Dr. Sharon Milgram — Making the Most of the Trainee Experience

>> Diego (narration): Hi everybody! Thank you for joining me on to another episode of Speaking of Science. I’m your host Diego Arenas and if you’re just tuning in for the first time, this podcast is all about the great diversity of biomedical research taking place in the Intramural Research Program of the National Institute of Health, or the NIH IRP; but none of that research would be possible without the hard work and dedication of intramural trainees.

There are over 5,000 trainees currently in the IRP. That includes postbacs, postdocs, summer interns, graduate students, clinical fellows —basically any NIH scientist in the early and mid-stages of their career. And while trainees work to support the NIH’s mission to turn discovery into health, the Office of Intramural Training and Education, that’s OITE for short, works to supports trainees in their professional pursuits.

>> Dr. Milgram: OITE is here to provide resources and support for trainees from their arrival until they get set to leave and go on to the next stage of their career.

>> Diego (narration): That’s Dr. Sharon Milgram. She is the director of OITE and as such, is a firm believer that good training begets good science.

>> Dr. Milgram: We need to stop thinking of training as separate from science. To do good science means to be able to work on teams. It means to be able to hear feedback, give feedback, resolve conflict. It means being able to lead. It also means being able to step back and let an expert in an area lead you. These are skills that we need to do good science in the complex environment we now work in.

>> Diego (narration): With Dr. Milgram at the helm, OITE offers trainees a wide range of programs and resources.

>> Dr. Milgram: We provide lots of workshops and webinars for professional and career development. We host a career center so trainees can meet with career counselors. We have an industry advisor. People can come and have a one-on-one consult. We host job search groups. We also sponsor poster sessions and special one-day events, a graduate school and professional school fair, a career symposium, a graduate student symposium. You know, anything that a trainee would benefit from in their time here, we either host or make sure they know about.

>> Diego (narration): You can learn more about those on the OITE website at training.nih.gov. But once you’re there, you’ll see that it’s not all about resumes builders, application assistance, and career advancement. OITE cares about the wellness of trainees and provides plenty of resources to help navigate the personal hurdles that honestly, any profession has to contend with, not just those in science. Bumps in the road like imposter syndrome, establishing a healthy mentor-mentee relationship, building a sense of community, advocating for yourself in job negotiations, and how to deal with frustrations of failure.

In this episode, Dr. Milgram talks about the many ways OITE supports students and fellows so that they can make the most of their experience in the IRP and maximize their potential towards becoming more resilient, empathic, and well-rounded leaders in whatever career path they chose.

[TRANSITION MUSIC]

>> Diego (interview): So, outstanding science is definitely priority number one while you're at NIH, but tending to those professional development and community building opportunities should be close behind. And that usually comes by focusing on like the softer skills like communicating your science, whether that's writing or speaking, you know, choosing the right mentor, learning how to be a good mentor, and the list goes on. So what do you recommend for trainees to develop those softer skills?

>> Dr. Milgram: Yeah. So, first, I actually think it's a sort of ironic thing that we use the language of softer skills, because developing interpersonal skills, developing the ability to set boundaries, to be appropriately assertive, to resolve differences of opinion, to be very welcoming across differences, that you may just be learning about, right? All of those things actually, I think, take a lot of attention and intention. You have to really want to develop the emotional intelligence, the interpersonal skills and self-management skills. And so, I'm not so sure that they're soft skills. I wish all of us in science spent more time on that. I think if we spent a lot more time on developing those skills early in our career and constantly refreshing them and growing and learning there, we might have a much more welcoming and a much more supportive community.

>> Diego (interview): So how would you suggest someone develop those not-so-soft skills?

>> Dr. Milgram: So we offer a lot of programs for that. We have a program called the Workplace Dynamics Series that builds from understanding our own communication style, the styles of others. It addresses team building skills and team science skills, conflict skills. I think that that's a great introduction. We have an extensive Resilience Program. And the honest truth is, while resilience, we think about it as our ability to, you know, to work effectively through adversity, much of resilience is learning how to work with others, to seek support, to give support, to set healthy boundaries. So I think that those kinds of trainings make a big difference. We have a diversity certificate program where people can learn what it means to be an ally, what it means to explore various dimensions of difference, understanding structural barriers to various communities, like our visiting fellow population.

So from the PhD, from the graduate level up through postdoc, we have a large contingent of international fellows that come from all over. I think that it's important to acknowledge all the unique perspectives that they bring. And I think it's also important to pause and reflect on what a challenging time it has been, not just the pandemic but complexities in our immigration law, some unwelcoming messages that are sent to our international trainees. I talk to a lot of trainees struggling. That's a part of my job. It's not always the part I like, but it's a part I think is really important. And I think sometimes our international trainees struggle a little bit more because they have the uncertainty of immigration issues and the distance from family.

>> Diego (interview): Yeah. There's a whole cultural shift for them, for sure.

>> Dr. Milgram: The whole cultural transition. But I do think that we have paid attention here at NIH to a more welcoming and diverse community—that we are putting energy into helping communities, that have maybe felt disconnected from NIH, apply and come here and thrive here. We run a whole series of summer programs centrally through the OITE to welcome diverse students all the way from High Step, which is high school program, through graduate programs, G-SOAR for Graduate Summer Opportunity For Advancing Research. We have a community college program we've been running for over a decade, CCSEP. And we're going to launch a program for medical students this year in collaboration with the UNITE Initiative at NIH. And so I hope, first, that people will take a look at our programs and give us a chance. We are growing and learning and want to be as welcoming as possible. Everyone who comes is a part of the positive change.

But I think that, as we welcome people, we also have to hold ourselves accountable and do the best that we can. And just like I think of the challenges that the visiting fellows have, I reflect a lot on the added challenge of coming here and feeling different and how much we could do to make that easier. Whether that be various races, ethnicities, gender identities, sexual orientation, individuals with either hidden or visible disabilities, chronic illness, I feel like we could do much better. So, I will advertise our programs from a place of humility that we still have work to do, and we still have growing and -- but, as a community, NIH is really having important discussions in that regard.

>> Diego (interview): Yeah. It’s amazing all the resources that you all provide. But it is a vast amount of options and trainings and I do think it can be a little intimidating if you’re already feeling overwhelmed. I mean, some people might see it as like another item on their already long to-do list and as much as they’d like to participate it’s just something that they simply don't have time for. So, what would you say to someone who feels that way?

>> Dr. Milgram: Yeah. I always talk about aspirational registrations. That's when people see something and say, “Oh, I should go to that!” So they register, but they don't come. They don't show up. In the moment, it's like, “Well, should I do my experiment or attend that training?” Because we're so focused on science and we want to ignore the rest, sometimes we do it at the expense of our health and well-being. And the honest truth is, I mean, I ran a lab for a long time. I did that, too. So, I was just as much a part of the problem as everyone. So, we're all a part of the problem, but we are also a part of the solution.

I would say that we need to stop thinking of training as separate from science. To do good science means to be able to work on teams. It means to be able to hear feedback, give feedback, resolve conflict. It means being able to lead. It also means being able to step back and let an expert in an area lead you. And so I think we should stop treating all of this as separate. These are skills that we need to do good science in the complex environment we now work in. I think we should treat learning how to do this effectively the same as we treat learning how to code or how to do PCR or how to understand CRISPR. We should just treat it as part of the skill set. A part of that means culture change that the PIs and faculty and daily supervisors embrace that. But the honest truth is the trainees also have to embrace that. And we are capable – look at all the change we made in the last two and a half years.

>> Diego (interview): Yeah.

>> Dr. Milgram: Somebody said work from home, right? And all of us in a matter of days figured it out, right? And maybe, you know, it was hard. We were all dealing with challenges there. But we are capable of dramatic change.

So, I think we have a – I think we have an opportunity. The pandemic raised our awareness about a lot of things: the racial injustice in our country, the political discourse has raised our awareness of the divide between science and society. We are, like, poised at this tipping point where I think we can make a lot of change. And so, you know, my hope is that, at every level, we all just embrace a little bit more willingness to learn about not the science itself but all the people doing the science. And I know we always say that people are our biggest resource, right? We should live that. That should be reflected in what we do.

>> Diego (interview): Definitely. So, do you think there are, like, any baby steps that I guess both trainees and mentors can take towards that ultimate goal of, you know, working more so with people than just the science?

>> Dr. Milgram: I think lots of people are really working hard to make change. You know, a couple of years ago, we started doing some workshops for PIs, and that really expanded over the pandemic. PI's come and, you know, they are really thoughtful in developing management skills and mentoring skills. The seriousness of the mental health issues we face have made many of us rethink the messages we send. You know, I love to work in the early morning, but then I realized I was sending a message to my staff that they, too, were supposed to be working, right. And that's my choice to work then. I get emails now from colleagues and, you know, right at the bottom, it says, “If this is outside of your work schedule, don't feel a need to respond.” And I know science work schedules expand, but we can send messages in a lot of different ways, that we have room to tend to our health and well-being. I mean, I think we're talking about the climate of science a lot more. But I think we have a ways to go. And it starts at the top, that leadership articulates the importance of this, that they focus on this themselves. And then it also is at the bottom where trainees say, “Okay, this matters to me; and I want to develop these skills.”

>> Diego (interview): Definitely. So I'm curious. Is there any one resource that you think is kind of underutilized currently or that, you know, you think people should take more advantage of that you don't see as often?

>> Dr. Milgram: I will say that I think that there are two trainings that I would love to see many more people take. One is a program called the Resilient Scientist Series. So that's a five-part program. It's five webinars and five small group discussions. There's a workbook that goes along with it. And we've done the Resilient Scientist Series on Zoom now for two years, so we've had students from all over. They learn, I think, more from each other in the discussions than they learn from the lecture. We engage in learning that is interactive. So, it can't just be sitting and listening. There has to be listening but not to one speaker. There has to be listening to all of the people there in your group. So that's one.

The second is our discussion group training program on health disparities. So, again, we follow this model of webinars and small group discussions now. It sort of came out of the pandemic, and it's also five parts with five small group discussions. Always the discussions are facilitated, and there's a guide. So it's not just getting in a room. Oh, what do you think? It's, you know, here's prompt number 1, number 2. I have seen such growth in people who've taken that program. I see growth in myself. Even though I thought I was a pretty open-minded person who supported diversity, I realized that there were so many things that I had never stopped to think about it, and I realized that I had messages from long ago.

>> Diego (interview): Yeah. I think we all have blind spots when it comes to that.

>> Dr. Milgram: We all do. And things are changing, right? I mean, now when I think about how many high school and college students identify as genderqueer or the number of trans students, right? So, our application systems are unwelcoming, because they require you to pick Mr. or Ms. Maybe neither fit you. So, even there, I don't even know that it's a blind spot. It's something new to learn about. And I guess I wish that that course was overrun.

I wish many, many more people interested in healthcare take it. I wish more people thinking about grad school or already doing research and, you know, finishing their PhD, I wish more people took it because I think it gives us the tools we need to navigate a very complex, messy, scary, frustrating world – and I, you know, I don't want to imply nobody does this. Our trainees are remarkably hungry for training, and a lot of them are leading the way in getting more training and having more difficult discussions. But I wish that it spread. You know, with 5,000 trainees, you could imagine, if people left here trained and they went all over the globe, they would bring training to where they are. And so the more people who participate the better.

>> Diego (interview): Yeah. I think that's the kind of super spreading that we all can get on board with.

>> Dr. Milgram: Yes.

>> Diego (interview): Well, one thing I really appreciate, and you touched on this, is that OITE not only cares about growing careers; it's about the individual and their personal well-being. And you mentioned the Resilience Program. During my brief stint in the lab, I experienced first-hand how failure is just as much a part of science as success is. And I think maybe some people see failure as kind of like a rite of passage, something that all scientists have to suffer through, and something you don't really talk about. But I think that’s such a disservice to everyone involved and only exacerbates the problem by making it even harder to deal with, especially earlier on. So can you speak a little bit more about the strategies you teach to become more resilient.

>> Dr. Milgram: So, you know, resilience is all about the ability to look at what is happening to you from multiple perspectives. It's the ability to find the learning in a setback. And the issue is that we are constantly telling stories about ourselves and what's happening. And we can tell stories that are helpful—a story of persistence, a story of it's okay to reach out and get support for this, a story of this happens to everyone. right? We can tell a story that helps. We can also tell a story that really doesn't help, “I'm a loser. Nobody makes mistakes like me, nobody must want me in their group anymore. My career is over.” Those kinds of negative stories drive really unhelpful behaviors. If I'm feeling like a loser, I'm certainly not going to take a class or reach out for support or tell somebody what happened. I'm going to hide from my PI. I'm going to hide from my friends.

So, we focus a lot of our teaching of resilience on this understanding that our thoughts and our feelings and our behaviors are intertwined. If you intervene in any of those three, you change the others. So, if I notice that I'm telling a really negative story, and I pause and I say, “okay, Sharon. Where's the data?” You know, you emailed your boss, and you didn't get an answer. And you're telling yourself, “Oh, she must hate my proposal.” But where's the data? Right? That allows me to calm down that anxiety, and maybe I then can focus. Things go better. On the other hand, you could just say, “Well, for me to do well at work, for me to tell more positive stories, I have to exercise. So I'm going to find time for that.” So the idea is that we learn about the stories we tell. We learn about emotional regulation. And emotional regulation really starts with being aware that we have emotions, right. A lot of us have been taught to just stuff them down.

>> Diego (interview): Yeah, yeah, yeah, right. They're, like, outside of, you know, the realm of what you do for your job.

>> Dr. Milgram: That's right. You don't feel at work. We just think. But, you know, when we don't deal with frustration, it eventually erupts, and that can be directed at people at work or people we love at home; how many times I was unkind to my son or my wife and I realized, well, I was frustrated at work, and I didn't find a way to process that. So we try to teach concepts of emotional awareness, that, you know, emotions aren't good or bad. They just are data points. And if you're frustrated, you have to pause and deal with it. If you feel alone, you have to pause and find support. And then behaviors, both our thoughts and our feelings drive behaviors. But also our behaviors, our well-being behaviors are setting boundary behaviors, those things can drive improved thinking. So our model is based on that. And we go through all the different types of stories, imposter fears. We talk about the unique stories that trainees of color might tell. We talk about how this material might be experienced differently by people who are neurodiverse. You know, we talk about how if we don't appreciate our old patterns, we can't change them. Some trainees have been in a lab that was a bullying environment, and they bring that view of work into a new environment. So, suddenly, they're in a much better environment. But somebody gives them hard input, and they're just remembering that bullying environment. And so we're trying to make people more aware that we bring a set of beliefs, a set of stories, a set of coping strategies. But the idea is that life is full of ups and downs. Work is full of ups and downs. Science as a high-knowledge field is full of failure. And even when you succeed, you get criticized, right? Oh, I got my paper accepted, but they critiqued it like crazy. Or I got a grant. But, boy, they didn't like this, this, and this. And I think that we need to uniquely teach skills for handling that.

>> Diego (interview): Yeah. It reminds me of that quote and I don't know who said it, but it's something like, “either I win or I learn.” So, like, even if, something doesn't come out exactly how you wanted it to, there is a learning opportunity.

>> Dr. Milgram: Yeah. I don't know who said that. It's interesting. In some ways, I would say even when I win, I learn.

>> Diego (interview): Definitely. Yeah, yeah.

>> Dr. Milgram: So that's the idea behind the Resilience Program. So, for me, it's probably been the single defining feature of my whole work. I mean, I've done science for a long time. I was at UNC. I ran graduate programs. I do a lot here. Probably if somebody said what was the most memorable experience of your career, it would be listening to students ask questions in this series. So I've learned a lot.

>> Diego (interview): Right, and I’ll say for me, personally, failure in the lab was really kind of an opportunity for self-refleciton and it’s part of what led me to science communication. I think it gave me the time to think about what could allow me to be fulfilled and happy. And, fortunately, I found something that was science adjacent. But are there resources at OITE that help trainees who might be in the same boat and want to explore other career directions?

>> Dr. Milgram: Yeah, let me just say flat out upfront that all careers are good careers.

>> Diego (interview): Oh, yeah.

>> Dr. Milgram: There's no such thing as an alternative science career. There is no good, better, or best.

>> Diego (interview): Or hierarchy of any sense. Yeah.

>> Dr. Milgram: That's right. If you're happy doing something, then it's the right career for you.

>> Diego (interview): Yeah. I can attest.

>> Dr. Milgram: And the honest truth is we feel this pressure from others, but really the only person who gets to decide is you. We offer nationally certified career counselors. We support trainees looking at every career: science policy, science communication, science law, teaching, research, research at an industry, government, academia. We don't see a hierarchy when it comes to the career decisions postbacs make. You know, I ran a lab myself for a long time. I have trainees running companies. I have trainees who are in academia. I have trainees doing grants management. I have a trainee who's a choir director. He's a remarkable person who realized one day that what was his hobby really needed to be his life. And I am equally proud of all of them. It's not like because some did one thing and some did another, that it matters. And I hope all of science can embrace that over time. I know we've come far in that regard. But there are still people who judge trainees for making the decisions that they make.

>> Diego (interview): Well, you yourself kind of pivoted, right, from lab work to what you do now. So can you tell me about how that process was for you?

>> Dr. Milgram: Yeah. It wasn't as much of a pivot to me as it was a slow steady march in one direction. So after my postdoc, I took a faculty position at UNC Chapel Hill. And, from the beginning, I realized that I loved doing graduate education work. And the chair of my department and the dean of research at UNC really gave me some freedom and flexibility to do some things creatively in education. So I was involved there in developing our first interdisciplinary graduate program. I launched the postdoc office at UNC Chapel Hill at a time when postdocs were not getting any resources. So I was always doing research and doing administration. And I think that, slowly over time, I wanted to do more and more in administration. So, you know, at Chapel Hill, I used to say I was a capital R researcher and a lowercase administrator. But the honest truth was I was moving towards administration for a long time. And I saw the ad here for Director of the OITE, which was a much smaller office at that time. And I sort of chuckled. “Oh, they're looking for somebody a lot older than me.” But I was very intrigued about coming to NIH. So I came with my lab. So my lab was in NHLBI. I had a joint appointment in genome. And, for about six years, I did both. But the job here felt a little bigger than I had imagined. And I realized I wasn't as good of a mentor in the lab. So slowly over time, I came to the appreciation that I probably was not going to be able to do both. So, I shut my lab. That was a big deal. That was a really big deal.

>> Diego (interview): Yeah. But I imagine having such a strong science background really makes you more empathetic and compassionate to everyone at all levels of the scientific enterprise since you’ve been through them all.

>> Dr. Milgram: Yeah. I think that the other thing that having run a lab gives me – you know, a lot of times we like to talk about what PIs don't do well. And let's be honest, there are some things to talk about. But it's also an incredibly hard job. Like, doing science at the highest level, opening a paper and being proud of it years later, that it stands on its own years later, that it caused a field to shift, change, move years later, I mean, that's an incredibly intense job. You know, the problems that we have to solve are large. They require multidisciplinary teams. And I think that, when I talk to PIs, I can appreciate all of the complexity involved in having a team of students who are developing do science with you.

>> Diego (interview): Absolutely. Well on that note, thank you so much for a such a profound conversation.

>> Dr. Milgram: Thank you very much for inviting me to chat.