It was a great project.

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I was just not a cardiologist, and I didn't know anything about cardiac transplant.

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But it made sense because I'm an apheresis jock, and many times we provide apheresis

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for patients who are experiencing cardiac transplant rejection.

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And so there was a connection there.

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It was a space I was in clinically, and it made sense to do research in that space.

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So a mentor mentioned to me that, hey, you know, you should think about studying this

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and really understanding the efficacy of plasma exchange in this group.

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And I just took it, and I ran with it.

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And I took massive action.

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I submitted grant after grant after grant after grant.

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And every time I talked to a program officer, they would express puzzlement, actually really

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more bewilderment as to why a hematologist was doing a project in cardiac transplantation.

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I mean, I think they would be nice, and they would say, so where are your mentors in cardiology?

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And I'm like, well, my mentors are not cardiologists.

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They're hematologists.

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Like, so why are you doing a project in cardiology?

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Like it's not really cardiology.

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I was taking massive action in the wrong direction.

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I eventually stopped taking action in that direction, and I pivoted and moved in a different

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direction, which was a little bit more accommodating, and I've been more successful in.

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But just to say that just because we're taking action doesn't mean we're moving forward.

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And so it is important to take action, but it's also important to be very strategic about

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the action that we're taking.

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And so that's what I'm talking about today.

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The key to your success, taking action, but not just any action, the right kind of action.

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Okay, so the first kind of action, or the first type of action I want to talk about,

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is action that is informed, informed action.

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And going back to my story of where I was pursuing a research project in cardiac transplant

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rejection, I wouldn't say it was an uninformed action, but it wasn't informed.

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So it wasn't uninformed because I intentionally took the action, but I had opportunity to

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find out more information, and it wasn't until a couple of years and many rejected submissions

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later that I finally figured out, oh, this is why I keep running into this barrier.

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And so what was the barrier?

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Well, the barrier was that I am a hematologist.

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And you know, there's a lot between hematology and cardiology in many ways.

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I mean, we talk about plaque rupture.

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I mean, that's, you know, it's really arterial thrombus, right, that causes an MI.

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Or we talk about, you know, thrombocytopenia that occurs in patients with heart failure.

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There's just a lot of things in which hematology and cardiology come together.

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And so it's not wrong.

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It wasn't wrong for me as a hematologist to be doing a project in cardiology.

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But what I wasn't informed about was what it takes to convince people that you're going

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to be successful in a project that is primarily thought to be the focus of cardiologists,

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specifically heart failure cardiologists.

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So transplant rejection, you know, if I was going to do a project in transplant rejection,

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I really needed mentors who were cardiologists and or were doing heart transplant rejection.

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And so it wasn't that at the end of every grant, I didn't have a letter from a transplant

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cardiologist.

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I just didn't have a transplant cardiologist who was my primary mentor.

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And that was a red flag for many of my career development awards that I was applying for.

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So a lot of my action was important action.

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I was doing I was doing the things I was submitting grants all the time.

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But it wasn't informed because if I had recognized what was necessary to be able to build a convincing

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picture that I was actually going to move forward with long term and be successful in

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my project in cardiology, I would have taken a different track.

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Maybe I might have moved into a hematology project that was closer to where my mentors

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were because the hematologist I knew, hey, I worked with them all the time, the cardiologist

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I was begging to have meetings with, right.

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And so informed information allows you to take informed action, which allows you to

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be strategic in the things that you do.

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It allows you to build in a way that makes sense in a way that is helpful to you.

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It allows you not to waste energy.

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It allows you not to waste effort.

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Informed action really honestly is the only kind of action that makes sense.

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Many times we are kind of spontaneously taking action, right.

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We are reactively taking action.

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And sometimes it's that someone's like, you have not closed that chart.

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Your deadline is midnight tonight, go.

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And all of a sudden you're like rushing frantically to close the chart.

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When that is not what you started out your day planning to do.

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You started out your day planning to finish a manuscript so that you get it out the door

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and send it to be reviewed.

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And instead, because of the anxiety driven by someone who gave you a deadline of midnight,

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you changed your plan, right.

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And so it's kind of frantic action.

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It's all over the place.

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Anyway, so I'm talking about informed action that allows you to take measured action that

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allows you to do the things that you don't regret in the morning.

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You know that feeling when you wake up in the morning and say, what was I doing yesterday?

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What was I taking the whole day to do?

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You know, that kind of action.

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The other piece of the informed action that I want to talk about also is the informed

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action about what it means to be a faculty member.

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OK, so we're clinicians.

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Our training is clinical for most of us who did not do an MD.

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I mean, a PhD program as part of our MD.

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For some of us, we did do research, not to a great extent, certainly not to the extent

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that the PhD researchers did, right.

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But for many of us, we've done a little bit of research, but not that much, right.

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So we've done a lot more clinical training than we've done anything.

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So when we come into faculty positions and we're like, I want to lead a research program,

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what we don't have is information about what it really takes to successfully lead a research

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program and what is necessary in terms of differentiating from being a clinician and

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being a researcher.

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And that's important because information allows you to recognize the limitations of continuing

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to drive your clinical program significantly while also trying to build a research program.

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And so if you're saying I want to build a research program and I also want to be a master

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clinician seeing patients five days a week, both of those things actually don't go together.

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They don't.

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So to say I'm 80 to 100% clinical and I also want to lead a research program actually doesn't

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really work because being 80 to 100% clinical really is a full-time effort.

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And as you know, clinic just likes to spill over into many different things and you're

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still doing the notes three days later.

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And so clinical work is a heavy workload.

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It's a whole career in itself, right.

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People do this full-time who are not in academia.

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But as academics, if we're going to have a program of scholarship, then we've got to

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be able to carve out time for that program of scholarship.

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And some of us start with a good chunk of clinical and we're trying to grow the pie

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that is scholarship.

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But there's a certain way to be able to do that successfully.

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And information allows you to know what actions make sense.

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And so when someone comes and says I'm giving you protected time to do your research and

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that's 10% time on Friday mornings, while you're also covering the pager for the infusion

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center, you recognize that that 10% time is not going to get me very far because you have

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information.

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And so you always want to have the right information to drive your action.

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You don't want to just take action without information.

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The challenge sometimes is that we don't know yet what we don't know.

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And for that reason, it is our responsibility to go out and look for information.

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Go to places where you haven't been before.

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Go do the career development program in another city, in another state, in another institution

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so that you start getting a sense of what other people are thinking is the information

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you should have.

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And I hear some of you saying, oh, I don't need to go anywhere.

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My mentors are fantastic.

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And I want to reiterate that your mentors are probably the most awesome people in the

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world.

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And if you've been with them even up to a year, you probably know a lot of the stuff

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they know.

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You have a lot of the same information sources that they have.

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And it's helpful to diversify your information sources.

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Because what you'll find is that some things are emphasized a little bit more strongly

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at your institution compared to another institution.

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But there are some things that are emphasized just as strongly.

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And so what you'll find, especially if you're growing a research career, is that grants

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and manuscripts tend to be emphasized anywhere you go, depending on what type of scholarship

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program you're building.

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If it's an education scholarship program, there's different emphasis.

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And so let's just say for everything you do, there is a specific type of emphasis.

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And information allows you to take the right action so that you can grow well into that

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emphasis.

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OK, I spend a lot of time on information, but informed action, so important.

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Number two is focused action.

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Focused action.

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What does that mean?

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Wow, as clinicians, we have so many jobs, right?

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We're clinicians, we are educators, we are researchers, and some of us are administrators

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as well.

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That's a lot of jobs, and they're all very different.

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In fact, people are full-time educators.

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People are full-time administrators.

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People are full-time clinicians.

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People are full-time researchers.

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So as a clinician, you likely have three or more full-time jobs in one.

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And because of the perfectionist that you probably tend to be, you want to do all four

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of them equally well.

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And so here you are pushing in four different directions equally.

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What do you get?

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Unfocused action.

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And so if you're going to be successful, you're going to want to focus your action.

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How do you focus your actions?

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It's like, well, I have four jobs.

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Hello, I need to do the four jobs well.

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I cannot focus.

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And the reality is that, of course, you can.

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And one of the ways you focus, decide what to focus on, is to prioritize.

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You choose the one that is the most important, that moves you forward the fastest, that is

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most significant to you, the one that people value the most, and that you value the most

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when those overlap.

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And you focus on those things first.

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And everything else you do well enough, but maybe not perfectly, like you are working

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to do the thing that is most important.

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But focused action is so important because you know that like a laser or like, you know,

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when you take a magnifying glass and you focus the beams or the rays of the sun, you can

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accomplish so much more with focused action compared to action that is completely diffuse,

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right?

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So focused action is so key, so important.

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And so I invite you to think about your activities, all your jobs, because if you're listening

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to me, you have more than one job for sure.

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And you know, we haven't even talked about the jobs you have outside of your career.

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Say you're a parent or you're a caretaker for your elderly parents, or maybe you really

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do have a second job outside of medicine.

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I don't know.

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You have many jobs.

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And it's about focused action.

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And it's also about focused action while you're at work.

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So one of the things that's interesting, I'll talk about my story, I love to talk to people.

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I really do.

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I like I'm always talking to people.

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And so I have work to do.

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I would prefer to just spend time in the hallway with you talking to you and asking about your

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mom and your dad and your sibling and how they're like, I love all that stuff, right?

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And what I'm saying is that focused action tells me that I'm at work to work.

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And we can catch up at the coffee shop later.

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But right now I'm at work to work.

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And so how do I take this time and make it count?

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Or for example, I'm in clinic, I get into trouble with this also in clinic in the clinic

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setting where instead of churning out the notes, I'm like, I prefer to talk to you,

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please.

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I don't want to write a note right now.

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I'll do the notes later.

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Focused action would say, hmm, while in clinic, let's do all the things that pertain to clinic

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so I can try to fit them in to the best of my ability right now.

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And that is some of the focused action that really allows you to move a mountain of work

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forward faster and intentionally as well.

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So focused action is key to moving forward.

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All right.

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The next type of action I'm talking about is sustained action.

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Okay.

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So for this one, I'm going to use the example of writing.

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All right.

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I don't know about you, but I used to be, actually I'm still a recovering binge writer.

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As a binge writer, a binge writer is somebody who wakes up one day, finds eight hours and

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then spends the whole time writing.

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And usually there is no one day where you wake up and find eight hours.

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So don't judge me.

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I was a binge writer who would like write in the middle of the night and be like, well,

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there's eight hours of sleep.

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I'm throwing it out the window and I'm converting it to my writing time.

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And I would just hustle and get that writing done.

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I'd be so proud of myself in the morning, bleary eyed, but done with the draft, maybe

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with the final version.

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But I said, don't judge me.

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Anyway, so I was and am still a recovering binge writer.

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And the thing about the binge writing is that you can only pull an all nighter so many days

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in a row before you're going to need to pay back the hours stolen from your body, hours

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of sleep that were necessary.

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And so, you know, you take one eight hour window and you recover for four, five, six

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days.

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You take another eight hour window, recover again.

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There's only so much action in terms of moving your writing forward that you can do.

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Now, if you take sustained writing action where you're writing for at least 30 minutes

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a day, maybe more if you can fit it into your schedule, it means, hey, eight days later,

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you've completed those eight hours and you're not looking for more sleep.

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Eight days later, well, I guess if you're doing eight hours of writing, you get to eight

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hours.

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Anyway, if you're doing 30 minutes a day, it may take you 16 days, but it's sustained.

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And every day that you revisit your work, you get fresh ideas.

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You are able to move things forward in a different way.

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You think a little bit differently about the way you wrote the sentence or the way you

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worded this paragraph or the way you structured this discussion section.

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Sustained action leads you so much further compared to the sprints.

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And so the binge writing is an example of a sprint and the writing every day is an example

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of sustained action.

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What are the things that are most important in your career as a clinician, scientist,

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and how can you do them every day?

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How can you move a little bit forward every day?

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Because this is the story of the tortoise and the hare.

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Even though the hare can leap and jump, the hare gets tired because it's expended all

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this energy and the tortoise, the turtle or the tortoise, it's a tortoise, is moving slowly

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and carefully and steadily, doesn't get tired, doesn't need to take a nap, can just keep

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going until the end.

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And that's the gift that sustained action gives you.

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Number four is repeated action.

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And that is action that you repeat over and over.

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Now, okay, so repeated action maybe sounds like sustained action.

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But what I'm saying is you do this thing and then you do it again and then you do it again

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and then you do it again.

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Okay.

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And that's just not saying, look, I wrote yesterday, I've done well, I've done my good

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deed for the day, I've done my good deed for the week, I've done my good deed for the month.

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You recognize that if you're going to be successful, especially as someone who's building a scholarly

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program of research, there are going to be some things that you are always doing, right?

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You're always making offers for grants, for grant money.

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You're always submitting proposals.

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And by always, I don't mean every day, but I mean you're always thinking, what's my next

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grant?

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What is it going to be about?

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What's my next resubmission?

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So it's something that you do again and again and again and again.

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Sometimes I hear people say that the reward for winning a grant is writing another one.

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And that I would say is the talk of someone who doesn't understand what grant writing

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can do for you and what grant writing can do to enhance and accelerate your program.

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And I'll have to send you back to season one to see some of the episodes or listen to some

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of the episodes about grant writing and the benefits of grant writing to understand why

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grant writing is a critical and important and really a personal development piece of

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your growth as a clinician scientist.

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But grant writing is important.

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And it's not the thing you do and say, well, I submitted three grants last year.

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What do you mean I need to write another grant?

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It's just recognizing that there are some actions you keep doing because honestly, you're

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putting in reps actually.

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The more you do it, the more feedback you get and apply, the better you get at it.

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And so the people who are really widely successful are not successful because they write the

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perfect grant.

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To some extent they do, but they write the perfect grant because it's what they're always

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doing.

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They repeat it and they repeat it and they repeat it again.

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And because they have all these reps, they're able to get better over time.

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And so repeated action is taking the things that are most important to your forward motion,

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to your career development and just doing them again and then again and then again and

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then again.

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And so that's the importance of repeated action.

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Number five is the importance of intentional action.

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You want to make sure your actions are intentional.

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And so, you know, many times we are kind of in reaction mode and somebody comes and tells

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us, oh, this is the way you need to do this.

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And you're like, oh, okay, I'm going to stop everything and do it this way.

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Or someone comes and says, what, you're writing this grant?

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This is ridiculous.

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You write this grant.

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And you're like, well, I'm going to stop everything and do it this way.

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And that is scattered.

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And that is also reactive.

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What you want to do is be intentional.

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You want to set out in your day, at the beginning of your day and say, this is my intention.

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This is what I plan to accomplish.

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Okay.

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And then you take that action.

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And yes, life happens.

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And so it may be that you say, this is what I was going to do.

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And then you didn't do it.

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That's fine.

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But at least you have a plan.

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The benefit of planning is in creating the plans.

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But you also want the flexibility to be able to adjust the plans.

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But when you have no plans, then it's hard to be intentional because what are you being

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intentional about?

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You are not even sure.

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And so planning allows you to take intentional action.

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And so that's why it is helpful to, at the beginning of the week, define for yourself,

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okay, these are my goals for the week.

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These are my top three writing goals.

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And intentionally, you work towards making sure that these goals are met.

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They are accomplished by the end of the week.

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You're taking intentional action.

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And to be honest, that's what most action should be, especially with regard to your

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career development and your scholarship, is you got to be intentional about what you're

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doing.

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Don't let half-hazardness come into your experience.

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And to be honest, there is some of that.

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The natural garden, it looks beautiful, but well, there are a lot of weeds.

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And the landscaped garden always looks better, always looks better by far.

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And it costs a lot more too.

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But being intentional allows you to pay the right price in the right direction so that

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you get the outcome that you're actually seeking, not the outcome that's kind of accidental

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and not quite the one you want.

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And so taking measures to make sure that you're intentional in the actions that you take,

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not allowing other things to crowd out the things that are most important, is super,

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super, super important and helpful.

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Okay, so those are the five things that I am sharing with you today about action.

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Number one is informed action.

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Number two is focused action.

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Number three is sustained action.

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Number four is repeated action.

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Number five, intentional action.

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And those are the five things I'm talking to you about today.

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As always, I want you to share this episode with someone.

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And I also want to invite you, if you are looking for a coach, if you are looking to

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work with a coach so that you can really clarify your scholarship and career goals and move

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forward in a way that's sustained and move forward in a way that benefits you, definitely

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reach out to me.

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I still have group coaching slots available.

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Send me a direct message on LinkedIn or Facebook or Instagram, or even better still, go to

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our website, coagcoach.com.

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That's our coaching website.

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And sign up for a coaching consultation call so we can talk about what you need and how

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I may best serve you.

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It's been a pleasure talking with you today.

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I look forward to talking with you again 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.