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FROM THE ARCHIVE: Keep Stress From Derailing Your Work and Life

Submitted by John Taborn April 3, 2018
Post written by Sharon Milgram, Ph.D., Director, Office of Intramural Training and Education at the National Institutes of Health, Bethesda, MD. Many of our trainees are currently managing the anxiety and pressures that accompany the job and graduate/professional school application process. This From the Archive post will offer insightful perspectives and strategies that will help you manage these pressures effectively. ________________________________________________________________ Stress is inevitable - in our relationships, at home and at work, pretty much all around us. At NIH our stresses include experimental roadblocks, bureaucracy, paper and grant rejections, the school/job search process, difficult workplace relationships, and/or the craziness of juggling our work and life. On top of these normal (and expected) workplace stresses, many of us are now experiencing a high level of stress related to the uncertainty of future government policies, here and abroad.  While some stress can be helpful, driving us to work hard and focus on things that are important to us, too much stress is counter-productive leading to sleepless nights, negative coping strategies, frayed relationships, and illness. Now, more than ever, we all need to pause and consider how we respond to stress and how we can work together as a community to manage the stress that seems to be swirling around us. I often talk with NIH trainees and staff about managing stress and wanted to share some insights from those discussions. I will begin by laying out a brief model for wellness we developed here at OITE that is rooted in acknowledging that we need to focus on multiple elements to truly lead a healthy and less stressed life.  This holistic approach to wellness prompts us to consider four areas - our physical, mental, emotional, and spiritual selves.

Wellness Model

Physical wellness includes things such as getting enough sleep, eating nutritional meals, exercising, avoiding harmful substances, getting regular health care, and taking breaks when we need them.  Mental wellness involves modifying unhelpful thought patterns (e.g., ruminating about the past/worrying about the future vs. paying attention to the present, perfectionism, comparing ourselves to others, negative self-tapes), as well as practicing self-affirmations and allowing the mind to engage in new things that interest us.  Emotional wellness focuses on being able to recognize and feel our emotions, expressing our needs honestly and directly, asking for help when we need it, creating and staying connected to a supportive circle of friends and family, and demonstrating compassion for ourselves and others.  Finally, spiritual wellness is about cultivating what gives us a sense of deeper meaning, purpose, and connection in our lives.  For some people this is done through religious beliefs and practices, while for others it is found in non-sectarian areas, such as nature, the world of science, social justice initiatives, creative endeavors and so on.  Whatever the arena, spiritual wellness involves having a connection to something beyond ourselves, seeking out resources that nurture us spiritually, investing time in what is most meaningful to us, reading books and/or watching inspirational media, and engaging in activities that support our life’s purpose.  It also means learning how to be a human being instead of a human doing.  It’s important to pay attention to all four areas as any one area affects our well-being in the other three.  Holistic wellness also involves increasing our mindfulness or awareness of how we’re doing in each area in order to practice good self-care. After looking carefully at my own wellness practices and noticing some important gaps, I started experimenting with some new approaches. I am sharing my new strategies here, and hope you will share yours in the comments section, with the hope that more explicit discussions about wellness will help all of us all have an easier time during these stressful times. I recently compiled a playlist of upbeat songs and am trying to take more mindful walks (physical, emotional, and spiritual wellness). I realized I needed to stop reading the news at night and have replaced surfing the internet with a good novel or calm conversation with my wife (mental and emotional wellness). To learn more meditation strategies (a big struggle for me!) I participated in a class where we meditated each time we met (mental, emotional, and spiritual wellness).  My most fun wellness addition --- I am learning to box! This is one exercise that totally takes me out of my head while relieving huge amounts of stress (physical and mental awareness). We all have a different set of wellness practices that work for us; let me know what wellness practices work for you; perhaps your ideas will inspire others! Resilience is defined as the ability to grow and learn through setback and difficult times. The foundation of resilience is wellness and a foundation of wellness is community. If you wish to bring your most creative and resilient self to work (and beyond) each day, make an investment in your future by engaging with your colleagues at work and by finding sources of community at home.  Also, join us next week for our Tune in and Take Care workshop focused on stress management, wellness and resilience on the Bethesda campus and watch for offerings on other campuses as well. Get involved in groups on campus and make an effort to get to know the people around you. And get out there and move…. sing…. dance…. paint…. meditate…. connect…… pray…. hike…. whatever makes you more resilient and happy! ________________________________________________________________ Visit the OITE website to learn about the variety of services offered to trainees.  We invite you to join us for the Spring 2018 Tune in and Take Care workshop or our weekly Mindfulness Meditation workshops.  Also, check out the new Graduate Student Discussion Group, the Postbac Discussion Group or the Post Doc Stress Discussion Group.  We invite our readers beyond NIH to access similar services in your community to help you with ongoing wellness and stress management.  

Family: An Important Influence in Career Decision Making

Submitted by John Taborn April 11, 2018

  In recent weeks, many of our trainees have received offers to attend graduate school or for academic and industry jobs.  Others are making decisions about where to apply and what career paths to choose. While exciting, it also can be stressful to choose among various options and offers.  Here are a few family related questions that trainees bring to counseling sessions. What are the best jobs for scientists with families? We are returning to our home country to be near our family raise our children.  How can I go about finding a job abroad? Should I disclose that I have a family during my interview? Will you help me find job in industry because I need to make money to take care of my family? My family wants me to be a doctor.  I want to do something else. Will my family be able to live with me in graduate school? How can I investigate school systems for my children when I accept a job? I cannot decide if I want a master’s or PhD because I want to have children and don’t want to be in school for a long time. What are the best companies for families? We are an LGBT couple, what are the best places to work? My parents are aging, so I need to be near them while raising my current family.  I need flexibility in my schedule which seems impossible as a scientist. What are my options? As you can see from these questions, the impact of family can change over the course of your time as a trainee preparing for a career in the sciences.  Career counselors often encourage clients to engage in self- reflective assessment at each stage to help our clients make better informed career decisions with more confidence.  Here are a few questions to reflect upon: Who is in your family currently?  Has this changed (i.e. marriage, children, extended family) What people in your life encouraged/discouraged/challenged you in your career pursuit? What messages did you receive from your family about your career choice? Ability to pursue this career? What is going on in the world around you now that will impact your career choice? Are you the first to pursue this path? Is your career choice the same as others in your family? Will family be relocating with you during this choice of careers? Have you considered housing, cost of living, school systems? Are three expectations of your partner/spouse relative to your career choice? In what way will your extended family be involved in your career plan?   The OITE provides a variety of programs and services that support trainees with families.  Feel free to make an appointment with a career counselor to discuss these or related to your career decision.  Visit our website to look at resources for trainees who are also parents and read the OITE Careers blogs “To Share or Not To Share: Family Planning in the Job Market and Scientists as Parents: A Balancing Act . If you are part of our extended readership beyond NIH, we encourage you to pursue similar services in your community.  

Before Accepting a Job Offer

Submitted by Amanda Dumsch April 16, 2018
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It can be easy to get swept up in the excitement of a job offer and immediately say, “Yes, I’ll accept!” During the interview, you probably already learned a lot about the organization and role; however, it is imperative that you take even more time – once an offer is in hand – to get clarity on job specifics. If you have recently been offered a position, here are some points to consider:

  1. Negotiate and confirm your salary while exploring options for bonuses. Salary negotiation can be stressful, but this is the only time in the entire job process when you can do it – take advantage! Here are some past blog posts on how to prepare when negotiating non-academic job offers and academic job offers.
  2. Clarify your title and the reporting structure for your role. This sounds pretty basic, right? It is surprising though how many times at OITE we hear trainees say they didn’t realize they’d be reporting to a postdoc or staff scientist instead of the PI. Make sure you are clear on the actual hierarchy within your new position and assess this person’s management style. Will it be a good fit for you?
  3. Understand your benefits and when they start. Employees have come to expect certain benefits be associated with their job – health coverage, retirement, commuting costs, tuition assistance, etc. Recognize that these benefits can widely vary between organizations. Additionally, they might not kick in immediately. Some organizations have a probationary period that you first must successfully complete. For example, at a new employee orientation, an employee was shocked to learn that health coverage didn’t start for two whole months. A delay in benefits can be costly, so be sure to ask these questions before you sign on the dotted line.
  4. Know how your performance will be evaluated/measured. What will be the main priorities for your role? In the first six months? First year? Are there certain metrics you will be required to meet? Even if the job isn’t in sales, many positions now quantify results they expect employees to hit. Ask this specific question now, so you aren’t surprised later. Also, try to ascertain if there are expectations to be “on” evening and weekends.One great way to do this is by…
  5. Meet your future colleagues. You have met your boss and your boss’s boss, but if you still haven’t met the team you will be working with day in and day out, then this should be a red flag. While it might not be completely transparent within the first meeting, you can get a glimpse of the work culture and office politics by meeting your future co-workers, either individually or in a group. This can also be a good chance to ask insightful questions to see if this work environment will ultimately be the best fit for you. Be sure to check out this past blog post on “Five Steps to Evaluate Organizational Culture Before You Accept the Offer”.

If you need more help evaluating a job offer, feel free to make an appointment with an OITE career counselor. The OITE can serve as a resource and sounding board as you embark on your decision-making process.

Before Accepting an International Job Offer

Submitted by Amanda Dumsch April 23, 2018
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In last week’s blog post, we discussed considerations for properly evaluating a job offer. On top of all those points, there are more things to consider if it is an international job offer. Here are some questions to ask:

  1. How and in what currency will you be paid?
  2. Will relocation costs be covered? Both to the new location and return?
  3. What else could they assist with in terms of relocation?
  4. What are the parameters of the commitment? If something comes up and you need to leave the job/country, what would they do to help? Would you be liable in some way if you needed to end the contract early for emergency (or non-emergency) reasons?
  5. Many international jobs mean that an organization has offices worldwide. Perhaps you won’t be working in the headquarters. What does this mean for your reporting structure? Will you have multiple reporting lines? Are these dotted line connections?
  6. If working with multiple offices worldwide, what are the expectations for weekly meetings/ check-ins? For example, an organization has an office in North America, Europe, and Asia and there are weekly staff meetings every Monday at 9:00 AM EDT/3:00PM CET. This means if you are one of the colleagues in Asia, you will have to log into meetings at 10:00PM on Monday nights. How would you feel about this?
  7. What kind of insurance is provided? Does it cover travel to neighboring countries? Does it cover you when you are in your home country? Does it cover repatriation if you become ill?
  8. What is the official (and unofficial) working language of the office?
  9. Will there be an English-speaking (fill in the blank with your language of choice) representative of the organization to assist with your in-country orientation and initial setup?
  10. Will you be offered an orientation before starting work?
  11. If needed, will this orientation include language and cultural classes to assist with your acclimation?
  12. Inquire about potential taxes owed in your new country as well as in your home country.
  13. Does your company offer any tax equalization benefits (usually only applicable if on a contract with your home country)?
  14. For example, if you are on an American contract working abroad, would you get credit for time in relation to Social Security?
  15. Are accommodations or a housing subsidy included in the job offer? If not, how will the organization assist you in finding housing?
  16. Can your employer sponsor your partner and dependents?

In addition to these specific questions about the job itself, it is important to consider your life outside of work and to evaluate how this move could have a larger impact on you and your life.

  1. How will the move impact your hobbies/values?
  2. What are the cultural differences that may impact your lifestyle? (Example: does the country prohibit alcohol?)
  3. What are the cultural underpinnings that may impact the way you are perceived in the job? (Example: countries where women's access to education/employment may be severely limited and hence it impacts the way female employees are perceived by their male and female colleagues/clients)
  4. Even if your employer can sponsor partners/dependents, what exactly will they do during the day while you are at work?
  5. Does the country you’re moving to afford the opportunity for you to practice your faith?
  6. Are there organizational affiliations that are important to you that you'll be asked to forfeit by taking the job? (Example: volunteering with specific organizations; engaging with community groups)
  7. The availability of therapists and support groups vary quite a lot by the country and region you are in. How will you cope if you don’t have easy access to groups (example: Alcoholics Anonymous, LGBTQ, etc.)
  8. Will you have dietary challenges in the country (vegetarian/vegan/gluten free)?

Have you taken a job abroad? If so, what do you wish you had asked or known before doing so? Comment below with your own questions and tips for others considering international job offers!

Re-Applying to Medical School

Submitted by John Taborn April 30, 2018

The decision to re-apply for medical school naturally brings mixed feelings.  You should be congratulated for the investment of time, effort, and expense that all applicants invest during the application process.  For those of you who are on waitlists for admission this cycle, there is still a possibility for matriculation this year.  Simultaneously, it is time for you to consider re-applying. You Are Not Alone The reality is that in 2016, the AAMC reported that there were over 49,000 medical school applicants.  From that pool of applicants, fewer than half matriculated into their first year of medical school.   Dr. Bill Higgins, Pre-Professional Consultant in the OITE, suggests that you address the following questions to decide if you should re-apply to medical school. Ask Yourself: What were the strengths and deficits in my application? Never just reapply without addressing the problems in your application. Can these be remedied prior to the next application cycle?   Take ownership of this process and do not re-apply with the same application you used previously.  Schools will appreciate the persistence towards the goal of admission to medical school; however, you should re-apply with a new and updated AMCAS application.  Preferably, you will also show a marked increase in clinical hours, new publications or awards, and or an increase in your science GPA and MCAT scores.   You will need to update your AMCAS application including your 15 experiences, personal statement, and references. Remember the golden rule: apply early in the cycle (during the month of June)! Am I creating a convincing personal statement about my preparation for medical school to a selection committee? It is recommended that you revise your personal statement.  As you review your statement, instead of asking are your telling a story, ask yourself if you are providing appropriate proof and examples to the selection. To get you started, review the blog regarding writing a persuasive personal statement. Is it in your best interest to re-apply for the next cycle? Be honest with yourself and decide if is better to apply during this cycle or apply or in one-year so that you are applying when your application will be at its strongest. Did you overlook applying to schools that could be a good fit? Make sure you have a realistic understanding of your credentials and the admissions requirements at various medical schools.  Factor in each school’s metrics (Science GPA and MCAT scores), mission, curriculum as well as your desires for a medical education, and your values. Do I need to apply to a pre-medical post-baccalaureate program? Completing a pre-medical post baccalaureate program can be the most effective way to gain the qualifications needed for medical school acceptance.  If you have determined that you need to increase your science GPA, gain clinical or research experience, re-take the MCAT, and/or need more support through the process, then there are a variety of programs that would suit your needs.  Visit the AAMC post-baccalaureate programs information site which describe the various programs nation-wide. Have you considered related health professions? Graduate programs? You may want to consider additional health care career options if you have not gained entrance to medical school after several attempts or if you have an interest in another field.  In fact, in 2015, the AAMC published an updated report on “The Complexities of Physician Supply and Demand: Projections from 2013-2105.”  The conclusion of this study suggests, “that the demand for physician services is growing faster than physician supply and that by 2025 demand will exceed supply by 46,100 to 90,4000 physicians.” While the demand for physicians will grow, so too will the demand for other health-care related positions like nurses or physician assistants.   You may also consider applying Doctor of Osteopathy programs or pursue doctoral education in a scientific career as well. Did you attend OITE workshops and utilize pre-professional advising services? If you are at the NIH the OITE Career Services Center provides pre-professional advising, career counseling and a host of workshops and programs that will support your decision to re-apply. For example, you can attend the next workshop, Filling Out the AMCAS workshop on May 8, 2018. If you are not at the NIH, check with your college or university for these services or at a community or private counseling center in your community.