Mastering the basics of research and writing

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 an absolute pleasure to be talking with you today. I want to talk today about mastering the basics, mastering the basics. And the reason I want to talk about mastering the basics is that you never ever get to a point where you feel like you can just forego the foundation.

1:23 You're like, oh, let's just give the simple, easy, basic steps. Let's go to the advanced steps. You're always building on a foundation of what's basic. And the reason that this topic comes to my mind today is that I had a recent meeting. I was introduced to someone who is a colleague who I didn't know yet, and this mutual friend thought, hey, you should meet this person because she's really cool. And so we had a meeting recently. And one of the first things she said in opening our conversation is, wow, you've published a lot of manuscripts. And I remember thinking, I have? And I thought, I don't think I've published that many.

2:06 And of course, if I'm comparing myself to people who've published at least 100 manuscripts, I am far behind that. Or if I'm looking at someone who's published 367, definitely far behind that. And for many of us, no matter what our number of publications or whatever it is we've accomplished, we usually don't have a sense of accomplishment, of greatness, right? We're like, yeah, I'm still on my journey. I'm still on my way. There's still so much I haven't accomplished. Because as people, and especially as academic physicians, we always have our eyes set on what we haven't done yet, the thing we haven't accomplished. And so sometimes we look down on the things we have accomplished and we don't really recognize our success.

2:49 But part of that too is that success is a journey. It's not a destination. And if it is a destination, the destination is always moving, right? Because if you think about your career in medicine, you started out in med school and you finished med school, that was successful. Congratulations. And there was the next step after that. And then you finished your story of residency and finishing residency was the destination. And then you got to a point where clearly you achieved that goal and then the destination moved. And so success is a journey. And sometimes it's a journey from success destination or from success goalpost to success goalpost.

3:29 But part of the journey is acknowledging, first of all, how far we've come, what got us there. What are the things that got us here that no longer will get us there? But also what are the basics that we always take with us, right? There's some things we leave behind and there's some things that are basics that we always take with us. So that's what I want to talk about, especially as you think about succeeding your career as a clinician scientist. What are the things that you always want to think about? And now I'm talking about scholarship in general. So you might not call yourself a clinician scientist. You might say, well, I'm not really a clinician scientist.

4:10 I'm just a doctor trying to do research. Whatever you call yourself, if you are somebody who is in medicine and you are advancing scholarship, you're advancing knowledge in any way, then you count as my audience, as someone I'm talking to right now. So yes, this is for you. The first thing I want to share is that it always starts with recognizing your expertise. It always starts with recognizing your expertise. Who are you? What do you excel at? What is your strength? And this is not the time that you get modest and you say, well, I really have no strengths because that is not true.

4:53 You've been hyper-focused in a certain field of medicine for the last decade, probably, perhaps even more. What is your specialty? And you may think, oh, it's obstetrics and gynecology. What do you mean? I'm not an expert in that area. Well, actually you are. And there's probably even a subset of obstetrics or a subset of gynecology that you are the expert in, but you've got to own your expertise first. Why do you need to own your expertise? Well, number one, your expertise is your foundation for all the work that you do. Now, you do want training in other areas, but you're already very well trained in a way that other people around you are not.

5:37 And so hopefully if you're doing your collaborations right, you're not necessarily collaborating with other gynecologists who have your exact same expertise. You're looking for people beyond your field. So they may still be gynecologists, but they have different skillsets that they're bringing to your collaboration. So in your space, in the work you do, you are the master of the thing you're doing. Yes, there may be somebody else across the country who is also kind of sort of master. This is not a game of comparison. It is just an understanding of the thing that you are really good at. The thing that you don't have to study too hard to know exactly what's needed in that space. That is your area of expertise. Now, you own your area of expertise because others who are going to collaborate with you don't have that expertise.

6:26 And if you're going to have a good synergistic collaboration, you've really got to show up and be responsible for helping direct them. For example, I have a colleague I work with and we collaborate in an area that I'm very interested in called thrombotic thermocytopenic perfora. That's TTP. Now, we sometimes like to distinguish immune TTP from congenital or hereditary TTP. And so we'll say ITTP. So confusing because there's another disorder of platelets that's called immune thrombocytopinia and that's ITP. Okay, that seems like a really basic thing to talk about, but my colleague doesn't know that ITTP is not ITP.

7:12 How would she know? She's not done this work before. This is not something she studies. So when she's looking through the literature, trying to identify articles that are relevant to the work we're doing, sometimes she's pulling in articles that are ITP because, hey, it's a thermocytopenia problem. Why wouldn't it be the same? And I have that expertise to say, oh, no, this is not the right disease we're looking at. Here's the difference between the two. I can own my expertise so that I can help my collaborators not waste time. That's what expertise does for you. Now, you're brilliant enough that you could go and study somebody else's area of expertise and be able to do or write something coherent, but in reality, you flow most easily in the area that you're most expert in.

7:58 But it's important to start from what you already have a strength in. Start from the place of your leadership. And so don't start from the place of your deficit. I don't have XYZ. No, start from what you have because what you have is what you build on. What you have is what you can expand. What you have is what you bring to the table. It's what you can gift to others as they collaborate with you. But it always starts with recognizing your power, your expertise, what you are a master at and building from there because then you will always be building from a position of strength and not a position of weakness. Many people start and they're like, well, I'm not really good at writing grants.

8:39 Well, stop telling me what you're not good at. Tell me first, what are you good at? It's important because the area in which you're an expert in, like you're an expert in this area, you start writing grants in this area, you write more easily than someone who's not an expert because you know the language, you know the lingo, you know what to say. You know when someone's saying something that doesn't quite sit right. So even though you may not have master grantsmanship for so to speak, you still have skill that someone else who's a master grant writer without knowledge in that area has. So you have strengths and it's important to focus on your area of strength. So that's number one, recognize your expertise.

9:20 It always starts with your expertise. Number two, decide how you want to contribute. You are so masterful. You have so many areas to which you could contribute. Going back to our era of gynecology, there are so many areas of gynecology that you could contribute to. So you do benign urogynecology or you do gynecology oncology and even in gynecology oncology, maybe you specialize just in ovarian cancer. There's an area that there's so many areas that you could contribute to. What do you want to actually contribute to? How do you want to contribute? In what way? Do you want to lead or do you want to be part of somebody else's leadership team?

10:00 How do you want to contribute? You could always contribute in scholarship, but how do you want to do it? You get to decide, nobody else can decide that for you. And I think it's one of the challenges, especially on our early career. We're looking to other people to tell us how to contribute and they can and they do, but there's no better place for the decision for how to contribute to come from than you because you know what makes you tick. Yeah, you know, someone might come and say, well, this area of urogynecology is the most important to me. And you might be like, I'm not really interested in that. For example, I'm a hematologist. I did hematology and oncology fellowship training. I couldn't care less about doing scholarship and oncology.

10:44 It just does not float my boat. And you know, we could go into many reasons why that is, but I prefer the diagnostic aspect of hematology. I love that. I'd love to figure out what's going on. And in fact, in all of hematology, I'm most interested in thrombosis. So what are these rare thrombotic disorders? How do they result? That's what makes me so excited. Right. And you could ask, well, why aren't you interested in bleeding? I do bleeding. I can, I can, I can, you know, I have expertise in that area too, but yeah, it's just not the thing that's most interesting to me. Right. Or people. And we don't have to explain why we're interested in anything. We just are. And so I get to say, well, this is how I want to contribute.

11:27 Maybe I don't want to be the person who's always collaborating with everybody. Maybe I want to lead something too. I get to decide that. But until you decide you can't be a good collaborator because sometimes you'll be leading when you should be following. And sometimes you'll be following when you should be leaning because you haven't really decided how you want to contribute. So you're just kind of filling gaps. But how you want to contribute helps you decide how to show up. But until you decide that you kind of look wishy washy to yourself mostly. So this is not even about how do you look to other people? It's to yourself. You haven't committed. Your mind hasn't committed with you. Right. But the moment you decide this is how I want to contribute, then you can hold fast to that.

12:09 Now I think this becomes more challenging for us when we are just trying to win. Right. Which trying to publish a paper. So then it doesn't matter how we contribute. It just matters that at the end we just want a paper. But I'm not talking about just publishing papers. I'm talking about really contributing to an area. And you decide how do I want to contribute? And sometimes we just want to do what's easy. Right. What gets me fastest to the published paper? And we do that, but it's not always the best strategy because that's short term thinking. If we're really going to contribute in a way that's meaningful and impactful, we're going to need to do it in the long term.

12:49 And that comes from you deciding how do you want to contribute. Okay. So you recognize your expertise. You decide how you want to contribute. And then the third thing you do is create a plan. Create a strategic plan. You can go to different things. Some people will say it's an individualized career development plan. But I think I'm speaking a little bit more narrowly. It's like, so in the next few months, how do you want to contribute? What do you want to contribute in the next few months? And you map that out. And the reason you want to do that is because it gives you a roadmap for where you're going. Okay. In the next three months, I will have contributed in this way. I will have written three manuscripts and submitted two. I will have given seven presentations.

13:31 That sounds like a lot, but you know, whatever, whatever floats your boat. But this is what I choose to do. These are my goals. And it's helpful because what it does is it creates accountability for you. You're saying this is what I want to do. And now you can work towards it and you have something to tell you if you miss the mark. And so creating a strategic plan is so important because wow, life is full of stuff. It just comes up. It takes your time. It leads you to places you don't want to go. You know, you could just go from week to week to week and say, wow, I've been so busy, but what did I do? So creating a strategic plan gives you accountability. It gives you direction, gives you a roadmap.

14:12 You know exactly where you want to go and you can execute on that roadmap. So a strategic plan is important. Now how do you create a strategic plan? I have a prior episode where I've talked about creating a strategic plan, but it's essentially looking at the next 12 weeks or more or less of your life, choose a defined period. There is no magic number, but choosing an extended period of time where you say, within this timeframe, it is reasonable for me to expect that I would have finished up this manuscript and submitted it for publication or I would have done this or I would have done that. Like you get to decide that. And then looking at the timeframe and saying, okay, well, how, what will I do in the next week?

14:53 In the next three weeks? What needs to be done in the next four weeks? And just really having a plan. At the end of the day, it's not the kind of plan you have. It's that you have a plan. Speaking of planning, number four is to have a weekly planning meeting. Yes. Every week you look at that big master plan that you've developed and you say, well, what can I accomplish this week? What can I move forward this week? One of the reasons planning is so important, especially for us in academic medicine, is that our schedules are so busy that the things that are so pressing and urgent just take priority. They take precedence. And then we forget to do the things that are not so urgent, that are not so important, right?

15:36 Oh, that are important, but they are not so pressing, right? They're not urgent. So important, but not urgent. And you forget to do them. And you feel accomplished because you're doing a lot of stuff. You may be answering a lot of important emails. But you're not moving the thing forward that you want to move forward. And so the key is that you plan so that you can move forward things that are very important, but not so urgent. And so planning is so important. But a plan that lacks execution is just a piece of writing. It's like ancient art. Oh, look at that beautiful plan, but no executions.

16:17 And then it is lifeless. And so a plan comes to life through execution. And what's the execution? It's committing to daily writing. That's number five, committing to daily writing. And now when I say writing, I say writing based on what I learned from Carrie Ann Rockmore in the National Center for Faculty Development and Diversity. She talks about writing is anything that gets you to a finished published outcome, right? So it's not just that I am physically writing the manuscript, typing words onto a page. It's that I'm doing the research that leads me to the manuscript. It's that I'm doing part of the reading that leads me to the manuscript. I'm doing all the activities that get you to the final finished product.

16:58 Because sometimes we're like, well, I didn't officially write more than three sentences than I wasn't writing. We tried to get, we start to get caught up in definitions. And it's not really about those distractions. It's just, are you moving forward? That's it. Are you making progress? Are you making progress in a meaningful way? Now you could read a lot of web pages in a 30 minute period and not really advance. You could be procrastinating, right? And you are the one who knows what a meaningful forward motion is. For example, I wrote the introduction to the manuscript today for 30 minutes, or I spent 45 minutes and I revised the discussion paragraph.

17:42 That's concrete. Or I did the analysis. That's concrete. Those are the kinds of things you want to commit to doing every day, every day. Now every day in your work week, right? So I'm going to come to breast shortly, but you're not going to do this every single day. There are going to be days that you're going to take breaks. And so for me, it's a four day writing week actually. Sometimes it'll go to five. But usually for me, I'm writing at least four, I'm writing four days a week. It's Monday, Tuesday, Wednesday, Thursday. I'm writing four days a week. Fridays are my days for my personal development and my growth. And so I will do some creative work on Friday, but usually not writing.

18:23 Sometimes because I really love writing manuscripts, I'll finish up some writing on Friday mornings. But really I'm writing four to five days a week, not six to seven. But define your period of time and commit to daily writing, commit to daily moving work forward. Now, daily writing is better than binge writing, right? The binge I'm talking about where you are waiting for that block of eight hour time that you're going to take and start the manuscript from start to finish. Because you don't make as much progress in that way. You make a lot of progress in that moment. Again, that's short term, but over the long haul, it takes longer because you get there and it's been maybe a few weeks since you touched this manuscript and you're like, wait a minute, where were we again?

19:05 What manuscripts did I find that I would cite? What, you know, you're just having to remind yourself of where you are, you were for the first couple of minutes or even sometimes an hour or two of your writing time. And instead of moving things forward, the benefit of writing consistently over time is that you keep that project front and center, you know, exactly where you were because, hey, you were just in it yesterday and you really make progress. It's like the difference between the tortoise and the hare, right? You know, the story, the tortoise was just plodding along slowly, but steadily, but surely the hare is moving so fast, getting tired and sleeping in between and missing the opportunity where the tortoise was able to just, because they were slow and steady, they won the race.

19:50 So you want to commit to daily writing, daily moving your research forward. Now I might hear you saying, I'm so busy, I have clinic daily. Well, yes, you have clinic, but you don't have clinic from morning till night. Well, maybe you do, but how can you set aside time for yourself? Whether it's just 20 minutes a day, whether it's just 30 minutes a day to say my clinic starts at 10 a.m. at 8 a.m. I'm going to complete 30 minutes of writing and I'm going to know that I've done that and I can put that aside and focus on my clinic. And early is better for me because I'm a morning writer, but maybe it's maybe, maybe the evening time is good for you. I'm usually pretty tired by the end of the day, but creating space to do it matters.

20:32 You may not have much time. You want eight hour blocks every day, but you don't have that yet. What do you have? Start with what you have. And you may be like, well, I only have 15 minutes. Okay, start with 15 minutes a day. What you'll find is that as you measure your 15 minutes a day, you're going to start to expand it. You're going to start to find more time. You may not find eight hour blocks, but you certainly can find those little pieces of time. And if you are struggling to find that in your schedule, we'd love to coach with you and coach you through how to how to best find writing time and to expand that. Okay. Number six is to celebrate your wins. Now, this is kind of, this has two components to it. If you're going to celebrate your wins, you first of all have to reflect on what you did and identify what was a win.

21:18 And so celebrating your win is a discipline. It's something you do to help you recognize what has come, what has come before. What effort did I put in? What did it yield? It's a place of reflection. It's also a place of appreciation so that you recognize how far you've come and how far you're moving forward. So celebrating your wins is one of the basics. That's important to do regularly. You know, what's even better than celebrating your wins alone is celebrating your wins with others. Because one of the things that other people can do for you is that they can help reflect your, they can reflect back to you what you had said you would do before and what you have done.

22:02 So in a way they can give you a nuanced view or a nuanced picture of your win that you might not have. Celebrating your wins with others is always more fun because parties are fun. Even if it's just a win celebration party, to definitely celebrate your wins. The last thing I want to share is that you do need to rest. Rest is so important. And this is not the kind of rest where you wait a few months and it's like, oh my gosh, it's time to rest. It's rest built into your daily schedule. What does a daily schedule look like that's not so packed full that you have no breathing space? What does a daily schedule look like that allows you to take downtime during the daytime?

22:42 What does a schedule look like that allows you to take off weekends? Now I know as academic physicians, you can get really busy, but you control your time. You control how you use your time. You control what you schedule. You control what you do. So at the end of the day, if you feel as if life is so rushed, you are not able to get any rest, the only person who gets to fix that is you. You may say, oh no, my mentor says I have to do X, Y, Z. I have no choice. You always have a choice. You get to decide whether you exercise that choice or you give it to other people to exercise for you. At the end of the day, rest is your responsibility.

23:25 It is your privilege and it is your right. And I hope that you take it because rest is a thing that allows you to recharge and allows you to come back stronger, come back with brighter ideas, come back with energy to really move the work forward. All right. So I talked about seven basics that you need to master and you take along with you no matter what. And that's first, recognizing your expertise. Second deciding how you want to contribute. Third creating a strategic plan. Fourth having a weekly planning meeting. Fourth committing to daily writing. Six, celebrating your win, especially with others. And seven, resting. I invite you to look and see which ones of these do you need to brush up your skills on and do a little bit more often so that you can advance in the way that you need to.

24:17 Thank you so much for listening. I look forward to talking with you again next time on the Clinician Researcher podcast. 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.