Making the most of your post-doctoral fellowship

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. I'm your host, Toyosi Onwuemene, and it is such a pleasure to be speaking with you today. Today, I'm going to be talking about how fellows can succeed in their quest to become a clinician scientist. And, you know, to become a clinician scientist is hard, and to be honest, it is challenging.

1:21 But we've been doing challenging things from the very beginning, and many times when the path is laid out for us, it seems less challenging. It's still challenging, but we know what we're doing, and so it feels less frustrating. And sometimes one of the challenges of doing this thing and trying to succeed as a clinician scientist is that the path is not so clear, and some people get great mentors, some people don't. And so how do we do that? How do we make the transition? How do we succeed so that we're able to move forward the research that we really want to move forward? And so that's one of the things I want to talk about, because when I was interviewing for jobs as a fellow transitioning to faculty, I wasn't really clear on what I wanted.

2:06 People said, well, what kind of job are you looking for? I was like, well, I'm looking for 75% protected time for research. And they'd be like, well, so what kind of research do you want to do? And I'm like, well, maybe cancer associated thrombosis, hemostasis thrombosis. And I was not very specific. I didn't even recognize that that was an issue until now I'm in the one interviewing, I'm the one in the seat interviewing people as they come through. I'm the one in the driver's seat asking people, hey, why are you here? What do you want to do? How do you want to succeed? And although I'm not making the final hiring decisions, I can now see how it was problematic for me back then to say, hey, I want 75% protected time.

2:46 And I couldn't clearly articulate what that 75% protected time would get me. So there are five things I want to talk to you about as far as how do you move forward in your fellowship in a way that allows you to set yourself up for success when you finally go for job interviews. And I'd like to actually stop here and let you know that one of the things I do is I help programs coach fellows so that they can be successful in that fellow to faculty transition. And it's really important if you can get it right early on, it makes your journey so much easier. And so if you're a fellow and you're like, well, I can't afford coaching because it's so expensive. Yes, it is.

3:27 But sometimes what happens is that fellowship programs support their fellows so they can get the coaching to negotiate the right jobs that put them in the seat to really help enhance and guarantee their success. And you can always do that with the help of a coach guiding you. So if that's you, if you are interested, send me a DM, reach out to me on my website, coedcoach.com, and we can set up a time to talk and see if this relationship is a right fit for the both of us. Okay. So the first thing you want to do in succeeding in your quest to become a clinician researcher is to use your fellowship time strategically. Use your fellowship time strategically.

4:09 What does that mean? Sometimes people are just kind of feeling their way around saying, well, I'm not sure what I want to do and maybe I'll do this or maybe I'll do that. We'll see how things go. And I want to tell you that whenever you have that feeling of not really being sure where you want to go, it is a sign that you have work to do. And I will tell you that in our training, there's a lot of disconnectedness that happens because of how much we work hard to disconnect ourselves from our feelings. We're delivering bad news. We try very hard to cut off all emotions so we don't cry, so we can be objective.

4:52 We are sleepy, but we have an overnight shift. And so we suppress the urge to sleep, sometimes chemically, sometimes just by sheer force of will. We need to go to the bathroom, but we're in the middle of an OR case. And so we are suppressing the urge to go to the bathroom. We practice for so long how to disconnect ourselves from our feelings, from our emotions. And because of that, when we get to the point where we should be thinking very clearly about what we want for our careers, we're stuck, we're confused, we don't know. We're waiting for external forces to move us in the right direction. Maybe when I get on this rotation, I'll find a patient whose disease I fall in love with.

5:36 It's not that that can't happen. It's that many times our inner voices, our inner compass is so suppressed that we can only recognize it when it slaps us in the face. We can only recognize what we want when it's right there in front of us. And that's why there's that sense that, well, if I encounter the right patient, if I'm just in the right mentor's presence, I'll know it. And yes, you might, but what if you don't get that mentor? What if you don't get that patient? What if you don't get around them? And then you're stuck. You're stuck not knowing what you want to do. And so anyway, so what I'm really saying is that, hey, it takes time, work, energy, and investment to figure out what you really want to do.

6:19 And it is important upfront to clarify what that is. And a lot of that can happen with the help of a coach. It doesn't have to be a coach, but allowing yourself to have the time and the space to really get back in touch with the way you feel about things, with what you really want to do. What is your driving sense of purpose? It allows you to make a decision so that you can use your fellowship time strategically. You don't know what you want to do. You don't know what your experiences, what experiences in fellowship are going to move you forward. And what happens is that you kind of wander around, and at the end, when you finally have to make a decision, you literally just pick whatever you find and then move on.

7:02 And so I just want to encourage you that if you are a fellow and you're not even sure what you want to do, talk with somebody, make time to really clarify what your desires, goals, wants are so that you can be very strategic about how your fellowship moves you forward. Don't accept a fellowship experience where you don't have clarity from the beginning about what you want to get out of your fellowship. So use your fellowship time strategically. The second thing you can do is to think carefully about the opportunities before you. That is to think carefully about the opportunities before you.

7:42 What does that mean? In fellowship, there'll be so many opportunities. It feels overwhelming. There's this scientist you could work with, and there's this other project. There's so many of them. And sometimes it's tempting just to go with, in a sense, just guess and say, I'll just go with this one. I'll go with my gut. And going with your gut has probably served you a lot. So I don't discount its power to serve you again. But really, as you grow and as you really start to take ownership of your career, you stop going with your gut, and you start asking your gut to explain why it feels the way it does.

8:25 And sometimes going with your gut is that you're so disconnected from how you feel. It's just literally you're looking for a rumbly in your belly to tell you, OK, this is what I want to do. And so what you really want to do is take a step back and say, well, how do I want to contribute? How do I want to be remembered? What do I really want to do? And then you say, what are the opportunities before me that helped me get there? And that's why number one is so important in clarifying what you want so that you can use your fellowship time strategically. Then it also allows you to analyze and evaluate all the opportunities before you to say, which opportunity gets me closest to my goal?

9:09 All opportunities are not created alike. Several mentors don't get you to the same place. But when you have a clear sense of direction, you're able to say, this mentor can do this for me. I can learn these techniques in this mentor's lab, or this mentor already has access to this expertise that allows me to connect to my purpose, that allows me to connect to my why. And so understanding where you want to go allows you to assess the opportunities before you so you can pick the one that really helps you move forward. Number three is to have a plan for your unstructured research time.

9:51 So what I find is that many fellows kind of just slug through the first year. It is such a hard year. And then at the end of it, they're recovering for three months and four months and five months and they're still recovering. But what is happening is that they have never been in the situation, not in the eight, nine, ten years of their training, where there's no clear plan for what they're supposed to do. And so many fellows have a hard time with that. Yes, they may show up to the lab in the morning and do all the activities, or they may show up to their research mentors' research program and do the things that are required of them. But where there's no experiment to be done or where they're waiting in between experiments, there isn't a clear sense of what to do with that unstructured time.

10:41 And so if you're going to be successful in making the transition to become a clinician scientist, you're going to become a master at making unstructured time structured. Everybody needs structure. Everybody thrives with structure. Everybody does well with structure. Many times you create the structure you need. Some people are waiting for their fellowship programs to say, hey, from nine to two, this is what you do. And then from two to five, this is your schedule. It's really nice if your fellowship program provides that for you. But a time is coming when you're going to need to be the one creating structure for your structured time.

11:22 Starting in fellowship is a great time to do it. Don't let unstructured time get away with you. Don't make believe that you are on an extended vacation doing research. Make sure you have the tools to create structure out of unstructured time. And again, I'm really partial to coaching in helping you get to where you need to be, get the coaching you need so that you can make the best use of your unstructured time. Perhaps you have a mentor who can help you do that. Whoever it is, get the help you need. Get the help you need. If you need me to help you, send me a DM.

12:02 We'll talk about how to help you create structure. But get the help you need to create structure so that you can be successful in your time as a researcher during your fellowship. Number four is to apply for as many opportunities as you can. Rejection is tough and rejection is a part of the work we do. The reason rejection is a part of the work we do is because our work is unfolding, our work is evolving, and it's not perfect at the beginning. We're prototyping. With each failure, so to speak, with each failure is an opportunity to do things differently next time. Some people are lucky.

12:42 They get it right the first time. They get the grant funded the first time. Most people are not. It takes two tries, three tries, four tries, five tries, and five tries iterating each time to bring something new, something different out of what existed in the past. Part of iterating, getting better each time you submit, getting more high quality feedback each time you submit is doing it again, and then doing it again, and then doing it again. Really applying for as many opportunities as makes sense for you is important because it not only advances your work in fellowship, but it also gives you opportunities as a faculty member because you get practice in the act of submitting and submitting again and submitting again, which really is what happens to as many people as are pursuing this path of becoming clinician scientists.

13:44 Your work is going to be rejected. You may not align with the funder, or maybe there's a more meritorious application, or actually your application is equally meritorious, but the priorities of the funder support the other project. There are always going to be reasons why your work is rejected, but applying for as many opportunities as you can allows you to refine your work, allows you to improve over time, allows you to get over the pain of rejection. It takes time to recover and to get used to it. You get over it, and then you're like, okay, what's the next opportunity? What makes sense? It increases your chances that you get funded, increases your chances that you are able to say, I'm someone who's put forward an application that's been successful, and that always looks good when you go to interview, but it's also good for you because it helps you establish a pattern of moving forward in spite of rejection.

14:40 And it doesn't have to be just about grants. You submit proposals for different things. You're putting forward a proposal for a new project, for a new education initiative. Applying for as many opportunities as you can gives you an opportunity to learn how to do it better each time, but it also gives you insight into where you don't go, where your work may not be as accepted. So there are many, many opportunities that come as a result of that. The fifth thing that fellows can do to succeed in their quest is to have a clear vision for their careers when they interview. So I have the opportunity now to interview so many people when they come our way and are looking for jobs at our institution, and I say, where do you see yourself in three years?

15:25 And they can't answer that question. I mean, people fumble through, but it's very, very different when somebody says, in five years, I will be applying for a career development award because what I want to do is be established as a clinician investigator in sickle cell research. Wow, that's so clear. And it may not be true, and I'm not saying you should lie, but I'm saying that you will evolve over time. What you feel so sure about today may not be what you feel so sure about tomorrow, but you should have a clear plan and a clear goal. Because what it communicates to people is that you've really thought about it. You've been very thoughtful. You're not just kind of like waving your hands in the air and thinking, oh, how might this work?

16:08 You have a clear plan for your future. And that means you're someone who thinks clearly. You're someone who takes action. You're someone who's decisive. And it helps you. It helps you because when you're saying, I want 75% protected time for my research, if that's what you want, you have a clear reason. You know what that will do for you. And you'll say, well, I've written this R01, I've written this grant, and I know it may be rejected the first or the second time around. And I know it's going to take time to really evolve it into the project I want it to be. And therefore, this protected time allows me to continue to refine my idea until it gets funded and I'm able to get my own independent funding.

16:51 It makes it very clear. It makes it very clear that you have a sense of your direction. No one's going to have to give it to you. And that helps people have confidence in your ability to deliver or make use of the help that's given to you so that you can deliver. So those are five things that fellows can think about in their quest to become a clinician researcher. And I want to say that if this episode has been helpful to you, if you think it will be helpful to someone else, please share it with them. We also are asking you to please subscribe and share your feedback by rating the podcast. We want to hear from you. And we know that as you rate the podcast, we're hoping you'll give us a five star rating.

17:35 It helps other people find us as well. All right. It's been a pleasure to talk with you today. I look forward to 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.

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