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.
Welcome to the Clinician Researcher podcast.
I'm your host, Toyosi Onwuemene, and it is an absolute pleasure to be talking with you
today.
I am here today to talk to you about the questions you should ask in developing your academic
success strategy.
Questions you should ask in developing your academic success strategy.
And the reason I want to bring you this episode, again, goes back to my early career experience
where I had no plan.
I came on the scene and I said, I just want to do research.
And when people asked, what exactly do you want to do?
I had no plan.
And they were like, well, how are you going to succeed?
I had no plan.
And how many manuscripts do you have?
I was like, oh yeah, I have three or four.
And I had no idea what that meant in terms of like what was acceptable at my career level.
And they asked me about grant funding and I was like, well, I haven't been successful.
I've applied for grants.
And what, although I had a desire to succeed in research, as many of us do, what I didn't
have was a strategic plan to accomplish that.
And you might say that, well, you know, your early career faculty, you had no idea.
Part of becoming a faculty member is developing that strategic plan in concert with a mentor.
So I would argue that it would have been helpful for me to at least have some plan before I
started.
Because if I had a plan before I started, at the least, I would have something to start
with.
I could always maneuver and change into something else as I've had to do.
And I believe many of us have had to do is to really, you know, move with the times and
be flexible and be able to pivot as needed.
But it would have been helpful to start out with a plan.
And so I want to talk to you about what that plan could look like.
Again, none of this is written in stone.
And if you decide that you don't want to follow any particular plan, you can just do what
you've already been doing and just go at it without a plan.
Or maybe you already have a plan.
And then you could see, well, to what extent does this plan compare with my plan?
And how could I, how could I incorporate some pieces of this plan to make my own plan stronger?
So at the end of the day, it will be helpful to you, whether you're starting with a plan,
no plan, or you're somewhere in between.
So, I'm talking very specifically about questions you should ask, right?
I don't have the answers for you, not in today's episode.
And you may have the answers or you may not.
But by understanding what questions to ask, it helps you clarify who do you ask the questions
of when you get the answer, what do you do with the answer?
Because one of the things about questions is that questions are so powerful in stimulating
thought in you, the questioner, but also in the person attempting to answer the question,
because then they have to give it deep thought.
They have to really think about, well, what is it about this that makes it this way?
Right?
And what it does is it gives you information.
Without that information, you are not able to make an informed decision.
But with the information, you're able to make an informed decision.
And at the end of the day, you could say, well, I know these are all the steps and I
don't want any of them.
Or you could say, huh, these are the steps and I guess I'm going to follow them.
But with information, you get to make an informed decision.
So question number one, and this may be the hardest question that you will ever have to
answer and it's hard because sometimes it feels like it's changing.
But the first question is who am I and what do I value?
Now your values are your values.
And when you take time to think about them, you recognize that you've been gifted a certain
set of values based on your upbringing, based on your family of origin, based on your environment
in which you grew up.
You've been gifted a set of values.
Everybody has values.
Everybody has a value system.
But it's usually like air.
It's like, oh, there's air or like fish, right?
Where two fish are going along and they find an older fish who says, hey, how was the water?
And the younger fish are like, what water?
Right?
So they're just inherent in our environment.
They're part of our makeup.
We don't even really think about them.
When we think about them is when our value system gets crossed.
And then all of a sudden we are left with the stark reality that there is a gap between
what we value and what is before us.
And then we have to be explicit or at least start to clarify what those values are.
And so you can wait until something is jarring and kind of rubs up against your value system
or you can clarify for yourself pretty early on what you value so that you can make decisions
in light of your values.
And so the first question you ask is of yourself, who are you and what do you value?
And it's a hard question because it takes a lot of deep reflection and thought for you
to really clarify for yourself what you value.
Now there are a lot of values exercises that are out there if you just Google values exercise.
And find out for yourself, do the work of clarifying for yourself what you value because
it helps you recognize what environment you will thrive in and what environments you'll
be challenged in.
And it's really important that you clarify for yourself what these values are so that
you can evaluate environments from the beginning.
For many of us, we talk about the issue of moral injury and medicine.
It's because the values of the organization sometimes are clashing with your own personal
values and you feel like you have to make a decision that does not respect your own
values.
And so not walking in line with your values can be injurious to you emotionally and mentally.
And so the very first question, and I would venture to say, do not pass code, do not collect
200.
That's referencing monopoly, at least in its older format when I played when I was a child
is not moving forward until you can clarify for yourself what you value because that drives
the decisions you make.
It drives the environments that you are in.
It also drives what you should and shouldn't tolerate or what you're willing to tolerate
or not tolerate.
So question number one is to ask yourself, who am I and what do I value?
Question number two is to ask the institution.
Now when I say ask the institution, I'm asking, I'm saying ask people within the institution,
right?
Because an institution is not a person.
It's a collection of people with its own value system.
Ask yourself, what does this academic institution value?
And that is a really important question.
Now, remember I said the academic institution is really referring to people who are the
custodians of the act of the values of this academic institution.
And how can I get them to tell me what the institution values?
Okay.
So there are people that you can think about.
Maybe you can talk to your division chief, maybe you can talk to your division director
or your dean or your chair, depending on who you have access to.
But one of the ways I find that's really easy to clarify really quickly what the institution
values is to find their promotion and tenure documents.
So if you find your institution and you just simply Google the institution, you can usually
find a set of documents that explain what the institution is going to promote and what
the institution is not going to promote.
And it usually will separate, especially in academic medicine, into tracks, whether that's
clinician educator track or that's basic science track or clinical research track.
And sometimes it's a tenure track versus the non-tenure track.
But in general, institutions clarify what is required for promotion.
I will tell you, it's interesting.
I did this exercise at our coaching meeting just earlier today and people were surprised.
They were like, well, nobody's ever talked about this.
No one said this is what is valued.
How is it that no one's talking about these things?
And it's a really important question.
I don't know why people are not talking about it.
This again, is part of the hidden curriculum.
But one of the reasons you want to know, you want to find your promotion and tenure documents
and you want to look it up, is to recognize that the institution has committed to paper
what they value.
Now there are things beyond the paper that they value that may not be made explicit,
but at a minimum, if you know what they're explicitly saying they value, it gives you
information.
What do you use that information to do?
Well, that information helps you.
Let's say the institution says, we will only promote people along the clinician educator
pathway if they have published 25 papers in the educational space.
And you're like, oh, really?
My promotion to associate professor is contingent on publication of 25 manuscript?
Wow, I'm in clinic every day.
How am I supposed to do this?
It's a great question because then you get to go and ask your division director, or maybe
it's your chair, and say, hey, here I am in this position that's, you know, I'm in clang
every day, but I'm hearing that I need to have 25 manuscripts published by the time
I go up for associate.
I'm just making up the number, okay?
It doesn't have to be 25.
I don't know.
Different institutions value different things or some institutions don't even say what the
numbers are.
But you recognize that it helps you have leverage to ask the questions of where will I find
the resources to be able to do the things that allow me to advance within the institution.
And then that's a question that people can help you answer.
And it's a question that can help you in your negotiations to say, well, if this is important,
I want space to be able to achieve this so that six years, seven, eight years down the
line when I want to go up for promotion, I'm ready to meet this particular specification,
right?
So, you want to ask the institution, and again, that's proxy for people, but even better or
easier, go find their promotion and tenure documents and clarify for yourself what is
valued so that you can plan a success strategy around what you value and how it aligns with
what the institution values.
Okay.
That leads me to question number three.
Ask yourself, how does what I value align with what the institution values?
So if you find out that there are two tracks, non-tenure and tenure track, and the non-tenure
track also has a requirement for 10 publications or more in international reputation to be
able to be promoted, ask yourself, well, if I'm coming here and I want to really be a
full-time clinician and I want to really have time for my patients and I want to educate
them, does this requirement for publications jive with what I'm thinking I'm coming here
to do?
And you want to ask that question so that you can answer the question.
It may be that you say, well, I don't really want to do that, but 25 publications or 10,
sure, I can make that happen.
Or it may be that you say, no, I don't want to do that.
I'm just here to see patients.
I don't want to worry about publications.
And it could be that you make that decision and you decide, I don't want to go up for
promotion.
It's not what I care about.
And that's okay.
The key is that you have information that allows you to make decisions intentionally.
What you don't want is where many people find themselves is where they're like, oh, here
I've been here for eight years.
I am now ready to be promoted because my peers around the country are getting promoted and
what do I need to do?
And then they pull up this list of requirements.
It's like, oh, 10 publications.
And you're like, I've published nothing because I didn't have space to, and then you didn't
intentionally make the decision to not be able to be promotable because you didn't have
information.
And so clarify for yourself to what extent do my values align with the values of my institution
and can we bring them together to create a career that is meaningful to me?
And that is one of the things you think about in crafting your success strategy is how do
I layer my values over what the institution values to create a niche for myself where
I can succeed and feel as if I'm also moving forward the things that matter to me.
Okay.
Number four is to ask others, how have you succeeded here?
Now it's one thing to say, oh yeah, great.
Of course I can make 25 publications while also seeing patients five full days a week.
It's another thing to go find the people who've been promoted and say, hey, how did you succeed
here?
How did you do this thing?
How did you make the requirement even though you're so clinically busy?
And it's so powerful to have these conversations because people will tell you what it costs.
And that is one of the keys to being strategic about your success.
It's one thing to say, I want to succeed in this way.
It's another thing to be ready to pay the price for what it takes to succeed in that
way.
Now, when I talk about paying the price, you know well, because if you're a physician,
you went through medical school, you knew what it would cost you to get into medical
school and you went and you paid that price.
You shadowed a physician, you did a little bit of research, you made sure you had your
extracurriculars well, all together.
You went and did bio 101 and chemistry and you did all the things that you needed to
do.
You paid the price so you could get into medical school.
When it came to getting a residency, you paid the price.
You did research in your specific area.
You know what it takes to succeed when it comes to going through the training process.
It doesn't stop when you become a faculty member.
You got to know what the end goal is.
And then you go back, you ask people, what did it cost you to get here?
It's what you did when you were training or when you were trying to get into training.
You ask the people who've been successful and you say, how did you do it?
And they tell you and you're like, okay.
And you ask enough people, you have a pattern of what success looks like.
And then you can craft your own plan based on that.
Or you can say, no, thank you very much.
I'm not doing this thing where for my 20s, I'm going to be doing 10 years of training.
No thank you.
You can make that decision.
But you want to have the information to make that decision.
You don't want to be blindsided by it or come to the end of a period of time and realize
that you don't have the resources you need or that you didn't pay the price that would
allow you to get to the place that you wanted to get to.
So ask other people, how have you succeeded?
So you recognize what price they paid.
And that brings us to question number five.
Ask yourself, am I willing to pay this price?
Am I willing?
Now I, for whatever reason, had this erroneous idea that I was going to become an attending
and life would be easier because medical school is hard and residency was hard and fellowship
was hard too.
And so there was this thought that I'm going to become a faculty member and it gets easier.
And I'm not sure where I got that thought from, but it didn't get easier.
It was super hard.
And maybe part of the hardness or part of why it was so hard was that I didn't have
clear expectations about what it would look like.
And sometimes part of this is setting our expectations to say, okay, I thought that
there wouldn't be another price to pay, but it seems as if there is.
And I've talked to enough people now who said, this is where I am and this is the price I
paid to get here.
This is where I am and this is the price I paid to get here.
And then you ask yourself, am I willing to pay the price or do I want life easier?
And here's a challenge in medicine, there's no easy path.
Sometimes I hear people saying, well, I'm just doing research because that's the easier
path or I'll just be a clinician.
That's the easier path.
And in reality, no path is easy.
All of them are pretty challenging actually.
And the question is, what do you love enough that you're willing to pay the price for it?
And you ask yourself that question so you can answer it and you can face the price head
on the same way you face the price head on as you were trying to get into medical school,
the same way you face the price head on as you're trying to get into residency and fellowship
if you went.
But you want to know what it costs and then you want to ask yourself, am I willing to
pay the price?
And if I am, what will I do to pay it?
And if I'm not, what else do I want to do?
Okay.
Number six is to ask others, what would you do differently?
So for those who succeeded, they've succeeded, but there are things that they wish they did
differently.
But you also want to ask others who didn't succeed, who may have left, and it doesn't
mean that leaving means they're not successful.
Just people who chose something different to ask them, what prompted your choice?
Why did you make a different move?
And so in asking the first group, you're saying, well, what did you wish you had done differently?
And there's a lot of learning that comes from that because even though you're looking ahead
and you're saying, okay, I want to pay the price, what you want to do is you want to
pay the exact price, you don't want to pay more.
Now, if you want to leave a tip, that's up to you.
But what you don't want to do is pay a crazy price.
And at the end of the day, you're like, this was not worth the price I paid.
And so people who've gone ahead of you who've paid a price can say, you know what, I did
pay this price, but here's how I would have done it differently.
And I wouldn't have had to pay as much of a price as I did.
Or you talk to people who left and succeeded in a different way, who say, well, this was
the place I came to where I decided the price was now too great for me to pay.
And again, all of this allows you to be informed in your decision making so that you can develop
your own academic success strategy.
And by knowing what people would do differently or what people or choices people made, it
allows you to craft a plan that is coherent and cohesive with who you are and where you
want to be, how you want to live within the academic environment if you so choose to stay.
And the final question to ask is of yourself.
How will I successfully navigate this environment?
Because now you have information.
Now you're clear about what you value.
You're clear about what the institution values.
You've had an opportunity to ask others, like, how does this work for you?
Or how did this work for you?
You have an opportunity to ask yourself, how did my values align with the institutional
values?
You've asked others who succeeded at the institution.
You've asked yourself, am I willing to pay the price?
You decided to pay the price.
You figured out from others who've done it differently how you're going to tweak the
way the price is paid.
And now ask yourself, how will I successfully navigate this environment?
And that forms the basis of your crafting a successful strategy.
Because now you're informed.
You're not clueless.
You're not wondering.
You're not dependent on only one person to tell you because you've done the work.
And I may hear people saying, well, I don't have time to do all of this.
I want to just challenge and push back a little bit and say, you don't have time to not do
it.
You don't have time to not figure out what will help you succeed.
There are too many people who are burned out in medicine, too many people who hate their
careers but continue to trudge on anyway, too many people who are disenchanted and disconnected
because they just went with the flow.
And I think I've said it here before, an untended garden is chaos.
That does not look beautiful.
And the people who have beautiful gardens, whether they did it intentionally or they
didn't, they created an environment where the garden could be beautiful.
And so if you're going to have a career that you appreciate, that you love, where you're
not burned out and angry all the time or bitter or wishing that you chose a different career,
then it's time to step up and collect resources that allow you to create what you want, what
aligns with who you are, what aligns with your values.
So I want to invite you today to think about which one of these questions can you answer
this week?
Because there's always something taking up your time.
You're busy.
You're so busy.
But instead of trying to answer all seven questions this week, what about you just ask
yourself one question or ask somebody one question and see how that impacts your ability
to start successfully strategizing your career.
And I'll summarize what those questions are again.
Number one, you ask yourself, who am I and what do I value?
Number two, you ask, what does the academic institution value?
And you'll typically get that through promotion documents.
Number three, you ask yourself, how does what I value align with what the institution values?
Number four, you ask others, how have you succeeded at this institution?
Number five, you ask yourself, am I willing to pay the price?
Number six, you ask others, well, what would you do differently?
Or you ask people who've already left, what made you make this decision?
And then finally, you look at all that information and you say, well, how am I going to use all
this information to successfully navigate this environment?
So pick one question today, one question this week, ask it and see what answers you get
and think about how that helps you to begin to already intentionally, strategically craft
your success strategy.
All right.
It's been a pleasure talking with you today.
Thank you so much for tuning in.
I look forward to talking with you again next time on the Clinician Researcher Podcast.
Thank you for listening.
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