Don't let fear hold you back from learning

0:00 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.

0:40 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 today's episode of the Clinician Researcher podcast. It's a pleasure to be talking with you today. Thank you so much for tuning in. I'm excited to be talking today about fear, fear in academia, and the importance of banishing fear. Specifically, I'm talking about not being afraid of what you do not know, do not be afraid of what you don't know.

1:24 The reason this episode comes is because of a recent conversation I had with a young person, early career, and this person is still a trainee. I remember we were talking about a paper that this person's writing, and this is their first paper, and I forgot that. You know when you've done a lot of writing or you've published a lot of manuscripts, at least relatively speaking for me, and I forget what it is like to write that first manuscript, how hard it is, and how little time we have to dedicate to that manuscript because dedicating time to writing is not what we do. I forgot that. And I remember I was saying, great, so this is where you are right now, what I need is a title page and I need an outline.

2:09 And then I paused and I was like, oh, wait a minute. Someone hasn't done this before. And not in a bad way, not in a judgmental way, but as a reminder to myself that wait a minute, if someone hasn't done this before, you can't have an expectation that they know what to do, and my job is to step in and to give them resources to be able to move forward. And I think it's so important that I was able to acknowledge that, especially because I think in that moment, this person was feeling like, well, I should know. I mean, clearly I've come very far in my education and in my training and how can I say I haven't done this before?

2:51 And so they didn't want to ask me questions because they were expecting that they should know the way we behave in medicine where we're like, well, we don't know, but we're going to go study about it when you'll find out. And then we're going to come back and know. I just want to say that that's not healthy. The whole idea that you should go to a corner and find out all the answers before you come out. To be honest, there isn't even time for that. We need help and we need help now. And we need people to help us cut short the time. So all the time we invest in going to look stuff up, we need to cut it short by just asking questions. And so that fear, the fear of being judged, the fear of shame, the fear of not knowing and being exposed for not knowing overwhelms so much of what we do and keeps us focused on what we already know and keeps us hiding and running away from the things we do not know.

3:46 So I want to talk about why we or the strategies that we need to help us really grow and expand. One of the things I talk about quite often is that clinical training is not research training. It absolutely is not research training. And I don't care if you had two whole years of fellowship time, nobody has two years, maybe you had 18 months of fellowship time to do research, that's still not really sufficient research training time. PhD researchers get at least six years just in the course of doing their PhD. And okay, so they'll say, okay, it was not exactly six years, but just the bottom line is not the number of years. It's that those who get training to do research get a lot of years invested in research.

4:31 And after they do their first degree, I mean, they get their PhD, then they also do more, and then they do more, and then they do some more. And so it takes a long time to learn to do research well. And if you're a clinician who's done all the things, you've gone through your clinical training, even if you've done your fellowship and you had time to do research and fellowship, you still don't have near enough research training. And this is not a ding against MDs or those who are only clinically trained. It's just saying, hey, you don't have the skillset and that's okay. What you're going to do is grow the skillset, but you can't be ashamed of not knowing what you were not taught.

5:14 And you cannot live in fear that someone's going to expose you for not knowing because you're not supposed to know and it's okay. So I want to talk about seven things specifically that can hold you back from growing in the way you're supposed to grow as a scientist, as a researcher, especially when you don't have the strong foundation of training that someone else's your counterpart might have. The first thing I want to share is that you have to banish shame. And I don't want to say you have to, should, or these terms that might suggest that you must do something. I'm saying that if you're going to succeed, shame cannot be part of your picture, not at all.

5:55 See, the thing about shame is that shame is a trick. Shame is a trick to keep you from growing and expanding in the way you should. It's a trick. How can you grow if you're ashamed of what you don't know? How can you ask questions when you're ashamed that someone's going to figure out that you don't know? But in reality, you don't know. And it's okay that you don't know. It's okay. But shame is a trick because we're ashamed that someone's going to find out that we don't know, meanwhile, they kind of already know that we don't know, or maybe they don't, but we don't know. And so we're hiding something that's true, but is nothing to be ashamed of because the fact that we don't know opens up a door of opportunity for us to know.

6:41 And it gives the person before us an opportunity to help educate us if they choose. And in medicine, there is a lot of judgment. So sometimes instead of educating us, people may actually say things that are hurtful. And that's happened too. But it does give them an opportunity to say, oh, you don't know, let me help you learn. And I would venture to say that many people around you have that heart, have that desire to help you. Once they figure out you don't know, they do want to help. But most of the time, we're so busy being ashamed of what we don't know. We don't give people opportunity to help us. And that is why shame is a trick.

7:21 Shame tells you that you are protecting your self image. Meanwhile, it's holding you back from getting the help that you need. And so I want to encourage you for whatever reason you're like, well, I'm not very good at writing any scripts. I don't even know how to write a grant. Don't be ashamed of that. Of course, you don't know. You weren't taught. It wasn't part of your training. No, you don't know how to write a grant. That's okay. And you can be like, well, my mentor tried to show me. No. It takes years to learn to know how to be a good grant writer. It takes time to get really good. And yes, you may have written one or two grants in fellowship. That's not near enough experience to get really good.

8:03 Look, this is not you. It's not your fault. You're not a bad person. You're not obtuse. You're not dense. You are somebody who really wants to learn and you have not had opportunity. Here's the other thing. You're a great learner. You are great at learning, getting good at skills. You're great at that, if given the opportunity. And so don't be ashamed of what you don't know. You just don't know and it's okay. Imagine a kid who's trying to learn to walk and we're yelling at them saying, I can't believe you can't even walk. What's wrong with you? We don't do that. We don't do that. We encourage them. And we say, hey, good job.

8:47 We encourage them. If they're crying and we're like, hey, kid, it's okay. Let's do this again. And so it is so important that we do not allow shame to keep us from growing and expanding in the way that we need to. The second thing I want to share is that it's time to remove judgment. And I'm not just talking about judgment of others. I'm talking very specifically about judgment of yourself. It is time to stop judging yourself. We look down on ourselves and we're like, I can't believe I don't know how to write a paper. I can't believe I don't know how to write a grant. I can't believe I can't finish this on time.

9:27 I can't believe I can't make the deadline. And it's like, no, it's not expected that you start writing grants today and you know that, wow, this seemingly small application actually has 25 pages to it. It's not expected that you would know if you've never done it before. And every time you look at yourself in judgment, you shrink under the weight of that judgment. So it's not just others that judge you that causes you to shrink. It's you judging yourself that keeps you from thriving in creativity. Encouragement helps you do better.

10:09 And there is no greater space for that encouragement than you. And sometimes you're looking at your mentor to encourage you and they may or may not. But we don't need to wait for the mentor to encourage us. We don't need to wait for somebody else to encourage us. We are the ones to encourage ourselves to stop being self-deprecating, to stop calling ourselves abusive names, to stop saying, oh, if only I knew better. It's just not helpful. It's not helpful. Criticism doesn't help anybody grow and criticizing yourself is a problem because it doesn't give you room to thrive. And so one of the most important things you're going to do if you're going to succeed as someone who has not done this before, who's not written papers, who's not written grants, who has not submitted proposals before, figured out what proposals to submit, is to remove judgment from yourself and to just accept what is.

11:11 Like, oh, okay, I haven't done this before. I'm going to need to do this for the first time without judgment, without criticism, without harshness. I'm just talking about not judging ourselves. But I'm also talking about not judging others. And this is something that, oh my goodness, was so hard for me to learn because I would look around at the people around me and I would say, you should have helped me. You should have known I didn't know this. You should have given me more of your time. And honestly, nobody owes me anything. Anything I receive from everybody, from anybody around me, mentor, division director, dean, all of it is a gift.

11:54 And if they don't give it to me, they don't have to give me any gifts. But if they do, I am grateful. And if they don't, I don't judge them for it. And the reason we have to let go of judging others is because, to be honest, judging others is a sign of how harshly we judge ourselves. Yep. And if we would let go of judging ourselves, then we would let go of judging others as well. And so I want to invite you to stop judging yourself first. But I also invite you to practice not judging others as well, no matter how badly they behave. Take whatever they give you as information.

12:34 Use it to make your next best decision. Okay, this mentor tends to yell a lot. Okay. All right. Don't be angry. Don't be mad. Just decide, are you going to stick around for it? Are you going to find yourself a new mentor? How are you going to work yourself out of the situation? Just use it as information. But remove judgment from your experience. It doesn't help you. The energy of judgment doesn't allow you to move forward in the way you want. It actually inhibits your learning. So remove judgment if you're going to advance in the space of your academic growth as a researcher. The third thing I want to share is that in as much as you're no longer judging yourself or others, don't accept others' judgment of you.

13:21 Okay, it's medicine. There's so much judgment everywhere. We judge each other so badly. But in reality, anybody can say anything and if you don't receive it as such, then it didn't happen. If somebody looks at you and they sneer and you don't accept it as a sneer, then it just it's like it didn't happen. If somebody says something that's a judgment against you and you don't receive it as a judgment, it's as if it didn't happen. And so don't accept judgment from other people. Let's say you've never written a manuscript and you write one and it's not a great draft.

14:01 You don't even know how bad the draft is, but you wrote the draft and you're like, oh great, well, here's a draft. And you present it to someone who's mentoring you in this area and they say, this is terrible. Don't accept the judgment. Say, okay, it looks like this could be better. Don't accept the judgment. Don't accept the shame that comes with the judgment. Don't accept the feelings that come with the judgment. Just say, oh, okay, well, I thought it was good, but I guess not. Okay. Don't accept the judgment. Don't accept those negative feelings that make you feel like I will never do this again. Why I will never put my foot forward in this way anymore.

14:44 Don't do that. Don't accept the judgment. People have judgments and for better or for worse, maybe they're trying to help us improve in medicine, we haven't always learned how to encourage people. But no matter how people come at you, if it feels like they're saying something bad about your work, don't accept it. And here's the flip side of that though. It's easy to say, don't accept the bad judgment, but don't accept the good judgment either. Don't let someone look at the very first manuscript you've ever written and tell you, this is fantastic. Don't accept that either. And what do I mean by not accepting that? Don't just say, oh, okay, great.

15:25 And pat yourself on the back and feel good. Say, oh, okay, what's great about it, right? And by not accepting judgment, what you're asking for is unbiased feedback. You're like, no, no, no, don't tell me it's great. Don't tell me it's terrible. Tell me how to make it better. Tell me how to improve it. If it's already great, as you're saying it is, well, tell me what's already good about it. So I know what to do again. Because you're not here for praise. You're not here for criticism. You're here to grow. That's it. You're here to grow. And what helps you grow? Feedback that is actionable. End of the story. Terrible. That's feedback that's not actionable, not useful. Don't accept it.

16:05 Amazing. That's feedback that's not actionable. Don't accept it. And by don't accept it, I'm not just saying just block it out of your ears and say, la, la, la, la, la, la, la, la, la, la, la. I can't hear you. Don't do that. But ask questions. Don't settle for what they told you. Like, OK, I hear that you don't like it. What is it about it that you don't like? Or I hear that you think this is really amazing. Tell me what it is about it that could make it better. Right? You're asking for feedback that's actionable. It's the only way you grow. Don't take any of it personally. But don't accept what they give you without pushing back and saying, I can see that this paper is annoying.

16:46 I can see that. Tell me how I can actionably, reasonably improve it. Push back and let people give you feedback that's actionable. And if you are in a situation or in a mentoring relationship where your mentor cannot give you feedback that's actionable, that is not a mentoring relationship that you want to continue in, no matter how amazing that mentor is on paper. Any mentor that cannot give you feedback that's actionable, that allows you to grow, is not a mentor for you. They may be great and give other people actionable feedback, but if they can't give you actionable feedback that you can grow, they are not the mentor for you.

17:27 So do not accept the judgment of others, whether good judgment or bad judgment. The fourth thing I want you to share is that it is so important for you to prioritize learning. And this is why we do the work of removing the shame and the judgment associated with this whole process, because we're here to learn. We're already really good clinically. We spent 10 years doing the clinical stuff. We're good at that. What we're not good at is writing papers over and over and over again, shepherding them through the manuscript publication process. We're not that great at writing grants. And that's okay. We are getting better, but we're not the best yet.

18:08 So we prioritize learning. We prioritize learning, and that's why we remove all the stuff that keeps us from learning so that we can learn, so that we can improve. We're not improving to impress other people. We're not. We're improving so we can grow. We're improving so we can grow and start to stand independently by ourselves to do this work. So we don't need to come every day to the office to say, mentor of mine, please edit my work. Right? So that we can do it on our own and get to the place where we can actually teach others so that they can do the same as well. So we can reproduce the skills we have in others. So prioritizing learning is so important, and that's why we reject the shame that keeps us from asking the questions that allow us to grow.

18:54 We reject the judgment that keeps us from getting feedback that's actionable. We reject judging ourselves so that we can thrive so that we can prioritize learning. At the end of the day, this is about our growth. We're already good at other things, but if we just stayed at what we were good at, then we would just be one-sided. But we want to expand. We want to have skills that we didn't have before. We want to be able to write in a way that's compelling. We want to be able to sell our science for better or for worse. We want to be able to write a six-page research strategy and get a couple of hundreds of thousands of dollars.

19:34 We want to be able to do that well, and therefore we embrace the opportunities to learn. The fifth thing we want to do in order for us to learn is to ask questions. Okay. So I think the whole process of being pimped in medical school and pimping when you became maybe the senior resident is that asking questions seems to be a bad thing. It's like, oh, what is she thinking? What is she thinking? What's the right answer? What if I don't have the right answer in the stress that comes out of asking questions sometimes? But I want us to step away from the stress of asking questions that comes with our spaces in the clinical space and go back to when we asked questions when we were kids.

20:21 Remember that time when we didn't even know we were annoying our parents and we asked, why is the sky blue? But why? And we keep asking. We're not asking to be annoying. We're asking because we really want to know. We have no idea. We have no clue, but we want to know. We are curious people. We want to know. And I want to invite you back to that beautiful space of just asking questions and just asking. Say, I just want to know. I don't know. Why is it that we have to write the title page in this way? Ask questions. Now, here's the thing about asking questions. There are going to be some people who love your questions, who welcome them, and who answer them all the time.

21:04 They are the people who are going to say, okay, this is a great question. You should read this paper that's going to answer three or four of the questions you have right now, and then let's talk about it next time. And that's okay. You're also going to get to the people who are like, don't ask me any more questions. And that's okay too, because in the way they respond to your question asking, they're giving you information. They're saying, I am not the kind of person you can ask questions of. I'm not someone who can help you grow and learn. Or they're saying, I just don't have bandwidth to help you grow in this way. Go to someone else. They're giving you information. But for you, your job is not to tiptoe around people who may not want to answer your questions.

21:44 Your job is to ask and to find the people who are so excited when you ask. You think about those teachers in early kindergarten, I hope you remember, who were so excited about your love for learning. They just loved how much you wanted to learn. Those are the people you look for. And if you're not finding them in your immediate environment, you've got to go further to find them. But your questions are beautiful, because they represent someone who wants to know more. And people who are excited to teach learners want questions like the ones you have. And I just want to invite you to not take any curmudgeonly answers, any curmudgeonly people around you, and to find the people who want to answer your questions so that you can keep on asking.

22:35 The sixth thing I want to invite you to do is to push for more. Don't accept what you already know. Sometimes I come across clinicians who say, you know what, I'm already a good clinician. I don't need all this. And it's like, yeah, you are a good clinician, but you want more out of your experience. Don't settle for what you've been given. Push for more. No, you don't know how to write manuscripts really well, but you want to learn because of how it helps you develop as a writer. Push for more. No, you don't need to spend all this time asking for grant funding. You just want to be able to settle your salary and go home. But there's a reason why you want to do more than what you're already doing because what you're doing right now does not satisfy that longing and the desire in you for more.

23:24 Push for more. Please don't settle. You can never be happy or fulfilled if you settle. You settle for less than your best, settle for less than your potential. And I'm not even saying everybody has to be a scientist. I'm not even saying that, but I'm saying if it is in your heart to do research, if it's in your heart to write papers, to publish, to be a scholarly person, even when you meet opposition, you should push for more. And the reason you push for more is that your highest self depends on you actualizing your full potential. And pushing for more allows you to do that.

24:06 And that brings me to number seven. As you're pushing for more, it's going to be uncomfortable for you, maybe for other people as well, but mostly for you. And it's going to be okay to sit with discomfort. That's going to be okay. It's going to be hard. It's going to be important for you to do that. You're going to ask a question and someone's going to look at you like, wait a minute, anybody, anybody with head, I don't even know what expression I'm trying to say. You know, like anybody should know that. How come you don't know that? Like a first year PhD student would know that. How come you don't know that, doctor? Just sit with the discomfort of, well, I don't know.

24:49 And I'm asking you, what do you want to do about it? And I'm not saying that you should do it with attitude or ugliness in any way, but just recognize that sometimes people are not used to people who are open and honest about what they don't know, especially in medicine. We're always hiding what we don't know. And so when you say, I don't know how to do this, and then you pause and it looks uncomfortable. You give the other person the opportunity to say, well, who will I be in this, in this moment? Am I going to be ugly and, and, and berate you? And maybe they will sit with that. They're going to be many uncomfortable moments, but they're going to be important and defining moments.

25:33 When you learn to sit with discomfort, you learn to expand who you are. You learn to expand your tolerance. You learn to be more. I invite you to sit with discomfort, especially as you're pushing for more. And so those are the seven things that I wanted to share with you today. Number one is to banish shame. Number two is to remove judgment. Number three is not to accept the judgment of others, whether good judgment or bad judgment. Number four is to prioritize learning. Number five is to ask questions. Number six is to push for more. And number seven is to learn to sit with discomfort. I hope that you will consider these things on your quest on learning to grow as a scientist.

26:16 You didn't have the training, not the extensive training that you could have. And it's okay. That's in the past. What you're doing is you're getting the skills today. And I want to invite you to do everything you can to grow and expand the someone who's learning in this space, even if you didn't have the training or the experience that you should have had by now, but don't judge yourself. Don't judge others. And if you need someone to help you walk through as you're learning to stop automatically judging things, I'd be happy to be there for you as your coach. But I encourage you to think differently about your experience and to enjoy this journey because the journey is the gift.

26:56 All right. It's been a pleasure talking with you today. I look forward to talking with you again next time on the clinician researcher podcast. Thanks for listening to this episode of the clinician researcher podcast where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. If you found the information in this episode to be helpful, don't keep it all to yourself. Someone else needs to hear it. So take a minute right now and share it. As you share this episode, you become part of our mission to help launch a new generation of clinician researchers who make transformative discoveries that change the way we do healthcare.