Why you should have mentors outside your institution

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 a pleasure to be talking with you today. Thank you for tuning in. Thank you for listening. I am excited to announce that we will have our next webinar coming up on December 20th at noon.

1:23 December 20th at noon, and we're going to be talking about what to do when you cannot find a mentor. And I'm super excited about it because I'm realizing that so many people are struggling with finding a mentor, and they need help. And this question really resonates with me because I was a mentee who struggled to find mentors. I was one of those where I would go to a mentor and they would say, well, that's such a great idea. Why don't you go to that other person? And then I would get to that other person and they would say, oh my goodness, that's so brilliant. That person can help you. There was always somebody else to help me. So I personally feel the pain of not being able to find mentors at different stages of my life, and I want to share with you what to do when you cannot find a mentor.

2:11 So that's happening December 20th at noon. Please save the date. Okay. The second thing I want to share is that we are definitely open for enrollment for our new cohort of faculty coming through our coaching programs. And so we have a new cohort starting in January. And if you are interested, please reach out to us on our website, Clinician Researcher Podcast dot com, or you can reach out to us on our coaching website, GoEyeCoach dot com, and just sign up to be added to the wait list. And then what we'll do is reach out to you to set up a coaching consultation call to make sure that this is the right fit for you. And yeah, we would be excited to have you as part of the program.

2:54 So yes. Okay. So we're going to talk today about why you should have mentors outside your institution. I want to tell you that I started out my career having one mentor at my institution. And this mentor was always very particular in saying there are too many people telling you different things. You focus on me. I will tell you what to do. I will tell you what to do. And honestly, I think if you have a great trusting relationship, it makes sense to just focus on this one mentor. And to be honest, I really trusted this mentor. So I just really focused on whatever this mentor told me to do. And I happened to be to accept to apply to a program outside of my institution. And I remember it was like the first week and a half of this program.

3:38 It was like a summer institute. And I remember thinking I was like, wait a minute, no one's ever told me these things before. Why haven't my mentors told me this? And I started to actually mistrust my mentor because I was like, but why how come this mentor asked me to just listen to them, but they haven't shared all these things that will advance my career. And I remember asking, I was like, but is my mentor misleading me? And I think I'm very grateful for the person who was leading their program who was not trying to detract from the importance of my mentors. She was like, no, they just don't necessarily know what you don't know or they may not feel like you can handle this information yet. So anyway, I feel very strongly about the value of adding external mentors to your mentoring team.

4:22 When I say mentoring team, I don't mean to your primary mentor. You should always have a mentoring team because you are a complex person. You have so many needs. One person cannot serve all of your needs. So please, please, please, please, please do what you can to have a team of mentors and add to your team an external mentor. And today I'm going to talk about why you should have mentors outside of your institution, why you should add to your mentoring team an external mentor. I'm excited about this topic. Okay, number one, at your institution, everybody's drinking the same Kool-Aid.

5:05 I'll say it again. At your institution, everybody's drinking the same Kool-Aid. And you know, this is not anybody's fault. It's just that that's what's served in the cafeteria. That's what's served in the taps. That's what people are breathing. People are going, you know, through the institution. There is an institutional culture that everyone at your institution is immersed in. There is an institutional culture that everyone at your institution is immersed in. And especially when it comes to your mentors, especially when they've been at your institution a long time, they get institutional culture. They live institutional culture. They breathe it. They eat it. They drink it. I mean, it's just in their system, right?

5:47 It's like fish in the water. And you're like, hey, how's the water today? And they're like, what water? You're just no longer aware of the environment that sustains you. It's like how many times do you think about the air that you're breathing? Not unless you require oxygen, supplemental oxygen for any reason, do you really think about the value or the importance of the quality of the air that you breathe, right? So it's the same way. Institutions have a culture. Go from one institution to the other. And there are different cultures. There are some institutional cultures where people make the lowest salaries possible for different reasons. And there's prestige that kind of can make up.

6:29 So we hear for that low salary. But it's an institutional culture that people don't earn above a certain amount. It's not said and stone. You go to the next institution and they're like, oh, no, no, no. Our faculty earn a 50 to 75th percentile of national benchmarks. This is what we do. So institutions have different cultures. And culture is not wrong. Culture is just culture. It's just people have come together. Their minds have come together and they've kind of agreed, consciously or unconsciously, that this is the way we do things. And it makes the institution work. And so your institutional mentors, unless they're brand new to the institution or unless they're radical, if they're radical, they probably will not last long at your institution and tend to be your mentors.

7:18 So the ones that are stable and conform to the culture of the institutions are the ones that tend to be your mentors. And so they are drinking institutional Kool-Aid. You should sort of recognize that. It's not bad. You are at a great institution. I bet. I'm at a great institution. And the institutional Kool-Aid we drink at my institution is pretty sweet. It's really good stuff. I mean, it's high quality Kool-Aid. I mean, it's Kool-Aid. It's not 100% juice. It is Kool-Aid. But it's really good stuff. And so I'm not saying it's bad Kool-Aid. I'm not saying that the culture at your institution is bad. I'm just saying that it is one perspective. And I've heard people say, when you've been to one major academic medical center, you've been to one major academic medical center.

8:02 And yes, we're all practicing academic medicine. But the moment you cross the street into the next academic medical center, there's a different culture. And it's not good or bad. It's neutral. But you just want to recognize that. You want to recognize that because that means you're getting one perspective. It's the institutional perspective. This is the way we do it. And you know this. If you have moved from one program to another, say, from residency to fellowship, you're like, yeah, we did things differently at my other institution. It's the exact same thing. So everyone at your institution is drinking the same Kool-Aid. If you want to have diverse perspectives, you're going to need to leave your institutional Kool-Aid and move to the next institution and see what their Kool-Aid is like.

8:46 Because you might like their flavor a little bit better. You might want to mix it in with the Kool-Aid at your institution. OK. Number two. Because everybody's drinking the same Kool-Aid, for anybody to suggest to you anything that's outside the norm of what is already done moves them to a level of discomfort. And most people do not want discomfort. And so most people are going to give you advice that fits within the institutional norms. OK. Sometimes unspoken institutional culture is that there are gender and racial disparities in salaries.

9:28 And this is not a good thing. But sometimes it's baked into institutional culture. And so when you come as a gender, racial, or ethnic minority and you say, hey, I would like to increase my salary above this certain amount, institutional culture contrives to pull you within what is considered the norm, whether explicitly or implicitly. And so for anyone to look and suggest anything to you that is outside the norm of what is acceptable puts them at risk for ostracism within the institution. It puts them at risk to be labeled a radical. Clearly, I am not concerned about that.

10:10 But many people are. But it's a certain measure of discomfort to suggest to you anything outside of the institution. For example, you've probably experienced a mentor who's extremely successful within your academic medical center who actually doesn't treat people well. This mentor is a revered member of the community. And for anybody to suggest that they are less than stellar is going against institutional culture that says that this person is widely respected and so amazing. And so any grad student who may have challenges in this person's lab, it's unlikely that they're going to be able to make significant changes because they're going against institutional culture.

11:04 And so the reasons you want to be thinking about mentors outside your institution is that mentors outside your institution don't have a place of discomfort suggesting anything outside of the norm of your institutional culture because they don't know your institutional culture. And so they're not going to a place of discomfort just to save you. They're just telling you things that they don't even know goes against your institutional culture. So you want to make sure that you add to the team of people who want to keep institutional culture alive even when it's good or bad. You want to make sure that you add somebody external to give you a different perspective. That's number two.

11:45 Number three is that mentors outside your institution have no investment in your institutional culture. They don't care about your institution. They're not like, oh, wait a minute. Let me not give you advice that they make the people at your institution feel bad. They have no idea. They don't. They're thinking broadly in terms of academia. They think their institutional culture is the default culture. And so they think from the perspective of their institutional culture. And that's where it's a platform from which they give you advice. They're not trying to make waves at your institution. They're just telling you things. And so they have no investment in upholding any norms at your institution. They're just going to tell you things like it is.

12:27 And so when you are struggling and you're like, oh, I don't like the way this is going on, but my mentor is such a well-respected member of my institution, very easily an external mentor has no concerns about perspective, your mentor or others at your institution. They're just going to give you advice that's going to be helpful to you. And that's important. And then that brings me to number four. Mentors outside your institution, I invested only in the things that advance you. So they're not there to give you advice so that your institution can continue to be ranked one of the top institutions in the nation. It's not their problem. Their problem is you. They're only invested in your institution to the extent that you are connected with that institution.

13:10 They're your mentors outside the institution and their job is you. They're like, you're the one I'm here to serve. So what do you need? And they give you advice consistent with what you need. It is about you. And I'm not saying that your mentors at your institution do not give you advice that helps you. There are excellent mentors who do that. But there is a conflict that exists inherently between what is acceptable in the institution and what you need. And for many of us who are young, the institutional cultures serve the people who have been there the longest, right? The senior people have the voting power.

13:51 And so they've created a culture that serves and supports them. It doesn't always serve and support the younger people. Because your mentor is telling you things that benefit you, I bet. There are other people who have some thoughts about some institutional things that are not acceptable that are not accessible to you. And they can give you some ideas on how to navigate it because they're not really interested in maintaining the status quo. They're not interested in maintaining the status quo of maybe you not having access to biostatistical support. They're asking, why don't you have biostatistical support? Who can get you biostatistical support? And you know it because you roll your eyes when somebody outside your institution says, what do you mean you don't have this resource?

14:34 You should go get it. Then you're like, you don't understand my institution. Yes, you want that. You want that. That brings me to number five. They're going to share ideas with you that stimulate your creativity. And they're going to share ideas with you that stimulate your creativity. But here's a challenge. Before they share ideas with you that stimulate your creativity, or at least before the ideas stimulate your creativity, they're first of all going to make you anxious and worried and afraid. For example, I had a conversation with someone yesterday. And she was talking about how, well, you know, at my institution, if I get extra money from a grant, but I'm already covered in another grant, well, they just keep the money.

15:16 And my first thought was that, no, they don't. That money is there to serve you. How are you going to negotiate to make sure that that money serves you? Maybe it hires somebody to serve your needs. And it was a new thought to her. But the first thought she had was, is that allowed? So first of all, there's the panic of like, oh, my gosh, am I even allowed to be thinking about this? Is this treason? Is this treason? That's the first thought. And then the second thought is, hmm, that's an interesting idea. And then the third thought is, hmm, how can I make this true for me? So it stimulates creativity, but it first of all causes a little bit of anxiety because it's like, oh, no, no, no, no, we don't do things that way at my institution.

15:57 Am I going to get into trouble? Is this going to be OK? And so they will share ideas that stimulate your thoughts and stimulate your creativity as to how do I solve this problem? If for example, you don't have access to biostatistical support and they're like, oh, no, no, no, no, the cancer center has people who are paid as part of their cancer center grant to support research development. You didn't know that. And now you're like, no, my mentors told me that I can't talk to the statistician. But now all of a sudden you're like, hmm, maybe I can't talk to the statistician. It changes your mind. The ideas that your external mentors share with you will change the way you think.

16:42 And then number six is that external mentors challenge your assumptions. You assumed that because your mentor told you that you shouldn't talk to the statistician yet that you couldn't have a conversation with the statistician. You just assumed that. You were like, well, I guess I'm not ready to have a conversation with a statistician. And this external mentor is telling you, well, what makes you think you can't access a statistician by yourself? Don't you already know what questions you have to ask? And so sometimes they just really challenge your assumptions that they're a gateway, that they're gatekeepers. Like, this is the gatekeepers or the biostatistical resource. And they challenge those assumptions. Like, well, aren't you a faculty member? Oh, OK. And you should be able to access the resource directly.

17:25 Have you asked? And then you're like, well, I haven't asked. I was just waiting for my mentor to tell me. They challenge your assumptions. And you need your assumptions challenged. Because the reality of a new faculty member, even if you've been around for a while, the reality when you come in is that you don't know what you don't know. You have no idea. You rely on people to tell you. And this is the value of institutional mentors is that their job is to tell you what you don't know. The challenge of institutional mentors, especially those who have been baked into the institution for decades, is that they no longer remember what is not known. It's like you in your clinical care. You have all these acronyms you use that are so, you know, they're just second nature to you.

18:07 Who doesn't know that HTN is hypertension? Who doesn't know that? Well, the medical student who just started on the wards has no idea. But you don't even remember anymore. That's something that you didn't used to know. And you just use these acronyms without thinking. And somebody who's brand new is like, well, what is this? And they're embarrassed to ask you. And so if you don't know what you don't know, then you start to make assumptions. Or if you're only listening to one person, this main mentor who's just the only person you listen to, you're making some assumptions based off of what they're telling you, that they're telling you everything. But they may not even remember what they don't know, what you don't know.

18:48 They don't remember what they haven't told you. You know, they're not close enough to it to remember that, oh, yeah, that did used to be a problem for me. Before I had three R01 grants, I did used to beg for biostatistical support. They don't remember that, you know? And so it is important for you to have external mentors who challenge your assumptions about what is true and challenge your assumptions about what's possible. OK. So I'm going to challenge your assumptions. The next thing is that they expand your networks. So you know, the people within your institution, they all know the same people, right? All the faculty members in your institution, they kind of have, you know, it's a known network.

19:30 And it's not like it's not a vast network because it is. But by the time you have been hanging out with your mentor or your mentors for a while, you kind of get to start to have a sense of the people they collaborate with, right? You know their network. If you're going to expand beyond their networks, you're going to have to find somebody who's outside of their networks. And that typically is an external mentor. And so what you do when you engage an external mentor in your mentor networks is that you really expand your opportunities. You know, I happened to be at a conference while I'm recording this episode. And I had a mentoring session with a mentor who's outside my institution. I don't know that he's connected with anybody who's at my institution.

20:13 And he helped me really think differently about the value of networking. He's like, you're too deeply focused in your research. Like this is not what's going to take you to the next level. What committees are you serving on? Do people know your name? Do they know the value of your work? And he gave me advice in a way that really helps to expand my networks that people at my institution have not given me and not that people at my institution, not that my mentor is don't care that that's don't know that that's true. It's just that it's just never come up in conversation. Why would I want anybody outside? Why would they want to recommend to me to expand my networks beyond the networks that they already have? They have great networks, right?

20:53 The very suggestion that I might not have enough exposure may challenge their goodwill. And anyway, so just encouraging you to connect with external mentors because they expand your networks. All right, I talked about seven things. I talked about the fact that at your institution, everybody's drinking the same Kool-Aid. It's good Kool-Aid. It's tasty Kool-Aid. It may be premium quality, but still the same Kool-Aid nonetheless. And then number two, if your mentors are going to suggest anything outside the norm of your institution, it moves them into a place of discomfort. So they're not going to do that. Number three is that mentors outside your institution have no investment in upholding your institutional norms.

21:35 They're not drinking your institutional Kool-Aid. They will tell you things that are not relevant to your institutional Kool-Aid culture. Number four is that mentors outside your institution are invested in only things that advance you. They're only interested in your institution to the extent to which it advances you. And for that reason, number five, they share ideas that stimulate your creativity. These ideas may first give you anxiety, but ultimately they're ideas that stimulate your creativity. Number six, they challenge your assumptions, things that you held to be true, that you didn't know didn't have to be true. They challenge them. They shake the foundation of the things you thought were true. And number seven, they expand your networks.

22:17 Their networks become your networks because you've engaged them. So these are seven reasons why you should have mentors outside your institution. Okay, somebody else needs to hear this, especially somebody who is struggling right now in a mentor-mentee relationship. We don't talk enough about how many of these relationships don't work out and what people should do about them. And I've heard story after story after story of faculty members just quitting their research or just quitting that particular focus of their jobs just because things were not working. And so you know somebody else who needs to hear this podcast episode, and I invite you to forward it to just one person, not two, not three, not four, just one person.

22:58 Change the life of one person today by forwarding this episode. All right, it's been a pleasure talking with you today. And thank you for giving me your time. And 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 are 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.

23:41 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.