The Thought Broadcast
The Thought Broadcast primarily aims to demystify the Scholarly Project and humanise research by sharing the trainee experience. We will focus on some of the stories behind successful projects, including how the authors came up with ideas and transformed these into published research. Additionally, to complement the podcast series and better support trainees, we will hear from consultant psychiatrists who are experienced in publishing and research, and in supervising and examining the Scholarly Project.
As The Thought Broadcast develops, we hope to expand the podcast to discuss a wide range of research-related content with other trainees and early career psychiatrists. We hope that The Thought Broadcast can be an interactive experience with trainees from across Australia and New Zealand getting involved, and shaping the podcast in the direction that will benefit them the most.
The Thought Broadcast
Challenges and Opportunities in Pursuing Clinical Academic Careers
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
Enjoying the podcast? Send us a text message
In this episode of The Thought Broadcast, Dr Ed Miller explores challenges and opportunities for registrars pursuing clinical academic careers. He is joined by Dr Fiona Wilkes, Yoon Kwon Choi and Katelyn Tadd.
Music: https://freesound.org/people/ShadyDave/sounds/277375/
Logo: Sidonie Prentice
Disclaimer:
This podcast is provided to you for information purposes only and to provide a broad public understanding of various mental health topics. The podcast may represent the views of the author and not necessarily the views of The Royal Australian and New Zealand College of Psychiatrists ('RANZCP'). The podcast is not to be relied upon as medical advice, or as a substitute for medical advice, does not establish a doctor-patient relationship and should not be a substitute for individual clinical judgement. By accessing The RANZCP's podcasts you also agree to the full terms and conditions of the RANZCP's Website. Expert mental health information and finding a psychiatrist in Australian or New Zealand is available on the RANZCP’s Your Health In Mind Website.
Hello and welcome back to the Thought Broadcast, the trainee focus podcast from Australasian Psychiatry. My name is Ed Miller, and I'm the trainee editor of Australasian Psychiatry. Joining me today are Deputy Editor of Australasian Psychiatry Fiona Wilkes and Associate Trainee Editors Caitlin Tad and Yoon Kwan Choi. Welcome everyone.
SPEAKER_00Hi.
SPEAKER_05Today we'll be coming from Congress and the lovely Gold Coast. We will be discussing an editorial that we've written for Australasian Psychiatry, which will hopefully be published later this year, in which we discuss challenges and opportunities for trainees who have been attempting a clinical academic career. And we'll be describing our perspectives and giving some of our own experiences of the challenges and opportunities that we've encountered in this space. And we'll also provide some suggestions for future improvements and some advice in general for future trainees who are looking to go down this path. So, although there are many benefits for clinical teams that have an embedded research culture, such as greater efficiency, staff satisfaction and retention, there are many barriers for individual clinicians who aspire to become clinician scientists. Across Australia and New Zealand, there is an urgent need to not just encourage the next generation of clinical academic psychiatrists, but to support them in this journey. Each member of Australasian Psychiatry's Early Career Group wrote an individual perspective piece of about one to two pages in response to the question, what has your experience of research and academia been like thus far? We then grouped these perspectives into five collective themes. And these were fostering agency, barriers and setbacks, mentors and self-care, saying yes to serendipity and stability in time. We'll now go over each of these themes, starting with Fiona.
SPEAKER_02Thanks, Ed. I love those topics that you've grouped them into as well. That's so lovely. So the first one is fostering agency. And and certainly for me, research that's been a big thing throughout my career as I'm finally, as of last week, got my letters, but all through my training and before that was about giving me something that I could focus on and be in charge of and felt like gave me a little bit of stability in the middle of trying to do all of the other thousands of things. Most of us, um, when we looked at the the one to two pages that we all wrote, first became interested in research during med school. Um for me that was a little bit earlier. I did an honours degree before I did medical school and then hummed and harred about PhD versus med school and then ended up doing both. Um but for medical school, for a lot of it, the participating in the medical in the mandatory research project, or choosing to do an additional qualification, such as and I know people did masters in honours in medical school as well, or even just becoming interested in a project when the opportunity arose. But in each case, for all of us, we identify that it's really important of fostering in fostering that sense of agency and personal contribution and sometimes to combat disillusionment with medical school. Participating in extracurricular research allowed one to work on a project of interest, such as in psychiatry. Funny story, when I was in medical school, I very much didn't want to do psychiatry. I was quite rude about psychiatry to my research project supervisor who was a psychiatrist, and who had very politely just let me do that and follow my original passion of neurosurgery until eventually I came around without any input from anyone else and am now doing psychiatry.
SPEAKER_05So did your supervisor's sort of lack of um you know having a go at you for that actually contribute to you coming around to psychiatry?
SPEAKER_02Absolutely. And and and then partly partly that and and partly the opportunities which arose out of the research, which then kind of led into event uh in a master's originally until I realised that I get paid if I change it to a PhD. Like that was all through him, and then all my co-supervisors were also psychiatrists, and so then when I was much later down the track doing neurosurgery and looking at how miserable all of the neurosurgeons were at every stage, and then was like, oh, all my my research supervisors are all really happy and fulfilled and have time and energy and are quite nice. That was a big part of them being so chill about everything, deciding maybe that was the way to go. Even when we were doing clinical rotations in other fields, we in in extracurricular research, it meant that we're able to follow areas of interest, which for me is brains, which is the common link. Some of us were lucky enough to present at conferences as medical students or contribute or first author publication, which helped to build confidence and fuel that fire for ongoing work. It's really nice to see some kind of evidence of what you're doing. There was also something different between being told about a topic and actually discovering or reporting a particular finding within a topic, however small as one's own thing. Like I did that. It's a lovely sense of fostering agency. And um sometimes can be a creative outlet and a personal choice, helping to combat the pressure of needing to study for or sit and pass exams. And I think for me in medical school, that was my first feeling like I like there were problems with my attention because there were so many things that you needed to flick your attention around between things. Like I'm not not I don't have childhood problems with attention, but certainly medical school was the the first time of because you have to flick between so many things. And I think for me, research is so nice when I do back and when I'm able to go back and sit and deeply concentrate on a problem rather than flick between different subjects for exams.
SPEAKER_05Is that your kind of flow state when you do research?
SPEAKER_02Yeah, absolutely. Yeah.
SPEAKER_05Yeah.
SPEAKER_02And it's so hard now to get that time to do that because our lives get so busy, like we've got kids, and that interrupts flow states sometimes. But yeah, that's that for me, that's my kind of settling, happy place sometimes of being able to properly concentrate on the topic.
SPEAKER_03Yeah.
SPEAKER_02And from medical school and from doing that for all of us, as we were talking about it, this sense of early that personal connection and contribution to the field is is a key point of difference for doing research. And is still I think what continues to drive us forward despite all of the things that get in the way, all of the barriers and the setbacks.
SPEAKER_04Thanks, Fiona. Um so I suppose encountering barriers and setbacks in our research journey is a universal experience. I suppose some of our early experiences including being told by our clinical supervisors as interns to not to do any research, or rather to just focus on being a clinical intern. Um, writing a paper with a supervisor as a medical student, but then moving rotations and a supervisor no longer replying to our emails, and not being encouraged or being told outright no when it comes to publishing our early research by our research supervisors.
SPEAKER_05Those two points were actually mine, my experiences. Wow. That was devastating. So the first one, I'd as a final year medical student, I had done uh research with the um Department of Psychiatry at Adelaide Uni, and I had presented at a conference, and so I was running really hot and I was feeling really confident about my research, and I had this plan with my supervisor to continue to do research as an intern. And one of the ideas we had was to um do a research project in the adult mental health ward that I was working in as an intern during doing my psychiatry rotation. And when I proposed that um project to my clinical supervisor who worked in that unit, um that was their response. They just said, no, um, you should focus on being an intern and not do any research. And that was that was really devastating for me because that was just such a hard um sort of no. Um, and and I really lost, I felt like I lost a lot of momentum because of that. Um and and I felt that power imbalance actually because there wasn't a lot I could really do about that. Um that was really tough. And the second one was when when I was a sixth year student, um, one of the reasons I did a particular rotation was because on the rotation description it said that that supervisor was interested in research. And so when I did the rotation, I asked I asked them about that. We did and we ended up doing a case write-up on a on a patient that we'd seen. So I spent all this time doing this case write-up and I looked at literature around that problem and and wrote it up. But by that stage, I I had moved on to a different rotation, and I'd I emailed my supervisor with what I'd done so far and never heard back from them. And again, that was really devastating because it was just that sort of radio silence. And and there's you can't do anything about it necessarily other than email them sort of two or three times, at which point you sort of get the message. Um so yeah, though those two, those two were really difficult.
SPEAKER_02That's so tough. That you get considered continued to persist despite multiple setbacks. Yeah. Where where was that in your because you've got several master's degrees, right? Like was that before your master's?
SPEAKER_05Yeah. Yeah, in some ways it did make me more, what's the word, determined or stubborn, or like I had a point to prove, you know, and and possibly antagonistic as well. Like, screw you guys, like I'm just gonna go and do this myself. And that and that was probably part of what made me go, I'm actually going to go to the UK, and which is where I did my my first well, both of my masters, but the first one, I was like, I'm actually gonna go somewhere where I feel like they value research. And that that was a lot of the thought process behind it.
SPEAKER_02Yeah, it's a real brain drain from Australia there.
SPEAKER_05Hey, if they're not gonna support you here. Yeah, and that that's two examples of exactly why I did that. Um, yeah.
SPEAKER_00It feels not uncommon that well-meaning people might give you that advice that inadvertently actually puts a dampener on what you want to do, and it can either sort of push you to one way or make you go, yeah, screw this, I'm gonna do it anyway. Like I had a similar experience, you know. I started like quite an ambitious research project before training. And I had people tell me, just put that to the side, don't worry about that, do a small manageable one, get through training, and then worry about that later. And I sort of went, Oh, you know, I waited up and then went, you know what? Like, I started it, I've got time, I'm gonna bloody do it. Um, but yeah, not uncommon.
SPEAKER_02It's tricky, isn't it, though? But then sometimes like I've had projects that I've floated to my supervisor and he's very kindly like shot me down. But then several years later I was like, oh, no feed that because that that's because that was a stupid idea and it was never gonna work, so I'm glad he saved me that time. But that's always been in the in the nice way, and then the and here is this other awesome project that you could do. Well, this is other things that we could do together, and and come in from that place of experience. But I think you've got to really have a relationship with someone before they can do that in a productive way.
SPEAKER_00Yeah, if you know whether that advice to maybe put that to the side is actually in line with what you're trying to achieve.
SPEAKER_04I suppose that all really, you know, connects with that theme of having that clinical supervisor or a supervisor in general who you know might may or may not have interest or may not be encouraging or may encourage actually for us to actually pursue research. I suppose for myself though, um I had a slightly different experience where I had uh registrars as well as psychiatrists in my service that I worked on as an intern approach me for research. And that actually got me into research at the time, a bit I had to do a lot of those work outside of my clinical duties as well, in addition to those internship hours, which can be a bit longer than my current hours as well. Um so, yes, I think it highlights the importance of having clinical supervisors who is very much engaged and wanting us to pursue this pathway. Um, I suppose some of us have also encountered a research supervisor telling us not to publish certain data or not to tell anyone about our findings, and clinical supervisors also discouraging us from presenting at conferences due to clinical needs.
SPEAKER_02That's so upsetting. I'm very lucky in that that hasn't happened to me. But if it's in here, that obviously means that it's happened to That happened to me.
SPEAKER_05That was that one was while I was in the UK, and I won't go into that that sort of story, but um yeah, I I learnt that actually there is no perfect institution or place and every you know, sort of everywhere has its individual flaws.
SPEAKER_02Um Although actually, and I say that didn't happen to me, but on the other hand, my service pulled my academic role because of clinical demand for a year.
SPEAKER_04So has happened to me, but from a service level rather than a And sometimes some of our some of us have discovered flaws in the practice of our supervisors, which we notice by being actively engaged in reading current guidelines and research, but uh which we struggle to articulate due to the power imbalances. I think you've highlighted that before as well.
SPEAKER_05Yeah, I this one I struggle with all the time. So I've got I've got a habit where I read articles on the way to work every morning.
SPEAKER_00And it's productive.
SPEAKER_05Yeah, but I just find it really, really interesting, and I've got several authors who I sort of respect and I'm interested by, and I'll get updates whenever they publish articles, and I'm reading those. And I just wonder, you know, how often do my supervisors or other you know consultants in the service actually read papers? Um and it is really frustrating because I might have read something and you know they're doing something completely different to what I've just read is you know a good way of of doing something. Um but the inertia in the system that we'll kind of come to in a moment is real is a real you know problem.
SPEAKER_01Um what's your commute like in the morning? Like are you on a train and then you're gonna be able to do it? I'm on a bus.
SPEAKER_05Yeah, so it's a forty-five minute bus ride.
SPEAKER_01Yeah.
SPEAKER_05Um, which is perfect for um doing research emails and reading articles. Yeah. And it just gets me into the workhead space as well.
SPEAKER_02Yeah, that'd be quite nice. I've I've always been lucky in that I've been lived quite close, but then it's uh but I also really like being on public transport and doing that. So yeah, it'd be good it'd be a good space that you kind of have to do something, don't you?
SPEAKER_04It's a good transition time.
SPEAKER_02Yeah.
SPEAKER_04I suppose sometimes we mention to our supervisors that we have done research or just published a paper only for it to never be mentioned again or recognized.
SPEAKER_05Yeah, I don't know if that's sort of tall poppy syndrome or exactly what what that is, but that was an experience I think that quite a few of us have had. Yeah, you could probably analyse that a lot if you really wanted to.
SPEAKER_00It speaks a lot, I think, to culture as well in the team or the service that you're working in, whether that's something that's of value and to be kind of further fostered or whether it's just, oh, okay, that's something you did, but we've got a job to do and it's this narrow scope sort of thing.
SPEAKER_02It's funny. I mean I kind of growing up in small town Queensland, um I internalise a lot of the tall poppy syndrome. So I like I won't I won't tell people when I publish things, but uh but I will if I notice that someone's at other registrars in our group have published stuff, then I'll make sure that I put that on the group chat and say how awesome it is that they've done this thing.
SPEAKER_05Yeah, I make a point of doing that as well. Yeah, to encourage people.
SPEAKER_02Yeah. Yeah. And then maybe one person will comment and then it'll be left and no one speaks of it ever again. Yeah.
SPEAKER_00But it's good to try and normalize that kind of yeah, amongst um yeah, amongst your peers.
SPEAKER_04There are additional red tape barriers uh throughout training. This includes the fact that attending or presenting a paper or post at a conference comes from trainees' total leave and uh leave allowances, meaning that there has been times when some of us have not been able to take other types of leave, such as exam or sick leave, because our leave allowance is running too low.
SPEAKER_00It's not in every state, actually. I think in Victoria conference leave can come out of a different pool. It's sort of up to the service to approve it. So you still have to apply, but that's sort of a nice.
SPEAKER_05I thought in the training guidelines you you're only allowed the 20 days. I thought that was um standardized leave guidelines.
SPEAKER_00Oh, you mean from a college perspective of taking leave?
SPEAKER_05Yeah. So it's 20 days, which could be ext extended to 30 days on application. Um, but it's but that but it's all types of leave. So sick leave, you know. So for example, us us sitting here right now recording this podcast, this is coming out of um my educational leave, which or our educational leave, you know.
SPEAKER_02Yeah, and you'd think yeah, for college, for if you're at Congress for a week, then that should count towards your training time. But totally.
SPEAKER_04In attempting to juggle training and clinical requirements of academia, some of us have uh some of us have never really felt like we are real academics and suffer from imposter syndrome of sorts. As we are constantly fighting to do the work or fit in our lives, we are rarely ever paid for the work that we do, and our supervisor and clinical service rarely ever acknowledge it. The occasional prize or acknowledgement is helpful, and it is the presence of mentors uh which are truly the guiding lights.
SPEAKER_00Yeah, so I think you know, well, we've sort of spoken about how finding people who kind of have our interests and goals in that perspective sort of in mind and can sort of mentor us and guide us through these ups and downs and those barriers that you spoke about. And so they could be sort of an academic in more of a formal role or clinician that's involved in research and and some of us I think had sort of a past registrar who act as a mentor and sort of got you interested. Yeah. And even last night, Elizabeth Moore, our current college president, mentioned the role of mentors and being a mentor during her presidential address this this Congress. But from a mentee perspective, you know, having a good mentor that provides that oversight and can help you think flexibly and in sort of a big picture way when you can get stuck sometimes. And you know, they're patient, they can problem solve and they can have really good insider knowledge to share, and just generally quite amazing, decent people. And I think, you know, again to all those setbacks and challenges that was universal amongst us um in our um experiences. I think you know, having someone who can believe in you and help you believe in yourself and to stop comparing yourself and kind of try to stop some of that tall puppy stuff that you mentioned, and especially if it feels like we're not getting anywhere or yeah.
SPEAKER_02I mean, I finished my PhD in COVID. There is no way I would have finished my PhD if my mentor hadn't been there believing in me. I wanted out.
SPEAKER_00Yeah. Yeah, totally.
SPEAKER_04And I suppose a different service that we work in as well and the different cultures. Um, because I suppose in my current role where I'm a part-time there's a bit of time for research and admin hours as well. It's very helpful, I realize, to do research during work hours um with the acknowledgement from the supervisors and the clinicians that work in my current service. Absolutely. Yeah. Yeah, so it does make a very big difference.
SPEAKER_00When I was doing research as a student and an intern, you know, I was presenting at a at a conference. This was in um you know, pediatric respiratory medicine, so a bit of a um, yeah, before I found psychiatry. But um, you know, I I felt very much like, what am I doing here? Presenting in front of all these people, what do I know? And you know, my supervisor, and who was a good mentor at the time, he sort of pointed out, you know, nobody knows this topic like you do because nobody's done it before. You've spent all these hours thinking about it, looking at the research, being really familiar with what's out there and what's not. Um and so that was also really nice to kind of hold on to. And I and I have held on to that, I think, yeah, as I've you know gone and explored research in psychiatry.
SPEAKER_05But someone said to me once, everyone is only one question away from something that they don't know. Which I kind of dissimilar to that quote. That's that's the one that I've kept coming back to.
SPEAKER_02Yeah. Well, the imposter syndrome for me more in um in clinical work rather than in academia. But I remember having this mad imposter syndrome all through medical school. But then it was only like halfway through internship where I looked around and realized no one knew what they were doing, and then I felt better.
SPEAKER_05That's the right of passage, isn't it?
SPEAKER_00Yeah. And look, there's ways to we spoke about different ways that you can f find some information online, and you know, people have done sort of blogs and things like that. There's a few that popped up, so there's resources like um The Thesis Whisperer, um, Franklin Women, um, and there's also a bunch of articles on the Australasian Psychiatry's trainee resources page. And then I think with all of this sort of the ups and downs, it's also worth remembering that we do need to be aware of our own mental health and self-talk because you can sort of get down on yourself throughout training um or on that research journey, you know, long days, on calls, on top of all the studying and work that you have to do with training, you know, making sure that you actually block out time for yourself. Because, you know, if we are trying to pursue these other things in your own time, keeping what's important to you and what makes you you and your life, you know, well rounded, family, friends, self-care, that sort of thing really important.
SPEAKER_02That's hard, hey. And that's been really nice about being up here at Congress on the Gold Coast is having that bit of time to decompress and appreciate things. Like I grew up on a small island a couple hours north of here, and so for me being back at the beach with my feet in the sand and it is is is really grounding and stabilizing for me. So it's been lovely to just reset being up here.
SPEAKER_00Absolutely. Yeah, finding that balance, being a good enough researcher, yeah, psychiatrist, trainee, all those things.
SPEAKER_05So the next theme is called saying yes to serendipity. And it's really around the fact that over our research journey, most of us have not just encountered good fortune, but we've taken that step, I guess, to actually respond to it and say, Yes, I'll give this a go. And and yeah, so so some of it is chance and then and then some of it is responding to chance. Um so most of us were sort of benefited in some way by having a project be available at the right time when we had, you know, sort of finished all our exams in medical school and we'd have had some free time and then a project was um just happened to be available, for example. And so sometimes that's a forum post, sometimes it's an email or a c a college newsletter, other times it's word of mouth. The other thing is is, you know, sometimes there might be a project that's available that isn't exactly what you want, but you can use it to get to what you want to do. So for example, I've I've done a meta analysis and the topic I did the meta analysis on wasn't something that was particularly interesting to me. But what I but it was the project that was available and what I thought would be useful about it was to actually do the meta-analysis part so to learn how to actually do all of the statistics and how the meta-analysis works rather than the topic that the meta-analysis was on, for example. Because I I thought that would be applicable to a whole range of different projects.
SPEAKER_02Yeah absolutely it's just about the process and about learning things. Like my PhD work, I'm not gonna work like I'm not gonna do that specific thing again. But it's it's it's about the process and the connections and and learning learning how to do the work.
SPEAKER_05Yeah. Well learning how to learn as well actually like yeah it's not what you're learning, it's how do I how do I frame a question and answer a question rather than the content I suppose. And so it's actually about being flexible. So and you really being able to change from one thing to another, learning new skills quite quickly. And this concept of serendipity it's also applies to the clinical teams in which we work that we've also touched on and sometimes it's about being lucky enough to even have had one good enough experience in a clinical team that does value research. And and I've had that a couple of times and I've sort of burnt that into my memory of this is kind of what I want it to look like and I've held on to that through all the rotations where it just feels like I'm going backwards at a hundred miles an hour and look and forgetting things I used to know. I've really made a conscious effort to remember what that was like and to at the very least model that for medical students and more junior trainees than me, even if no one above me is modeling it for me. But that is really I think a rarity to have a clinical team that that that does do that. And unfortunately most of the teams do st struggle from with that inertia question because research is anti-inertia research is about moving forward and riding the wave and problem solving and being creative and it's it's an anti-inertia which is all too common unfortunately in most of our experiences.
SPEAKER_02Yeah it's funny because as I'm in that position of transitioning to being a consultant and thinking about what I want my team to look like and wanting to be able to embed research into that. So I I'm I'm still waiting for all of the thousands of different bits of paperwork to process but I'll eventually I'll move from being the advanced trainee in my team to being the consultant in my team but I'm actually gonna move apart from that apart from cutting down a couple of days a a week so I have more time and doing day private. But you know, I'm substantively staying in the same team. And so as I'm I'm now looking for okay what collaborations can we do? How can I support the team to do research? Because I think the team in some everywhere everyone has these issues with clinical demand and with it's just so busy and there is more work than we have people for and it can be so overwhelming. And then sometimes teams get into this spiral where then everyone gets more stressed and then so people are taking lots of sick days and so then everyone who's left gets more sick and they get sex days and people leave and then it it it's much worse. And so through no particular fault of anyone's is my team's a little bit in that stage at the moment. So looking at well and it's going to get better and there's been a whole heap of reasons and it is getting there but just looking forward to okay now if I'm staying how do I make this sustainable and one of those things is for me is making sure that I can support people to do research that we are doing that as a team and I think that will actually help with with morale and with purpose and with everyone being together and working together. But stability and time is so hard and there's there's a few of us within the group who've had the absolute um privilege of working in roles where there's been an integrated or funded academic post. You were saying you were in one at the moment. I was in one um for a year of my advanced training and it was then the second year of my advanced training because clinical demand it was not there. But when we have it that's cheers just the best role in the world. You get time to do things and people appreciate it and you get to teach and research and you're involved in this team. But really just giving that stability and at the time lets you sit in that flow state and actually have a bit of time to think deeply about things rather than flicking between the thousands of things that I'm constantly flicking through at the moment. Like at the moment I'm most of my research stuff, most of my emails to you guys get sent at bloody 10 pm when my kid's in bed because I don't have time in my clinical job and I don't have time in my parent job so it's after that that we get to do it.
SPEAKER_00So trying to move from this idea of serendipity and chance to actually being m more considered in how you bring this sort of thinking to a team in the clinical way.
SPEAKER_02It needs a both I think and and you're talking about the looking after your own mental health. Yeah yeah serendipity absolutely geez there are some amazing serendipitous things that I've grabbed a hold of but then once you grab a hold of it you've got to put in the work and it helps if you've got the space to be able to do that. So even but you know funded placements are few and far between. So for those of us who haven't had them or for those of us who have but then there's been other times where we haven't, having a stable research department or a professor really helps with continuity as well knowing finding a team knowing a team but as we've already said the status quo was that research is normally squeezed in around everything else. Lots of us have done research on weekends and public holidays or during sleep days for night shifts. I love I'm I no longer have to do a night shift ever again now that I'm I love it but that was one of the few things that I liked about night shifts was having those couple of days off at the end of it to try and catch up on things.
SPEAKER_05The best feeling was because you can do research this is going to sound super nerdy but you can do research on the first day of nights because you still I was in I don't sleep during the day I do it like during the day and then if you have a not super bad night shift if I can fit in like one or two hours of research in the morning after a night shift then then I'm feeling great. Then I'm feeling amazing.
SPEAKER_02But that I think we can all safely say we're giant no it's like that's okay. That's safe to say sometimes like as you're saying night shifts I think yeah have sometimes been good for me to or just catch up on other things if it's you're you're lucky enough to have a Q word night shift. But otherwise sometimes that I find useful is having a reviewer's comments come with a short deadline for a response which on the one hand is bad because then you put cramp things in but on the other hand I do not work without a deadline. I have too many balls in the air. I will happily drop most of them unless someone is telling me I have a deadline and then it will get done. Like I think the la most of my PhD got done in the last six months of my PhD. But you know it means that we're doing sometimes we're doing long hours. Set shifting trying to do research in the clinical offices if you don't have protected time can be really hard and really draining. Have you guys tried to do that much at all?
SPEAKER_05Like what's your Yeah this this this is the one that I find super frustrating because you know let's say I have a patient cancel an outpatient appointment and suddenly I've got two two hours or an hour and a half or something and I'm and I'm thinking ah here's I can do something I've got two hours but trying to it takes me a bit to get into that flow state that we were talking about and by the time I'm kind of in it it's almost up you know the times I'm or someone's interrupting me you know in the office and asking me questions and I just that that's what I find really frustrating because I've got that block of time which I've not been able to use effectively. So I do my best research on a Saturday and Sunday morning where I write wake up early, go and grab a coffee and then sit there until lunchtime with no interruptions and then do the work. So trying to do it bit in a bitty way around clinical work is just I I just find that just really frustrating.
SPEAKER_00It's a nightmare I can't do it that's constant. The clinical stuff fills the time that you have so if someone cancels there'll be other ways at least finishing my notes always I was going to say I used to um I used to have to go to a different office in the building if I wanted to set shift and work on my research. I couldn't sit at my desk where I'd do the clinical work. I'd find another one I'm in there I'm doing that. You're lucky to have multiple free desks in the workplace the hunt for the the hunt for the secret uh the secret free office was yeah real.
SPEAKER_02But it's tricky isn't it because it's like I I don't want to say no to my team like if my team are coming and asking something like I want to be around I want to be supportive and that was actually that was another reason that I left neurosurgery was because one of my junior one of my senior Regis was just such an unpleasant person to deal with at all times and it was only halfway through being on call one in three for you know six months that I was so sleep deprived that I realized the reason you do that is because it discourages people from asking questions. And so then you get to sleep when you're on call because no one's going to call you because you're gonna bite their heads off. And I didn't want to be that person and you could see that that's how you end up having to do it. And like the same thing with trying to do research in clinical time, right? Like I don't I know if I was rude to them they would stop asking me things but I don't want to be that person. So you're trying to find a different office or go elsewhere.
SPEAKER_05I think they know when you're not working on clinical stuff they pick up on it. Like when you're doing your own thing they perceive that as not helping them which is hard when you're actually sitting in your workplace office. You know it's hard to justify that in s you know some sometimes even though research and clinical work do go hand in hand often they don't see it that way.
SPEAKER_02Yeah it's tough. And then of course when you're talking about doing it in the training program then you're not changing rotations, you're changing people, you're learning new people, new processes, systems on calls, all of the exams and sometimes so you know that's my mentors main first rule of training is get your letters, get your letters, get your letters and that's and there is and I and I also do have lots of colleagues who've procrastinated, done other things and then end up just getting stuck on one bit of exam that like just takes several attempts to pass and all of the things blow out. So trying to juggle all of them is really tricky.
SPEAKER_00But that said, you know, the SCOLI project is one of those um central assessments that do delay people fellowing because it's you know it can easily get put in the too hard basket or if you're not if you don't find a supervisor or a supportive rotation you kick it down the road, I'll do it this exam instead, I'll do this exam instead and next minute you find yourself, you know, with a year left of training and then have to really think about what can I achieve in that short period of time.
SPEAKER_02And one of my the scholarly pro at least the scholarly project so you don't have to wait until the next resubmission. You can if there are small errors you can put them back in and then it's not too long. But one of my friends got his conditionally passed but he still had to change things for the stupidest reasons and I looked at like I I'd I'd looked at the paper. I was like this is a really good paper before he put it in and then we were both gobsmacked and and that just pushed it back again. Yeah and sometimes people take time out of training sometimes locum all work spontaneously to fit into train to into research as to the total time. Lots of us are around the PGY 10 mark I'm PGY 10 this year.
SPEAKER_04So I suppose with all those themes in mind we have drawn our collective experiences to make the following suggestions for those at an individual clinical service and college level to continue to help encourage a culture of research for psychiatry trainees, training adjacent doctors and early career psychiatrist across Australia and New Zealand. Suppose at an individual level we encourage junior doctors and trainees to have research related conversations with our supervisors, including asking the supervisor to suggest articles to read, approaching the supervisors with suggested articles to also discuss together as well. We encourage consultant psychiatrists to engage junior doctors at all levels who work in their service to participate in research by including them in research related discussions and encouraging them to present articles at journal clubs or unit meetings. This includes offering them a role in service related quality and service improvement projects. The Rural College Psychiatry offers some helpful resources for interns called Foundation doctors in the UK and the supervisors for how to advocate for psychiatry including research. At a service level we encourage health boards to work with the college training committees to schedule regular journal clubs, allow attendance at research meetings and support senior registrors with non-clinical time to work on small service related research projects. We also advocate for services to incentivize and reward clinical units who participate in research by awarding prizes, certificates, rewards and ceremonies for such units where they can perceive acknowledgement from peers and impart a healthy level of competition.
SPEAKER_00Yeah so to wrap it up some supervisors have told us that research gets in the way of clinical work and puts you at risk of burnout but we don't as a group see it that way. Research can give us hope for solutions to complex problems for new answers and insights and it can be fun and exciting because it allows us to collaborate and contribute to the field as a whole. And there's that thrill when we see someone cite our articles and discover how our work contributed to their thought. Most importantly as a group we have faith that research will help improve outcomes for our patients and set higher standards of practice. Not to mention good researchers are also good clinicians, knowledgeable efficient, good at time management and organised and there's an appeal to reading the latest research and thinking about how it might be incorporated in some way into our clinical work for the benefit of our patients. And we also think fondly of the people along the way who believed in us despite the setbacks and challenges and we can hold on to those examples and try to be that role model for others. We hope this editorial can continue to inspire, encourage and motivate others to continue on the research journey.
SPEAKER_05So that's all we have time for today. I'd like to thank Fiona, Yoon and Caitlin for coming on today and having such a rich and interesting discussion.
SPEAKER_02Thanks. It's been fun thanks.
SPEAKER_05We'd also like to acknowledge David Bill and Nishtakuma from the college who give us so much support in producing and editing the show. We're also thankful to Australasian psychiatry for the opportunity to make these podcasts as well as Sadoni Prentice for our artwork and Shady Day for our music. We encourage our listeners to rate the podcast on whichever app you have accessed it as well as promoting it to other registrars or supervisors. We always love getting feedback or suggestions for future episodes including volunteers interested in being a guest. Please get in touch by email at thethbroadcast.podcast at rankzcp.org That's all for now my name is Ed Miller thanks for listening and we'll catch you next time