How to know the manuscript is ready for submission

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

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

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

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

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

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program.

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

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

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

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

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Now introducing your host, Toyosi Onwuemene.

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Welcome to the Clinician Researcher podcast.

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I'm your host, Toyosi Onwuemene, and it is an absolute pleasure to be talking with you

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today.

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Thank you so much for tuning in.

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Today, I'm talking about how you know your manuscript is ready for submission, how you

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know your manuscript is ready for submission.

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This particular episode is coming to you with my trainees and my mentees, really.

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I'll call them my mentees in my research program, in mind, because I want to help them understand

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that there really is a process.

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There's a process, and sometimes I think when you first come to manuscript writing, especially

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scientific manuscript writing, there is a sense that it's like a college term paper

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where you maybe stay up all night and then you hammer out this huge manuscript and it

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takes you maybe eight hours and you're like, whoa, good for me, I've done it.

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Then you send it over to your mentor and they come back saying, wow, this is really good

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and here are all the edits and there's what looks like red everywhere, depending on how

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the track changes come to you.

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Then you're like, oh my gosh, I spent so much time.

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Then you take the next time of binge writing and you binge write and edit all the work.

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Then you send it back and they send it back to you and it's like, oh, this is really good

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and now these are all these edits.

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Sometimes it feels like torture where it's like, wait a minute, when is this manuscript

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going to be done?

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I've now spent maybe 32 of these binge writing sessions writing this manuscript and each

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time you keep sending it back to me saying it's not ready, what's wrong with you?

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If you are like many clinicians who are trying to write around clinic and around all the

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activities that you're doing, these 32 hours didn't happen over four days.

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These are 32 hours that have happened over maybe 17 weeks because when it comes to time

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to binge write, it doesn't really come very easily.

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You have to wait for the right time and for many of us, it's like, oh, a couple of weeks

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from now during summer vacation, travel, I can do this.

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Unfortunately, the time that is needed to invest in a manuscript is time that is needed.

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Whether that time is spread over years or that time is spread over days, it really takes

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time and investment to write a good manuscript.

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I want to talk about how do you know?

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As a mentor, when I edit manuscripts and even when I'm a collaborator on manuscripts, though

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there's a little bit of a difference there.

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If I'm the senior author on a manuscript, I know when the manuscript is ready and I

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think there's a lot of frustration with my mentees in my program because it's like, you

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keep sending it back to me.

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You keep sending it back to me.

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Every time I say, hey, it's getting better.

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This is great.

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They're like, no, it's supposed to be done.

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I just want to be very clear about how I think about manuscripts and how I think about when

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they're actually ready for submission.

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I hope that my mentees are listening because this is really for you.

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I think that this is helpful to anybody who is writing and this really applies to manuscripts

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specifically, though it can be thought about for grants as well.

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I will tell you because I need to, I just need to get this out of my mind right now,

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is that there is a current manuscript that I'm working on right now that sparks this

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specific episode.

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I will say that at the end of revising and I want to tell you and I tell you at the risk

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of my mentees listening and saying, that's our paper she's talking about, but I want

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to tell you that we started working on this manuscript in 2021, I believe.

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This is 2021, end of 2021, I believe.

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So we've been working on this manuscript for three years and no, it has not been three

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years of continuous writing, clearly because it would have been done by now, but it's been

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three years of staccato binge writing and we're still where we are.

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And it takes a long time to write a manuscript, right?

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You're collecting data and then you are synthesizing the data and then you're going and you're

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writing the manuscript.

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So there have been other things that have been going on in between, but I will tell

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you that as far as writing the manuscript, we've probably been writing for over a year

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and it's still not ready.

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And so this manuscript is front and center in my mind as I tell you about this episode,

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as I share these insights and I hope my mentees, if you're listening, this is for you.

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Number one, writing a manuscript is not about getting a publication, it's about making a

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contribution.

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I want to say that again, because it's a little bit long, but it's important.

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Writing a manuscript is about making a contribution.

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I know we need publications.

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I know they say you should publish or perish.

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I know people are counting the numbers of your publications.

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I know you're desperately trying to get into medical school or get into residency or get

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a promotion or insert whatever goal you have there.

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I know you're trying to achieve a goal and having a number of publications is associated

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with that goal.

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And for that reason, it drives a little bit of craziness around writing and submitting.

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It's like, let's just submit it, let's just get it done so that we can publish this manuscript.

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And I just want to say that it's the wrong place to start.

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The publication goal, the number of publications you need to check off your list will always

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be the wrong place to start.

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Now is number of publications important?

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As long as we're in academic medicine, it will always be important.

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Is publication important to the people who want to look at you as the expert?

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Yeah.

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If they don't see publications, they don't agree that you're the expert.

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If you've sent 3 million patients with a disorder, they don't agree.

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They're like, show me the money, show me what you've done.

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So publications are important.

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And I'm not trying now to diminish the importance of publications.

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But I'm saying if you're starting from the place of, I just need publications, I just

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need to check off the numbers, you're already starting from the wrong place because you're

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starting from a place of desperation and a place of scarcity.

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Yeah.

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And no good can come out of that.

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It's just like, I just need a man, I just need a man.

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It's like, okay, all right, you get what you get.

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That's the same thing.

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It's like, I just need a publication.

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It's like, oh, you get what you get.

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And so if you're really going to do this well, and if you're going to work in my research

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program mentees who are listening, you're going to start from the point of what contribution

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can I make?

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What contribution can I make?

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And why is this different?

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It's different because when you start from the place of contribution, you've got to start

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from the place of substance.

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If you're just going to publish anything, you're just looking for what to publish.

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And to be honest, this is one of my biggest frustrations with people who say they want

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to work with me.

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And it's like, they don't want to work with me.

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They just want a publication.

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And the kind of energy that comes from just, I just want any publication with my name on

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it.

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It's just, it's actually now a little bit, a little bit upsetting to me.

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I am confessing right now, it is a little bit upsetting to me because the energy and

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the frenzy that comes with that is not good.

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It's not good because it's willing to just throw things together, throw them in the wash

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and hope for the best.

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No good can come out of that.

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Or it's willing to go borrow things without appropriately attributing credit.

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And that is plagiarism.

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It's willing to cut corners because it just wants to be published.

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And that's challenging.

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But when we start from the place of contribution, we start from the place of what can I bring?

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What thing of value can I bring?

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I know I'm trying to publish.

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I know what the end goal is, but what substance can I bring?

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And every time you start with value, every time you start with substance, every time

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you start with something that's important that you want to give, good things come out

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of that space because it drives you in a different way than the desperation of achieving the

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end goal drives you.

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And it shows up in the way your paper comes together.

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I can tell when people are just trying to get a publication because I read it and I'm

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like, what is this?

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And maybe some people are successful at pulling together publications that they're just trying

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to get publication out of and it's like, oh, well, it turned out well.

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But I think that's the exception rather than the rule.

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In reality, if you are going to have a quality submission, you're going to start with a quality

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contribution.

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And so the starting point is really making a contribution.

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And I want to say that if you don't have contribution as a starting point, what is the point?

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Just amass a lot of publications and get those boxes checked.

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What is the point?

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Everybody has different goals.

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And maybe your point is just, I don't even care how awesome those publications are.

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I just want the publications.

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That's fine.

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This conversation is not directed at you.

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I really am talking about people who want to do good in the world and they also want

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to submit publications.

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And I want to say it starts with doing good in the world and saying, how do I contribute?

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How does this paper contribute to the discourse in the literature?

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So number one, start with contribution.

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Number two, no matter the topic, you've got to bring your excellence to it.

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Yes.

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And I'm saying bring your excellence.

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I'm not saying go find excellence because you already have it.

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And how do I know you already have it?

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Because you are listening to me, which means that you're in medicine.

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You're probably a physician.

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You've probably done the four years in medical school.

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You've probably done the four years of residency or three or 10, however many you needed to

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do.

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And you're probably in fellowship or maybe you're beyond that.

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I don't know where you are in this process, but you've already invested a considerable

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amount of time in expanding yourself to get to a place that other people are never going

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to be able to get to for different reasons.

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No judgment.

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But you're somebody who can bring excellence to the table because you've had to do that.

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To get to medical school, you have to bring a level of excellence.

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To get into residency, you had to bring a level of excellence to the table.

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Excellence lies in you.

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So when you go to publish a manuscript, don't leave your excellence at the door and then

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just try to hastily put something together and say, voila, here is the paper.

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You've got to bring your excellence to it too.

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And we can tell when you bring anything less than your excellence to the paper because

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it looks so bland.

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And there's just a quality about it that's like, ugh, ugh.

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And for those of you who don't understand that sound, it's the sound of disgust.

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Like, what did you bring here?

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You're an excellent person, but why did you give me trash?

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And when you don't bring excellence to your manuscript writing, that's how people feel

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at the end of reading.

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It's like, ugh, this is just ew.

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And I'm not just talking about typos.

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I'm not just talking about grammatical incorrectness, which even when we bring our excellence, we

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still make mistakes.

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So it's not about the mistake making.

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It's about the fact that you're just pushing something together.

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You're just pulling it together and saying, here, here, here, take it.

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Rather than saying, how do I craft something beautiful that is consistent with the kind

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of excellent person that I am?

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And you know, I want to say that it's one of those intangibles that it's hard to explain.

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Like, how can you tell when something's not excellent?

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You just can't.

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You can just tell that it lacks excellence.

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And yes, it is the typos.

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Yes, it's the grammatical incorrectness.

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It's everything.

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But it's just the whole package says, I just swashed this together, and I really didn't

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put time and effort into it.

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And from people who are used to being excellent, who can be super excellent, whenever you see

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work that is less than excellent, you can tell, and it is off putting.

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And I want to say that it takes a lot of time and investment to get a manuscript published,

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writing, submitting the manuscript, waiting to receive the reviews, working through the

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reviews, moving from one journal tier to the next journal tier.

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It takes a lot of time and investment.

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If you're going to do it, you want to be excellent all the way.

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And that's sometimes the challenge with not getting manuscripts published.

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Even when your manuscript is excellent, it's hard to get it published.

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But when it's not excellent, it is even harder.

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And so what a waste of energy to be moving manuscript from journal to journal to journal,

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and it's not excellent.

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It's a waste of energy.

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And I don't want to make that kind of investment.

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So I want to invite you, when you're going ahead and pulling a manuscript together, think

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about contribution, number one.

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And number two, bring your excellence to the writing.

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Number three, be careful about making factual statements.

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Okay.

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So make a factual statement in its very loose definition.

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It's something that somebody else has shown in another manuscript.

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That's it.

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Because you're going to cite this.

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You don't even know, is it true?

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Is it not true?

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In general, you don't want to write in your manuscript things that are not true.

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But anything you're saying has to first of all, this is like, for example, you're starting

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with the introduction.

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Your introduction will always be based on what is already written.

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Somebody else has written something.

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So go pull what's written, write it in your paper.

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Not verbatim, you're going to paraphrase, but you're also going to cite it.

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This is really important.

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Be factual and write factual statements.

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Many times there is an overlap of what is factual and what is opinion, right?

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We saw that there was a difference between these two populations.

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Therefore, this population must suck while the other one must be great.

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Yes.

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So yes, the difference between the populations, that's factual.

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This population sucks relative to the other population, not factual.

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That is opinion.

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That is conjecture.

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When you go to write in your paper, especially as you're making arguments, laying out the

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introduction, you want to be clear to pull in fact and separate all the other stuff.

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And so where you go, and I'm exaggerating a little bit to make a point, most of us will

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not write that in the paper, I hope.

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Though actually I will tell you that I've read many a paper that talks about opinion

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as fact.

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But what I want to say is that when you bring in elements from other people's manuscripts,

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be careful to only extract what is relevant to your paper, but based in fact, right?

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They got three.

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The median was three.

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That's fact.

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They got a median of three.

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Maybe they made it up.

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We don't know.

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We hope they didn't.

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There was a reproducibility crisis in medicine and medical research, so we know that.

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But if they said the median was three in this group and in the other group it was 15 and

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the p-value was 0.001, that's fact that you can pull into your paper.

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There were differences found between the two groups and you want to make sure you do that.

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Now you don't want to say that it means that this group is always bad compared to this

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group.

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Now you're making judgments.

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They may have said that in the discussion because anybody can write whatever they want

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in the discussion, but you have to be careful pulling it into your paper.

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So my point is that make sure that you are making factual statements and supporting them

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with a citation.

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Sometimes what I see is that my mentee, one or two mentees, actually this is actually

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a common problem, so I'll say a lot of my mentees, will just write a statement and just

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slap a couple of citations on them.

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And then you go back to the citations, you're like, wait a minute, this citation doesn't

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... it doesn't say that.

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It doesn't say that.

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Yeah, I know we're talking about this disease.

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Let's say we're talking about TTP and I know that this is a manuscript about TTP, but it

291
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doesn't support what you said.

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Why is this citation there?

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And that goes back to the whole thing about excellence.

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Don't put a citation.

295
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You didn't even really read, you didn't even really make sure that it actually supports

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your assertion.

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You just put it in there.

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You want to make sure it supports the assertion.

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Another thing that sometimes I see done is that someone will make a statement and then

300
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put 16 references and it's like, do you need 16 references?

301
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And do all 16 references actually fit?

302
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Already it arouses suspicion.

303
00:17:41,940 --> 00:17:45,020
It's like 16 references for this one statement?

304
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Now I have to go back and read all 16 because I'm suspicious.

305
00:17:49,020 --> 00:17:54,320
Okay, so I just want to make the point that you want to be factual about the statements

306
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you make and you want to make sure that these statements actually come from other manuscripts.

307
00:17:58,420 --> 00:18:02,260
I mean, there's a part of the manuscript that's going to be your own data, which you can't

308
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cite anybody else.

309
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It's your data.

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You're now kind of developing your body of work that other people are going to cite.

311
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But every time, especially in the introduction, even in the methods and in the discussion

312
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where you say, well, somebody else did this and this is what they found.

313
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I want you to pay attention to being very factual about those things and not to add

314
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opinion as fact.

315
00:18:22,660 --> 00:18:23,660
Okay.

316
00:18:23,660 --> 00:18:24,780
I feel very strongly about this.

317
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Can you tell?

318
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Okay.

319
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Number four, draw conclusions carefully.

320
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Now this is something I've been learning and I want to say it's become very, it's become

321
00:18:33,940 --> 00:18:38,500
more intense in my learning over the last few weeks, especially because of certain public

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case, certain manuscripts that I sent out that the revise and resubmit was like a major,

323
00:18:43,420 --> 00:18:47,920
major, major resubmission or major, major, major revision.

324
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What I recognize to be important is that if you're not sure, don't say you're sure.

325
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And this is a challenge for me because I like to be definitive.

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I like to say that I know.

327
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And in reality, there's a lot that's not known.

328
00:19:01,460 --> 00:19:07,000
And so it is important that you make it clear what your assertions are based on.

329
00:19:07,000 --> 00:19:11,060
You can say the recommendations are that everybody should get a platelet transfusion and it's

330
00:19:11,060 --> 00:19:15,860
okay to say that, but it's also important to say, well, you know, there was this randomized

331
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trial that says everybody should get it.

332
00:19:17,940 --> 00:19:18,940
Great.

333
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Or you say, well, there were three case reports.

334
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And then I'm not sure that this is the right recommendation for all patients because we're

335
00:19:25,380 --> 00:19:27,980
not sure based on the case report, right?

336
00:19:27,980 --> 00:19:32,340
Based on the level of evidence, you can be a little bit more firm in your recommendation.

337
00:19:32,340 --> 00:19:35,960
And for the most part, I'm in hematology.

338
00:19:35,960 --> 00:19:39,700
We don't have a lot of randomized control clinical trials that tell us this is exactly

339
00:19:39,700 --> 00:19:41,240
what you should do.

340
00:19:41,240 --> 00:19:46,100
Even when we do, there are patients who stand before us who don't exactly fit.

341
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And therefore, when you come to putting your stake in the ground and saying, this is what

342
00:19:52,500 --> 00:19:57,940
is the interpretation of our data, be careful the way you word it.

343
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Don't say everybody should do this.

344
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And I've gotten dinged for that too.

345
00:20:01,380 --> 00:20:03,380
So this is something I'm learning.

346
00:20:03,380 --> 00:20:07,420
It's important to say based on this survey data, it may suggest that this is what people

347
00:20:07,420 --> 00:20:08,420
do.

348
00:20:08,420 --> 00:20:11,260
And that's okay to say this is what people do.

349
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Rather than saying based on survey data, everybody should do this.

350
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It's like, wait, the survey data can't let you feel so strongly about that recommendation.

351
00:20:18,620 --> 00:20:22,180
And so be tentative when necessary.

352
00:20:22,180 --> 00:20:27,340
And if you feel like you want to really lay down a recommendation, be very clear about

353
00:20:27,340 --> 00:20:30,420
what data allows you to be so confident.

354
00:20:30,420 --> 00:20:38,660
So when you draw conclusions, pay attention and be careful and be aware of your bias as

355
00:20:38,660 --> 00:20:39,660
well.

356
00:20:39,660 --> 00:20:43,180
So the example I gave earlier where there's a difference between two groups and you conclude

357
00:20:43,180 --> 00:20:45,820
that this is the bad group and that's the better group.

358
00:20:45,820 --> 00:20:47,460
There's a lot of that in science.

359
00:20:47,460 --> 00:20:50,500
That's interpretation, that's bias, it's not science.

360
00:20:50,500 --> 00:20:54,380
So be careful about the conclusions you draw because sometimes other people come to your

361
00:20:54,380 --> 00:20:58,620
paper and they just take those conclusions verbatim without really evaluating the work

362
00:20:58,620 --> 00:20:59,620
before them.

363
00:20:59,620 --> 00:21:04,060
So you be careful about the conclusions you draw and be careful about the conclusions

364
00:21:04,060 --> 00:21:05,300
other people are drawing too.

365
00:21:05,300 --> 00:21:10,060
Just because the discussion says this is the definitive strategy that we should use in

366
00:21:10,060 --> 00:21:12,220
this patient population doesn't mean you have to agree.

367
00:21:12,220 --> 00:21:15,700
You go back to the paper and you say, I don't know, but I'm drawing the same conclusions

368
00:21:15,700 --> 00:21:17,780
as you are from this data.

369
00:21:17,780 --> 00:21:22,460
So recognize that you are somebody who can make your own decisions about other people's

370
00:21:22,460 --> 00:21:26,900
data that could be different from the decisions that they're making as well.

371
00:21:26,900 --> 00:21:31,700
And so think about it as you draw conclusions in your own paper to make sure that you are

372
00:21:31,700 --> 00:21:35,180
drawing the appropriate conclusions based on the level of the evidence that you are

373
00:21:35,180 --> 00:21:36,180
presenting.

374
00:21:36,180 --> 00:21:42,020
Number five, and this is something I think that really surprises many of my mentees,

375
00:21:42,020 --> 00:21:44,380
is that this is an iterative process.

376
00:21:44,380 --> 00:21:46,340
Writing a manuscript is an iterative process.

377
00:21:46,340 --> 00:21:50,540
No, there is no manuscript where you write the first draft and the first draft is the

378
00:21:50,540 --> 00:21:51,740
final draft.

379
00:21:51,740 --> 00:21:53,700
It just doesn't happen that way.

380
00:21:53,700 --> 00:21:57,980
And that's because it takes a lot to build a manuscript.

381
00:21:57,980 --> 00:22:00,460
Creating a manuscript is creation.

382
00:22:00,460 --> 00:22:02,220
It's a creative process.

383
00:22:02,220 --> 00:22:07,660
You put something together and you delete half of it and then you're like, well, let's

384
00:22:07,660 --> 00:22:09,660
pull back a little bit more.

385
00:22:09,660 --> 00:22:11,820
And then you shape it.

386
00:22:11,820 --> 00:22:16,960
The final finished product looks nothing like what you started from.

387
00:22:16,960 --> 00:22:19,820
It doesn't look anything like the first draft.

388
00:22:19,820 --> 00:22:21,420
And that's for a reason.

389
00:22:21,420 --> 00:22:26,460
It's important that it is that way because it's a creative process.

390
00:22:26,460 --> 00:22:29,620
And here's the thing, if you're writing by yourself, maybe you could sit down and in

391
00:22:29,620 --> 00:22:31,180
eight hours produce a paper.

392
00:22:31,180 --> 00:22:35,140
But if you're writing with other collaborators and especially if you're working with a senior

393
00:22:35,140 --> 00:22:40,100
person as the person who's the first author, if you're working with someone like me, I

394
00:22:40,100 --> 00:22:41,540
want to shape a paper with you.

395
00:22:41,540 --> 00:22:45,940
I'm not just going to accept what you give me as the final format because there are nuances

396
00:22:45,940 --> 00:22:47,740
to some of the things that we're talking about.

397
00:22:47,740 --> 00:22:49,300
There's some things that you're not aware of.

398
00:22:49,300 --> 00:22:54,340
There's some data that maybe are not yet pulled into the manuscript.

399
00:22:54,340 --> 00:22:58,300
So I'm saying that this is an iterative process.

400
00:22:58,300 --> 00:23:03,060
Do not expect your first draft to look anywhere near the final version.

401
00:23:03,060 --> 00:23:07,620
So if it's an iterative process, you have to expect that there will be back and forth,

402
00:23:07,620 --> 00:23:09,700
a lot of back and forth.

403
00:23:09,700 --> 00:23:14,540
I've had many a times when my mentees will say, Dr. Mimina, the paper is ready.

404
00:23:14,540 --> 00:23:18,180
And I'll read it and I'll say, great, great progress.

405
00:23:18,180 --> 00:23:19,820
And there's more.

406
00:23:19,820 --> 00:23:23,540
And then they'll submit again and they'll say, Dr. Mimina, it's ready now.

407
00:23:23,540 --> 00:23:28,860
And I read it and I'm like, oh, no, it's not.

408
00:23:28,860 --> 00:23:30,700
And that's because it's an iterative process.

409
00:23:30,700 --> 00:23:34,860
And I know how much it takes you to be able to sit down for those eight hours or five,

410
00:23:34,860 --> 00:23:38,500
or however many you spend pulling the manuscript together.

411
00:23:38,500 --> 00:23:41,580
And then you feel as if it's wasted time, if at the end it's not approved.

412
00:23:41,580 --> 00:23:44,860
I just want to say that if you're going to write a good manuscript, it's really going

413
00:23:44,860 --> 00:23:46,740
to take a lot of back and forth.

414
00:23:46,740 --> 00:23:49,200
And you have to expect that.

415
00:23:49,200 --> 00:23:53,900
So make it your expectation that the manuscript is going to come back a few times to you and

416
00:23:53,900 --> 00:23:56,140
create space for that.

417
00:23:56,140 --> 00:23:59,680
And so this particular paper that I was talking about earlier, and we've been writing for

418
00:23:59,680 --> 00:24:04,740
over a year, it's because my mentees don't really have as much time or they have not

419
00:24:04,740 --> 00:24:07,820
created the space to devote to this manuscript.

420
00:24:07,820 --> 00:24:09,860
And you can't really short circuit the process.

421
00:24:09,860 --> 00:24:13,520
So just because we started writing a year and a half ago, doesn't mean that I'm going

422
00:24:13,520 --> 00:24:18,500
to get the paper and say, let's just accept it and let's just send it out.

423
00:24:18,500 --> 00:24:22,500
Because even excellent papers struggle in the publishing world.

424
00:24:22,500 --> 00:24:25,500
What more a paper that's not so good.

425
00:24:25,500 --> 00:24:30,780
And so you can't short circuit the time it takes to do the work of iteration, create

426
00:24:30,780 --> 00:24:32,300
space for it.

427
00:24:32,300 --> 00:24:37,300
And what's more valuable is time spent working on it regularly.

428
00:24:37,300 --> 00:24:42,920
So create regular intervals during your work week to move forward on the paper, other than

429
00:24:42,920 --> 00:24:47,540
like the weekend binge, which honestly doesn't produce as many good things as we want it

430
00:24:47,540 --> 00:24:49,300
to produce.

431
00:24:49,300 --> 00:24:55,660
So it is an iterative process, have an expectation that it's iterative and create space so that

432
00:24:55,660 --> 00:25:00,180
you can continue to iterate and create space consistently and routinely.

433
00:25:00,180 --> 00:25:03,060
So it doesn't take three years to write one paper.

434
00:25:03,060 --> 00:25:08,180
And I'm not saying that in judgment because as clinicians we are so busy, but we've really

435
00:25:08,180 --> 00:25:13,580
got to begin to create space for consistent, sustained research writing.

436
00:25:13,580 --> 00:25:20,500
Otherwise, we're not going to grow the way we need to as writers, as communicators.

437
00:25:20,500 --> 00:25:22,180
Okay.

438
00:25:22,180 --> 00:25:28,060
Number six, is that the process starts with content, the process starts with content and

439
00:25:28,060 --> 00:25:29,860
it ends with details.

440
00:25:29,860 --> 00:25:32,660
It starts with content and it ends with details.

441
00:25:32,660 --> 00:25:33,660
What do I mean?

442
00:25:33,660 --> 00:25:37,780
When you first start pulling the manuscript together, it's really about, do you have all

443
00:25:37,780 --> 00:25:39,540
the content there?

444
00:25:39,540 --> 00:25:42,380
Let's say you're writing an original research manuscript.

445
00:25:42,380 --> 00:25:46,180
For the most part, the results help you shape the whole paper.

446
00:25:46,180 --> 00:25:50,760
So you want to make sure, is everything I need to include an introduction here?

447
00:25:50,760 --> 00:25:52,960
Is everything I need to include in the methods here?

448
00:25:52,960 --> 00:25:54,820
Is everything I need to include in the results here?

449
00:25:54,820 --> 00:25:58,240
Is everything I need to include in the discussion section here?

450
00:25:58,240 --> 00:26:00,420
At first, you're just worried about content.

451
00:26:00,420 --> 00:26:04,260
And so I like for my mentees to give me an outline.

452
00:26:04,260 --> 00:26:07,820
They want to give me a first full draft and I'm like, I don't want a draft.

453
00:26:07,820 --> 00:26:09,460
I want an outline.

454
00:26:09,460 --> 00:26:12,620
The reason I want an outline is because I want to ask the question first.

455
00:26:12,620 --> 00:26:16,920
I want to answer the question, is the content here?

456
00:26:16,920 --> 00:26:21,500
Now the problem with giving me a full draft is that now I'm like, is this grammar correct?

457
00:26:21,500 --> 00:26:23,740
These sentences structured appropriately?

458
00:26:23,740 --> 00:26:26,060
Is this the right logical flow?

459
00:26:26,060 --> 00:26:27,300
That's distraction.

460
00:26:27,300 --> 00:26:31,660
At the beginning, I just want to know, is everything on the page that needs to be on

461
00:26:31,660 --> 00:26:32,860
the page?

462
00:26:32,860 --> 00:26:37,740
So when you start this process, and this is why the first draft is so different from the

463
00:26:37,740 --> 00:26:42,960
final draft, because at the beginning, you're not worried about beauty or correctness or

464
00:26:42,960 --> 00:26:44,740
even fact, not yet.

465
00:26:44,740 --> 00:26:45,740
You're just worried about content.

466
00:26:45,740 --> 00:26:47,600
Is everything here?

467
00:26:47,600 --> 00:26:49,780
Everything we need to address is here?

468
00:26:49,780 --> 00:26:53,420
Did we bring everybody who's supposed to be at the party to the party?

469
00:26:53,420 --> 00:26:54,580
That's your first goal.

470
00:26:54,580 --> 00:26:55,920
That's the content goal.

471
00:26:55,920 --> 00:26:56,920
Is everybody here?

472
00:26:56,920 --> 00:27:00,100
Is every fact that needs to be addressed here?

473
00:27:00,100 --> 00:27:02,340
Is every result here?

474
00:27:02,340 --> 00:27:07,420
And then as you progress, you're focusing now more on making everything come together

475
00:27:07,420 --> 00:27:10,180
and flow beautifully.

476
00:27:10,180 --> 00:27:12,500
The most beautiful manuscripts, they just flow.

477
00:27:12,500 --> 00:27:13,500
They flow.

478
00:27:13,500 --> 00:27:14,540
It's like a dance.

479
00:27:14,540 --> 00:27:18,060
It's like water just moving about in a wave.

480
00:27:18,060 --> 00:27:19,060
They're beautifully written.

481
00:27:19,060 --> 00:27:23,340
And I know you've read a lot of manuscripts that are just like, oh my gosh, please get

482
00:27:23,340 --> 00:27:24,860
me to the end of this manuscript.

483
00:27:24,860 --> 00:27:25,860
I can't.

484
00:27:25,860 --> 00:27:27,180
I'm going to do the conflicts too much.

485
00:27:27,180 --> 00:27:29,300
You've read those manuscripts and I hope you're not writing them.

486
00:27:29,300 --> 00:27:31,900
I hope you're not settling for writing them.

487
00:27:31,900 --> 00:27:33,820
But a beautiful manuscript is the goal.

488
00:27:33,820 --> 00:27:36,420
I mean, we're not looking for perfection here.

489
00:27:36,420 --> 00:27:38,140
Goal is not perfection.

490
00:27:38,140 --> 00:27:39,900
Goal is to complete it.

491
00:27:39,900 --> 00:27:43,980
But we are looking for something that reads well, because you want your reader to read

492
00:27:43,980 --> 00:27:44,980
your manuscript.

493
00:27:44,980 --> 00:27:48,040
Have you ever had that experience where you start reading, you're like, I can't finish

494
00:27:48,040 --> 00:27:49,340
this paper.

495
00:27:49,340 --> 00:27:52,060
Sometimes my mentees send me work and I'm like, I can't even read this.

496
00:27:52,060 --> 00:27:53,060
This is so bad.

497
00:27:53,060 --> 00:27:58,260
And I have to deal with my emotions and then give them quality feedback because that's

498
00:27:58,260 --> 00:27:59,260
what I do.

499
00:27:59,260 --> 00:28:00,960
But you start with content.

500
00:28:00,960 --> 00:28:05,540
You don't care how the content is put together at first, but then you end up with something

501
00:28:05,540 --> 00:28:08,300
that flows beautifully for the reader to read.

502
00:28:08,300 --> 00:28:11,140
And at the very end, you're paying attention to details.

503
00:28:11,140 --> 00:28:12,980
Are the punctuations correct?

504
00:28:12,980 --> 00:28:14,540
Is the flow of logic perfect?

505
00:28:14,540 --> 00:28:16,340
I mean, maybe not perfect.

506
00:28:16,340 --> 00:28:18,540
I hate to use that word, but is it complete?

507
00:28:18,540 --> 00:28:20,340
Does this read well?

508
00:28:20,340 --> 00:28:23,380
Then you pay attention to detail.

509
00:28:23,380 --> 00:28:27,780
And so one of the things that I think I see challenges at both extremes, sometimes I see

510
00:28:27,780 --> 00:28:28,780
content is missing.

511
00:28:28,780 --> 00:28:32,700
I'm like, how can you talk about this important topic and you don't talk about one of the

512
00:28:32,700 --> 00:28:35,420
most important papers in this area?

513
00:28:35,420 --> 00:28:37,420
That's like missing content.

514
00:28:37,420 --> 00:28:41,860
So it takes completeness and it takes attention to detail to make sure all the content is

515
00:28:41,860 --> 00:28:42,860
there.

516
00:28:42,860 --> 00:28:47,300
So sometimes there are errors in bringing all the content to the table.

517
00:28:47,300 --> 00:28:50,140
And then sometimes this content that's like, is this really applicable?

518
00:28:50,140 --> 00:28:54,780
So it does take time to learn what content needs to come together.

519
00:28:54,780 --> 00:29:00,580
But then I also see mistakes on the detail end where things are missing that shouldn't

520
00:29:00,580 --> 00:29:03,780
be missing, where there's not a good proofreading.

521
00:29:03,780 --> 00:29:09,380
I mean, at this time in our lives, if we're using Microsoft Word or whatever word processing

522
00:29:09,380 --> 00:29:11,620
software we use, there is spell check.

523
00:29:11,620 --> 00:29:14,660
There is no reason ever to have errors in your document.

524
00:29:14,660 --> 00:29:16,900
Now that we have spell check, there's no reason.

525
00:29:16,900 --> 00:29:19,460
Please make use of spell check at a minimum.

526
00:29:19,460 --> 00:29:22,500
Sometimes before you send it out the door, you want to make sure you spell check.

527
00:29:22,500 --> 00:29:26,820
And yes, the spell check will catch the list of references with all these names and flag

528
00:29:26,820 --> 00:29:27,820
them as wrong.

529
00:29:27,820 --> 00:29:32,220
And it's very frustrating to go through it, but it's still worth doing just to make sure

530
00:29:32,220 --> 00:29:38,180
that your tired brain, which is not as scrupulous about catching these errors, can be helped

531
00:29:38,180 --> 00:29:41,180
by the word processing system.

532
00:29:41,180 --> 00:29:47,380
So yeah, detail orientation is just sometimes about making sure you're using the tools that

533
00:29:47,380 --> 00:29:49,220
are available to you.

534
00:29:49,220 --> 00:29:51,500
But it's also how do the figures look?

535
00:29:51,500 --> 00:29:52,740
It's also the font.

536
00:29:52,740 --> 00:29:55,140
Is the font the same throughout?

537
00:29:55,140 --> 00:29:59,220
Sometimes I'll get papers sent to me and the font for the introduction is different from

538
00:29:59,220 --> 00:30:03,300
the font for the methods.

539
00:30:03,300 --> 00:30:07,980
And then the pages are numbered and that font is different.

540
00:30:07,980 --> 00:30:09,280
It's frustrating.

541
00:30:09,280 --> 00:30:16,140
And it's frustrating not because I'm trying to be annoying and nitpicky.

542
00:30:16,140 --> 00:30:22,820
It's frustrating because when a reader sees a manuscript that is nicely formatted, the

543
00:30:22,820 --> 00:30:24,180
font is all the same.

544
00:30:24,180 --> 00:30:26,780
The sizes are exactly as they need to be.

545
00:30:26,780 --> 00:30:30,620
There is a certain psychological release of stress that happens.

546
00:30:30,620 --> 00:30:35,220
It's like, okay, this is a nice paper to read.

547
00:30:35,220 --> 00:30:40,020
As opposed to when you get a paper and everything is everywhere and things are not organized

548
00:30:40,020 --> 00:30:44,340
and the font and the images is different from the font in the writing, it brings a certain

549
00:30:44,340 --> 00:30:46,780
amount of chaos to somebody's mind.

550
00:30:46,780 --> 00:30:49,500
They may not be thinking about it, but your paper makes them mad.

551
00:30:49,500 --> 00:30:52,820
The moment they look at it, they're already frustrated.

552
00:30:52,820 --> 00:30:54,500
You don't want that.

553
00:30:54,500 --> 00:31:00,340
You want to address the psychological background of the person reading your paper.

554
00:31:00,340 --> 00:31:04,700
Before they, they're not even thinking about this, but you're going to think about it for

555
00:31:04,700 --> 00:31:06,140
them because you're going to prepare.

556
00:31:06,140 --> 00:31:10,660
You're going to prepare by formatting and making things look good.

557
00:31:10,660 --> 00:31:13,800
Okay, that's the detail orientation.

558
00:31:13,800 --> 00:31:15,420
That's number six.

559
00:31:15,420 --> 00:31:19,740
Number seven, you know the manuscript is ready for submission.

560
00:31:19,740 --> 00:31:24,220
When you look at the manuscript, you read it and you're like, this is a good, this is

561
00:31:24,220 --> 00:31:27,600
a good contribution and that's it.

562
00:31:27,600 --> 00:31:30,420
You look at it and you're like, oh, this is good.

563
00:31:30,420 --> 00:31:34,140
Actually, you know what I really wanted to say is, damn, this is good.

564
00:31:34,140 --> 00:31:37,460
Yes, excuse my French.

565
00:31:37,460 --> 00:31:41,580
That's what I'm saying is after you've done all this work, you've invested a lot of time

566
00:31:41,580 --> 00:31:46,260
in the paper because any good paper requires time investment.

567
00:31:46,260 --> 00:31:49,820
You look back and you read it and you're like, oh yeah, this is good.

568
00:31:49,820 --> 00:31:50,820
This is good.

569
00:31:50,820 --> 00:31:54,980
Now, you know, your reviewers may look at it and be like, yep, this is crap and that's

570
00:31:54,980 --> 00:31:55,980
fine.

571
00:31:55,980 --> 00:31:56,980
That's their opinion.

572
00:31:56,980 --> 00:32:01,380
They're allowed to have their opinion, but if at any point in time you look at your manuscript

573
00:32:01,380 --> 00:32:03,820
and you don't think it's good, please do not submit it.

574
00:32:03,820 --> 00:32:04,820
Do not pass go.

575
00:32:04,820 --> 00:32:06,280
Do not collect 200.

576
00:32:06,280 --> 00:32:10,100
Do not make another person read it because you don't think your work is good.

577
00:32:10,100 --> 00:32:14,300
Then there is no point sending it out to anybody else and asking them if this is good.

578
00:32:14,300 --> 00:32:18,580
And whatever it takes for you to get to a place where you're like, this is good work.

579
00:32:18,580 --> 00:32:20,700
That's exactly what you need to do.

580
00:32:20,700 --> 00:32:24,700
And many times I see like my mentees will write something and hope that it will work

581
00:32:24,700 --> 00:32:25,700
out.

582
00:32:25,700 --> 00:32:27,660
I hope I hope Dr. Remenow will fix this.

583
00:32:27,660 --> 00:32:31,500
And I'm like, no, if you will not give me your best work, it makes it harder for me

584
00:32:31,500 --> 00:32:36,020
to give you my best work because I'm going to be so distracted trying to fix your work.

585
00:32:36,020 --> 00:32:37,220
That's not your best work.

586
00:32:37,220 --> 00:32:42,620
I can't really get to the higher level of building on your on your best work.

587
00:32:42,620 --> 00:32:44,300
It's how you get good feedback.

588
00:32:44,300 --> 00:32:50,740
You submit your best as close as you can get, and then they give you their best feedback.

589
00:32:50,740 --> 00:32:56,220
But if you submit nonsense and you could have made it better, people are giving you feedback

590
00:32:56,220 --> 00:32:59,860
in areas where you already know you needed improvement.

591
00:32:59,860 --> 00:33:01,460
You submitted something that was full of typos.

592
00:33:01,460 --> 00:33:03,420
You knew the typos needed to be addressed.

593
00:33:03,420 --> 00:33:05,060
And then the reviewers come back to you.

594
00:33:05,060 --> 00:33:07,800
All they can give you feedback about is the typos.

595
00:33:07,800 --> 00:33:08,800
It doesn't help you.

596
00:33:08,800 --> 00:33:13,060
I mean, it makes the paper better, but that's stuff that you could have done without the

597
00:33:13,060 --> 00:33:14,120
reviewers.

598
00:33:14,120 --> 00:33:20,700
So the feedback you want from anybody looking at your paper is feedback you can't give yourself.

599
00:33:20,700 --> 00:33:24,340
There is a fine line with, you know, getting to the point of submission and not not trying

600
00:33:24,340 --> 00:33:25,340
to be perfect.

601
00:33:25,340 --> 00:33:27,000
It's not about perfection.

602
00:33:27,000 --> 00:33:28,940
You look at your work like this is good work.

603
00:33:28,940 --> 00:33:30,180
Let's submit it.

604
00:33:30,180 --> 00:33:34,900
If you look at your work and you don't think it's good work, and it's not ready for submission,

605
00:33:34,900 --> 00:33:36,220
that is the summary.

606
00:33:36,220 --> 00:33:37,220
All right.

607
00:33:37,220 --> 00:33:38,220
I talked about seven things.

608
00:33:38,220 --> 00:33:41,340
Number one, writing a manuscript is about making a contribution.

609
00:33:41,340 --> 00:33:43,300
Number two, bring your excellence.

610
00:33:43,300 --> 00:33:47,660
Number three, make factual statements carefully and add citations.

611
00:33:47,660 --> 00:33:49,860
Number four, draw conclusions carefully.

612
00:33:49,860 --> 00:33:53,860
Number five, expect feedback to be iterative.

613
00:33:53,860 --> 00:33:57,540
Number six, it starts with content and ends with detail.

614
00:33:57,540 --> 00:34:01,580
Number seven, when you look at the manuscript and you're proud of what you wrote, it is

615
00:34:01,580 --> 00:34:02,580
ready.

616
00:34:02,580 --> 00:34:03,580
All right.

617
00:34:03,580 --> 00:34:06,620
I want to tell you today, as always, if you're looking for a coach, I'm always here to help

618
00:34:06,620 --> 00:34:10,780
you, especially as you think about how do you manage mentees within your research program?

619
00:34:10,780 --> 00:34:13,380
You want them, you love them, but they overwhelm you.

620
00:34:13,380 --> 00:34:15,500
You're like, I'm better off doing it by myself.

621
00:34:15,500 --> 00:34:19,100
I want to say you are never better off doing it by yourself because you are only better

622
00:34:19,100 --> 00:34:20,620
off when you multiply yourself.

623
00:34:20,620 --> 00:34:22,460
And yes, it takes work and investment.

624
00:34:22,460 --> 00:34:26,420
Yes, it takes you longer, but it's always absolutely worth it.

625
00:34:26,420 --> 00:34:28,620
And you want to choose your mentees carefully.

626
00:34:28,620 --> 00:34:29,620
All right.

627
00:34:29,620 --> 00:34:33,540
I'll add more when you reach out to me and let me know how I can help you.

628
00:34:33,540 --> 00:34:34,540
All right.

629
00:34:34,540 --> 00:34:35,660
It's been a pleasure talking with you today.

630
00:34:35,660 --> 00:34:37,180
Thank you so much for tuning in.

631
00:34:37,180 --> 00:34:41,900
I look forward to talking with you again next time on the Clinician Researcher Podcast.

632
00:34:41,900 --> 00:34:54,180
Thank you for listening.

633
00:34:54,180 --> 00:34:59,540
Thanks for listening to this episode of the Clinician Researcher Podcast, where academically

634
00:34:59,540 --> 00:35:04,940
clinicians learn the skills to build their own research program, whether or not they

635
00:35:04,940 --> 00:35:06,300
have a mentor.

636
00:35:06,300 --> 00:35:12,420
If you found the information in this episode to be helpful, don't keep it all to yourself.

637
00:35:12,420 --> 00:35:14,140
Someone else needs to hear it.

638
00:35:14,140 --> 00:35:18,220
So take a minute right now and share it.

639
00:35:18,220 --> 00:35:23,660
As you share this episode, you become part of our mission to help launch a new generation

640
00:35:23,660 --> 00:35:29,460
of clinician researchers who make transformative discoveries that change the way we do healthcare.

641
00:35:29,460 --> 00:35:30,460
Thank you.

642
00:35:30,460 --> 00:35:59,700
Take care.