It is never too late to start your research career

0:00 Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills to build their own research program, whether or not they have a mentor. As clinicians, we spend a decade or more as trainees learning to take care of patients. When we finally start our careers, we want to build research programs, but then we find that our years of clinical training did not adequately prepare us to lead our research program. Through no fault of our own, we struggle to find mentors, and when we can't, we quit. However, clinicians hold the keys to the greatest research breakthroughs.

0:40 For this reason, the Clinician Researcher podcast exists to give academic clinicians the tools to build their own research program, whether or not they have a mentor. Now introducing your host, Toyosi Onwuemene. Welcome to today's episode of the Clinician Researcher podcast. I am excited to be with you today. I'm your host Toyosi Onwuemene, and today I'm talking about the fact that it's never too late to build a research program. It's just never too late. And I am excited to announce that for everyone, everyone who's building a research program, no matter how late a start you're getting, Academics Negotiate is the program for you.

1:32 And I encourage you to check it out on our website, clinicianresearcherpodcast.com. Check out when we're enrolling the next cohort of Academics Negotiate so that you can be a part of that cohort and you can get help negotiating your career so that you can build the research program that has maximum impact and allows you to thrive as a clinician researcher. So I invite you to check it out and sign up for our wait list. Okay, today I am talking about building a research program. It's never too late. It's just never too late.

2:13 So when I came to the game as far as research is concerned, people thought it was too late for me. And when was I coming? I was an early career faculty. I was just starting my first job. And I was interviewing and saying I wanted to have a research career. And the questions I was being asked, at least by the people who took me seriously, like most people were like, oh, you don't, you're a clinician. That's all you want to do. Go do research on the side if you want to. But when I first got to a program that actually was like, okay, we take that seriously. We have clinician researchers here. Tell me about your qualifications. Tell me how many grants you submitted.

2:53 Actually, they didn't ask me how many grants I'd submitted. They asked me how many grants I had. And I was like, well, I don't have any. Am I supposed to have them? Oh, oh, too late for you. Okay, okay. Tell us about how many publications you've had. I was like, well, I have four. And I was feeling really good about my four. And I was like, you don't even really have many publications. But what? What? And so there was just this sense that I was late. That if I had used my fellowship time wisely, I would have had more publications by now. I would have had some grant funding. And the fact that I'd missed out meant that I couldn't really come in in a research position.

3:36 That I could come in a clinical position and then good luck with making the research happen. And this happens to so many of us where we have a heavy clinical focus during our fellowship time and we miss opportunities to create research products. But it doesn't mean it's too late for us. It just means we need to think strategically and we need to think differently. Okay. So I'm going to talk to you today about how to build a research program starting where you are. And I want to encourage you that I am talking to you. You may be like, well, but I've been in clinical medicine for 25 years. What do you mean? It's not too late. All I have ever done is clinical.

4:16 It doesn't matter. If you have a desire to build a research program, then this message is for you. Because where you are is the most important place that you can start. Not yesterday, not tomorrow, but right now, today, where you are. I'm going to share with you seven insights about how to build a research program from exactly where you are. The first thing you need to do is to own your strengths. Yes, you have not done research or research training for the last maybe 10 years of your career or maybe you are like me at the beginning of your academic faculty experience and you didn't have the receipts that people were expecting you to have from your fellowship.

5:03 What do you have? Don't start with what you don't have. Start with what you do have. What do you have? If you are a beginning academic, a beginning faculty member, you have your clinical expertise. And although that is not research expertise, please do not be confused. Clinical expertise is not research expertise. But you do have clinical expertise. And that has value. Because if you're going to build a research program starting from where you are, you start in the place of your clinical expertise. People are going to say, well, but your clinical expertise doesn't get funded.

5:45 Do not buy the lie. Do not believe it. Because the kind of person who can make that area of clinical expertise get funding is you because you understand the area. And so your clinical expertise must always be your starting point. Perhaps you look around and you're like, well, I'm a hematologist and the only person I see around me is a cardiologist. I guess I have to do cardiology research. Don't do it. Do not do it. Your strength is your strength is your strength is your strength. It's like asking a bird to run a marathon. OK, with enough practice and training, any bird can run a marathon.

6:25 But will the bird still be alive at the end of the marathon is an important question. And perhaps the bird is alive at the end of the marathon. Is that the bird's greatest strength? Is that the bird's greatest strength? The bird's greatest strength isn't flying. And yeah, a bird can run a marathon. But really, if you want to see a bird do well, you ask the bird to fly. You are like that bird in the area of your clinical expertise. If you are going to fly in the place of research, it's got to be in your area of expertise. It doesn't matter how many non-experts there are around you. Or it doesn't matter that you don't have a mentor specifically in your area of clinical expertise.

7:06 The fact that you have clinical expertise is an area of strength and you've got to recognize that. And don't let anybody take you out of a place where you have strength. Think about how you're going to bring them in to facilitate your area of strength. But don't give up your area of strength just for the promise of a future that you don't have any control over. Okay. Own the strength that you already have. Your clinical expertise is number one. Number two is your experience. So if you're coming to this, maybe a few years after you started and you've been in clinical for a while and you're like, you know what? I really do want to do research. Own your experience. And your experience is really important because not only do you have clinical expertise, you now have experience.

7:51 It's one thing to understand theory. It's another thing to say, I've treated 7,000 patients with this condition now. I have a good understanding of what's going on with these patients. And the reason your clinical expertise is, I mean, your clinical experience is helpful is because you know where the gaps are. The longer you've been doing this, the more the gaps bug you, the more the gaps bother you, the more dissatisfied you are with the status quo. Because you're like, I have these patients and these medications are not helping them and these changes they're making are not helping them. It's not advancing them far enough. You have the experience to understand where the pain points are in your patient population.

8:34 So you not only have clinical expertise, you have the experience. So when it comes to deciding what research questions should be asked of this population, you are gold. You know, because you understand what really matters. And so if you're going to start from where you are, the first thing you have to do is to own your strengths. Don't let anybody take you outside of the place where you're strong. Own what you already have. Don't focus on what you don't have because you're going to go get that. You're going to go get someone who has it. But own what you already have because only when you understand value can you negotiate value. Okay, own your strengths. That's number one. Number two is to evaluate your need. Okay, you want to get into research.

9:16 What do you need? And in order to understand what you need, you got to figure out where you want to go. Where do you want to go? You know, sometimes when clinicians say I want to do research, they don't understand what it takes to do research. And so there's this sense that I can just do research on the fly. But research is a full-time career. Remember, there are people who went to school just to do research. And they went to school not for one, two, three, four, but five, six, seven years. And some people went for longer periods of training just to do research. So research is not a side job that you just do in the middle of the night when you're like, oh, I have a couple of extra hours. And a lot of clinicians do that.

9:58 But to be honest, it's hard to make impact that way. Research is a full-time job. So if you are a full-time clinician trying to do a full-time research job, what do you need to make it work? How do you offload some of your full-time clinician jobs so that you can do some of your full-time research job? Or how do you leverage the opportunities that other people can give you so that they're working on your full-time research job while you're working on your full-time clinician job? What do you need? And some people say, well, I don't want to give up any clinical. It's OK. You don't have to give it up. But who's going to be doing the full-time work for you while you're not giving up your full-time job as a clinician?

10:42 Who's going to be doing the full-time research? You've got to figure that out. Ideally, you want to do at least some of it, even if not all. And so how much of your full-time clinical job are you going to give up so that you can do some of your full-time research job? What do you need? You've got to evaluate your need. And no one evaluates that need for you. You do. Because here's the thing. Sometimes there's a sense that our institutions need to support us better. And sometimes I hear that, and I'm like, well, what does that mean? What does support us better mean? Because what I need is different from what you need. There is not a blanket support system. Because the support system that's blanket is for a majority that's probably not you.

11:28 And it's for a weird majority, right? Because you take the average of everybody. You can't make a good human with the average of all the people. Sometimes we're different in different ways. Some of us have longer arms. Some of us have shorter legs. Some of us have a bigger head. You can't just take the average of every measurement and say, this is the human I'm creating this resource for. Because different people need different things. And there is no greater person to help you figure out what you need than you. And you may struggle with what that need looks like. Go figure out what other people are doing so other people who are succeeding as clinician researchers, what do they have?

12:09 This is not so you can be covetous or so you can be like, I can't believe they have that. But it's just to get a sense of, I like what that person has. Because this is how it could meet my need. I don't care for what that person has. So looking at people is not to compare yourself to them so you can feel bad or feel superior. Either one is a problem. But it's looking at them, people who are already succeeding in that way, to say, I like what that person has because it will help me do X. So evaluate your need and get help doing it if you can't do it by yourself. Hello? You can reach out to me. Okay. Number three is you've got to push for protective time. Okay. Research is a full time job.

12:49 Say after me, research is a full time job. I do know that there are people who are doing two jobs. If you're a clinician researcher, you are doing two jobs. You're doing a full time clinical job and a full time research job. And you're like, wait a minute, I only have one job. You do. But you're doing two full time jobs. And if you're going to do it well, you're going to either be the one doing the full time job or you're going to hire people to do the full time job for you. And research is like entrepreneurship. You're building a program and you're leveraging the power of other people to move the program forward for you. That is really what you're doing. You're growing to be the leader of the enterprise. And over time, you can step away from the enterprise while your people just keep your work going.

13:32 And initially and in the beginning, your time is needed to really move the work forward. It is possible to start if you already have a team in place to move you forward. Right. You already have a team that's going to take you, your work and move it forward. And then you can start part time. But if you're really going to start, you've got to really put in a chunk of time into it. And I know this is a place at which I feel like I'm losing people. They're like, well, I can't do it. I have a full time clinical job. I can't do it. Yes, you can. The question is not can you or can't you. The question is how can you? How can you push for protected time?

14:12 What will it take? OK, you're 100% clinician today or maybe you're 80% clinician today. How can you shrink some of your clinical footprint so that in your 80% job, you find 20% of that time for research? How can you do it? How can your unruly Monday clinic be tamed? And you're like, oh, no, no, no. The Monday clinic is awful. It can never be tamed. How can it happen? What kind of support do you need in the clinic so that it frees you up to do the other full time job? What kind of support do you need? Are you making all your own appointments? What kind of support can you negotiate for so that you're not spending time calling your own appointments?

14:53 Are you doing your own prior authorizations? What kind of support can you negotiate for so you're not spending time listening to music on the phone? And what you start to do is you start to build just a little seed of protected time for yourself because the first person who's going to gift you protected time is you. And then you can go asking for more. You're like, this is the space of protected time I've created. This is what that space has created for me in the realm of research. And then you take that as evidence to go ask for more protected time. But you've got to push for protected time. First, nobody is going to push for protected time like you are because the reason you're pushing is because you're going to make it time that's productive.

15:35 And that allows people to really advocate for you. OK, push for protected time. Number four, assemble your team. OK, you're not going to do this by yourself. Nobody ever does research by themselves. They don't, right? We build on the work that other people have done. And we have people help us move our work forward. Anybody who can do research by themselves is not doing research that's going to make any kind of impact. I mean, it's just the reality. If you can do your research in a broom closet by yourself in the corner of your house, it'll be great research, I'm sure. But it's probably not going to impact very many people. OK, so if you are going to really make impact, and I know that the reason you came to research was not just so you could say I pipetted a couple of samples.

16:23 It's because you want to lead a question. You want to answer a question that's important to you, that's important to your patients. For that reason, you're going to need a team. What will it take? OK, you're like, well, I don't have funding for a team. I guess I can't do it. No. Who do you already have? If you're a clinician researcher, there are three teams that you need. Number one, you need your home team. OK, some of you are lucky and you have a partner that just takes care of the home front. Good for you. And some of you are lucky and you don't have a partner that takes care of the home front. Either way, you're lucky. You're lucky that you have opportunities to create a team that helps you take care of the home front. What are the things you need? You need your groceries done.

17:04 You need your shopping done. You need your laundry done. What do you need? And who's the team that's supporting you to do that? Oh, I see some people rolling their eyes. I'm like, I don't have a team. Well, what an opportunity. What an opportunity for you to create a team. And no, it doesn't mean you have to pay a concierge person to like run around your house doing groceries and in your shopping and cleaning up after you. But if you can't afford that, you should go for it. But who is your team? I'll tell you some of my team. My team is Amazon, Amazon Prime. My team consists of Walmart, you know, where you pick up your groceries at the door. My team also consists of Food Lion.

17:47 And I have other team members. I can't remember them all right now. But who are the people who make life easy for you and it doesn't have to be a discrete person. It could just be a company and the services they provide that offload you. Yes, they're part of your home team. You want to make sure you assemble them so that they resource you. And you're not spending time doing things that other people can do for you. Okay, that's your home team. And then what about your clinical team? Okay. If you are still rooming your own patients, then that's a problem. It's a problem for you and it's a problem for your institution because I tell you that the clinicians highest value to the institution is not in rooming patients.

18:31 It's just not. And if you're doing it, it's a sign that you need support. And anything you're doing in the clinical space, you should be maximized and resourced to bring in the most clinical revenue for the work you do in the time that you're in the clinic. Now, if you're a clinician researcher, clinical revenue may not be the most important to you, but as long as you're in the clinic seeing patients, well, you better maximize that time. Don't just be in the clinic seeing patients and spending all the time on the phone. You could be doing something else with that time, right? And so how do you maximize the resources you have to create maximum clinical value? Ask for those resources. Do you need an MA to support you? They're like, well, you're only in clinic a half a day a week.

19:12 Well, that's half a day of clinical revenue that I want to generate well. And so yes, I need an MA. And if I can't see three patients because I'm spending the whole day rooming patients, that's a problem. Help people see the value. They can't see it. You show them. Don't say, oh, I'm just in clinic for half a day. It's not that important. I'll just know. Make it count. And if you can be so efficient as to squeeze five hours worth of patients into three, guess what you could do with the other two, right? Assemble your team in the clinic. Don't schedule your own patients.

19:53 Don't schedule your own appointments. Don't. And in fact, if you can get an opportunity for somebody else to close your charts for you to write your note, do it. Like, oh, I don't want to scribe because it might mean I have to see three more patients. You need to figure out the math. How much does it cost for the three patients that you cannot add to the schedule? How much would it bring? How much revenue would it bring? And how much would it cost for a scribe to come and see those and help you see those three patients and close all your charts on time? And I know everyone's having different conversations about whether scribes are not scribes. It doesn't have to be a scribe. What helps you be efficient in the clinic? Assemble the team.

20:35 Negotiate the team. They may already exist. You're already working with them. How do you make the most out of them? Some of you are so disenchanted with your MAs, you don't even allow them to work for you. You keep doing their work. How can they grow and expand if you keep doing the work of your MA? How can you coach your MA to help you be better? Or how can you negotiate for a different MA? Assemble your team. If you're a scientist, the science part of you needs a team. Please, don't be the person who's proposing the research, who's writing the research grants, who's submitting the research grants and doing the revision, and also be the one who's generating all the data and analyzing all the data and doing your own biostatistics and writing your own first draft.

21:22 Don't be that person because you know what? You can't do it all well. You're the leader of a research program. You should have a team to support you. Okay, you may not have the finances yet, but oh my goodness, there are all these medical students and residents looking for a job. They're like wanting to succeed in research. And there you are with all this clinical expertise and experience. Assemble them as part of your team. Give them work to do. You're like, oh, it's too hard. It's too hard to train them. Okay? What you're going to do is recognize that anybody who is in the medical space, medical students, residents, are high achieving people.

22:03 They can learn things fast. You only have to teach them once or twice and then they can run. As long as you can align what they need with what you need, they need a paper, a first author paper. You're looking to lead a research program, make it worth their while. Give it to them, help them run with it. Assemble your team. Okay, number five, find seed funding. You need money for this team. Okay, you can get a volunteer team. Absolutely you can. If you're leading a clinical research program, you can get the medical student who's available for maybe summers or you can get the resident who is going to on their own time do research with you. You might get the fellow who says you're the best person ever. I want to work with you.

22:45 But you are actually needing people that are paid to do your work. You do. You need the people who are like you give me a paycheck, I do your work. So you got to find seed funding. You do. And all you need is a little bit of funding to start. That's it. Just a little bit. And the best place to look for that usually is at your institution. There are all these seed funding things that they're talking about because they want clinicians to be involved in research. Or maybe it's your society, right? There are all these things that your society is recommending, you know, touting as like oh please apply for these funds. Just get a little bit. Because the seed, seed is all that's needed. And the moment the seed is planted in the ground, look at what it creates.

23:28 A forest of trees. Just a couple of seeds. A forest of trees. One seed, multiple fruit. Because the moment you get just a little bit of funding, someone has voted with cash to give you money to do something. Then you're going to expand it. And how are you going to expand it? You're going to water it, you're going to make it grow. You're going to make that seed birth something, right? You're going to produce from it. And then you're going to say look at what this seed did. And somebody else is going to be like what? Look at what that seed did. And if they don't, you're going to show them. You're going to say hey, look at what this seed did. You want to put more where this seed went? You want to supply more? Right? You're going to use what you've created through the seed funding that you have to advocate for more.

24:13 It always starts with a seed. It doesn't start with a big grant. It always starts with a small grant. And the small grant leads to the next grant leads to the next grant. And in life, people are biased. Bias towards the person who can get funding. And so if you've gotten any funding, even the slightest bit of funding, you've already voted for yourself as someone who can get more funding. So just go off and find the first seed. It doesn't have to be a big seed. It does need to be a small seed. A seed. It's just got to be a seed. And so you create that seed. Use it. You find the seed. You plant it. You grow something. You produce. You show everybody what you've produced. And then you can use that to now grow more funding for your program. Because your ultimate goal is to be the leader of the program, not the one working in it.

24:59 And have people to help you work in it. All right. Number six is be patient. Be patient. Really. You're just starting. Don't compare yourself with people who've been doing this for years and years. Don't compare yourself with people who started, you know, in kindergarten to do research because their mother was a scientist. Don't. Don't compare yourself. Be patient with yourself. And show yourself compassion. Show yourself compassion. The reason you started this research thing late in the game, so to speak, is because you had a desire to see something be solved. You had a desire to solve a problem. That problem is still important. And even when it's slow going, even when it looks like no one's supporting you, be patient with yourself.

25:43 You're going to make amazing things happen. But good things only come to people who are patient. So be patient. Number seven, get the help you need. This is hard. If you're going to build a research program, it takes help. It takes help. Some people have great mentors. Most people do not. Can I say that again? Most people don't have great mentors. Most people do not. And just so you don't have a great mentor doesn't mean you're not going to succeed. But get the help you need. Who do you need? You're like, well, I can't find a mentor. I guess I quit. No. You need more than just a mentor. You need many mentors. Which mentor are you missing? Which mentoring category are you missing? OK, maybe you don't have a research mentor.

26:24 But if your institution has any researchers in it, then you have options. Which one is going to be the best for you? What are they going to give you that you don't already have? Don't wait for one person to give you everything you need. Take what they can give you and then go find the next thing from the next person. Have a cadre of mentors. And you may not even need a mentor to learn some of the things you need. For example, this podcast says here's a resource for you. I'm not your mentor, but you can learn a lot from this space. So get the help you need. Don't sit back and hope for the best. Get the help you need. With these seven things, number one, owning your strength, your clinical expertise, your experience.

27:08 Number two, evaluating your need. Number three, pushing for protected time. Number four, assembling your team. Number five, finding seed funding. Number six, being patient. Number seven, getting the help you need. These are seven things that are important to help you build a research program. And it's never too late to do that. One thing I want to add at the end of all of this is that the who matters so much. You've never done research before, but there are other people who have. And so you should seek them out to help you on your journey. And you should actually think about partnering with them. Maybe you're going to be just a clinical expert and they're going to be the research expert.

27:48 And together you're going to make a dynamite combo. It is going to be so good. It is never too late to build a research program. And I hope that you will believe that and that you will go out this week and start asking, how can I push for protected time? What do I need? I want you to start asking these questions and I want you to take a look at what you already have, what you already have and what you already have can create. And then I want you to start pushing for what you need. Start grabbing what you need. Start reaching out to people who have what you need. I want you to believe in your power to make it happen.

28:29 All right. If this episode has been helpful to you, you got to share it. Please choose just one person who wants to do research, but feels like it's too late for me. Just one person, please. And share this episode with them. All right. It's been a pleasure to talk with you today. 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.

29:10 If you found the information in this episode to be helpful, don't keep it all to yourself. No one 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.