How to transition from clinician to research leader

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 for tuning in. Today, I'm going to talk about how clinicians can make the transition from clinician to researcher. And I want to share it with you because it's a transition that I had to make when I first started in my faculty career.

1:22 Now, the ideal time to start to make the transition is really in your fellowship, for those of you who did a postdoctoral fellowship, because it's an opportunity for you to take two years of research, which is usually the case in most of these fellowship programs that have a research component. You take the two years to connect with a mentor, work in a mentor's research program, create opportunities for scholarly productivity, so write papers, publish, and submit grants. And so ideally, you're done with the fellowship and you have already a couple of manuscripts in hand. You have an area of expertise that you're building and you might have some grant funding.

2:03 Okay, that's the ideal. For someone like me, it didn't quite work out that way. And it's not that I didn't really work hard to get some research opportunities during fellowship, it's that for different reasons, I wasn't able to get the mentoring that helps me build the research in the way I wanted to. And so I did apply for grant funding, I did publish a manuscript or two, but it really wasn't where it needed to be by the time I ended my faculty career. I mean, by the time I ended my fellowship. And the challenge is when you now go, or at least when I went to seek a clinical research job or a job where I could be a clinician scientist, it didn't look as if I was a serious person from the perspective of the hiring party, right?

2:54 So from the academic institution trying to hire me, it was like, well, you don't look like someone who knows how to do this. You don't look like someone who can't succeed. And so it makes it difficult when they go to advocate for this hire, they say, well, you want to hire this person as a physician scientist. And then people, the institution asks, where is the evidence that this person is going to be able to do this successfully? The evidence they have for people like me is that, you know what, we've been doing clinical training for a long time and we're really good at the clinical things. But the research getting, the grant getting, the research structure, the creating manuscripts, there is not that much evidence to support that.

3:37 And so I ended up really in a clinical job at the beginning. And for many clinicians, that's our trajectory. We start out fully clinical when we start our faculty careers, even though we want to succeed as researchers. And that's a group I'm talking to today. I'm talking to the group of people who didn't do all the things that were supposed to happen at the time that you completed your fellowship. And now you're a faculty member trying to build a research program, but you're really fully clinical or mostly clinical. Nobody's ever 100% clinical, at least that's what they say on paper. But I want to talk to you because I do think it's possible. I know it's possible. I'm living the life. So I know it's possible.

4:18 I also know that it is challenging. And I know that if you're going to do it, you actually need direction. Like it's not that kind of thing that just happens by accident. It's the thing that happens because you are intentional about creating opportunities for that to happen. So I want to share some insights about that today. And I also want to share with you that you can. You can succeed no matter what anybody says. You are qualified. As someone who has come through medical training, you've already done the impossible. You can do it again. And so if anybody ever tells you you can't, you're not qualified, it's really not true. The question will always be, is this what you want to do? And are you willing to pay the price to do it? That's the question.

4:58 And if the answer to both is yes, then you absolutely should do it. And I'm going to talk about seven ways that you can think about doing it. So number one is you've got to commit. A research leadership pathway is a commitment. It's not a let's just do it and see how it works out. It's a commitment you make because it's going to be hard. You're going to fail. I like to say fail forward. There's going to be challenges. There are times where you're going to be like, is this even worth it? It really is a commitment. It's a commitment. You say, I'm going to do this. I'm going to make it work. And if you're going to make this kind of commitment, it's like don't commit to someone in marriage unless you love them, right? Do not commit to research unless there's something about research that you really love, right?

5:43 Unless there's a project you want to move forward, unless it's a patient population that really resonates with you. Don't commit unless there is love. I really do mean that. And I know sometimes people are like, well, you know, everybody says you should do research, so I just want to do it. And I have to tell you that that doesn't sustain this long-term relationship. It is a long-term relationship. And there are people who quit along the way. And it's not to say that you can't quit. I'm just saying that I'm not talking to people who are not committed. Because there's a different way you move forward when you are kind of like non-committal. You can like try it and see if it works out. But you know, if you are trying it and you're not sure this is what you want to do, then I want to say that it's going to be hard.

6:31 And whenever the hard knocks come, it's going to knock you out. Because research is not for the faint of heart. Leading a research program is not for anybody who's wishy-washy about it. Like, it literally is a commitment. It's a commitment to persistence. It's a commitment to going after funding after you've been rejected time after time after time after time. I mean, who wants to do that? And so you only do it if you commit. And so that's the first thing you got to do is commit to building a research program. Say to yourself, this is going to be hard. I'm going to be rejected. There are times it's going to suck and I'm committing to this process. And that's really the first step. I would say that if you cannot commit, if you are not committed to the process, if you're not committed to the journey, then I'm not really sure that you should move forward.

7:24 And I know everybody's not here to lead a research program. You can participate in research without leading research. You can contribute without leading research. But that's not what I'm talking about. I'm really talking about leading a research program. That's the commitment. Participating in research doesn't require commitment. You do a little bit here, you do a little bit there. If it works out, great. If it doesn't work out, great. But if you're going to build a program in which other people come and build their careers out of your program, you got to commit. So step number one is commitment. You make a commitment. Okay. Step number two is get clear about what is needed to succeed. And one of the things that clinicians especially need to get clear about is the fact that clinical training is not research training.

8:10 I'm going to say that again. Clinical training is not research training. Yes, you did some research methods. Yes, you had a chance to do a little bit of scholarly activities throughout your clinical training, but it is not research training. If you want to see what research training looks like, you go to a PhD program where people are actually trained in research methods. That is research training. Okay. So you got to get clear about what is the gap between where you are right now, oh, excellently trained clinician, and where you're going to be someone who is able to understand research, what methodology is needed, what is required to make a program succeed.

8:50 And if you don't know, it's time to phone up a friend, usually a PhD scientist or maybe an MD scientist or an MD physician or an MD PhD who is succeeding in research, right? Because everybody who's MD who's doing research is not necessarily leading a program. And everybody who's MD PhD is not necessarily leading a research program either. So don't go by title, go by what people are doing and spend some time with people. Ask questions. Hey, how is this working out? What do you need to succeed? What does it take? And you really need to do this because people will get real with you. And the reason it's important is because people will tell you, you cannot succeed in building a research program being 100% clinical.

9:31 It doesn't happen. The reason it doesn't happen is because clinical care is not research. This is very hard for many clinicians to imagine that leading a research program means not being fully clinical. Because for many of us clinicians, we didn't go into medical school to lead research programs. I mean, we didn't go into medical school to not do clinical care. We did the whole thing. We went through residency and fellowships so we could take care of patients. And so when you finally figure out that research and to really build and lead a research program means taking time away from clinical care, for many clinicians, it's like a shock.

10:12 It's like, no, I love my patients. And it's good. And the reason you need to get clear is so that you decide, is this what you want to do? If leading a research program means that you're not going to be seeing patients five days a week, is that for you? Is it what you want? Is it the life you want to build? And if the answer is no, it's okay. It is absolutely okay. But you want to know and you want to choose and you want to make an informed decision. So go get clear about what you need. Call your friends, not your friends. Usually they're ahead of you because if you're in this place, you're not. Your friends might not be leading research programs.

10:54 They're ahead of you probably. But anyway, get clear about what is needed to succeed in research. Okay. Now you've figured out, okay, you've made the commitment. You're clear about what is needed to succeed. Your next step is to create structure. And what do I mean by creating structure? It's creating structure by which research succeeds. What do I mean by that? Okay. If you are a research scientist, you are also a writer. You are a science communicator. That means you take time to communicate your science, number one, to funders. You got to say, hey, funders, this is my idea. This is why you've got to give me money. That's one form of communication.

11:36 Your second form of communication is to the research community, the scientific community, saying, hey, I've already done some stuff. This is what we found. Here it is, right? You got to get through the peer review process to be able to communicate your research through journals. Okay. So you're a science communicator communicating your research through publication. But then you're also a communicator as you're communicating to your peers. You're saying, hey, I'm going to come to your conference and talk about my research. So you are a science communicator. And you've got to create structure to be an effective science communicator. And that means creating structure for your daily writing. I did say daily, not binge writing.

12:17 Like every once, once every three months, you have eight hours and then you can go churn out a manuscript or churn out three manuscripts or maybe even four. Not that, but daily consistent writing, daily consistent thinking about your research, daily consistent moving your research forward. It doesn't happen by accident. Doesn't happen seridebitiously. If you're a clinician, your patients will always take you away. Your patient care activities, I shouldn't say patients, your patient care activities will always try to take you away from leading your research program. Creating structure allows you to say, hey, patient care related activities, this is where you fit.

12:57 And hey, research related activities, this is where you fit. And structure allows you to do that. Okay. So create structure. The next thing you've got to do is own your clinical expertise. You have got to own your clinical expertise. If you are a clinician trying to break into research, you cannot be a clinician in one field and a researcher in a different field. It doesn't work well. The reason it doesn't work well is because there's no overlap between what you're interested in clinically and what you're doing for research. You have to go every time you're having to take time away from your usual life to go figure out whatever is needed in your research.

13:39 And that's why it makes sense and it works best if what you're researching is in your clinical area. So you're a hematologist, you're doing hematology research. You are very interested in thrombosis. You're seeing patients who have thrombosis. You're doing research in thrombosis. So your clinical area and your research area do need to overlap. I have to tell you that it's very difficult. I can't tell you whether it's impossible or not, but it is very difficult to do research in an area that's disparate from your area of focus. Now your area of clinical focus. Now that's not to say you can't have a mentor outside of your field because what you get from mentors is not necessarily the clinical expertise.

14:22 You already have that, but you've got to really make sure that your focus, your research area, your disease focus really overlaps with what you see clinically. And that allows you to own your clinical expertise. It allows you not to go looking for the clinician who can help you move forward. And that's one thing that I see that I think can be a challenge. When we as clinicians already expert clinically in one area, we don't actually need another clinician to partner with in research in the sense that, yes, we can partner with researchers who are with clinicians who can provide patients for our studies, sure.

15:04 But when it comes to partnership that brings synergy, usually what I've seen work is the partnership of a clinician with a methodologist. But owning your expertise allows you to come to the table as a contributor. Someone saying, hey, I'm not here just for you to feed me. I'm bringing something solid to the table and I want you to be a partner because it is so important that you do that. One of the things I see is this deficit mindset from many junior faculty where it's like, well, I don't know, I don't know, I don't have, I need a mentor, there's nobody to help me. And yes, you do need a mentor. You need many things, but first own what you have, own what you got, own your expertise.

15:49 That's the first step. It's the first step to confidence. It is difficult to lead a research program if you are not confident. If you have this mindset of deficit where it's like, I don't have enough, I don't have enough, and you come across to people as needy. I have to tell you that many people do not like to connect with needy people. People like to connect with people who are bringing something to the table. When you own your clinical expertise, you are clearly an expert who's bringing something to the table. And so I want you to own your clinical expertise. The next thing you're going to do is you're going to collaborate with research methodologists. Look, the reality is clinical training is not research training.

16:32 And I am excited for you if you were able to get two full years of research out of your fellowship. Many of us were not, but even then, that's not really a full breadth of research training as say our colleagues, the PhD scientists get. And so you can go and start from scratch. You can go get a PhD. Absolutely you could. Or you could just connect with a PhD researcher who already has a methodology that you are trying to learn. And you bring your clinical expertise to them and you're helping them learn and grow. Because if you're going to be a successful researcher, you actually do need some clinical knowledge as well as research knowledge.

17:15 You need both. If you're going to do research, it's going to be beneficial to patients. You need both. And so when you come to the research methodologist, you're like, hey, I'm a clinical expert here. I don't know as much methodology. How can I learn from you? And they're like, well, I'm the research methodologist. I'm an expert here. But I don't have the clinical expertise. Then, oh my goodness, what synergy exists between you and the research methodologist? Because then you can both simultaneously mutually benefit each other. It is such an amazing experience. And you don't have to do their work for them. They don't have to do your work for you.

17:55 But in providing a clinical expertise and learning from their research expertise, you grow in your research expertise. I will tell you that I had a conversation with one of my collaborators recently. And she said, I was speaking like a methodologist. It was so exciting. I was like, oh my gosh, I'm learning. I'm learning. And that's what happens when you collaborate with someone whose expertise is in an area that's different from your own expertise. You grow and you learn. It's a beautiful thing. And it helps you accelerate your research. OK. Then the next thing you've got to do is connect to resources. OK. Research doesn't happen unless it's funded.

18:36 And it may be that you've been funding it by working without pay on nights and weekends. Please do not let that be your life. Or you find a funder who helps you fund the work so that you can do it during the daytime as part of your daytime work. Absolutely recommended. You need funding. Connecting to resources is about finding funding. But here's the thing. Everybody wants to start with NIH funding. And NIH funding is awesome. Thank you, government NIH, for giving us federal financial assistance through the form of NIH grants. Yes, NIH grants are awesome. And you know what? The competition for those is kind of stiff. And if you're just starting out, you're not likely to be competitive for an NIH grant by yourself.

19:20 Maybe collaborating with a PhD scientist, you might be able to be. But starting out, especially if you're applying as the leader of your research program, as like the PI, you might not be so successful. But you might be more successful looking at foundation grants. You may be more successful looking at seed grants within your institution. You may be more successful looking at seed grants from corporations or industry. There is an opportunity for you. OK. If you are someone who's not been funded yet, I just want you to say after me, there is an opportunity for me. Oh, you know what? Even if you have been funded, you're probably looking for more funding.

20:02 Say after me. There is an opportunity for me. Great. Great. It's important for you to recognize that there are people waiting to fund you. It may not be NIH just yet, but there are people waiting to fund you. Don't look at the people who are not letting you in. Look around for the people who are letting you in. Connect to resources. And resources are not just funders. Resources are medical students looking for a project. Resources are residents who want to publish. Resources are fellows who are looking for opportunities. Look around and see what you already have. Do not close your eyes saying, I have nothing.

20:44 And then literally people around you waiting for opportunity. Connect to resources. They are all around you. The final thing I want to share with you is the need to connect with community. If you're a clinician looking to transition to become a research scientist, you are a minority of folk. Right? You're in the minority. And there are not many people around you that want to do the same unless you are intentional about finding that community. I want to invite you to find community, to reach out to people who are thinking like you, trying to do what you're doing. Find community. When I am talking about community, I'm not just talking about mentors.

21:26 Oh, yes. Mentors are everywhere and they're so hard to talk to. They're so busy. And I thank God for all my mentors. Mentors, I appreciate you very much. I'm a mentor. You know, there's just a lot going on. And the mentors don't think like you do anymore because they're past a lot of things. They don't even remember the things they used to not know. Right? It's the way it is. But there's a group of peers who's trying to do what you're doing. There's a group of people across the country, across the world even, who are trying to move in the same direction that you're moving in. You got to get in community with them because there will be some people in that community who are a little bit ahead of you and will inspire you to more.

22:09 There'll be people who are not as far as you and you'll be able to inspire them to more. There'll be people who are right about where you are and you'll be able to encourage each other. It'll be so awesome. But you do have to find community. And most of the time, if you're going to find a community of clinicians trying to make the transition to lead research programs, you got to leave your regular environment, your regular habitat and go find them. They're there. We are here. And we exist. And we're in hiding because you got to move away from people who are not doing what you're doing so you can get the encouragement you need to succeed in the way you want to succeed. And I invite you to join community.

22:49 I invite you to join my community even as I am launching the next coaching series. And so we're starting our next coaching session with our first webinar. So we have a webinar coming up. It's happening on November 20th at 6 p.m. Eastern time. I want you to check out our research podcast, our podcast website. That's ClinicianResearcherPodcast.com. You can also check out our website, Coedcoach.com, for more information about the upcoming webinar. But I do want you to come and find out. I'm going to talk about five ways to make the transition from clinician to researcher.

23:30 I'll be talking a lot about what I've talked about today, but in a lot more detail and giving you insight about how you too, if you are looking to make the same transition, can transition. All right. So I want you to please share this episode. Somebody else needs to hear that they can. Somebody else needs to hear that it's possible. Somebody else needs to hear that it's not crazy. You absolutely can do this. And I just want to encourage you to make the transition and to find the community that helps you do that. All right. It has been an absolute pleasure talking with you today. Thank you for taking the time to listen. I look forward to talking with you again the next time.

24:15 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.