How to think about financial challenges in academia

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 the Clinician Researcher podcast. I'm your host, Toyosi Onwuemene, and it is such a pleasure to be talking with you today. Thank you so much for tuning in or listening. I am talking about how to think about financial challenges in academia, and I want to just say that I'm not really going into depth about talking about financial challenges in today's episode.

1:23 In fact, what I'm going to do in a future episode is I'll bring somebody who is a financial coach and have that person talk about how to really think about really growing your net worth even when you are earning your academic salary. And I have some thoughts about that today I will share, but I do want you to know that I'm not a financial counselor, not a financial coach. I'm not even here to give you advice about finances. I'm just here to set the stage for one way to think about financial challenges in academia. And why do I share this episode today? Well, you know, I'm at the animal meeting, and so the series of podcast episodes that I'm releasing this week is really about things that I thought about at my animal meeting.

2:08 And I have had conversations with lots of colleagues. You know, the animal meeting is that place where you meet people that you may not meet but once a year. And when you meet, you take off from where you're left off. And it's like, yeah, I haven't spoken to you in a whole year, but I still am into you. I still dig you. I still have connected with you. I still resonate with you. And you can have these really great conversations. And so one of these conversations that I had was with a colleague who is so dear to me, so amazing, so wonderful. And this colleague talked about, frankly, about financial challenges that they are having. So this is a colleague who switched from a private practice position into an academic position.

2:48 And there is a big gap there as far as the financial things. And the thing about having a certain level of income as a family is that there is a certain expectation for the way you live that sometimes feels punitive if you have to cut down to fit the new standard, right? You do what you have to do. But definitely, you know, we had this frank conversation about the challenges of that, the challenges of taking a pay cut, coming into academia, and the challenges of seeing pay increases that really can make a difference, right? And so it really did cause me to pause because part of the conversation in the background that I'm not necessarily going into is that there are disparities in pay, the disparities in pay on so many levels.

3:32 And so, yes, the person I'm talking to is a woman of color in academic medicine. When you put all people together in general, women of color in academic medicine tend to fall on the lower end of the pay spectrum. And you can talk about the different reasons why that is. But ultimately, it is. You know, it is the way it is. And you know, it's funny when these kinds of conversations come up, there's a lot of defensive posturing. Like, no, it's the way it is because if you only brought more value, there's a lot of that. And it's like, well, can we just call it what it is? And so there is a lot of bias in the system.

4:16 And there are systemic and systematic issues that lead to persistent pay disparities. And so maybe this is not a conversation you're having with your colleagues. Maybe you're all good because you're earning at the top of your game, which is great. And congratulations and well done. I'm talking to a group of physicians that is struggling to make this thing in academia work. And that's my audience today. So if you're not my audience today, it's OK if you don't listen to the rest of this episode. But if this resonates with you, then hang on. I have a little bit to say about it. Again, I'm going to have a coach come on to the show in a future episode. But today, I just want to share it because it's something that's on my mind, came up at the meeting, and I want to just speak to this person.

5:02 And I want to speak to people who are like you, thinking about what am I thinking? Why am I here in academia taking the low salary to what end? OK, so the first thing I want to share with you is to remember why. Remember that you chose at the beginning of all this journey, you chose to play the long game. You chose because when you started medical school, you knew that at the end of the four years of medical school was not Nirvana. You knew that at the end of four years of medical school is going to be another period of training. You knew when you started residency, you know that it was going to end and then you were going to start from scratch. If you went into practice right out of residency or you knew that you were going to end residency and then you were going to start this thing again called fellowship.

5:50 You chose to play the long game from the beginning. From the very beginning, you were looking at it. You're like 10, 20, 30 years into the future. That's how long this career is. So it's a choice that you made. And I just want to remind you of your choice that in the same way you've made a choice to be here and to play the long game, you can choose at any point in time not to. And it's OK. When I say things like that, when I say you can choose not to alarm bells go off in people's heads because they're like, what do you mean? Oh my gosh, no, no, no, no, no, no, no. What do you mean? And it just, you know, there's anxiety and there's fear. Like I don't know how to do anything else. I'm a physician. I have no other skills. And I just want to say stop, chill, relax and breathe in and breathe out and recognize that you have so many skills.

6:44 You may not realize them because you are so close to your medicine, so close to your medical game that you forget all the possibilities that you have. You forget the medical school and the whole experience of training was really leadership training. You forget about your power to connect with people. You forget about your presentation skills. You present you forget about your ability to go read something that you had no idea about and come and present it as if you're the expert. You got many, many skills. And so if at any point in time you say, I don't do this thing anymore, you're going to be OK. You are going to be OK. And I say all that to say you are making a choice here.

7:26 The choice has not been made for you. You are an active participant in this choice. And if at any point in time you feel like the financial story doesn't work for you, you have the power to choose. And the power you have to choose is not just to say medicine or no medicine, but to say how can I get this to work? Can we all say that together? Can you say after me? How can I get this to work? How do I get the books to balance? How do I get my net worth to grow? How do I make the finances work? See? See? We're not saying I can't make this work. We're not panicking. We're not going and being and doing things that we shouldn't be doing.

8:09 We're just asking how? How can we make this work? Remember that you chose. You're still choosing. You have the power to choose and ask powerful questions that help you make different choices. OK. You can choose at any time. At any time to say I'm not doing this. And it's OK. You can land on your feet. You're going to be OK if you choose not to. And if you choose to stay, ask yourself how do I make the finances work? OK. The second thing I want to talk about is that part of your spending time in academia, part of all the stuff you're doing and why scholarship matters is that you're working to become a thought leader that people pay for their expertise.

8:57 It's one of the things you're working towards. So it may not be explicit to you, but can I just put it out there? The reason that you, I mean, there are many reasons you do your scholarship. And I hope you do your scholarship for the love of all things knowledge. And I hope you do your scholarship because you want to advance patient care and you want people to be better. You're trying to save the human race. These are all great things. I hope that's why you do your scholarship. And I want to let you in if you're not already clued in. The part of doing your scholarship is that you become a thought leader. People want to hear what you have to say. And so that's why, you know, sometimes it's like, oh, yeah, for promotion, I need to go give talks. And it's great. Please go give talks.

9:37 Have your friends try to arrange for you to come to their institutions and you can give talks. But the reason people invite you to give talks is you have something to say. You're a thought leader because you think about this area a lot. And so people want your opinion. And so part of spending your time in academia is really developing yourself as a thought leader that people pay for their expertise. And so some of the work you're doing is really building that thought leadership. And I hear some people staring and saying, that's not going to put food on the table. I get it. And I will also add to that that everybody does not have equal access to thought leadership.

10:17 Right. You may be a thought leader, you've been working in this space, but there are certain people who may be called to give talks and others who are actually not. Right. I'm just, you know, let's just put it out there that, yeah, the whole goal of thought, of the work that you do, the scholarship, I mean, beyond other goals is that you're becoming a thought leader that people want to pay for their expertise. And yes, we don't have access, equal access to being able to express our thought leadership in these ways. But I just need you to understand that it's one of your skills. You know how where it's like, wow, have you heard the story about fields, acres of diamonds? And to be honest, I'll tell you that I've heard enough about it that I feel like I know the story and I can tell the story, but I've actually never read it.

11:03 So now I have to challenge myself to go read the book. But in summary, this is a farmer who traveled the world looking for diamonds and missed the opportunity that was in his own field. Right. And so what I mean in his home, on his farm, were all these diamonds and he traveled the world finally gave up into and went in despair, you know, gave up. And really the diamonds were right where he started from the beginning. And so I think in telling you that about your opportunity to grow as a thought leader is just to remind you of the diamonds that exist in your experience as someone who's growing as a clinician and a scientist.

11:44 OK, you are a thought leader. And in recognizing the fact that thought leadership and opportunities to express our thought leadership is not equally accessible to all, you know, men versus women, people of color versus people not of color. It's not equally accessible, but it's also recognizing that you have the thought leadership. You may need to position yourself differently to be able to get the most out of your thought leadership. OK, all right. This, you know, we're getting into the offline conversation, but I just want to put that out there. OK, all right. Number three is to recognize that you have everything you need.

12:25 Financially, you have everything you need. Do you have a roof over your head? OK, you're not living out of your car. OK, check. You have everything you need. You got food. You can eat. Your people at home can eat. Great. Got it. And I know it's like you're rolling your eyes and you're like, well, yeah, is that it? Like, I can meet my needs. So that's where I should be. That's not what I'm saying. What I'm saying is the importance of recognizing how much you already have. You're already living above meeting your needs. Everything you have beyond your very basic needs are wants. Your big house. It's a beautiful big house.

13:07 I love to come visit your beautiful big house. It's a want. Yeah, you do need shelter, but it doesn't need to be that big. You do need shelter, but you know what? A tent will work. But you have chosen to live in a big, beautiful home because it's what you want. And it's OK. It's OK to go after what you want. And this is more important than just the whole thing about meeting your basic needs. It's OK to go after a bigger financial future for yourself than what academia can give you. I said it. And now you have to deal with it because now you potentially could be having a conniption fit in your head as to, did she just say that? I did say that.

13:50 It's OK to have everything you need. You already have everything you need. You don't need any more. And it's OK to recognize that anything you want beyond what you need is a want. And it is OK to go after your wants. And if your want is a bigger paycheck, it's OK to go after that. Now recognize that there are opportunities to extract a bigger paycheck from the person who already pays you. And recognize that in an employment type situation, there is little incentive to continue to pay a bigger and a bigger paycheck to the employee. And so it's recognizing that if you're going to go after what you want as far as financial things are concerned, as far as growing your net worth, you need to begin to think outside the financial box of the employer-employee model.

14:43 It may be that you diversify your employers. That's another strategy you can consider. Or it may be that you diversify sources of income. But what I'm saying is that it's OK to go after your wants, recognize the limitations of pursuing only one source as the source of making your financial wants accessible to you, and recognize the opportunity for creativity. OK? The opportunity for creativity. OK. Number four is to talk with people outside of medicine about how to diversify your income streams. And yet, I'm not a financial coach. I don't even really do things financial.

15:23 I just felt like it was important because this was a conversation that came out. But I need you to understand that medicine is a great way to make an income. And I'm so grateful that you make an income. And even when you're not satisfied or even if you don't have pay parity, you do make a lot more than some of the people around you. But there are people outside of medicine who don't necessarily make the kind of income that you do that have a higher net worth than you do because they use different strategies. And so what I'm inviting you to do is to stop looking around at your immediate environment and those in academia and start to ask people who are outside of academia what their strategies are in diversifying income streams.

16:12 And it's just thinking outside the box. And it's reminding you that, hey, you're an academic and that's great. I love academics and that's not your only identity. Bigger than an academic, there's so much more to you. And you have a wealth of resources available to you. Many times in medicine, we get stuck looking at each other saying, hey, what are you doing? I want to do that too. And that's great. Yeah, you're what people will call a high net worth individual. Great. Sometimes it's easy to talk to high net worth individuals like yourself, other physicians. But I would say diversify your sources of information about growing financially. And yes, we're all working and investing towards retirement, but also to consider how do you diversify income for right now and to get you to where you want.

17:02 Because what you want is valid, it is valuable, and you should definitely go after it. OK, so think about talking with people outside of your immediate academic circles about strategies to diversify income streams. And in fact, think about joining masterminds. You're like, I don't have time. You know, we're making choices all the time. And not having time is also a choice that we make. Yeah, I went and said it. Now I'm not going to pursue it. I'll have to devote a future episode to it. OK. So always making choices and consider making the choice of talking with experts outside of your immediate academic environment about what it means to diversify income streams.

17:43 OK. All right. The fifth thing I want to tell you is to relax. Don't let it stress you out. The anxiety is actually causing you more trouble than is needed. The anxiety you have about the finances, the anxiety you have about all the stuff, it's internally generated. Yeah. And it's easier said than done. But I invite you to relax, relax, relax. Because one of the things that's important to recognize about yourself as a clinician, as a physician scientist, is that you have capacity to create income.

18:26 You absolutely do. And the more anxious and worried you are about it, the less your creativity is released to be able to support you doing that. And so maybe this should have been number one. The first thing, I mean, it's number five. But it's important to learn to relax. You got this. You've done some impossible things over the course of your life. And becoming someone who can create income or create more income or create opportunities for wealth because sometimes more income is not necessarily the opportunity. Relax. You have the opportunity to do that.

19:07 And I'm excited. I'm going to bring you a financial coach. She's coming on the podcast a couple of weeks from now and I will alert you when that's available. But yeah, definitely just relax. You can do this. There's no need to be stressed. Remember, remember how it is where it's like sometimes the immune response is bigger than the actual inciting event, right? And it's a problem because it destroys the surrounding environment. Same thing. It's like relax. Your anxiety is causing you pain and suffering. Relax about it. You can do this. You can absolutely do it. All right. So how to think about financial challenges in your academic job? Number one, remember that you were choosing to play the long game at any point in time.

19:48 You can choose to play a different game. Number two, part of spending time in academia is to become the thought leader that people pay for their expertise. You think about how to position yourself as a thought leader that you are and you may need to be creative. Absolutely. Number three, recognize that you have everything you want, everything you need, and you are really just pursuing wants now. And that's okay. But you just need to recognize that you're going above and beyond and it's okay to want what you want. Don't be ashamed to want what you want. Okay. And number four is talk with people outside of medicine about how to diversify income streams. Talk with people outside of academic medicine because in academic medicine it's just not the thing we think about.

20:30 There are other people who think about it a lot more and there are ethical ways to do it. Please, this is not an invitation to go do some things that are unethical. You did not hear that from me. And number five, relax. You have the power to create wealth. You have the power to create income. And as you relax, you let the creativity come forth so that you can do it and help others do it too. All right. It's been a pleasure talking with you today. Please share this with someone else and me because I think we got to talk about it sometimes. And I'm glad that I got to share some of these thoughts with you. All right. It's been a pleasure talking with you today. Please join us at the next time that we meet.

21:11 And yeah, have a great, great time. I look forward to talking with you again the next time. 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.