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 --> 00:01:01,160 Now introducing your host, Toyosi Onwuemene. 12 00:01:01,160 --> 00:01:03,360 And welcome to the Clinician Researcher podcast. 13 00:01:03,360 --> 00:01:07,920 I'm your host, Toyosi Onwuemene, and it is such a pleasure to be talking with you today. 14 00:01:07,920 --> 00:01:12,880 I'm especially excited because I have a special guest, Dr. Toma Omofoye. 15 00:01:12,880 --> 00:01:16,680 Toma, welcome to the show. 16 00:01:16,680 --> 00:01:17,680 Thank you for having me. 17 00:01:17,680 --> 00:01:18,680 It's an honor. 18 00:01:18,680 --> 00:01:19,680 I'm thrilled to be here. 19 00:01:19,680 --> 00:01:23,040 The pleasure is ours. 20 00:01:23,040 --> 00:01:26,440 We're so excited to have you on our show. 21 00:01:26,440 --> 00:01:31,360 And I wonder if you could introduce yourself to the audience, especially with regard to 22 00:01:31,360 --> 00:01:34,960 your journey as a clinician scientist. 23 00:01:34,960 --> 00:01:43,720 Well, I'm an associate professor of radiology, and I work in a large academic medical center. 24 00:01:43,720 --> 00:01:50,160 I did my training at Duke Medical School and residency at Duke Medical School, so I had 25 00:01:50,160 --> 00:01:55,680 come from that sort of high academic output institution. 26 00:01:55,680 --> 00:02:03,720 However, when I started my first attending role, I was hired really as a community-based 27 00:02:03,720 --> 00:02:04,720 academic. 28 00:02:04,720 --> 00:02:10,840 So I was one of those registered who's actually reading studies out in the community, helping 29 00:02:10,840 --> 00:02:17,040 bring kind of high quality evidence-based care into community practice settings. 30 00:02:17,040 --> 00:02:24,800 And so in that role, it was really emphasized that I needed to focus on the clinical skills 31 00:02:24,800 --> 00:02:32,640 and less so focusing on any of the research or academic output kind of skills. 32 00:02:32,640 --> 00:02:33,640 Okay. 33 00:02:33,640 --> 00:02:37,340 Are you going to speak more about that? 34 00:02:37,340 --> 00:02:38,640 Speak to that a little bit more. 35 00:02:38,640 --> 00:02:39,640 Just here you are. 36 00:02:39,640 --> 00:02:44,160 You're hired as a full-time clinician, really, but in a community academic practice. 37 00:02:44,160 --> 00:02:48,880 So there is some expectation potentially, and there's a little bit of academics within, 38 00:02:48,880 --> 00:02:51,320 but you really are tasked with being clinical. 39 00:02:51,320 --> 00:02:56,240 How did you now make this transition to start doing research on that? 40 00:02:56,240 --> 00:03:03,400 Well, I think the first thing is that I had a hobby that I couldn't quite let go of. 41 00:03:03,400 --> 00:03:11,360 It really was a passion of mine to try to empower clinicians outside of the United States 42 00:03:11,360 --> 00:03:16,640 who are practicing in low-reforce settings to be the best clinicians they could be with 43 00:03:16,640 --> 00:03:18,920 the resources that they have available. 44 00:03:18,920 --> 00:03:25,680 And so the hobby that I had while I had this very clinical job was to create educational 45 00:03:25,680 --> 00:03:31,600 context for radiologists who are practicing in remote middle-income countries. 46 00:03:31,600 --> 00:03:37,200 What is really interesting in radiology is that when most of the world started expanding 47 00:03:37,200 --> 00:03:43,760 their frontiers and engaging in global health, radiology lags behind because a lot of our 48 00:03:43,760 --> 00:03:50,520 work is dependent on really expensive, really bulky technology that was really out of the 49 00:03:50,520 --> 00:03:56,040 reach of a lot of countries that were still developing socioeconomically. 50 00:03:56,040 --> 00:04:02,800 And so you saw this revolution, I think, like in internal medicine, you saw this HIV care 51 00:04:02,800 --> 00:04:05,040 led by partners and Paul Farmer. 52 00:04:05,040 --> 00:04:09,240 You saw these incredible roles in neonatal medicine. 53 00:04:09,240 --> 00:04:14,680 You saw all of this work on maternal, fetal medicine, maternal mortality outcomes, and 54 00:04:14,680 --> 00:04:19,480 radiology just really wasn't participating in the same way in global health because we 55 00:04:19,480 --> 00:04:25,320 really were hampered by not having the technology available on the ground there that we would 56 00:04:25,320 --> 00:04:28,280 want to use to improve outcomes. 57 00:04:28,280 --> 00:04:37,400 And I think for me, practicing in a place that is so well recognized, it was a lightbulb 58 00:04:37,400 --> 00:04:44,080 moment to realize that what was really providing excellent outcomes in our practice wasn't 59 00:04:44,080 --> 00:04:49,520 access to all of the super high-tech equipment. 60 00:04:49,520 --> 00:04:56,120 It was actually the ability to navigate that high-tech equipment or the entire spectrum 61 00:04:56,120 --> 00:04:59,680 of available equipment based on your expertise. 62 00:04:59,680 --> 00:05:02,000 It's still precision medicine, right? 63 00:05:02,000 --> 00:05:07,440 And that precision medicine could be about offering a patient the newest thing on the 64 00:05:07,440 --> 00:05:13,160 market or it could be about offering a patient something that's been around for a long time. 65 00:05:13,160 --> 00:05:14,280 It's cheap. 66 00:05:14,280 --> 00:05:19,480 It's really widely available, but it's actually going to answer their question in a way that 67 00:05:19,480 --> 00:05:25,720 does it quickly and definitively and minimizes their adverse effects. 68 00:05:25,720 --> 00:05:30,960 So realizing that even for us, having access to everything high-tech didn't mean we were 69 00:05:30,960 --> 00:05:33,320 using everything high-tech all the time. 70 00:05:33,320 --> 00:05:36,320 It just meant that we were using things well. 71 00:05:36,320 --> 00:05:43,600 And it made me, as somebody who is an immigrant, really aware of the potential that we made 72 00:05:43,600 --> 00:05:49,440 in places that didn't have all of the newest equipment to still provide a lot of really 73 00:05:49,440 --> 00:05:54,480 precise medicine to try to reduce breast cancer disparity globally. 74 00:05:54,480 --> 00:06:00,000 And so I started out just with making videos and placing them online. 75 00:06:00,000 --> 00:06:05,920 And thankfully, my department was very generous and they allowed me to use the department 76 00:06:05,920 --> 00:06:08,240 learning management software to create a website. 77 00:06:08,240 --> 00:06:11,760 And so each video had a pre-test and a post-test. 78 00:06:11,760 --> 00:06:18,080 And in talking with the collaborators, my friends, my colleagues who are working abroad, 79 00:06:18,080 --> 00:06:22,960 they would basically be the ones to dictate the topics they needed to hear about. 80 00:06:22,960 --> 00:06:29,440 And we could collaborate on what would be really the best answer to managing that disease 81 00:06:29,440 --> 00:06:35,040 state in a setting that was sort of a lower resource. 82 00:06:35,040 --> 00:06:37,360 And so it just kind of blew and blew and blew. 83 00:06:37,360 --> 00:06:43,960 And one thing led to another, and we found that one third of the residency programs in 84 00:06:43,960 --> 00:06:50,080 Singapore kind of signed up to use this as their adjunct, educational adjunct for their 85 00:06:50,080 --> 00:06:53,680 residents who are trying to learn breast radiology. 86 00:06:53,680 --> 00:06:57,560 And it was a game changer for them because prior to this, they would have to send their 87 00:06:57,560 --> 00:07:02,320 residents outside of the country, to the US or the UK, to get this kind of training. 88 00:07:02,320 --> 00:07:07,240 But again, getting that training in a resource-rich environment that doesn't really mimic what 89 00:07:07,240 --> 00:07:09,600 they may necessarily have at home. 90 00:07:09,600 --> 00:07:16,600 And so now providing this resource that was resource-adapted, it's available online, it 91 00:07:16,600 --> 00:07:24,000 was something that was being customized as we went, it ended up providing a lot of value 92 00:07:24,000 --> 00:07:25,680 to the teams that were using it. 93 00:07:25,680 --> 00:07:28,320 And so one thing led to another. 94 00:07:28,320 --> 00:07:33,320 I really, I mean, this gets more into the topic of the podcast here. 95 00:07:33,320 --> 00:07:40,240 I was really, really encouraged by department leaders, by department chair to publish it 96 00:07:40,240 --> 00:07:46,000 because I was spending so many nights and weekends doing this on my own time. 97 00:07:46,000 --> 00:07:53,720 And she said, it doesn't matter how much effort you put into it, it doesn't have the value 98 00:07:53,720 --> 00:07:59,480 unless it takes the shape of academic currency and academic currency as publications. 99 00:07:59,480 --> 00:08:06,120 And so if you cannot create a scholarly question around what you're doing, if you cannot create 100 00:08:06,120 --> 00:08:12,800 publication around what you're doing, you're not receiving the maximum benefit for the 101 00:08:12,800 --> 00:08:16,280 input that you are actually working on. 102 00:08:16,280 --> 00:08:17,280 Okay. 103 00:08:17,280 --> 00:08:24,080 I want to go back to the very beginning where you call it a hobby. 104 00:08:24,080 --> 00:08:28,680 And I just want to ask you about that because what I hear as you're talking about it just 105 00:08:28,680 --> 00:08:34,360 is that you had so much past that and it was kind of just a really strong pull to make 106 00:08:34,360 --> 00:08:35,360 a difference. 107 00:08:35,360 --> 00:08:40,640 And so I think a lot more than a hobby for sure, but I want you to speak to why you think 108 00:08:40,640 --> 00:08:43,960 of it as a hobby or if you would describe it differently. 109 00:08:43,960 --> 00:08:53,800 Yeah, I thought of it as a hobby because starting out as an attending, everyone's asking you 110 00:08:53,800 --> 00:08:56,960 to define your area of academic interest. 111 00:08:56,960 --> 00:08:58,000 What are you going to do? 112 00:08:58,000 --> 00:08:59,880 What are you going to do research in? 113 00:08:59,880 --> 00:09:06,000 And to me, it felt like the areas I would perform research in were different topics 114 00:09:06,000 --> 00:09:07,000 than this, right? 115 00:09:07,000 --> 00:09:10,760 It was what is that cutting edge of the field? 116 00:09:10,760 --> 00:09:16,560 What is the newest question that's being bandied about in our journal? 117 00:09:16,560 --> 00:09:19,600 And those to me felt like my areas of interest. 118 00:09:19,600 --> 00:09:23,520 Education and teaching is something that I've always done, right? 119 00:09:23,520 --> 00:09:30,200 So I was a peer learning leader doing tutoring in college. 120 00:09:30,200 --> 00:09:32,320 It was one of my first jobs. 121 00:09:32,320 --> 00:09:38,000 I had done all sorts of little teaching things as a resident and throughout my career. 122 00:09:38,000 --> 00:09:42,000 And education was something that I wanted just why I signed up to be this, you know, 123 00:09:42,000 --> 00:09:44,160 with an academic practice. 124 00:09:44,160 --> 00:09:48,600 But it didn't feel to me like I was approaching this in the way that you approach something 125 00:09:48,600 --> 00:09:54,360 where you have a hypothesis, that you have, you know, a very clear idea of what you're 126 00:09:54,360 --> 00:09:58,160 building and who your team is and what your outputs are going to be. 127 00:09:58,160 --> 00:10:03,920 I really was approaching this as something that allowed me to scratch the itch of wanting 128 00:10:03,920 --> 00:10:08,200 to teach because I just enjoyed that for its own sake. 129 00:10:08,200 --> 00:10:14,840 But I think in a broader sense, what this means is that we often have passion in academia 130 00:10:14,840 --> 00:10:19,440 that may not be the specific area of your interest, right? 131 00:10:19,440 --> 00:10:23,000 So my initial publications were another topic. 132 00:10:23,000 --> 00:10:27,440 But that little passion for teaching itself was something that I was going to care with 133 00:10:27,440 --> 00:10:28,440 me throughout my life. 134 00:10:28,440 --> 00:10:33,560 And today, even if I wasn't publishing on this topic now, even if it wasn't now a part 135 00:10:33,560 --> 00:10:37,640 of my official role, I would still be doing some teaching. 136 00:10:37,640 --> 00:10:44,160 I think that especially when you're an academic, you're probably an academic because you are 137 00:10:44,160 --> 00:10:45,160 a tinkerer. 138 00:10:45,160 --> 00:10:46,160 That's what I say. 139 00:10:46,160 --> 00:10:47,880 I think most academics are tinkers. 140 00:10:47,880 --> 00:10:52,080 You look at things and you think, how could this be a little bit better? 141 00:10:52,080 --> 00:10:54,440 You look at education and go, how could this be better? 142 00:10:54,440 --> 00:10:56,960 You look at research and go, how can I make this a little bit better? 143 00:10:56,960 --> 00:11:02,280 You look at all these questions that you're constantly trying to improve on yourself. 144 00:11:02,280 --> 00:11:09,200 And so if you are that kind of person, it's not that big of a leap to take that tinkering 145 00:11:09,200 --> 00:11:17,000 mindset and just put a scientific question around it and go ahead and plan for a publication 146 00:11:17,000 --> 00:11:18,000 around it. 147 00:11:18,000 --> 00:11:21,380 And even the process of peer review becomes more enjoyable to you because you get those 148 00:11:21,380 --> 00:11:27,600 revisions back from the editors and the reviewers and you go, I didn't see it that way. 149 00:11:27,600 --> 00:11:30,640 That's a topic for the next paper on this, right? 150 00:11:30,640 --> 00:11:35,040 It allows you to enter it with a sense of curiosity. 151 00:11:35,040 --> 00:11:39,160 And that's what academia, I think, really rewards is the people who want to play around 152 00:11:39,160 --> 00:11:40,160 with their hobbies. 153 00:11:40,160 --> 00:11:44,040 They want to play around with 3D printing. 154 00:11:44,040 --> 00:11:45,920 How could this change my practice? 155 00:11:45,920 --> 00:11:48,400 AI, that's cool. 156 00:11:48,400 --> 00:11:50,520 How did it change my practice? 157 00:11:50,520 --> 00:11:56,560 Those individuals who have that sort of curious growth mindset, that's really all it takes. 158 00:11:56,560 --> 00:12:03,760 It's not necessarily having a PhD to provide you all of the skills from the get go. 159 00:12:03,760 --> 00:12:06,360 It's having that curious mindset. 160 00:12:06,360 --> 00:12:09,600 Thank you. 161 00:12:09,600 --> 00:12:13,560 One thing that comes up for me is your, actually there are two things that come up. 162 00:12:13,560 --> 00:12:18,240 And I wonder if you can speak to them maybe at the same time or we can do them one at 163 00:12:18,240 --> 00:12:19,240 a time. 164 00:12:19,240 --> 00:12:23,560 But one thing is you did something that many people have not been able to successfully 165 00:12:23,560 --> 00:12:24,560 do. 166 00:12:24,560 --> 00:12:29,320 You turned something that you're really passionate about education into academic currency. 167 00:12:29,320 --> 00:12:32,200 Can you speak to how you did that? 168 00:12:32,200 --> 00:12:35,240 I think that where there's a will, there's a way. 169 00:12:35,240 --> 00:12:43,800 I would find it extremely hard to believe that somebody who can navigate high school 170 00:12:43,800 --> 00:12:51,320 and it's stress and college and medical school and residency that is such, you know, I mean, 171 00:12:51,320 --> 00:12:57,240 it's really the crescendo I think in terms of difficulty and responsibility and get to 172 00:12:57,240 --> 00:13:02,120 a situation like this now where you're doing something as part of your role, as part of 173 00:13:02,120 --> 00:13:04,920 your professional identity. 174 00:13:04,920 --> 00:13:08,680 And not be able to turn it into currency. 175 00:13:08,680 --> 00:13:13,600 In fact, I think that you get to this point and it's really about you believing that the 176 00:13:13,600 --> 00:13:14,600 goal is worthwhile. 177 00:13:14,600 --> 00:13:21,080 If you believe that the goal is worthwhile, I truly believe that we are creative enough. 178 00:13:21,080 --> 00:13:22,440 We are determined enough. 179 00:13:22,440 --> 00:13:30,080 We are stubborn enough to figure out the way to align what we're doing with the language 180 00:13:30,080 --> 00:13:32,520 that's necessary for currency. 181 00:13:32,520 --> 00:13:36,040 Of course, there's work that has to be done, but that work is done because the goal is 182 00:13:36,040 --> 00:13:37,840 worthwhile, right? 183 00:13:37,840 --> 00:13:45,320 Once it became important to me to put currency around this, then I sat there and did a literature 184 00:13:45,320 --> 00:13:46,320 review, right? 185 00:13:46,320 --> 00:13:51,960 Like I went into PubMed and Google Scholar and actually looked at what had been written 186 00:13:51,960 --> 00:13:53,320 and what angles had been taken. 187 00:13:53,320 --> 00:13:57,920 And I mean, everybody who's written on the topics of e-learning, people who have written 188 00:13:57,920 --> 00:14:04,880 on the topics of resource-adapted care, they all at the end of their manuscript will have 189 00:14:04,880 --> 00:14:09,760 some printings about next steps, which most of the time they didn't get to, right? 190 00:14:09,760 --> 00:14:15,080 And so you get to be the one that adds to the body of literature by incorporating some 191 00:14:15,080 --> 00:14:17,160 of those next steps into your work. 192 00:14:17,160 --> 00:14:22,440 And also you get to benefit from their hard work by not having to make all the mistakes 193 00:14:22,440 --> 00:14:23,440 yourself. 194 00:14:23,440 --> 00:14:27,200 You can kind of use some of the methods that they have used, of course, giving appropriate 195 00:14:27,200 --> 00:14:30,760 credit so that you're able to do your work efficiently. 196 00:14:30,760 --> 00:14:39,280 But I think the real key to being able to make that transition, especially with educational 197 00:14:39,280 --> 00:14:44,820 work and transitioning that into currency is believing that it's a worthwhile goal. 198 00:14:44,820 --> 00:14:46,100 And I think that it is. 199 00:14:46,100 --> 00:14:52,020 I think that it is because it does give you, number one, the credibility that what you're 200 00:14:52,020 --> 00:14:57,920 doing is evidence-based, that what you're doing is in fact something that does no harm 201 00:14:57,920 --> 00:14:59,720 because that's what peer review does, right? 202 00:14:59,720 --> 00:15:04,920 It allows people to look into your work and critique it and make sure that it is ethical. 203 00:15:04,920 --> 00:15:05,920 It is a buzz board. 204 00:15:05,920 --> 00:15:08,120 The IRB is looking at this. 205 00:15:08,120 --> 00:15:14,600 I think the ability to do, to create publications out of our work and research out of our work 206 00:15:14,600 --> 00:15:19,400 is also a way for us to establish ourselves as experts. 207 00:15:19,400 --> 00:15:23,800 There are hundreds and thousands of people who are doing e-learning programs. 208 00:15:23,800 --> 00:15:30,320 I am probably not even in the top 10 or top 100 or top 1,000 of the most hardworking or 209 00:15:30,320 --> 00:15:32,720 the smartest, right? 210 00:15:32,720 --> 00:15:38,440 But if you are, unfortunately, quiet about what you're doing, then it's a step you didn't 211 00:15:38,440 --> 00:15:39,600 do it at all. 212 00:15:39,600 --> 00:15:41,440 That's the unfortunate thing. 213 00:15:41,440 --> 00:15:44,560 And so you get to establish some expertise. 214 00:15:44,560 --> 00:15:50,560 And if you think about it this way, you're not becoming an expert for pride or ego. 215 00:15:50,560 --> 00:15:55,440 You're becoming an expert to help other people who are interested in doing similar work make 216 00:15:55,440 --> 00:15:58,040 fewer mistakes the next time around. 217 00:15:58,040 --> 00:16:02,720 You're becoming an expert so that people who are looking for the kind of problems, kind 218 00:16:02,720 --> 00:16:07,600 of solutions that you're solving can now access that through your work. 219 00:16:07,600 --> 00:16:09,160 So I think that that provides that. 220 00:16:09,160 --> 00:16:12,720 But I also say one important thing to think about is that time is limited. 221 00:16:12,720 --> 00:16:16,280 Time gets more limited, I feel like, every year. 222 00:16:16,280 --> 00:16:20,240 And so with academia, they want you to be visible to that. 223 00:16:20,240 --> 00:16:21,240 You're a clinician. 224 00:16:21,240 --> 00:16:22,240 You're an educator. 225 00:16:22,240 --> 00:16:23,240 You're a researcher. 226 00:16:23,240 --> 00:16:30,080 And so if you are able to kind of be synergistic in the way that you work, so your education, 227 00:16:30,080 --> 00:16:32,600 check that box, is also research. 228 00:16:32,600 --> 00:16:33,600 Check that box. 229 00:16:33,600 --> 00:16:36,920 You're actually sort of streamlining your workflow. 230 00:16:36,920 --> 00:16:39,280 And then things start to feed into each other. 231 00:16:39,280 --> 00:16:45,080 In my case, since my education and my research and my hobby were all kind of lining up, it's 232 00:16:45,080 --> 00:16:52,720 like, okay, this was also a way to refresh myself and be rejuvenated by my work, as opposed 233 00:16:52,720 --> 00:16:58,720 to feeling like I needed to engage in scientific projects that were very highbrow and serious. 234 00:16:58,720 --> 00:17:02,440 For the sake of highbrow and serious, even when I didn't love them, I could do something 235 00:17:02,440 --> 00:17:09,000 that I loved and get maximum benefit out of it on multiple fronts. 236 00:17:09,000 --> 00:17:13,940 So you talk about this kind of the energy that comes from doing this work, the ability 237 00:17:13,940 --> 00:17:16,840 to layer it on top of things you're already doing. 238 00:17:16,840 --> 00:17:21,400 And it makes me wonder, there are other projects you were doing before you really started taking 239 00:17:21,400 --> 00:17:24,600 the education and creating academic currency out of it. 240 00:17:24,600 --> 00:17:27,680 How did that shift the focus of your work? 241 00:17:27,680 --> 00:17:30,480 To what extent did you continue to do the other work? 242 00:17:30,480 --> 00:17:34,440 And what was the difference in energy in the work you were doing before compared to the 243 00:17:34,440 --> 00:17:36,920 work you now started to push forward? 244 00:17:36,920 --> 00:17:40,040 Yeah, I think that's a great question. 245 00:17:40,040 --> 00:17:43,480 When I started to do this, it was very slow. 246 00:17:43,480 --> 00:17:46,600 Even getting it published the first time was very difficult, right? 247 00:17:46,600 --> 00:17:50,560 There's just sort of multiple rejections and the editors couldn't quite, I mean, I'm talking 248 00:17:50,560 --> 00:17:56,040 death rejections, like you send it and within 30 minutes, they're like, nope, thank you. 249 00:17:56,040 --> 00:17:57,840 I didn't have a clear enough idea. 250 00:17:57,840 --> 00:17:59,200 They didn't have a clear enough idea. 251 00:17:59,200 --> 00:18:04,880 And so between the first death rejection and the second submission was actually a good 252 00:18:04,880 --> 00:18:06,000 six months. 253 00:18:06,000 --> 00:18:08,720 I restructured what I was doing, right? 254 00:18:08,720 --> 00:18:10,640 So it was very slow. 255 00:18:10,640 --> 00:18:12,400 It was a very slow ramp up. 256 00:18:12,400 --> 00:18:17,800 And so the other projects I was engaging in, I continued to kind of engage in them all 257 00:18:17,800 --> 00:18:18,800 along. 258 00:18:18,800 --> 00:18:23,520 And then I will say it's sort of nothing, nothing, nothing, and then everything all 259 00:18:23,520 --> 00:18:25,040 at once, right? 260 00:18:25,040 --> 00:18:31,520 It happened that the next submission came right after COVID when suddenly learning 261 00:18:31,520 --> 00:18:32,520 was the thing. 262 00:18:32,520 --> 00:18:38,920 It was very, you know, it was just, it was just the, I guess, the global mindset at that 263 00:18:38,920 --> 00:18:39,920 time. 264 00:18:39,920 --> 00:18:46,360 And then what happened with that is because it was something that globally was of interest, 265 00:18:46,360 --> 00:18:52,720 we now had, I now had editors that would reach out and say, would you review this paper, 266 00:18:52,720 --> 00:18:53,720 right? 267 00:18:53,720 --> 00:18:58,880 Or would you write an editorial or an invited article on this particular subtopic of the 268 00:18:58,880 --> 00:19:00,480 work that you're doing? 269 00:19:00,480 --> 00:19:05,600 And so initially it was very slow with this work and I could continue to engage with the 270 00:19:05,600 --> 00:19:07,480 other work that I was doing. 271 00:19:07,480 --> 00:19:13,120 But at the point where I decided to apply for grants, a foundational grant for this 272 00:19:13,120 --> 00:19:19,040 work, a foundation grant for this work, I knew that, I mean, just the grant writing 273 00:19:19,040 --> 00:19:20,360 process itself, right? 274 00:19:20,360 --> 00:19:23,280 Like I did not have a master's degree. 275 00:19:23,280 --> 00:19:24,280 I don't have a PhD. 276 00:19:24,280 --> 00:19:25,520 I've never done it before. 277 00:19:25,520 --> 00:19:30,240 The process of trying to write a grant, I had to slow down just about everything else 278 00:19:30,240 --> 00:19:34,960 that I was doing to learn this, right? 279 00:19:34,960 --> 00:19:39,920 And so everything else at that point actually, I would say I froze it. 280 00:19:39,920 --> 00:19:44,080 And I started to go very seriously to grant writing. 281 00:19:44,080 --> 00:19:47,720 Now when I submitted the first grant, which I did not get, and the second grant, which 282 00:19:47,720 --> 00:19:51,600 I did not get, and the third one, I think I got the third one. 283 00:19:51,600 --> 00:19:52,600 Maybe I didn't get the third one. 284 00:19:52,600 --> 00:19:53,600 Might have been the fourth one. 285 00:19:53,600 --> 00:19:59,520 But each of those, each of the comments that came back from all of those grants showed 286 00:19:59,520 --> 00:20:03,560 me where I had gaps in my research. 287 00:20:03,560 --> 00:20:10,720 So they gave me additional topics in this work that I could then explore to publish 288 00:20:10,720 --> 00:20:17,160 papers on to strengthen my next application, basically, which may be the hard way. 289 00:20:17,160 --> 00:20:18,160 I don't know. 290 00:20:18,160 --> 00:20:20,920 Maybe I should just have kept applying to more grants more frequently instead of trying 291 00:20:20,920 --> 00:20:24,120 to actually respond to what reviewers were saying. 292 00:20:24,120 --> 00:20:28,200 But it actually allowed me again to build that credibility as I went along. 293 00:20:28,200 --> 00:20:33,280 And so at that point, once I got to the point where now I'm applying for grants, I really 294 00:20:33,280 --> 00:20:36,760 did kind of stop the other things that I was doing. 295 00:20:36,760 --> 00:20:41,320 Once I got the first grant, and in the process of doing that, of course, you have collaborators 296 00:20:41,320 --> 00:20:46,000 that you've now built around you and mentors you've built around you locally at your institution 297 00:20:46,000 --> 00:20:49,500 and nationally and attached to the grant itself. 298 00:20:49,500 --> 00:20:52,760 It felt more like the work was more shared. 299 00:20:52,760 --> 00:20:58,880 And so it was now easier for me, I think, to start to pick back up some of the other 300 00:20:58,880 --> 00:21:00,680 topics that I had dropped. 301 00:21:00,680 --> 00:21:06,920 And I think that that's a decision each person makes is do you want to just be 100% in this 302 00:21:06,920 --> 00:21:08,040 particular field? 303 00:21:08,040 --> 00:21:12,680 Are you interested in still being the multi-faceted researcher? 304 00:21:12,680 --> 00:21:15,240 I think that depends for everyone. 305 00:21:15,240 --> 00:21:21,440 But I did become more selective about asking people, what is it that you would need from 306 00:21:21,440 --> 00:21:23,200 me on this project? 307 00:21:23,200 --> 00:21:26,440 And what is the timeline on this? 308 00:21:26,440 --> 00:21:32,920 So that I could be more careful about how I was able to distribute my time and what projects 309 00:21:32,920 --> 00:21:39,180 I was really going to truly be able to invest in and contribute to in a way that was beneficial 310 00:21:39,180 --> 00:21:41,180 for that team. 311 00:21:41,180 --> 00:21:49,520 Wow, I see a lot of kind of strategy, strategic investment and focus when it was time to do 312 00:21:49,520 --> 00:21:51,680 that. 313 00:21:51,680 --> 00:21:56,600 And then once there was a cadre of people involved and working collaboratively, you 314 00:21:56,600 --> 00:22:00,640 could let go of some of the heavy lifting to go back into some of the other work. 315 00:22:00,640 --> 00:22:05,800 So it sounds like kind of selective to zooming in and zooming out as needed. 316 00:22:05,800 --> 00:22:07,720 Yeah, I like that. 317 00:22:07,720 --> 00:22:08,800 Zooming in and zooming out. 318 00:22:08,800 --> 00:22:09,800 I like that. 319 00:22:09,800 --> 00:22:10,800 Absolutely. 320 00:22:10,800 --> 00:22:12,600 And I did this. 321 00:22:12,600 --> 00:22:16,680 I listened to a lot of podcasts and read a lot of books. 322 00:22:16,680 --> 00:22:22,680 In fact, most of the time I wasn't even reading books about academia or research. 323 00:22:22,680 --> 00:22:28,960 It was probably about strategy and maintaining different skill sets and strengths. 324 00:22:28,960 --> 00:22:31,560 Because there are strengths that I have and there are strengths that I don't have and 325 00:22:31,560 --> 00:22:36,040 learning how to find the right collaborators for it. 326 00:22:36,040 --> 00:22:41,360 There are teams on which, you know, they probably consider me a great co-author. 327 00:22:41,360 --> 00:22:46,240 And there are teams where I probably just did not bring value because the role that 328 00:22:46,240 --> 00:22:49,240 I was offered was not one that matched my strengths. 329 00:22:49,240 --> 00:22:55,320 And so that was a big part of it for me was if I have limited time, can I spend some time 330 00:22:55,320 --> 00:23:00,720 on strategy instead of just trying to spend all the hours on doing work, right? 331 00:23:00,720 --> 00:23:06,240 It's that whole mindset of are you just a worker being or are you also able to be the 332 00:23:06,240 --> 00:23:09,800 queen bee or are you also able to be the manager of your own work? 333 00:23:09,800 --> 00:23:15,760 It's not just about, and this happens, the busier you are, the more projects you have 334 00:23:15,760 --> 00:23:20,440 going on, but easier it is to just default to to-do list and just think, I just need 335 00:23:20,440 --> 00:23:25,960 to work, you know, 16 hours a day, 18 hours a day, just more work, just to check things 336 00:23:25,960 --> 00:23:26,960 off. 337 00:23:26,960 --> 00:23:32,480 But there's a lot of benefit I've learned in actually zooming out, like you say, and 338 00:23:32,480 --> 00:23:34,880 saying, do I need to do this at all? 339 00:23:34,880 --> 00:23:40,120 Or can I offer this team a different role that I could play that's going to match my 340 00:23:40,120 --> 00:23:41,120 strengths a little bit easier? 341 00:23:41,120 --> 00:23:44,240 It'll be faster for me and it'll be better for everyone involved. 342 00:23:44,240 --> 00:23:47,400 Are there things that I can just completely move to next year? 343 00:23:47,400 --> 00:23:49,520 Are there things that I can delegate? 344 00:23:49,520 --> 00:23:50,920 Are there things that are synergistic? 345 00:23:50,920 --> 00:23:55,200 Are there other collaborators I can invite into this work that will flip the load? 346 00:23:55,200 --> 00:24:03,400 And I think that was a huge, huge, huge factor in terms of not getting lost in the week. 347 00:24:03,400 --> 00:24:04,400 That's really powerful. 348 00:24:04,400 --> 00:24:08,040 One of the things I want to highlight that you mentioned right now and you actually talked 349 00:24:08,040 --> 00:24:10,480 about earlier is really the importance of strategy. 350 00:24:10,480 --> 00:24:16,600 Because as clinicians who are so busy clinically, and I think there's no clinician who doesn't 351 00:24:16,600 --> 00:24:21,280 understand how busy clinical work can be, for you to be able to do what you described 352 00:24:21,280 --> 00:24:26,120 early in layering, like this is my clinical work and I'm going to layer that on top of 353 00:24:26,120 --> 00:24:31,320 my academic work and layer that on top of a hobby I'm going to be doing anyway, is strategic 354 00:24:31,320 --> 00:24:32,820 use of your time. 355 00:24:32,820 --> 00:24:37,680 But then also thinking about how can I strategically bring people into this project so that I'm 356 00:24:37,680 --> 00:24:39,240 not doing all of the heavy lifting? 357 00:24:39,240 --> 00:24:44,780 And I think that's so critical in the sense that clinicians are not PhD scientists. 358 00:24:44,780 --> 00:24:46,320 And it's not that they cannot be. 359 00:24:46,320 --> 00:24:49,200 Given all the time in the world, we absolutely could be. 360 00:24:49,200 --> 00:24:53,380 But if we're coming to research a little bit later in the game, which most clinicians are, 361 00:24:53,380 --> 00:24:57,520 then we have to think strategically about how do we build it on top of and in spite 362 00:24:57,520 --> 00:24:59,760 of all the other things that we're doing? 363 00:24:59,760 --> 00:25:04,160 And I think you highlight how to do that really effectively. 364 00:25:04,160 --> 00:25:07,480 Well, thank you. 365 00:25:07,480 --> 00:25:11,040 I think it sounds so much cleaner in retrospect than it felt in the moment. 366 00:25:11,040 --> 00:25:12,040 It felt really messy. 367 00:25:12,040 --> 00:25:14,800 And you know what, that's worth saying. 368 00:25:14,800 --> 00:25:16,240 It felt messy. 369 00:25:16,240 --> 00:25:19,120 It felt like I was pulled in a million directions. 370 00:25:19,120 --> 00:25:23,040 And there's probably the people who were more strategic than I was who could have done it 371 00:25:23,040 --> 00:25:24,900 in a way that was more seamless. 372 00:25:24,900 --> 00:25:28,680 But I do encourage those for whom it does feel messy. 373 00:25:28,680 --> 00:25:32,400 That doesn't necessarily mean you're doing it wrong or that it won't be successful. 374 00:25:32,400 --> 00:25:38,720 If that adds with anything else, you're developing the skill sets that allow you to make each 375 00:25:38,720 --> 00:25:44,920 iteration better, more organized than the previous one. 376 00:25:44,920 --> 00:25:49,920 And one of the things I ended up learning were what are the tools that are available 377 00:25:49,920 --> 00:25:50,920 at my institution? 378 00:25:50,920 --> 00:25:52,960 And there were a lot of them. 379 00:25:52,960 --> 00:25:57,680 There is a grant writing office that will assist with reviewing your grants. 380 00:25:57,680 --> 00:26:02,920 Most of it is just editing, right, not necessarily scientific writing. 381 00:26:02,920 --> 00:26:07,440 But that was helpful because then I don't need to sit there and parse out whether this 382 00:26:07,440 --> 00:26:09,960 needs a comma or semicolon. 383 00:26:09,960 --> 00:26:10,960 We can leave that. 384 00:26:10,960 --> 00:26:14,120 We can just get to the meat of what needs to be discussed. 385 00:26:14,120 --> 00:26:20,080 So really figuring out what tools were available that I could harness was helpful. 386 00:26:20,080 --> 00:26:25,920 I reached out to people who had previously been awarded the grant that I was going after. 387 00:26:25,920 --> 00:26:30,760 And they were so kind and shared components of what they had written with me and mentored 388 00:26:30,760 --> 00:26:31,760 me through. 389 00:26:31,760 --> 00:26:35,480 And we became friends, right, because they were applying for other grants down the line 390 00:26:35,480 --> 00:26:39,560 or they were trying to work out a research question. 391 00:26:39,560 --> 00:26:41,600 And they would run that by me. 392 00:26:41,600 --> 00:26:47,120 And so it actually, again, becomes synergistic because it's an area of interest anyway. 393 00:26:47,120 --> 00:26:50,680 And so reaching out to those people, they become your friends, they become your collaborators. 394 00:26:50,680 --> 00:26:53,800 We've now collaborated together on other projects. 395 00:26:53,800 --> 00:26:57,360 Really thinking about what do I have in my toolkit? 396 00:26:57,360 --> 00:26:58,360 And that includes people. 397 00:26:58,360 --> 00:27:00,720 What people do I have in my toolkit? 398 00:27:00,720 --> 00:27:02,920 What resources are my institution? 399 00:27:02,920 --> 00:27:08,440 What resources do I have from the research training class that I took in medical school? 400 00:27:08,440 --> 00:27:09,940 What can I find from there? 401 00:27:09,940 --> 00:27:12,480 You have a lot more than you think. 402 00:27:12,480 --> 00:27:16,520 Tell me about mentors who supported you in this process. 403 00:27:16,520 --> 00:27:23,440 Well, that's a great question. 404 00:27:23,440 --> 00:27:31,800 I think that I had sponsors more than I had mentors, but I didn't realize it at the time. 405 00:27:31,800 --> 00:27:36,840 So I had a department chair who saw this vision from day one. 406 00:27:36,840 --> 00:27:40,280 And she just would talk to me about what did you do this weekend? 407 00:27:40,280 --> 00:27:44,840 I was recording videos and she would go, have you applied for that grant? 408 00:27:44,840 --> 00:27:45,840 Yeah. 409 00:27:45,840 --> 00:27:48,000 She just saw this vision from the beginning. 410 00:27:48,000 --> 00:27:50,800 And I think that that push was really important. 411 00:27:50,800 --> 00:27:54,600 I think when I now got to the point where I was applying for the grant, because I wanted 412 00:27:54,600 --> 00:28:01,360 to have more flexibility in my schedule, that's another reason to make the transition. 413 00:28:01,360 --> 00:28:04,380 If you do have grant funded work, typically that protects your time. 414 00:28:04,380 --> 00:28:07,520 You have more flexibility in your schedule. 415 00:28:07,520 --> 00:28:15,200 When I went to go do that, that's really when I realized, oh, she's a sponsor. 416 00:28:15,200 --> 00:28:16,200 She's not necessarily a mentor. 417 00:28:16,200 --> 00:28:21,160 She's not necessarily the person who's going to line edit the work that I'm doing. 418 00:28:21,160 --> 00:28:22,160 Just too busy. 419 00:28:22,160 --> 00:28:23,960 She's got too many things going on. 420 00:28:23,960 --> 00:28:30,880 But again, I think once you believe in the goal, which she did, it's such a motivator 421 00:28:30,880 --> 00:28:35,320 then to figure out all the things between here and there. 422 00:28:35,320 --> 00:28:43,720 I also had sponsors who were interested in the big picture of how can we get radiology 423 00:28:43,720 --> 00:28:46,360 more interested in global health, period. 424 00:28:46,360 --> 00:28:50,240 And so they weren't necessarily sold on what I was doing. 425 00:28:50,240 --> 00:28:52,120 They didn't know anything about what I was doing. 426 00:28:52,120 --> 00:28:55,840 But they overall had a belief that this was important. 427 00:28:55,840 --> 00:29:01,640 And their skill set around just what I would call bench research, more of the true clinical 428 00:29:01,640 --> 00:29:08,260 translational research, but in global health, allowed me to modify my work to have the kind 429 00:29:08,260 --> 00:29:13,600 of hypothesis that you actually need for a grant application, but you may not necessarily 430 00:29:13,600 --> 00:29:17,200 see in educational projects. 431 00:29:17,200 --> 00:29:18,480 And then I would take for mentors. 432 00:29:18,480 --> 00:29:20,040 Yeah, that was a big one. 433 00:29:20,040 --> 00:29:28,280 So those sponsors, there was the head of education for our division, heard of my work and said, 434 00:29:28,280 --> 00:29:32,080 I think we need to put a better research question around this. 435 00:29:32,080 --> 00:29:35,160 Let me introduce you to other people who are doing educational research. 436 00:29:35,160 --> 00:29:41,320 And so they helped connect me with the kind of mentors who had done similar things that 437 00:29:41,320 --> 00:29:42,740 then became my collaborators. 438 00:29:42,740 --> 00:29:46,520 So they then mentored me on different aspects of the project. 439 00:29:46,520 --> 00:29:53,080 One of the biggest things for me, specifically, because global health, is that some of my 440 00:29:53,080 --> 00:29:56,160 mentors are global experts. 441 00:29:56,160 --> 00:29:59,840 So I don't want to say local experts, but in-country experts, right? 442 00:29:59,840 --> 00:30:05,400 I consider them to be the experts that guide the work that I do. 443 00:30:05,400 --> 00:30:10,160 And often they are so busy clinically, they are extremely busy clinically. 444 00:30:10,160 --> 00:30:15,440 There's one radiologist per million people in sub-Saharan Africa, one radiologist per 445 00:30:15,440 --> 00:30:16,440 million. 446 00:30:16,440 --> 00:30:22,760 Some countries have zero specialty trained radiologists. 447 00:30:22,760 --> 00:30:28,280 So they are juggling the entire country in terms of clinical volume on their back, but 448 00:30:28,280 --> 00:30:31,120 they are experts in what they need. 449 00:30:31,120 --> 00:30:39,000 And so you are helping to be the arm that writes out and executes some of the projects 450 00:30:39,000 --> 00:30:41,840 that they think are going to be super impactful. 451 00:30:41,840 --> 00:30:46,800 And so they were extremely helpful as mentors, even though they could do the clinical science 452 00:30:46,800 --> 00:30:51,400 writing piece, they were extremely helpful as mentors in terms of defining the work that 453 00:30:51,400 --> 00:30:59,120 I was trying to do, making sure that it made sense and it had been critiqued and was likely 454 00:30:59,120 --> 00:31:00,640 to be successful. 455 00:31:00,640 --> 00:31:06,160 And then of course, in actually helping to make it successful when we launched. 456 00:31:06,160 --> 00:31:07,520 Thank you for that, Thoma. 457 00:31:07,520 --> 00:31:11,800 What I'm hearing is that you really pieced your mentoring together from as many people 458 00:31:11,800 --> 00:31:13,960 as possible. 459 00:31:13,960 --> 00:31:17,720 And I think it speaks to the experience of many clinicians who don't necessarily have 460 00:31:17,720 --> 00:31:19,620 the one mentor. 461 00:31:19,620 --> 00:31:23,080 And for what you're talking about, you're creating something new. 462 00:31:23,080 --> 00:31:25,680 And I think many clinicians are doing the same. 463 00:31:25,680 --> 00:31:27,480 They're not following a tried and true path. 464 00:31:27,480 --> 00:31:31,080 And when you're doing that, there's not one person who's going to rise to the floor as 465 00:31:31,080 --> 00:31:35,200 the expert that I'm going to go apprentice and they're doing apprenticeship in their 466 00:31:35,200 --> 00:31:36,200 lab. 467 00:31:36,200 --> 00:31:38,920 And they are taking what you need. 468 00:31:38,920 --> 00:31:41,080 So I want you to just speak about what does it take? 469 00:31:41,080 --> 00:31:45,720 What does it take to be the kind of person who knows what, who goes after what you want, 470 00:31:45,720 --> 00:31:47,360 who knows you have to know what you want, right? 471 00:31:47,360 --> 00:31:50,180 And then the person can go after it. 472 00:31:50,180 --> 00:31:54,160 And it takes, I think it's a special skill and strength to do that. 473 00:31:54,160 --> 00:31:58,640 And can you speak to how you develop those strengths to be able to figure out what you 474 00:31:58,640 --> 00:32:03,320 want and go after it in different people? 475 00:32:03,320 --> 00:32:07,640 All of those strengths, they all have terrible names, right? 476 00:32:07,640 --> 00:32:12,640 The strengths are things like stubbornness, you know? 477 00:32:12,640 --> 00:32:17,560 You know, it's probably, I guess we could say it's... 478 00:32:17,560 --> 00:32:22,960 We have to be careful not to be egotistical about the work that we do. 479 00:32:22,960 --> 00:32:30,120 But you do have to believe strongly enough that there is importance to the work. 480 00:32:30,120 --> 00:32:34,440 It doesn't have to be about me, but it's important for this work to get done. 481 00:32:34,440 --> 00:32:39,760 And it's important enough for me to bug somebody about it. 482 00:32:39,760 --> 00:32:45,560 It's important enough for the people who benefit from this work for me to be humble enough 483 00:32:45,560 --> 00:32:52,560 to open myself up to mentorship from all of these sources, right? 484 00:32:52,560 --> 00:32:56,720 Because these mentors are not necessarily friends, right? 485 00:32:56,720 --> 00:33:00,280 So you have to have that skill set of flexibility and adaptability. 486 00:33:00,280 --> 00:33:08,760 Like here, the pearls you're getting through whatever format they're being given to you, 487 00:33:08,760 --> 00:33:15,580 it's not a situation where you can build all of the depth of relationship maybe that would 488 00:33:15,580 --> 00:33:19,720 allow you to be coddled and get lenudged and all of that. 489 00:33:19,720 --> 00:33:24,600 You're working with people who have different expertise, they have different skill sets, 490 00:33:24,600 --> 00:33:25,600 they're busy. 491 00:33:25,600 --> 00:33:30,800 But being able to get pearls, being able to clearly define the questions you want answered 492 00:33:30,800 --> 00:33:33,200 by this individual is helpful. 493 00:33:33,200 --> 00:33:42,920 And so I think the communication with individuals could say, I'm doing this, I would love to 494 00:33:42,920 --> 00:33:46,560 collaborate with you, can you help me with this, right? 495 00:33:46,560 --> 00:33:48,680 It's really short emails, but very clear ads. 496 00:33:48,680 --> 00:33:52,340 And some people would just say no, some people would just respond with like a paper they 497 00:33:52,340 --> 00:33:56,080 had written and it's like, okay. 498 00:33:56,080 --> 00:34:02,880 But even though in the beginning of pursuing all of these people, it can be a little unclear 499 00:34:02,880 --> 00:34:09,000 as to how the relationship will take shape and how much benefit you'll get from it. 500 00:34:09,000 --> 00:34:14,680 What ends up happening is that you're pursuing, people love that, people love a winner, people 501 00:34:14,680 --> 00:34:16,320 love a winner. 502 00:34:16,320 --> 00:34:22,840 People also love to be acknowledged for their efforts because they've probably been emailed 503 00:34:22,840 --> 00:34:29,000 10 times in the last three months from all sorts of sources looking for help. 504 00:34:29,000 --> 00:34:33,080 And so you being the one who comes back to say, hey, I bugged you about this, but here's 505 00:34:33,080 --> 00:34:38,200 what I'm doing and I'm highlighting in the acknowledgement section of this paper and 506 00:34:38,200 --> 00:34:42,480 I may be applying for a grant later that I think we could collaborate on or I could have 507 00:34:42,480 --> 00:34:45,800 you as a co-walker on this paper if you want to work on this. 508 00:34:45,800 --> 00:34:49,920 It starts to show them the fruit of their labor and then they engage with you a little 509 00:34:49,920 --> 00:34:50,920 bit more. 510 00:34:50,920 --> 00:34:56,760 So I think there's a component of this that is having thick skin in terms of how the information 511 00:34:56,760 --> 00:35:03,760 is communicated to you, how those pearls come, how infrequently you may have contacts, how 512 00:35:03,760 --> 00:35:08,400 much gobbling you have to do to get their attention to begin with, how persistent you 513 00:35:08,400 --> 00:35:09,880 have to be around that. 514 00:35:09,880 --> 00:35:16,360 But you all, I think, come back to them with gratitude and humility and this understanding 515 00:35:16,360 --> 00:35:18,160 that this is going to be my life's path. 516 00:35:18,160 --> 00:35:22,400 And so if I'm doing this, this is the only paper that came out of this. 517 00:35:22,400 --> 00:35:25,320 Thank you for helping me get this far and this allows me to sleep a little better at 518 00:35:25,320 --> 00:35:26,320 night. 519 00:35:26,320 --> 00:35:30,440 So I think, I don't know if you could find the skills in there, but maybe you guys still 520 00:35:30,440 --> 00:35:33,560 have some skills in there that folks could use. 521 00:35:33,560 --> 00:35:41,920 I hear you talking about the importance of knowing what you want, the skill of being 522 00:35:41,920 --> 00:35:45,880 able to clearly define it for someone else so that they're very clear on what you want. 523 00:35:45,880 --> 00:35:50,040 And they can say yes or they can say no, but at least you're making it very explicit. 524 00:35:50,040 --> 00:35:55,720 And then I also hear you talk about tenacity and also you talk clearly about humility and 525 00:35:55,720 --> 00:36:00,200 coming back and letting people know how their help has advanced your work. 526 00:36:00,200 --> 00:36:02,880 And I think those are all really amazing things. 527 00:36:02,880 --> 00:36:04,800 I think that captures much of what you said. 528 00:36:04,800 --> 00:36:07,240 What do you think? 529 00:36:07,240 --> 00:36:08,320 I think you're absolutely right. 530 00:36:08,320 --> 00:36:12,600 I think you summarized that beautifully. 531 00:36:12,600 --> 00:36:17,200 So along the lines of all this amazing work you've been doing, big things are happening 532 00:36:17,200 --> 00:36:18,200 for you. 533 00:36:18,200 --> 00:36:24,120 What do you share with our audience where this work is going and how the big things 534 00:36:24,120 --> 00:36:25,120 that are coming out of it? 535 00:36:25,120 --> 00:36:26,120 I think that's all I can say. 536 00:36:26,120 --> 00:36:27,120 Yeah. 537 00:36:27,120 --> 00:36:28,120 Yeah. 538 00:36:28,120 --> 00:36:31,000 So a lot of big things that I really didn't anticipate. 539 00:36:31,000 --> 00:36:37,760 So once it was published, I had people reach out from Africa really interested in using 540 00:36:37,760 --> 00:36:42,480 the curriculum, modifying the e-learning curriculum for sub-Saharan Africa. 541 00:36:42,480 --> 00:36:49,120 And so we applied for a grant which was funded to modify this for sub-Saharan Africa. 542 00:36:49,120 --> 00:36:54,840 One of my collaborators actually also helped us to create more sustainability around this 543 00:36:54,840 --> 00:37:00,480 project in terms of doing not just the online learning, but what we call Project Echo, which 544 00:37:00,480 --> 00:37:06,680 is a telemedicine where people show monthly cases, which I mean, a community now that 545 00:37:06,680 --> 00:37:14,880 is so wide, we have people monthly who have joined from Zambia, Tanzania, Nigeria, Ghana, 546 00:37:14,880 --> 00:37:22,800 Uganda, Rwanda, I mean, just all over sub-Saharan Africa using components of this curriculum 547 00:37:22,800 --> 00:37:25,160 and this educational community. 548 00:37:25,160 --> 00:37:30,280 And then as part of this work, and again, I think the benefits of building credibility 549 00:37:30,280 --> 00:37:38,000 around this, as our institution itself decided to reframe its strategy for global health, 550 00:37:38,000 --> 00:37:42,240 and they were looking for experts in breast cancer, the fact that I had publications 551 00:37:42,240 --> 00:37:47,400 from this and I had a grant from this meant that I ended up getting an institutional role, 552 00:37:47,400 --> 00:37:56,000 a director of breast imaging for global oncology to help create curricula and seminars for 553 00:37:56,000 --> 00:37:58,840 different countries, Mozambique. 554 00:37:58,840 --> 00:38:02,000 We have projects throughout the Caribbean, even in the United States, so now leveraging 555 00:38:02,000 --> 00:38:04,720 institutional networks. 556 00:38:04,720 --> 00:38:08,480 And the institution also collaborates with the World Health Organization and Pan American 557 00:38:08,480 --> 00:38:12,680 Health Organization, which is the sub-regional office of the WHO for the Caribbean and Latin 558 00:38:12,680 --> 00:38:18,160 America and collaborates with the International Atomic Energy Agency. 559 00:38:18,160 --> 00:38:25,880 And so I get to kind of leverage the skill set and all the mistakes that I've made in 560 00:38:25,880 --> 00:38:32,600 trying to help these international agencies both create programs for the countries that 561 00:38:32,600 --> 00:38:37,120 they serve, but also better define the problems in those countries. 562 00:38:37,120 --> 00:38:43,000 Because I can say, here are all the roadblocks I've faced working in X, Y, and Z country, 563 00:38:43,000 --> 00:38:48,200 and that becomes something that helps to inform guidelines, right? 564 00:38:48,200 --> 00:38:50,920 And helps inform further processes going on. 565 00:38:50,920 --> 00:38:55,240 So I'm really not saying any of this has happened because I'm so brilliant. 566 00:38:55,240 --> 00:38:59,280 I'm really all, it's a combination of all the things, right? 567 00:38:59,280 --> 00:39:06,600 Certainly hard work, but also these collaborators who remembered that, hey, Tawna's doing something 568 00:39:06,600 --> 00:39:13,680 in Zambia, so let XYZ person know that she is someone who should be considered for this 569 00:39:13,680 --> 00:39:14,680 role, right? 570 00:39:14,680 --> 00:39:20,920 So it just, all of the things snowballed, all of those same frameworks I put in place. 571 00:39:20,920 --> 00:39:25,600 The fact that I was reading business books around strategy and while those business books 572 00:39:25,600 --> 00:39:29,880 also had leadership skills, and okay, now you have a team that you have to lead, right? 573 00:39:29,880 --> 00:39:36,920 I think all of the pieces that we put in place to do our work, as precursors that we are, 574 00:39:36,920 --> 00:39:42,880 we're able to go back and use all of those same pieces to implement the work and to find, 575 00:39:42,880 --> 00:39:46,320 I think, effectiveness in the work that we're doing. 576 00:39:46,320 --> 00:39:47,720 So it's been great. 577 00:39:47,720 --> 00:39:51,400 We applied for another foundation grant just earlier this year and that was funded. 578 00:39:51,400 --> 00:39:56,720 In fact, they overfunded, they offered to fund more than we would even ask for, which 579 00:39:56,720 --> 00:39:58,160 blew my mind. 580 00:39:58,160 --> 00:40:04,920 But I think all of this is a testament to perseverance and having the teams around you 581 00:40:04,920 --> 00:40:10,480 that may not be surrounded, you may not be surrounded by people doing similar or the 582 00:40:10,480 --> 00:40:13,960 exact same, like you pointed out, so I'm not surrounded by people doing the exact same 583 00:40:13,960 --> 00:40:15,640 thing that I'm doing. 584 00:40:15,640 --> 00:40:19,160 But I'm surrounded by people who are so brilliant. 585 00:40:19,160 --> 00:40:23,920 And the fact that they'll ask tough questions and they'll offer just tiny little pearls 586 00:40:23,920 --> 00:40:28,360 or just game changers and the humility to try to pick up on those pearls and try to 587 00:40:28,360 --> 00:40:34,160 act on them has made all the difference in my career and I'm very thankful. 588 00:40:34,160 --> 00:40:35,960 So beautifully summarized. 589 00:40:35,960 --> 00:40:40,600 Just you were doing all this work, you're not silent about it, you're making your work 590 00:40:40,600 --> 00:40:44,520 known, you're reaching out for collaborators so people know what you're doing. 591 00:40:44,520 --> 00:40:49,160 And when the time came to think about people who were doing this work, you came to mind 592 00:40:49,160 --> 00:40:53,600 because you had really put arms and legs around your work. 593 00:40:53,600 --> 00:40:56,480 You really had built currency out of it. 594 00:40:56,480 --> 00:41:01,920 Yeah, the currency, it turns out that's important. 595 00:41:01,920 --> 00:41:06,400 Well, I feel like you said so many amazing things. 596 00:41:06,400 --> 00:41:11,080 We're coming to the end of the show and I just wonder, is there anything that you feel 597 00:41:11,080 --> 00:41:15,000 has been left on the set that is important for the audience to know? 598 00:41:15,000 --> 00:41:19,320 Because many people are trying to make this transition, feeling that it's so hard, feeling 599 00:41:19,320 --> 00:41:24,000 that they're not supported and somehow you kind of have all of that in the back of your 600 00:41:24,000 --> 00:41:25,000 story. 601 00:41:25,000 --> 00:41:28,680 We didn't ask about your challenges, but I feel like many of your challenges came through. 602 00:41:28,680 --> 00:41:34,000 But I wonder for someone who feels like, wow, this is hard, what are some thoughts that 603 00:41:34,000 --> 00:41:38,760 you want to share in the closing? 604 00:41:38,760 --> 00:41:44,280 One thing I'll share for some people that relates to kind of imposter syndrome, I think 605 00:41:44,280 --> 00:41:51,240 when you're going into something new, as somebody who's been a perfectionist in most of the 606 00:41:51,240 --> 00:41:56,160 other areas of your life and you have exceeded expectations in most of the other areas of 607 00:41:56,160 --> 00:42:00,800 your life, going into something new can be extremely difficult because you're not good 608 00:42:00,800 --> 00:42:02,080 at it. 609 00:42:02,080 --> 00:42:07,080 And so you can spend a lot of time really beating yourself up. 610 00:42:07,080 --> 00:42:13,800 And what that does is just create more angst around the work beyond the challenges that 611 00:42:13,800 --> 00:42:14,800 you're having. 612 00:42:14,800 --> 00:42:18,040 There's like the external challenges and now you're creating internal challenges that 613 00:42:18,040 --> 00:42:21,560 make you want to procrastinate and not do the, I mean, it's just, it's this terrible 614 00:42:21,560 --> 00:42:22,640 cycle. 615 00:42:22,640 --> 00:42:30,640 I think that approaching this from a sense of gratitude was so wonderful for me. 616 00:42:30,640 --> 00:42:35,520 I came in feeling as if I was hired to be a community-based academic. 617 00:42:35,520 --> 00:42:39,840 I was hired to just work in the clinic. 618 00:42:39,840 --> 00:42:47,680 And the fact that I get to do any of this is above and beyond what I would have imagined. 619 00:42:47,680 --> 00:42:48,680 What a gift. 620 00:42:48,680 --> 00:42:50,160 I didn't earn any of this. 621 00:42:50,160 --> 00:42:53,400 I didn't go to get a PhD. 622 00:42:53,400 --> 00:42:57,640 I didn't do any of the things that you normally would do, but I'm getting to do this kind 623 00:42:57,640 --> 00:43:01,720 of work that some of the people who have the PhDs are doing. 624 00:43:01,720 --> 00:43:06,680 And so when I came into it with that mindset, it created a sense of humility. 625 00:43:06,680 --> 00:43:11,200 Yes, if I walk into a room and if you look, everybody there has a million titles and they're 626 00:43:11,200 --> 00:43:16,040 all MDPHC and they've got, you know, multi-millions of dollars in funding. 627 00:43:16,040 --> 00:43:18,960 I'm not walking in there thinking, whoa, it's me. 628 00:43:18,960 --> 00:43:21,200 Look how unqualified I am to be in this room. 629 00:43:21,200 --> 00:43:24,480 I walk into the room and I think, what a gift. 630 00:43:24,480 --> 00:43:28,900 I don't know how I got in this room with these people, but I'm going to use up every second 631 00:43:28,900 --> 00:43:29,900 of my time in here. 632 00:43:29,900 --> 00:43:32,200 I'm going to ask every question. 633 00:43:32,200 --> 00:43:34,000 I'm going to make every connection. 634 00:43:34,000 --> 00:43:35,560 I am taking notes. 635 00:43:35,560 --> 00:43:36,560 I am becoming friends. 636 00:43:36,560 --> 00:43:37,560 I'm following them on LinkedIn. 637 00:43:37,560 --> 00:43:39,320 I want to see their pathway. 638 00:43:39,320 --> 00:43:43,320 I just walked in with the sense that, no, I don't actually deserve to be in this room. 639 00:43:43,320 --> 00:43:46,960 I don't know how I got here, but you guys are, I mean, you're going to hear from me 640 00:43:46,960 --> 00:43:47,960 now. 641 00:43:47,960 --> 00:43:49,440 You know, now I'm in. 642 00:43:49,440 --> 00:43:53,680 And I think it also made it more fun so that it was collaborative. 643 00:43:53,680 --> 00:43:55,040 It wasn't competitive, right? 644 00:43:55,040 --> 00:43:58,640 I'm not in this room thinking, look at what they have versus what I have. 645 00:43:58,640 --> 00:44:00,920 It's like, look at what they have. 646 00:44:00,920 --> 00:44:02,840 We could do this together. 647 00:44:02,840 --> 00:44:09,160 And I think going in with that mindset is generous and it's a growth mindset that allows 648 00:44:09,160 --> 00:44:19,160 you, I think, to really get the full juice out of the work that you're doing. 649 00:44:19,160 --> 00:44:20,160 So beautifully said. 650 00:44:20,160 --> 00:44:22,640 And what a great way to end the show. 651 00:44:22,640 --> 00:44:25,440 I think it's coming at it with a sense of gratitude. 652 00:44:25,440 --> 00:44:28,000 It just changes our whole perspective. 653 00:44:28,000 --> 00:44:29,000 And so thank you. 654 00:44:29,000 --> 00:44:30,240 Thank you for sharing that. 655 00:44:30,240 --> 00:44:33,680 Well, everyone, you heard Dr. Thoma. 656 00:44:33,680 --> 00:44:40,480 It is hard, but it is not impossible with creativity, hard work, and really pursuing 657 00:44:40,480 --> 00:44:45,400 the right mentors and sponsors and collaborators so much of this is possible. 658 00:44:45,400 --> 00:44:51,200 Dr. Thoma, I want to say thank you so much for being on the show. 659 00:44:51,200 --> 00:44:52,480 Thank you so much for having me. 660 00:44:52,480 --> 00:44:55,040 I really appreciate the opportunity. 661 00:44:55,040 --> 00:44:56,960 It is our pleasure. 662 00:44:56,960 --> 00:44:59,160 All right, everyone. 663 00:44:59,160 --> 00:45:00,200 Thank you for listening. 664 00:45:00,200 --> 00:45:06,880 We look forward to having you again on the next episode of the Clinician Researcher Podcast. 665 00:45:06,880 --> 00:45:07,880 Wonderful. 666 00:45:07,880 --> 00:45:08,880 Hi. 667 00:45:08,880 --> 00:45:22,000 Thanks for listening to this episode of the Clinician Researcher Podcast, where academic 668 00:45:22,000 --> 00:45:27,320 clinicians learn the skills to build their own research program, whether or not they 669 00:45:27,320 --> 00:45:28,840 have a mentor. 670 00:45:28,840 --> 00:45:34,800 If you found the information in this episode to be helpful, don't keep it all to yourself. 671 00:45:34,800 --> 00:45:36,680 Someone else needs to hear it. 672 00:45:36,680 --> 00:45:40,720 So take a minute right now and share it. 673 00:45:40,720 --> 00:45:46,200 As you share this episode, you become part of our mission to help launch a new generation 674 00:45:46,200 --> 00:45:52,240 of clinician researchers who make transformative discoveries that change the way we do healthcare.