Coping with setbacks as early career professionals: transforming negatives into positives

Setbacks and challenges are an unavoidable part of everyday life. As a clinical and research community, we can be proud of how we rallied to counter the recent COVID-19 pandemic. However, we are now faced with war, natural disasters, and global inflationary pressures that are likely to have a sustained impact on the lives of researchers and clinicians, particularly our early career (EC) professionals [1]. All too familiar issues such as increased workload and childcare responsibilities and decreased funding, mentorship, and networking opportunities continue to challenge our EC community [2,3]. If not managed effectively, these pressures can negatively impact mental health, career trajectories, and the work and family environment [4]. Therefore, it is crucial that, as a community, we share our collective experience and wisdom to better support EC professionals by helping them to develop effective coping strategies that can transform negative experiences into positive outcomes.

On a regular basis, EC researchers have to deal with failed experiments and rejected manuscripts or grant applications, which can be discouraging. Similarly, EC clinicians are faced with patient illness and death, negative feedback from patients or mentors, and clinical errors or medical malpractice litigation. There are several coping strategies that can help EC professionals maintain positivity despite these setbacks. One strategy to limit excessive disappointment is to expect setbacks and not be discouraged. When reaching for lofty goals, failure is an integral and “natural” part of the journey [5]. This is best achieved when your mentors and peers stand shoulder-to-shoulder with you. Their support renders your future successes all that much more meaningful. We can learn from the experience of those who have gone ahead of us. This was highlighted by a 10-year longitudinal study of medical students, in which the anticipation of setbacks, reaching out for support from mentors and peers, and reflective learning were found to be essential strategies for future success [6].

The resilient character these approaches breed can prove critical during the inherent unpredictability of a career in research or clinical care. Resiliency can trigger future success as evidenced by the fact that EC researchers whose grant applications came just below the funding range were more likely to author high-impact articles in the future than those whose applications were successful from the start [6]. Initial setbacks can, and will, have long-term positive impact on those who learn to persevere despite adversity [7]. However, for career success, we must be innovative and daring in our goals and we must help our peers cope with setbacks. The conveyance of the accomplishments or setbacks that others have experienced, and the identification of the tools that they used to reframe impediments into learning opportunities can help identify pathways to success [5]. Everyone fails but sharing stories of how failures were turned into successes will help others realize that the path to success is strewn with failures [8].

Even with successful grant proposals, constrained budgets pose ongoing challenges that in today’s climate are stretched further than ever. These challenges are even greater for EC researchers in Reach-the-World (RTW) countries, who need to be resourceful and innovative to overcome funding constraints. By focusing on priorities and doing more with less, RTW researchers can still get the job done. For example, instead of buying expensive commercial kits, RTW researchers often develop in-house assays or use less expensive technology to quantify outcomes. These resourceful strategies can even provide RTW researchers a deeper understanding of laboratory methods. Collaborations with other institutions and development of networks of researchers are other strategies that help researchers in RTW countries to maintain a competitive edge in the global research community.

While setbacks can be dealt with in a problem-focused manner, the emotional burden of failures must be acknowledged [9]. EC professionals face uncertainty about their ability to provide for themselves and their family, their work-life balance, and their opportunities for promotion or career advancement. These challenges can contribute to emotional exhaustion and subsequent burnout [10]. Thus, it is important to process these emotions by sharing negative feelings with supervisors, colleagues, family, and friends, before turning to active reflection. Taking time for self-care through rest and relaxation will improve mental health and replenish resilience. A recent study on clinicians and nurses during the pandemic found that positive reinterpretation of events as a coping strategy was associated with reduced risk of burnout, whereas avoidance increased the risk of burnout [11]. Organizational programs and executive leadership are also vital for reducing the risk of burnout. Providing flexible work hours, fostering a sense of community, such as providing formal spaces to interact with colleagues, and recognizing and celebrating successes are just some examples of how system changes can foster job satisfaction [12].

Unfortunately, competitive work and societal cultures in our field may undermine healthy work-life balance for researchers and clinicians. Such work-life interference is a known risk factor for burnout [13]. Yet the same research emphasizes the importance of social support from supervisors and work meaningfulness as major protective factors [13]. Whilst supervisors can provide some guidance to EC professionals, advice from a mentor is also highly valuable and has been associated with significantly lower burnout scores [14]. Owing to their impartiality, mentors can provide a more balanced insight into mental health, productivity, ambition, and personal boundaries. Mentorship from associates, both formal and informal, may require a proactive approach, but building a mentoring network is critical for success across the entire professional path [15].

An overarching theme in all coping strategies mentioned above is the importance of structured institutional support. Regrettably, there are disparities in the support offered by institutions, particularly in RTW countries. As a global organization focused on diversity and inclusion, the International Society on Thrombosis and Haemostasis (ISTH) is helping overcome some of these barriers. Free online access to a broad range of educational webinars and materials, a mentoring network, and an EC committee focused on the challenges faced by those starting out in clinical practice or research are there to help. The MyISTH community provides an online platform on which EC professionals can seek and receive support from networks of peers and experts. The new Mentor-Mentee Match program launched this year, coupled with networking opportunities provided through MyISTH and at the annual Congresses, will bolster opportunities for formal and informal support. Finally, short-term fellowships to visit expert laboratories and hospitals and the recently announced Fundamental Research Career Development Awards provide dedicated funding aimed at advancing EC research programs and collaborations.

In conclusion, it is important for EC professionals to accept setbacks as an inevitable part of research and clinical practice and to embrace them as invaluable opportunities for growth and innovation. Cultivating resilience, adaptability, and resourcefulness will lead to more effective management of inevitable challenges, whilst better preserving mental health and well-being. It is, therefore, our collective responsibility, as a community, to proactively undertake this mission with proven and innovative strategies as it will ultimately lead to greater advancement in scientific knowledge and delivery of better care for patients.

Appendices

ISTH Early Career Committee (2022-2023): Early Career Committee Advisor: Jeffrey I. Weitz, Hamilton, Ontario, Canada

Early Career Committee Members: Muntadhar Al Moosawi, Muscat, Oman; Paul C. Armstrong, London, UK; Robert Campbell, Salt Lake City, Utah, USA (Chair); Thita Chiasakul, Bangkok, Thailand; Sofija Dunjic Manevski, Belgrade, Serbia; Renee Eslick, Canberra, Australia (Vice-chair); Aaron Iding, Maastricht, The Netherlands; Shrey Kohli, Leipzig, Germany; Lauren Poole, East Lansing, Michigan, USA; Nicola Potere, Chieti, Italy; Zara Sayar, London, UK; Leslie Skeith, Calgary, Alberta, Canada