Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills
to build their own research program, whether or not they have a mentor.
As clinicians, we spend a decade or more as trainees learning to take care of patients.
When we finally start our careers, we want to build research programs, but then we find
that our years of clinical training did not adequately prepare us to lead our research
program.
Through no fault of our own, we struggle to find mentors, and when we can't, we quit.
However, clinicians hold the keys to the greatest research breakthroughs.
For this reason, the Clinician Researcher podcast exists to give academic clinicians
the tools to build their own research program, whether or not they have a mentor.
Now introducing your host, Toyosi Onwuemene.
And welcome to the Clinician Researcher podcast.
I'm your host, Toyosi Onwuemene, and it is such a pleasure to be talking with you today.
I'm especially excited because I have a special guest, Dr. Toma Omofoye.
Toma, welcome to the show.
Thank you for having me.
It's an honor.
I'm thrilled to be here.
The pleasure is ours.
We're so excited to have you on our show.
And I wonder if you could introduce yourself to the audience, especially with regard to
your journey as a clinician scientist.
Well, I'm an associate professor of radiology, and I work in a large academic medical center.
I did my training at Duke Medical School and residency at Duke Medical School, so I had
come from that sort of high academic output institution.
However, when I started my first attending role, I was hired really as a community-based
academic.
So I was one of those registered who's actually reading studies out in the community, helping
bring kind of high quality evidence-based care into community practice settings.
And so in that role, it was really emphasized that I needed to focus on the clinical skills
and less so focusing on any of the research or academic output kind of skills.
Okay.
Are you going to speak more about that?
Speak to that a little bit more.
Just here you are.
You're hired as a full-time clinician, really, but in a community academic practice.
So there is some expectation potentially, and there's a little bit of academics within,
but you really are tasked with being clinical.
How did you now make this transition to start doing research on that?
Well, I think the first thing is that I had a hobby that I couldn't quite let go of.
It really was a passion of mine to try to empower clinicians outside of the United States
who are practicing in low-reforce settings to be the best clinicians they could be with
the resources that they have available.
And so the hobby that I had while I had this very clinical job was to create educational
context for radiologists who are practicing in remote middle-income countries.
What is really interesting in radiology is that when most of the world started expanding
their frontiers and engaging in global health, radiology lags behind because a lot of our
work is dependent on really expensive, really bulky technology that was really out of the
reach of a lot of countries that were still developing socioeconomically.
And so you saw this revolution, I think, like in internal medicine, you saw this HIV care
led by partners and Paul Farmer.
You saw these incredible roles in neonatal medicine.
You saw all of this work on maternal, fetal medicine, maternal mortality outcomes, and
radiology just really wasn't participating in the same way in global health because we
really were hampered by not having the technology available on the ground there that we would
want to use to improve outcomes.
And I think for me, practicing in a place that is so well recognized, it was a lightbulb
moment to realize that what was really providing excellent outcomes in our practice wasn't
access to all of the super high-tech equipment.
It was actually the ability to navigate that high-tech equipment or the entire spectrum
of available equipment based on your expertise.
It's still precision medicine, right?
And that precision medicine could be about offering a patient the newest thing on the
market or it could be about offering a patient something that's been around for a long time.
It's cheap.
It's really widely available, but it's actually going to answer their question in a way that
does it quickly and definitively and minimizes their adverse effects.
So realizing that even for us, having access to everything high-tech didn't mean we were
using everything high-tech all the time.
It just meant that we were using things well.
And it made me, as somebody who is an immigrant, really aware of the potential that we made
in places that didn't have all of the newest equipment to still provide a lot of really
precise medicine to try to reduce breast cancer disparity globally.
And so I started out just with making videos and placing them online.
And thankfully, my department was very generous and they allowed me to use the department
learning management software to create a website.
And so each video had a pre-test and a post-test.
And in talking with the collaborators, my friends, my colleagues who are working abroad,
they would basically be the ones to dictate the topics they needed to hear about.
And we could collaborate on what would be really the best answer to managing that disease
state in a setting that was sort of a lower resource.
And so it just kind of blew and blew and blew.
And one thing led to another, and we found that one third of the residency programs in
Singapore kind of signed up to use this as their adjunct, educational adjunct for their
residents who are trying to learn breast radiology.
And it was a game changer for them because prior to this, they would have to send their
residents outside of the country, to the US or the UK, to get this kind of training.
But again, getting that training in a resource-rich environment that doesn't really mimic what
they may necessarily have at home.
And so now providing this resource that was resource-adapted, it's available online, it
was something that was being customized as we went, it ended up providing a lot of value
to the teams that were using it.
And so one thing led to another.
I really, I mean, this gets more into the topic of the podcast here.
I was really, really encouraged by department leaders, by department chair to publish it
because I was spending so many nights and weekends doing this on my own time.
And she said, it doesn't matter how much effort you put into it, it doesn't have the value
unless it takes the shape of academic currency and academic currency as publications.
And so if you cannot create a scholarly question around what you're doing, if you cannot create
publication around what you're doing, you're not receiving the maximum benefit for the
input that you are actually working on.
Okay.
I want to go back to the very beginning where you call it a hobby.
And I just want to ask you about that because what I hear as you're talking about it just
is that you had so much past that and it was kind of just a really strong pull to make
a difference.
And so I think a lot more than a hobby for sure, but I want you to speak to why you think
of it as a hobby or if you would describe it differently.
Yeah, I thought of it as a hobby because starting out as an attending, everyone's asking you
to define your area of academic interest.
What are you going to do?
What are you going to do research in?
And to me, it felt like the areas I would perform research in were different topics
than this, right?
It was what is that cutting edge of the field?
What is the newest question that's being bandied about in our journal?
And those to me felt like my areas of interest.
Education and teaching is something that I've always done, right?
So I was a peer learning leader doing tutoring in college.
It was one of my first jobs.
I had done all sorts of little teaching things as a resident and throughout my career.
And education was something that I wanted just why I signed up to be this, you know,
with an academic practice.
But it didn't feel to me like I was approaching this in the way that you approach something
where you have a hypothesis, that you have, you know, a very clear idea of what you're
building and who your team is and what your outputs are going to be.
I really was approaching this as something that allowed me to scratch the itch of wanting
to teach because I just enjoyed that for its own sake.
But I think in a broader sense, what this means is that we often have passion in academia
that may not be the specific area of your interest, right?
So my initial publications were another topic.
But that little passion for teaching itself was something that I was going to care with
me throughout my life.
And today, even if I wasn't publishing on this topic now, even if it wasn't now a part
of my official role, I would still be doing some teaching.
I think that especially when you're an academic, you're probably an academic because you are
a tinkerer.
That's what I say.
I think most academics are tinkers.
You look at things and you think, how could this be a little bit better?
You look at education and go, how could this be better?
You look at research and go, how can I make this a little bit better?
You look at all these questions that you're constantly trying to improve on yourself.
And so if you are that kind of person, it's not that big of a leap to take that tinkering
mindset and just put a scientific question around it and go ahead and plan for a publication
around it.
And even the process of peer review becomes more enjoyable to you because you get those
revisions back from the editors and the reviewers and you go, I didn't see it that way.
That's a topic for the next paper on this, right?
It allows you to enter it with a sense of curiosity.
And that's what academia, I think, really rewards is the people who want to play around
with their hobbies.
They want to play around with 3D printing.
How could this change my practice?
AI, that's cool.
How did it change my practice?
Those individuals who have that sort of curious growth mindset, that's really all it takes.
It's not necessarily having a PhD to provide you all of the skills from the get go.
It's having that curious mindset.
Thank you.
One thing that comes up for me is your, actually there are two things that come up.
And I wonder if you can speak to them maybe at the same time or we can do them one at
a time.
But one thing is you did something that many people have not been able to successfully
do.
You turned something that you're really passionate about education into academic currency.
Can you speak to how you did that?
I think that where there's a will, there's a way.
I would find it extremely hard to believe that somebody who can navigate high school
and it's stress and college and medical school and residency that is such, you know, I mean,
it's really the crescendo I think in terms of difficulty and responsibility and get to
a situation like this now where you're doing something as part of your role, as part of
your professional identity.
And not be able to turn it into currency.
In fact, I think that you get to this point and it's really about you believing that the
goal is worthwhile.
If you believe that the goal is worthwhile, I truly believe that we are creative enough.
We are determined enough.
We are stubborn enough to figure out the way to align what we're doing with the language
that's necessary for currency.
Of course, there's work that has to be done, but that work is done because the goal is
worthwhile, right?
Once it became important to me to put currency around this, then I sat there and did a literature
review, right?
Like I went into PubMed and Google Scholar and actually looked at what had been written
and what angles had been taken.
And I mean, everybody who's written on the topics of e-learning, people who have written
on the topics of resource-adapted care, they all at the end of their manuscript will have
some printings about next steps, which most of the time they didn't get to, right?
And so you get to be the one that adds to the body of literature by incorporating some
of those next steps into your work.
And also you get to benefit from their hard work by not having to make all the mistakes
yourself.
You can kind of use some of the methods that they have used, of course, giving appropriate
credit so that you're able to do your work efficiently.
But I think the real key to being able to make that transition, especially with educational
work and transitioning that into currency is believing that it's a worthwhile goal.
And I think that it is.
I think that it is because it does give you, number one, the credibility that what you're
doing is evidence-based, that what you're doing is in fact something that does no harm
because that's what peer review does, right?
It allows people to look into your work and critique it and make sure that it is ethical.
It is a buzz board.
The IRB is looking at this.
I think the ability to do, to create publications out of our work and research out of our work
is also a way for us to establish ourselves as experts.
There are hundreds and thousands of people who are doing e-learning programs.
I am probably not even in the top 10 or top 100 or top 1,000 of the most hardworking or
the smartest, right?
But if you are, unfortunately, quiet about what you're doing, then it's a step you didn't
do it at all.
That's the unfortunate thing.
And so you get to establish some expertise.
And if you think about it this way, you're not becoming an expert for pride or ego.
You're becoming an expert to help other people who are interested in doing similar work make
fewer mistakes the next time around.
You're becoming an expert so that people who are looking for the kind of problems, kind
of solutions that you're solving can now access that through your work.
So I think that that provides that.
But I also say one important thing to think about is that time is limited.
Time gets more limited, I feel like, every year.
And so with academia, they want you to be visible to that.
You're a clinician.
You're an educator.
You're a researcher.
And so if you are able to kind of be synergistic in the way that you work, so your education,
check that box, is also research.
Check that box.
You're actually sort of streamlining your workflow.
And then things start to feed into each other.
In my case, since my education and my research and my hobby were all kind of lining up, it's
like, okay, this was also a way to refresh myself and be rejuvenated by my work, as opposed
to feeling like I needed to engage in scientific projects that were very highbrow and serious.
For the sake of highbrow and serious, even when I didn't love them, I could do something
that I loved and get maximum benefit out of it on multiple fronts.
So you talk about this kind of the energy that comes from doing this work, the ability
to layer it on top of things you're already doing.
And it makes me wonder, there are other projects you were doing before you really started taking
the education and creating academic currency out of it.
How did that shift the focus of your work?
To what extent did you continue to do the other work?
And what was the difference in energy in the work you were doing before compared to the
work you now started to push forward?
Yeah, I think that's a great question.
When I started to do this, it was very slow.
Even getting it published the first time was very difficult, right?
There's just sort of multiple rejections and the editors couldn't quite, I mean, I'm talking
death rejections, like you send it and within 30 minutes, they're like, nope, thank you.
I didn't have a clear enough idea.
They didn't have a clear enough idea.
And so between the first death rejection and the second submission was actually a good
six months.
I restructured what I was doing, right?
So it was very slow.
It was a very slow ramp up.
And so the other projects I was engaging in, I continued to kind of engage in them all
along.
And then I will say it's sort of nothing, nothing, nothing, and then everything all
at once, right?
It happened that the next submission came right after COVID when suddenly learning
was the thing.
It was very, you know, it was just, it was just the, I guess, the global mindset at that
time.
And then what happened with that is because it was something that globally was of interest,
we now had, I now had editors that would reach out and say, would you review this paper,
right?
Or would you write an editorial or an invited article on this particular subtopic of the
work that you're doing?
And so initially it was very slow with this work and I could continue to engage with the
other work that I was doing.
But at the point where I decided to apply for grants, a foundational grant for this
work, a foundation grant for this work, I knew that, I mean, just the grant writing
process itself, right?
Like I did not have a master's degree.
I don't have a PhD.
I've never done it before.
The process of trying to write a grant, I had to slow down just about everything else
that I was doing to learn this, right?
And so everything else at that point actually, I would say I froze it.
And I started to go very seriously to grant writing.
Now when I submitted the first grant, which I did not get, and the second grant, which
I did not get, and the third one, I think I got the third one.
Maybe I didn't get the third one.
Might have been the fourth one.
But each of those, each of the comments that came back from all of those grants showed
me where I had gaps in my research.
So they gave me additional topics in this work that I could then explore to publish
papers on to strengthen my next application, basically, which may be the hard way.
I don't know.
Maybe I should just have kept applying to more grants more frequently instead of trying
to actually respond to what reviewers were saying.
But it actually allowed me again to build that credibility as I went along.
And so at that point, once I got to the point where now I'm applying for grants, I really
did kind of stop the other things that I was doing.
Once I got the first grant, and in the process of doing that, of course, you have collaborators
that you've now built around you and mentors you've built around you locally at your institution
and nationally and attached to the grant itself.
It felt more like the work was more shared.
And so it was now easier for me, I think, to start to pick back up some of the other
topics that I had dropped.
And I think that that's a decision each person makes is do you want to just be 100% in this
particular field?
Are you interested in still being the multi-faceted researcher?
I think that depends for everyone.
But I did become more selective about asking people, what is it that you would need from
me on this project?
And what is the timeline on this?
So that I could be more careful about how I was able to distribute my time and what projects
I was really going to truly be able to invest in and contribute to in a way that was beneficial
for that team.
Wow, I see a lot of kind of strategy, strategic investment and focus when it was time to do
that.
And then once there was a cadre of people involved and working collaboratively, you
could let go of some of the heavy lifting to go back into some of the other work.
So it sounds like kind of selective to zooming in and zooming out as needed.
Yeah, I like that.
Zooming in and zooming out.
I like that.
Absolutely.
And I did this.
I listened to a lot of podcasts and read a lot of books.
In fact, most of the time I wasn't even reading books about academia or research.
It was probably about strategy and maintaining different skill sets and strengths.
Because there are strengths that I have and there are strengths that I don't have and
learning how to find the right collaborators for it.
There are teams on which, you know, they probably consider me a great co-author.
And there are teams where I probably just did not bring value because the role that
I was offered was not one that matched my strengths.
And so that was a big part of it for me was if I have limited time, can I spend some time
on strategy instead of just trying to spend all the hours on doing work, right?
It's that whole mindset of are you just a worker being or are you also able to be the
queen bee or are you also able to be the manager of your own work?
It's not just about, and this happens, the busier you are, the more projects you have
going on, but easier it is to just default to to-do list and just think, I just need
to work, you know, 16 hours a day, 18 hours a day, just more work, just to check things
off.
But there's a lot of benefit I've learned in actually zooming out, like you say, and
saying, do I need to do this at all?
Or can I offer this team a different role that I could play that's going to match my
strengths a little bit easier?
It'll be faster for me and it'll be better for everyone involved.
Are there things that I can just completely move to next year?
Are there things that I can delegate?
Are there things that are synergistic?
Are there other collaborators I can invite into this work that will flip the load?
And I think that was a huge, huge, huge factor in terms of not getting lost in the week.
That's really powerful.
One of the things I want to highlight that you mentioned right now and you actually talked
about earlier is really the importance of strategy.
Because as clinicians who are so busy clinically, and I think there's no clinician who doesn't
understand how busy clinical work can be, for you to be able to do what you described
early in layering, like this is my clinical work and I'm going to layer that on top of
my academic work and layer that on top of a hobby I'm going to be doing anyway, is strategic
use of your time.
But then also thinking about how can I strategically bring people into this project so that I'm
not doing all of the heavy lifting?
And I think that's so critical in the sense that clinicians are not PhD scientists.
And it's not that they cannot be.
Given all the time in the world, we absolutely could be.
But if we're coming to research a little bit later in the game, which most clinicians are,
then we have to think strategically about how do we build it on top of and in spite
of all the other things that we're doing?
And I think you highlight how to do that really effectively.
Well, thank you.
I think it sounds so much cleaner in retrospect than it felt in the moment.
It felt really messy.
And you know what, that's worth saying.
It felt messy.
It felt like I was pulled in a million directions.
And there's probably the people who were more strategic than I was who could have done it
in a way that was more seamless.
But I do encourage those for whom it does feel messy.
That doesn't necessarily mean you're doing it wrong or that it won't be successful.
If that adds with anything else, you're developing the skill sets that allow you to make each
iteration better, more organized than the previous one.
And one of the things I ended up learning were what are the tools that are available
at my institution?
And there were a lot of them.
There is a grant writing office that will assist with reviewing your grants.
Most of it is just editing, right, not necessarily scientific writing.
But that was helpful because then I don't need to sit there and parse out whether this
needs a comma or semicolon.
We can leave that.
We can just get to the meat of what needs to be discussed.
So really figuring out what tools were available that I could harness was helpful.
I reached out to people who had previously been awarded the grant that I was going after.
And they were so kind and shared components of what they had written with me and mentored
me through.
And we became friends, right, because they were applying for other grants down the line
or they were trying to work out a research question.
And they would run that by me.
And so it actually, again, becomes synergistic because it's an area of interest anyway.
And so reaching out to those people, they become your friends, they become your collaborators.
We've now collaborated together on other projects.
Really thinking about what do I have in my toolkit?
And that includes people.
What people do I have in my toolkit?
What resources are my institution?
What resources do I have from the research training class that I took in medical school?
What can I find from there?
You have a lot more than you think.
Tell me about mentors who supported you in this process.
Well, that's a great question.
I think that I had sponsors more than I had mentors, but I didn't realize it at the time.
So I had a department chair who saw this vision from day one.
And she just would talk to me about what did you do this weekend?
I was recording videos and she would go, have you applied for that grant?
Yeah.
She just saw this vision from the beginning.
And I think that that push was really important.
I think when I now got to the point where I was applying for the grant, because I wanted
to have more flexibility in my schedule, that's another reason to make the transition.
If you do have grant funded work, typically that protects your time.
You have more flexibility in your schedule.
When I went to go do that, that's really when I realized, oh, she's a sponsor.
She's not necessarily a mentor.
She's not necessarily the person who's going to line edit the work that I'm doing.
Just too busy.
She's got too many things going on.
But again, I think once you believe in the goal, which she did, it's such a motivator
then to figure out all the things between here and there.
I also had sponsors who were interested in the big picture of how can we get radiology
more interested in global health, period.
And so they weren't necessarily sold on what I was doing.
They didn't know anything about what I was doing.
But they overall had a belief that this was important.
And their skill set around just what I would call bench research, more of the true clinical
translational research, but in global health, allowed me to modify my work to have the kind
of hypothesis that you actually need for a grant application, but you may not necessarily
see in educational projects.
And then I would take for mentors.
Yeah, that was a big one.
So those sponsors, there was the head of education for our division, heard of my work and said,
I think we need to put a better research question around this.
Let me introduce you to other people who are doing educational research.
And so they helped connect me with the kind of mentors who had done similar things that
then became my collaborators.
So they then mentored me on different aspects of the project.
One of the biggest things for me, specifically, because global health, is that some of my
mentors are global experts.
So I don't want to say local experts, but in-country experts, right?
I consider them to be the experts that guide the work that I do.
And often they are so busy clinically, they are extremely busy clinically.
There's one radiologist per million people in sub-Saharan Africa, one radiologist per
million.
Some countries have zero specialty trained radiologists.
So they are juggling the entire country in terms of clinical volume on their back, but
they are experts in what they need.
And so you are helping to be the arm that writes out and executes some of the projects
that they think are going to be super impactful.
And so they were extremely helpful as mentors, even though they could do the clinical science
writing piece, they were extremely helpful as mentors in terms of defining the work that
I was trying to do, making sure that it made sense and it had been critiqued and was likely
to be successful.
And then of course, in actually helping to make it successful when we launched.
Thank you for that, Thoma.
What I'm hearing is that you really pieced your mentoring together from as many people
as possible.
And I think it speaks to the experience of many clinicians who don't necessarily have
the one mentor.
And for what you're talking about, you're creating something new.
And I think many clinicians are doing the same.
They're not following a tried and true path.
And when you're doing that, there's not one person who's going to rise to the floor as
the expert that I'm going to go apprentice and they're doing apprenticeship in their
lab.
And they are taking what you need.
So I want you to just speak about what does it take?
What does it take to be the kind of person who knows what, who goes after what you want,
who knows you have to know what you want, right?
And then the person can go after it.
And it takes, I think it's a special skill and strength to do that.
And can you speak to how you develop those strengths to be able to figure out what you
want and go after it in different people?
All of those strengths, they all have terrible names, right?
The strengths are things like stubbornness, you know?
You know, it's probably, I guess we could say it's...
We have to be careful not to be egotistical about the work that we do.
But you do have to believe strongly enough that there is importance to the work.
It doesn't have to be about me, but it's important for this work to get done.
And it's important enough for me to bug somebody about it.
It's important enough for the people who benefit from this work for me to be humble enough
to open myself up to mentorship from all of these sources, right?
Because these mentors are not necessarily friends, right?
So you have to have that skill set of flexibility and adaptability.
Like here, the pearls you're getting through whatever format they're being given to you,
it's not a situation where you can build all of the depth of relationship maybe that would
allow you to be coddled and get lenudged and all of that.
You're working with people who have different expertise, they have different skill sets,
they're busy.
But being able to get pearls, being able to clearly define the questions you want answered
by this individual is helpful.
And so I think the communication with individuals could say, I'm doing this, I would love to
collaborate with you, can you help me with this, right?
It's really short emails, but very clear ads.
And some people would just say no, some people would just respond with like a paper they
had written and it's like, okay.
But even though in the beginning of pursuing all of these people, it can be a little unclear
as to how the relationship will take shape and how much benefit you'll get from it.
What ends up happening is that you're pursuing, people love that, people love a winner, people
love a winner.
People also love to be acknowledged for their efforts because they've probably been emailed
10 times in the last three months from all sorts of sources looking for help.
And so you being the one who comes back to say, hey, I bugged you about this, but here's
what I'm doing and I'm highlighting in the acknowledgement section of this paper and
I may be applying for a grant later that I think we could collaborate on or I could have
you as a co-walker on this paper if you want to work on this.
It starts to show them the fruit of their labor and then they engage with you a little
bit more.
So I think there's a component of this that is having thick skin in terms of how the information
is communicated to you, how those pearls come, how infrequently you may have contacts, how
much gobbling you have to do to get their attention to begin with, how persistent you
have to be around that.
But you all, I think, come back to them with gratitude and humility and this understanding
that this is going to be my life's path.
And so if I'm doing this, this is the only paper that came out of this.
Thank you for helping me get this far and this allows me to sleep a little better at
night.
So I think, I don't know if you could find the skills in there, but maybe you guys still
have some skills in there that folks could use.
I hear you talking about the importance of knowing what you want, the skill of being
able to clearly define it for someone else so that they're very clear on what you want.
And they can say yes or they can say no, but at least you're making it very explicit.
And then I also hear you talk about tenacity and also you talk clearly about humility and
coming back and letting people know how their help has advanced your work.
And I think those are all really amazing things.
I think that captures much of what you said.
What do you think?
I think you're absolutely right.
I think you summarized that beautifully.
So along the lines of all this amazing work you've been doing, big things are happening
for you.
What do you share with our audience where this work is going and how the big things
that are coming out of it?
I think that's all I can say.
Yeah.
So a lot of big things that I really didn't anticipate.
So once it was published, I had people reach out from Africa really interested in using
the curriculum, modifying the e-learning curriculum for sub-Saharan Africa.
And so we applied for a grant which was funded to modify this for sub-Saharan Africa.
One of my collaborators actually also helped us to create more sustainability around this
project in terms of doing not just the online learning, but what we call Project Echo, which
is a telemedicine where people show monthly cases, which I mean, a community now that
is so wide, we have people monthly who have joined from Zambia, Tanzania, Nigeria, Ghana,
Uganda, Rwanda, I mean, just all over sub-Saharan Africa using components of this curriculum
and this educational community.
And then as part of this work, and again, I think the benefits of building credibility
around this, as our institution itself decided to reframe its strategy for global health,
and they were looking for experts in breast cancer, the fact that I had publications
from this and I had a grant from this meant that I ended up getting an institutional role,
a director of breast imaging for global oncology to help create curricula and seminars for
different countries, Mozambique.
We have projects throughout the Caribbean, even in the United States, so now leveraging
institutional networks.
And the institution also collaborates with the World Health Organization and Pan American
Health Organization, which is the sub-regional office of the WHO for the Caribbean and Latin
America and collaborates with the International Atomic Energy Agency.
And so I get to kind of leverage the skill set and all the mistakes that I've made in
trying to help these international agencies both create programs for the countries that
they serve, but also better define the problems in those countries.
Because I can say, here are all the roadblocks I've faced working in X, Y, and Z country,
and that becomes something that helps to inform guidelines, right?
And helps inform further processes going on.
So I'm really not saying any of this has happened because I'm so brilliant.
I'm really all, it's a combination of all the things, right?
Certainly hard work, but also these collaborators who remembered that, hey, Tawna's doing something
in Zambia, so let XYZ person know that she is someone who should be considered for this
role, right?
So it just, all of the things snowballed, all of those same frameworks I put in place.
The fact that I was reading business books around strategy and while those business books
also had leadership skills, and okay, now you have a team that you have to lead, right?
I think all of the pieces that we put in place to do our work, as precursors that we are,
we're able to go back and use all of those same pieces to implement the work and to find,
I think, effectiveness in the work that we're doing.
So it's been great.
We applied for another foundation grant just earlier this year and that was funded.
In fact, they overfunded, they offered to fund more than we would even ask for, which
blew my mind.
But I think all of this is a testament to perseverance and having the teams around you
that may not be surrounded, you may not be surrounded by people doing similar or the
exact same, like you pointed out, so I'm not surrounded by people doing the exact same
thing that I'm doing.
But I'm surrounded by people who are so brilliant.
And the fact that they'll ask tough questions and they'll offer just tiny little pearls
or just game changers and the humility to try to pick up on those pearls and try to
act on them has made all the difference in my career and I'm very thankful.
So beautifully summarized.
Just you were doing all this work, you're not silent about it, you're making your work
known, you're reaching out for collaborators so people know what you're doing.
And when the time came to think about people who were doing this work, you came to mind
because you had really put arms and legs around your work.
You really had built currency out of it.
Yeah, the currency, it turns out that's important.
Well, I feel like you said so many amazing things.
We're coming to the end of the show and I just wonder, is there anything that you feel
has been left on the set that is important for the audience to know?
Because many people are trying to make this transition, feeling that it's so hard, feeling
that they're not supported and somehow you kind of have all of that in the back of your
story.
We didn't ask about your challenges, but I feel like many of your challenges came through.
But I wonder for someone who feels like, wow, this is hard, what are some thoughts that
you want to share in the closing?
One thing I'll share for some people that relates to kind of imposter syndrome, I think
when you're going into something new, as somebody who's been a perfectionist in most of the
other areas of your life and you have exceeded expectations in most of the other areas of
your life, going into something new can be extremely difficult because you're not good
at it.
And so you can spend a lot of time really beating yourself up.
And what that does is just create more angst around the work beyond the challenges that
you're having.
There's like the external challenges and now you're creating internal challenges that
make you want to procrastinate and not do the, I mean, it's just, it's this terrible
cycle.
I think that approaching this from a sense of gratitude was so wonderful for me.
I came in feeling as if I was hired to be a community-based academic.
I was hired to just work in the clinic.
And the fact that I get to do any of this is above and beyond what I would have imagined.
What a gift.
I didn't earn any of this.
I didn't go to get a PhD.
I didn't do any of the things that you normally would do, but I'm getting to do this kind
of work that some of the people who have the PhDs are doing.
And so when I came into it with that mindset, it created a sense of humility.
Yes, if I walk into a room and if you look, everybody there has a million titles and they're
all MDPHC and they've got, you know, multi-millions of dollars in funding.
I'm not walking in there thinking, whoa, it's me.
Look how unqualified I am to be in this room.
I walk into the room and I think, what a gift.
I don't know how I got in this room with these people, but I'm going to use up every second
of my time in here.
I'm going to ask every question.
I'm going to make every connection.
I am taking notes.
I am becoming friends.
I'm following them on LinkedIn.
I want to see their pathway.
I just walked in with the sense that, no, I don't actually deserve to be in this room.
I don't know how I got here, but you guys are, I mean, you're going to hear from me
now.
You know, now I'm in.
And I think it also made it more fun so that it was collaborative.
It wasn't competitive, right?
I'm not in this room thinking, look at what they have versus what I have.
It's like, look at what they have.
We could do this together.
And I think going in with that mindset is generous and it's a growth mindset that allows
you, I think, to really get the full juice out of the work that you're doing.
So beautifully said.
And what a great way to end the show.
I think it's coming at it with a sense of gratitude.
It just changes our whole perspective.
And so thank you.
Thank you for sharing that.
Well, everyone, you heard Dr. Thoma.
It is hard, but it is not impossible with creativity, hard work, and really pursuing
the right mentors and sponsors and collaborators so much of this is possible.
Dr. Thoma, I want to say thank you so much for being on the show.
Thank you so much for having me.
I really appreciate the opportunity.
It is our pleasure.
All right, everyone.
Thank you for listening.
We look forward to having you again on the next episode of the Clinician Researcher Podcast.
Wonderful.
Hi.
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