You don't always have to play it safe

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 share this episode with you about not playing it safe. So I think I'm calling the episode, Don't Play It Safe.

1:22 The reason I want to bring it up is because I think that most of the time we get the encouragement to play it safe. Do the thing that's tried and true. Do what someone else has already tested and completely optimized, and there's no real time for you to try to do something new. And I'm here to say that I'm sharing with you the contrary advice. I am saying, don't play it safe. I am saying, take risks. And yes, I am speaking with regard to your career. I'm speaking with regard to your research career. And one of the things that's challenging about that is that if you are not playing it safe and everybody else is, you stand the possibility of losing big time.

2:05 And that's true. You absolutely could fall flat on your face and be totally embarrassed. But here's the other piece of it. You could win big time. And so the possibility of real failure is high and the possibility of super, super success is high as well. And what I would say is that it's not a gamble, but it definitely is important in terms of stretching and really discovering all you can be. Because until you set a goal that feels unusual and unreachable, you don't know how much you can stretch into that goal. The example I have to share does not come from academia, but comes from raising children.

2:49 For those of you who have children or are friends or family members with those who do, what you recognize and something that I think parents say quite a bit is that you get to this point where you're like, we figured this thing out. We can now coast. Everything changes. Everything transforms. And you're having to relearn new skills and learn new things. And it's always just amazing experience of personal development because they're changing and that means you have to adapt as well. And so why is that relevant to our careers? Well, the reality of our careers is that they're always changing. And to be honest, the landscape is not staying still.

3:30 For example, for many of us who have mentors who are 20, 30 years before us, there was a certain pattern or certain path that they went through and they did fine. When mentors, when I was starting out, my mentor would say, yeah, you want to make sure you have 75% protected time. And I laughed because everywhere I went, that's how people laughed at me. They were like, 75% protected time? In whose earth? In what reality do you want that? And the reality is that some people get it, but not everybody. And to be honest, when I look around at early career faculty, the overwhelming majority do not have the 75% protected time.

4:12 The overwhelming faculty do not have the 75% protected time. I didn't have it. And so the career that our mentors experienced or started 20, 30 years ago is different from the ones that we are experiencing right now. And the advice they have for us is still valid, but we must adapt it to the changing times. For many of us, we exist within academic medical centers that are really evolving as corporate structures. And so things are changing and it's important for us to think about how do we adapt to a changing environment while also stretching and growing and expanding.

4:52 And that's what I want to talk about today. I want to say, first of all, that you really want to stretch to take hold of new experiences and the reality is for many of us who are making that transition from clinician to clinician scientist, it's like you're just trying to figure out so many things at once, publications and grant funding and submitting proposals and negotiating resources and giving talks and building your national reputation. There's so many moving pieces that you're trying to figure out all in a short period of time. And so whenever you get to a point in one part of your career where you're like, okay, I figured this thing out, I'm now able to give talks on a great level.

5:36 I know how to be seen and heard. People are inviting me to talk. You're like, oh, I got this. You don't want change because you're like, no, no, no, it took me a long time to get to this place of equilibrium. Thank you. I'd like to stay here, please. But the challenge of staying where you are is that you get bored. I get bored. And all of a sudden it just starts to feel like more of the same. And yes, it's safe. And yes, it's tried and trusted. And yes, it produces predictable results. But wow, how boring is that? And what really, really helps us is to grow and expand and stretch for what is different and new, stretch for what helps us discover new aspects of ourselves that we've never discovered before.

6:24 Because I have to say that this career, academic medicine, it's a long career for many of us who stay in academic medicine. For me, I've been here 20 years. And I'm counting from when I started med school. I've been here 20 years. And you might say, well, med school is different from residency, it was different from fellowship. But in reality, it's all being part of one long, big career. And staying 20 years in one career is a long time, except you continue to reinvent the career, right? When we went from med school to residency, that was a reinvention. Yeah, it was more of the same, but there was a transformation. It was not the same. And when we went from residency to fellowship, there was another big transformation.

7:07 And when we went from fellowship to faculty, wow, huge transformation. But when we get to faculty, there can be a sense of stagnation. It's like more of the same doing clinical care, more of the same, okay, I wrote the grant and then I wrote it again and then I submit it again. There's a feeling of you're doing the same things over and over. And sometimes to be honest, this is why our clinical spaces are so attractive, because there's variety in patient care. In reality, every case that you see, or every person with any disease entity you see, there's a variation on a theme. It's interesting. There's a conundrum. So that's one of the reasons why we love patient care, because patient care is so dynamic.

7:49 It's always transitioning. It's always changing. We're always challenged. We're always looking for new answers. It's really cool. And how about we apply that to our academic careers? We think about how do we continue to create novelty or to create situations that allow us to grow and stretch within our academic careers. And I will say that it doesn't happen unless you're prepared for it, or unless you're prepared to seek and take the opportunity when it comes before you. You know how people say opportunity knocks but once? Such a lot, right? Opportunity is always knocking. But for people who don't recognize opportunity, there's the sense that opportunity is scarce and only shows up once every blue moon.

8:29 And so if we are open to stretching, if we're open to expanding, we see opportunities that move us in a new direction. We're not afraid to take hold of them. So I want to invite you to stretch, to take hold of a new experience that presents itself before you and to not be afraid to take hold of it and experience it for yourself. And it may be that you're like, you know what? I don't like this. Or you might be like, wow, I am stretching in this experience, but I actually really enjoy it. And so I'm encouraging you first of all to stretch, to take hold of new experiences. The next thing I want to invite you to do is to challenge yourself to the next level. Have you been successful in getting foundation grants? Great.

9:10 How about the next level of like it's small foundation grants? How about the next level of bigger foundation grants? Maybe you've been successful in say your NIHK award. Great. You know that the next stretch is your R01. And maybe you've been successful in the R01s. Great. Your next stretch is the bigger grants. And for some of you are like, no, no, I don't want to stretch in that way. And I don't want to challenge myself to that next level. In fact, I'm tired and that's okay. Right. I want to be the next big grant, but you may say to yourself, you know what? I'm at a point in my life where I want to think about doing something different. Maybe I want to move into a leadership and it's okay. Like whatever part of your career that you're in, whatever new challenge you seek, whatever new way you seek to differentiate yourself, it's okay.

9:56 But it is important that you are challenging yourself though. I will say that there are places, there are parts of our career where we're like, you know what? I want to be challenged in this space and that space. I just want things to remain the same. I want to be able to do this work with my eyes closed in this space. I want to do that. And you can choose that, but I would say that if you are stretching and growing, if you, if you want to stretch and grow, and I hope you do, you want to do it in at least one area. So yeah, keep all things constant while you stretch and grow in this one area, but don't allow your whole academic career to just kind of be status quo. Right. Yes. I know it's not the same theme, but really the gift you bring to yourself at the end of your academic career is you, is a transformed, wise, experienced you that is able to face challenges and be cool and calm about it, be able to think under fire and be able to be creative under pressure.

10:50 That's the real gift of your academic career is a transformed you. It's not someone who's mastered everything and is perfect at everything. You know, we always want to be perfect, but that's not the gift. The gift is someone who's dynamic and changing and not afraid of taking a leap or doing something new or doing something different. The way you get there is by challenging yourself to the next level. Okay. The next thing I want you to think about is ask yourself, how can I do this faster, better, more efficiently? Okay. You've been doing this thing for a long time. Let's say it's proposal development. You've gotten really good. Okay. So how can you do it faster, better, more efficiently, or even better still, how can you teach someone else to do it as well as you do?

11:34 I really do feel like legacy is an important part of what we're building here. And in reality, for many of us, as we're building research programs, there's mentorship embedded into that, right? There's the med student who wants to work with you, or maybe it's the resident or the fellow. There's somebody who wants to work within your program and you bringing them in can help you build the legacy of really pouring yourself into them. And that is what mentorship is all about. Now you have to be intentional about it. And to be honest, you do need to be educated. Mentoring is not something that comes naturally. It's not a skill that comes naturally. For those who say it comes naturally, there are many mentees burned in the process of that natural happening. And in reality, if we're going to be good mentors, we've got to really study to be good mentors.

12:17 We've got to develop ourselves, expand ourselves, stretch so that we can be beneficial or a benefit to a future generation that we're mentoring. But it's important to think about, well, if I'm able to do it already faster, better, more efficiently, how do I teach others to do the same? And how do I teach others to do the same in a way that preserves their integrity, preserves their sense of self, and allows them to see that I respect them within my research program? Sometimes in academic medicine, there's just a sense that, look, I'm not here about you. Your job is just to get the grant. You get the grant, you're successful. Good. You'll thank me later. Right now, I'm just going to pull you through. And maybe that used to be the way it worked, but I don't think that's the way, that's the right strategy anymore.

13:01 Because the real purpose of mentoring relationships is not the grant, it's not the proposal, it's not the published manuscript. It really is the development of the relationship in a way that is productive. I mean, it's not just about relationship because it's like, why are you here in academic medicine? Let's just be friends outside. It's about developing the relationship within the context of academic productivity. But academic productivity should not be the only thing we pursue and then sacrifice the health of the relationship on the platform of academic productivity. And many, I feel like that's kind of like the way many of us have come through, where it's like, you know what, I'm just going to tolerate this because the paper is coming out. And I'm saying that we can have both.

13:42 I'm asking that as you're thinking about your mentoring, as you're thinking forward to the future, as you're stretching yourself as a mentor, is to say, well, how can we build relationship and also encourage academic productivity? How can both things coexist? And so ask yourself, how can you do what you've been doing before, but in a way that's better, faster, more efficient, and in a way that brings others along as well? The work thing I want to ask you to think about is to be ready for the pushback. Be ready. Every time you're like, I want to do things differently here. Everyone's like, oh, no, no, no, no. We love the status quo. It's the way things have always been.

14:24 We don't want anything to be different. Please keep everything the same, right? You always will get people who push against what's new. And unfortunately, for better or for worse, many of the times, it's our more senior people. Sometimes it's our mentors who are like, nope, I don't want you doing anything. No, please stay with what's tried and true. You know? And it's helpful to be conservative. In reality, innovation is what allows us to transform and move forward and keep up with the changing times. And if you're going to do something different, if you're going to challenge the status quo in any way, you've got to be ready for the pushback that's coming, not just from those who are above you who may be more senior and more used to the way things are supposed to be or the way things were, but even the support staff around you who might be like, no, no, no, no, no, Dr. Superstar, person with RO1s doesn't do it this way.

15:22 Whoa, slow down, right? There's going to be some of that pushback. And you're going to be able, you're going to need to pause and ask yourself, so what do I do with this? Pushback is not a sign that you should quit, pushback is not a sign that you should just go back to the old way of doing things. Pushback is a sign that you need to be creative with the path forward. And what does the path forward look like? a path forward is to reassess how you push the innovation or how you push the change that is coming, right? What do you wrap it up in so that it's palatable to everybody who is around you, right? Sometimes you do that. It takes a little bit of energy to do that. Or maybe you say, hmm, who is on board with this changing innovation and how do I partner with them to move forward while leaving behind, or at least not involving those who are not as excited about this innovative strategy, right? It's been intentional. It's been strategic.

16:18 It's innovating beyond the challenge, right? It's not the impetus to say, well, I tried. Opposition game, I'm done. Just because they oppose you does not mean you should not move forward. Just because they oppose you does not mean you should fold up and throw in the towel, right? Just because they oppose you does not mean just wanting that you should not move forward. And so I just want to encourage you to expect pushback. Just know it's coming. Know it's coming. You're trying to do something new. You're trying to reach for the stars. Know that it is coming. The opposition is coming. And so when it comes, you'll say, oh, Teyosi told me it was coming. I'm ready now. Or maybe you're not ready, but at least it won't take you by surprise. It won't hit you to the point where you're like, oh, I've got to just, I've got to, I've got to get my breath back. Oh my gosh. That game and just, that just came and took me by surprise, right? It won't be that shock. You'll know it's coming.

17:13 And so you'll be prepared for it. The fifth thing I want to tell you is that you're going to be uncomfortable a lot and it's going to be okay. Every time you reach for something that's new, every time you reach for something that you've never reached for before, every time you do something that's kind of changing the status quo, whether for yourself or your environment or for others, there's got to be some times of discomfort and people are going to look at you cross-eyed and some people are going to downright stare you down. They're going to be like, I don't know what you're doing, but I'm going to stare you down until you change. And there may be moments of discomfort, maybe moments where your mentor is like, what's happening? What's going on here? You're going to be uncomfortable as you say, yeah, this is the way I want to move forward. I have thought about it and this is the way I want to move forward. And I just want to say those moments will come, but the price or the reward for the discomfort is forward motion, is advancement, it's transformation. It's having more, being more. Yes, it's being more than you've ever been before. The gift we walk away with at the end of our careers is us. I am the gift at the end of my career. I've been stretched.

18:24 I've been expanded. I'm able to do things that I didn't think I could do before. I'm transformed in an amazing way. Yeah, I can write grants and submit proposals. I can make arguments for things. I can handle conflict in the literature. I can do all that stuff and that's great. But the beauty of those skills, the power of those skills is who I become in the process of mastering those skills. It's who I become. The gift is who I become. And that's why it's important not to play it safe. I mean, maybe in some areas you're like, okay, I'll play it safe here, but definitely push the envelope. Don't settle because that's where many of us are. We're just settling. We're settling and we're like, it's okay.

19:11 No one's yelling at me. People are, they can't see me. I'm invisible. And the reality is you're miserable. Yeah, everybody's happy with you because somehow you've managed to not push the envelope and not try to do anything differently, but inside you're dying because you, you, the kind of person you are is a person who's used to transformation, who's used to thinking about things differently, who's used to pushing for more. And I want to invite you not to stop doing that. I want to invite you to continue to push for more. Okay. That was five things I talked about, about not playing it safe. Number one, stretch to take hold of new experiences. Number two, challenge yourself to the next level. Number three, ask yourself, how can I do this faster, better, more efficiently? And how can I bring people on in a relationship to do the same? And then number four, be ready for the pushback.

20:04 And number five, she can be uncomfortable and it's okay to be uncomfortable. That's all I have for you today on the Clinician Researcher Podcast. It's always a pleasure to talk with you. Thank you so much for joining me today. This episode needs to be shared with someone else. I'm inviting you to share with just one person, just one person today and do your good podcast deed for the day. All right. It's been a pleasure. I'll talk to you again the 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.