Finding and Sustaining Career Success and Satisfaction

Join Dr. Heather Whitson, from Duke University School of Medicine and Dr. Cathleen Colon-Emeric, from Duke University School of Medicine, as they explore ways to find and sustain career success and satisfaction. They also discuss describe challenges and strategies for success in research on multiple chronic conditions (MCCs) in developing your team, research program and a personalized professional development plan.

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Transcript

Heather Whitson, MD: Hello, this is Heather Whitson. I am the Director of the Duke Aging Center, and I'm delighted today to be speaking with my colleague, Dr. Cathleen Colón-Emeric. Dr. Colón-Emeric is the Division Chief of the Geriatrics Division at Duke University, and she is also a professor in medicine and a geriatrician.

So glad that you're here today, Cathleen. She is one of the authors of the module on Sustaining Career Success and Satisfaction in MCC Research, something that she knows a lot about. So welcome, Cathleen. 

Cathleen Colón-Emeric, MD, MHS: Thanks so much, Heather. 

Heather Whitson, MD: So as we both know, career and professional development planning is so important for all researchers to engage in, but I wonder if you could talk about some of the particular pitfalls or issues for people who are doing multiple chronic conditions research and things that we should especially think about as we're building our careers.

Cathleen Colón-Emeric, MD, MHS: Yes, absolutely. And I really think about these in three categories. 

The first category is thinking about the team of people you need [00:01:00] around you to be successful in MCC research. As you know, MCC research is really inherently interdisciplinary and crosses specialties. So in other words, your team is gonna be larger and more complex than most researchers have to deal with. Different disciplines use different vocabulary. They may have different expectations around writing style, and they may have different competing demands or priorities for their time. So MCC researchers really need to be intentional about building their team. 

The kinds of questions I encourage people to ask themselves as they're thinking about this are, you know, what are the mentors and sponsors in different areas I need to be successful? Who are the operational and community partners I need to engage with both for developing whatever intervention I'm working on now, as well as ultimately disseminating it when it's successful in the future. And then who are the research professionals who are gonna be interacting with my subjects with multiple chronic conditions - my research coordinators or interventionist or study nurses? And do they have the particular [00:02:00] skillset and training to be successful in dealing with this really frail and complex population? 

Do you have other thoughts about that? I know you've done a lot of research as well. How have you built your teams?

Heather Whitson, MD: Yeah. Well you mentioned one of the important pitfalls is that sometimes even people who have a lot of experience in clinical research may not have experience in this particular population. So, you know, making sure that the team - everything from the people who are, who are recruiting kind of the first face of, of the research - to the people who are, who are analyzing the data and cleaning the data, you know, sort of understand the particulars of an older population that where we may not be focusing on one single disease, but a lot of different conditions together. 

So I wondered for that sort of pitfall of potentially having people on the team who, who have plenty of experience but not experience in this population. What are some of the, the strategies or specific skills that you can give them? To help get around that pitfall? [00:03:00] 

Cathleen Colón-Emeric, MD, MHS: Yeah, that's a great question. So one of the resources that I'm really excited that has just come online here at Duke is the Duke 5 Ts Framework that was put together by our colleague Barrett Bowling.

And I know Heather, you were in, involved with Barrett in, in developing that framework to start with. But this is a great resource. It's a website that you can go to that has training for research staff and, and team members. And tools that you can use to, to help solve problems that are commonly encountered with dealing with these populations.

So how do you deal with cognitive impairment or sensory impairment? How do you arrange transportation? How do you make your enrollment more inclusive of the population that you ultimately want to, to reach? So that's a really great resource that you can find in the module. 

Heather Whitson, MD: That's great to hear. And, and I think it's so true. I, I find myself often -the simplest thing that I tell my staff is just talk more slowly and ask if you're being heard. 

Cathleen Colón-Emeric, MD, MHS: Absolutely. [00:04:00] 

Heather Whitson, MD: Sort of a, a simple thing, but something that, that someone who's been recruiting for a long time might not, might not know to do that on the telephone. With an older population.

What are some of the other pitfalls that you've seen that, that MCC researchers should consider? 

Cathleen Colón-Emeric, MD, MHS: Yeah. So the, the second category of issues I really want people to think about pertains to your own professional development as an MCC researcher. You know, you're gonna need some extra skills to be successful because of this inherently interdisciplinary, interprofessional research that you've undertaken. You need knowledge and skills and multiple disciplines. So you, Heather, for example, are a geriatrician, you did a lot of, of research and visual impairment and had to kind of become a- really understand the world of ophthalmology. I've got mentees who are, are working in dialysis units and nursing homes, even though they didn't train in those areas.

MCC researchers also have to navigate multiple professional homes. I was talking to an MCC researcher the other day who has six or seven [00:05:00] potentially relevant professional societies that they could be a part of, and they were trying to decide how do they prioritize. That it's too much of a, a drag on your time to, to participate in all of those fully, how do you choose one or two or maybe three at the most that you can really call your home and, and, and play a more substantial role in?

And then finally, you really need to learn to communicate with multiple audiences. You're talking to practitioners across specialties. You're talking to grant reviewers from different disciplines. You're talking to collaborators who have different vocabulary and you need to understand what they care about.

The arguments that you need to make the case, that you need to make for your research is gonna be different, slightly different for each of those audiences. 

Are there any other issues for NCC researchers or their teams that came up in your module? 

Yeah, and the, the final category I really wanted to call out was thinking about your own research and telling that story.

A really common pitfall with MCC research is that it sounds so [00:06:00] complex and infeasible and, and, and it, it just makes your grant reviewers, it makes your other potential partners really not understand what you're trying to accomplish. So how do you find enough focus within your MCC research area to first make it feasible to actually study it and, and intervene on it? And, and also importantly, to convince others that it's really important without overwhelming them with the complexity. 

The corollary to that is how do you find the right funders for your MCC research and convince 'em of the importance of your work when it doesn't clearly fall into one disease or organ system.

On the one hand sometimes it's really helpful because you may have multiple NIH agencies that would be potential funders for your work, but again, they're gonna have different sets of reviewers with different priorities and different expectations around grantsmanship and other things that you need to take into account as you're, you're writing your grant. 

And then finally, thinking ahead towards your own career progression. How do you really show the impact [00:07:00] of your, your work in MCCs to your promotions and tenure committee at your institution? In particular, MCC researchers commonly have primary mentors who are outside of their immediate discipline, and your mentor may not be as familiar with the milestones or what is expected for promotion in your discipline. So you really need to be proactive in making sure you understand what that is and have folks within your own discipline frequently giving you feedback on your career progression. 

Heather Whitson, MD: Yeah. Great advice. Are there any particular tools that you've used to sort of convey the message or, or make it, make it clear to those important stakeholders, funders, or your superiors at work why, what, what you're doing in multiple chronic conditions is important and how it's relevant to maybe the patient populations that they care about? 

Cathleen Colón-Emeric, MD, MHS: Yeah, that's a great question. And I think it gets back to the idea that you really have to understand the context of where your patients with multiple chronic conditions are being cared for and the reality of the [00:08:00] workflow and priorities of the, the clinicians working with those folks.

And so that may take spending some time shadowing in clinical areas that you're less familiar with that may involve attending conferences and journal clubs outside your immediate discipline to really get to know those issues. It may require understanding billing and funding issues within that discipline.

So you really have to take a deep, deep dive into, to the, the disciplines that are relevant to the, the conditions you're studying. 

Heather Whitson, MD: Yeah. Great suggestions. Well, Dr. Colón-Emeric, it was a pleasure to speak with you today and thank you for these additional insights about sustaining a career in a great area. 

Cathleen Colón-Emeric, MD, MHS: Thanks so much for having me, Heather.