What to do when the job you have is not the one you want

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. I want to thank you for tuning in, because if you didn't tune in, I wouldn't be speaking. I'm excited to share with you today's episode, which talks about what if you got the job you didn't want.

1:22 This conversation has come up quite a bit in some of the symposiums and workshops that I've attended or served as a panelist on recently, and I really did want to address that concern. I wanted to address that challenge, because it's a real thing. I resonate with the experience that people are sharing of being in job situations that they feel like they don't want. For many reasons, we get into these situations because we don't feel like we have a choice. You don't feel like we have enough information or that people are fighting for us. When I started my faculty career, I feel like I took my job really reluctantly, because what I wanted to do was to lead a research program.

2:05 And then I was told I wasn't really qualified, and there was still so much more that I would need to do to be able to do that. And I was like, well, okay, I guess I'll take this job because they're promising to support me later if I can make it work. But it wasn't the job I wanted, but it was also in the location I wanted, and it was close to family. So there were good points of the job. It wasn't all bad, but it was also not the job I wanted. And so I will tell you that I'm still in the same job as when I first started, and I love my job today. It's so fulfilling, and it's so great and so awesome. And it is because over the course of 10 years, I've been remaking my job, and there have been some major remakes and there have been some minor tweaks.

2:51 There have probably been more minor tweaks that led to major breakthroughs that led to more minor tweaks. And it's really been an ongoing journey. It's still continuing to evolve because our careers continue to evolve. And that's why I want to share with you today what to do if you get the job that you didn't want. There are about seven things, seven strategies to consider, because I think it's important to recognize that the X factor in any situation is you. You are absolutely the wild card in this game. It's not the job. It's not the institution. It's not your mentor.

3:31 It's not the person who's your division chief. It's you. It's you. You're the wild card here. And in reality, there are many challenges that surround us, and we would prefer life without the challenges. But the reality is that we're up to every challenge. We absolutely can adapt and grow and expand to match the challenge. And every time a challenge comes before you for whatever reason, for example, you have a job that you don't want, I want to tell you that, you know, you can make it a job you want. And no, it's not going to be easy. But the real question is, do you accept the challenge?

4:13 And that's why number one strategy for what if you got the job you didn't want is to accept your mission Impossible Challenge, accept your challenge, your mission Impossible Challenge. I don't know if you recall the series of movies, Mission Impossible, that had as its star Tom Cruise, and it was like, oh, my gosh, this mission is impossible, and yet they would always do it with extra dramatic flair, right? This is the same challenge that lies before you. Because if you're someone who's aspiring to lead a research program, and instead you've been given a full time clinical job, hmm, how do you make it work? Do you give up on your dream altogether?

4:55 Do you just decide that maybe it was never meant to be? Do you just quit academia? And I think the answer to all of that is no, don't do any of that. Fight for the job you want. Fight for the mission that you want to accomplish. Fight for what you want to do. And I hear many people say I'm tired of fighting. I've been fighting all my career. I've been fighting to get into med school, and I fought again to get into residency, and then I fought again to get into fellowship. And now you're telling me I finally got into the pinnacle of all of my training, I'm done? You're telling me I need to fight again? And I get it. I get it. And that's my number one is really asking you do you accept the Mission Impossible Challenge.

5:39 It's a choice. Do you accept it? Because on the other side of accepting the challenge is the career you want. It's the experience you want. It's a rich, wonderful experience as a faculty member. If you cross over to the other side, but you're right now on the side that you don't want to be on. And yes, in between you, where you are right now, and where you're going, that amazing place is a big chasm. Is that a chasm? I think maybe it's a chasm or a chasm. It's a chasm. A big chasm between you and where you want to go now.

6:20 And you're staring at the chasm and you're like, I don't think so. I'm not going to do that. What I want you to do, and I'm inviting you right now to close your eyes and imagine the career you want. Imagine the way you feel. Imagine what people are saying about you, how they're in awe of the way you expertly answer questions as you give presentations. Imagine how patients are transformed because of the work that you've done. Imagine when you go and present your clinical trials and people are like, oh my goodness, thank you so much. They give you a standing ovation.

7:03 Imagine the possibilities. Imagine your life with you having a fully funded research team that you direct and people bring you data and you help them analyze and interpret it. And they're first authors who are writing manuscripts with you as senior author. Imagine the possibilities. And if you imagine the job you want, then the question is, do you accept the challenge? Do you accept your mission impossible challenge to take the job before you and to make it what you want it to be?

7:43 And I kid you not, it's an impossible challenge. But like Tom Cruise's character, I think Ethan Hawke probably, I forget, in all those movies showed, it's like, yeah, it's hard impossible, but you can make it. You can absolutely make it. Do you want to? You can. And if you're going to take on this mission impossible challenge, you're going to do things in a way that's not orthodox. You're going to do things uniquely and innovatively. You're going to do things differently. So everyone's like, yeah, we're going to enter through the front door of the building. You're like, no, I'm going to scale the building and enter through the roof. But this is the kind of mission impossible challenge that's before you.

8:28 And the question is, will you accept the challenge? I mean, you don't have to accept the challenge. You can decide that you quit because that's a decision that other people have made. Or you can decide that, you know what, you're trying too hard. Just settle and do what everybody else is doing. You can do that. And if you do what everybody else is doing, you'll likely get the same results that everybody else is getting. But if you say, I accept the challenge, then you've got to be willing to embrace some unorthodox strategies, some unorthodox methods to move it forward. So if you don't accept the mission impossible challenge, you can't pass scale and you can't collect 200. Just, you know, just, I guess, settle.

9:10 But you don't want to settle because if you wanted to settle, you wouldn't be listening to me right now. You want what you want because you know that what you want changes lives. It changes your life for sure. But it also changes the lives of the people around you. It changes your experience in the academy. And it changes the impact that you've come to make. And so I'm believing that you're going to accept your mission impossible challenge and you're going to move forward to create out of what you don't want exactly what you want. And I want to invite you to say that there was no challenge before you that's too great for you because you've demonstrated over the course of your life and your career that this is the kind of thing you do.

9:52 And because it's the kind of thing you do, don't let it phase you. You're going to do this one too. Okay. All right. So accept your mission impossible challenge. That's number one. It's a challenge and you can do it only if you choose to. The second thing I'm going to invite you to do is get a coach. I am inviting you to get a coach. And I have benefited so much from coaching and I am a coach. So it seems like a little bit of a conflict of interest to say, hey, I'm a coach. You go get a coach. But I really do mean it. And I'm not saying have me as your coach though. I'm a great coach.

10:32 You should absolutely come coach with me. Then I'm saying you should get a coach. Because if you're going to play any game at the level of the Olympics, you cannot do it by yourself. It doesn't matter how amazingly raw your talent is. It's difficult to do. Is it impossible? No. But it's difficult to do. And your coach is not going to play the game for you. They probably wouldn't even run beside you when you're doing all these hard exercises. What they do do is help you fulfill your potential. Because only you can discover how far you can go.

11:13 Only you can discover how much your capacity can expand. Only you can do that work. But a coach will support you to do that work. And if you are a clinician trying to make a transition to a research leadership position, you're going to want to think differently. You're going to want to be innovative. You're going to want to be strategic. You're going to want to negotiate. You have a lot of things you're going to need to do. And it is hard to do it by yourself. And I invite you to not do it by yourself because doing it by yourself has likely gotten you to where you are. Or maybe you haven't done it by yourself and you've done it with someone who hasn't supported you all the way through.

11:58 Or maybe you've done it with someone who's kind of halfway supported you or given you advice that now you're questioning whether that was okay to do. And saying whatever you do, don't go this journey alone. Don't go it alone. Have someone by your side in your corner who's rooting for you to win, who's rooting for you to accomplish the goals you set for yourself, not the goals they set for you. And so I'm inviting you to get a coach. And yes, it is an investment in your future. It is not cheap to have a coach. No, it is not. It is not. You may go once or twice when you hear what the rates are for coaching.

12:42 But it's absolutely worth the investment because you are worth the investment. And until now, you have been investing in yourself. You made a major investment in yourself in going to medical school. You made a major investment, not just financially, but you made a major investment in terms of your time. You gave up most of your 20s to do this thing. And so why stop investing now? Why say, hey, I'm done investing? You keep investing because you're worth it. And so number two, number two is get a coach. Number three is with the help of your coach or even if you decided to be hard headed and not get a coach, get clear about what success means to you.

13:32 Be very clear and it will take time for you to figure this out, but it's really important work that you need to do. Because for some of us, success in our careers is part success. I mean, it's a big driver of our success. But what you also want to do is you want to be successful in your personal relationships and you want to be successful in your personal goals. And so get clear about what success means. Yes, we know that success in the academy means published papers and grants and national recognition and people inviting you to be on committees. And we know what that looks like because it's in the AAP&T handbook.

14:16 That's fine. But what about you? What does success look like to you? Forty years from now, will you be excited about the count of like 300 papers that you have or will you feel empty inside? What does success mean to you? You got to get really clear about that. Because if you're in a job situation that you didn't want or a job situation that you didn't choose, chances are you're doing a lot of things or people are asking you to do things that you might not necessarily choose as the first thing that you would want to do. And so when you're very clear about what success means to you, then you become strategic about the way you craft your experience.

14:57 But you can't craft your experience until you understand what success means and how you're going to achieve that success. So get clear about what success means to you in your spiritual life, in your career, in your family life, in your health. Very clear what success looks like. And you may not know the destination of the success, but you know, you know where you want to go. You have a sense of it. You know, you've looked at people and you're like, I don't want to do this thing where I'm in the office every day of the week, seven days of the week. You know, you know.

15:39 And so get clear, not just about what you don't want, but be clear about what you do want and how you want to show up in this world and how you want to incorporate all your amazing medical knowledge. Get clear about what success means. The fourth thing you want to do is ask questions. One of the biggest tools that you have to you in advancing your career is your power to ask questions and to ask good questions. Now not will you increase my salary or not, because that's a yes or no closed ended question. You know about closed ended questions, but an open ended question of, hmm, I see here that I'm at below the 25th percentile of national benchmarks.

16:24 How come? It's a different, it's a different, it's a different conversation. Those two questions will elicit different answers. And so you're going to get good at not just formulating great open ended questions, but having the courage to ask these questions. And who do you ask these questions of? You ask these questions of everybody and anybody around you. You ask these questions of the people who look like they have the kind of job you actually wanted. You ask these questions of the people who look like they're in charge of defining your job description. So division chief, chair, dean, those kinds of people.

17:08 You ask questions of your family and how they see you in this world and what would make them happy if you have a significant other? Ask questions about what about your current work situation may not make them happy. Ask questions about salary and what is an equitable salary and where do your salary, what is your salary compared to national benchmarks and across the board of your institution? Ask those questions. The worst thing that will happen is that you end up exactly in the same place as you were before you asked the question, which is ignorant of the answer. But the best thing that will happen and most likely thing that will happen is that you get an answer that allows you to cross over from uninformed to informed.

17:57 And so you ask questions. You ask questions. How do we move forward in research? How do I buy down my clinical time? How does this grant coming in change my experience? How will you support me in the letter that you write for my career development award? Ask lots of questions. Ask lots of questions. Before you ever make any ask, ask lots of questions. Before you say give me, I want, ask lots of questions. And the reason you ask lots of questions is because of number five, get information. There's stuff you're going to ask and get information because you ask and then there's stuff you're going to go dig up by yourself.

18:41 You're going to go find the AP&T paperwork for your institution and you're going to read and say, okay, is this what it takes to be promoted? Okay, I got it. Get information about the most recent people who've been promoted. Like okay, what did they do? Okay, I got it. Get information about those people who are succeeding in the way you want to succeed. Get as much information as you can. And the reason you get as much information as you can is because of number six, you begin the series of negotiations. So I've talked a little bit on this podcast about negotiating and negotiating is such a critical component of our career as academics.

19:23 We're pretty good at negotiating on behalf of our patients. We're a little bit less sure as far as coming to negotiating on behalf of ourselves. But we're going to begin a series of negotiations to move us towards the job we actually want and we're going to do it strategically. But we're also going to recognize that it's going to take time to achieve the goals that we want. And that's why it's a series of negotiations. And sometimes we have unrealistic expectations. We've kind of accepted a job we didn't want. And to be honest, we chose. You may have been like, well, I didn't have any choice. We always have choice because walking away from a job you don't want is a choice.

20:09 Finding something different to do outside of academia and yet continuing to be academic within the non-academic workspace is a choice. And you've made choices. And so when you're thinking about your series of negotiations, you want to recognize that you're going to really work gradually to get to where you really want to be. And so that gets me to number seven, which is you're here to play the long game. If you're very clear what your career direction is, where you want to end up, then you know that you're here to play the long game.

20:52 You're here to negotiate and to negotiate and to negotiate again. And then when you're done negotiating, you're satisfied and you negotiate again. You know because you're playing the long game. Your career will span decades. Does that feel like a long time? You stay in academic medicine. In fact, even if you don't stay, no matter what you do, have a good solid decades of working life left. You're here to play the long game, whether you agree or not. And if you're going to play the long game, then you know that your job is to win the war and not just the battle.

21:33 And there are some battles you're going to give up because you have the bigger picture in mind. You're very clear where you're going. And so what you want to do is recognize that in your career, you're playing the long game. You are biding your time for the opportunity or for the opportune moment to come up where you can move forward in a way you've wanted to move forward. You are strategizing, walking and talking with mentors outside of your institution, within your institution to move you closer and closer to the goal. You're working hard on a daily writing schedule where you're moving research projects and manuscript writing and grant writing forward every little bit at a time.

22:17 You're working to get the resources needed to write for grant funding, to submit high quality and competitive proposals. You're going and getting the training you need to improve the quality of your writing. You're going and seeking the mentorship you need so that you can move research projects forward. You're reaching out and you're looking at collaborations that help you move forward. Oh, you're here to play the long game. And so I say all those things just to remind you that you can have the career you want, but only if you shape it. It doesn't depend on anybody else. It depends on you.

22:59 And I don't say this to not recognize that there is a power differential that exists between you and whoever is in the position of leadership at your institution. I'm not here to deny that gap. What I am here to tell you is that you have greater power than you know or understand in shaping your own career. That's because the greatest power you have is over yourself. And you may not be able to change a mentor's mind. You may not be able to change a division chief's mind, but you can change your mind. And part of this journey is you experiencing and understanding your power to transform you so that you begin to transform your experience as a faculty member.

23:40 Yeah. Seven things I told you about what to do if you get the job that you didn't want. Number one, accept your mission Impossible Challenge. It is impossible and you can do it because you're just that kind of person who can make it work. Number two, get a coach because you're going to want someone by your side who's going to encourage you all the way through, who's going to help you maximize your potential throughout your experience. Number three, get clear about what success means. Don't accept their word for it. Don't believe just what the mentors have told you success looks like. You decide. And don't just think about one aspect of your life. You think about all aspects of your life. What does success mean?

24:21 Number four, you're going to get good at asking questions. You're going to stop requesting things and you're instead going to ask for questions that get you information. You're going to get good at asking people open-ended questions. The number five is you're going to get information because information allows you to negotiate well. And number six, you're going to begin the series of negotiations. Number seven, you're going to recognize that this career you're building, you are playing the long game. You're not going to be anxious or worried about finances. You're not going to be anxious or worried about the next manuscript. You're going to recognize that you are in this game to have the career that you want over the arc of years, decades of your experience.

25:07 All right. It's been a pleasure talking with you today. I invite you, if you are looking for a coach to work with, please reach out to me. We'd love to work with you. We can set up a coaching consultation call and you can decide within that call. We can both decide if it's a mutually agreeable thing for us to move forward with. But I do want to invite you, don't do this alone. Don't go in alone. All right. Somebody else needs to hear this episode and I invite you to share it with them. I want to thank you again for being part of the Clinician Researcher podcast. Please subscribe and leave us a five-star review if this podcast has been beneficial to you and it's been helpful. All right.

25:47 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. 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.