Okay. I think we can get started. We'll probably have some more trickle in. Welcome tonight to our inaugural industry webinar series. I'm Dr. Christina Lewicki-Gaup and I'll be moderating tonight's webinar. We're going to be learning today on helping to advance early career physicians by Dr. D. Fenner. Dr. Fenner is going to present for about 45 minutes and then the last 15 minutes of the webinar will dedicate to questions. Dr. Fenner is the chair of the Department of OB-GYN and the Bates Professor of Diseases of Women and Children at the University of Michigan. She completed her residency in OB-GYN at the University of Michigan and then followed with a fellowship in pelvic reconstructive surgery and urogynecology at the Mayo Clinic in Scottsdale. As you all probably know, she's a nationally recognized expert in defecation disorders, surgical education, and reconstructive surgery. She was instrumental in working with the American Board of OB-GYN and the American Board of Urology to gain official certification for our subspecialty, female pelvic medicine and reconstructive surgery. And in full disclosure, Dr. Fenner is not only my friend, mentor, and sponsor, but much of my career I owe to her. And so I feel like it is an honor for us to be able to listen to her talk today. Go ahead, Dr. Fenner. Thank you, Christina. Can you hear me? Great. Well, good evening, everybody. I don't know that I'll talk for a full 45 minutes because I really do want to try and answer many of your questions and see what I can do to help you to advance your careers. I have no relevant financial disclosures for this discussion. So I'm going to go through, I think, some rules that I have always thought about as I mentor my junior faculty and fellows as they begin their careers in academic medicine or as they go out and begin their careers in either a hospital practice or part of a HMO or whatever type of career they might have. I think the one thing everyone needs and that is a good team. And I think this has really evolved in terms of thinking about your team support over the years since I was in your position. We talk about mentors. I say to have many. I think it's very important to have peer mentors who you can talk about your trials and tribulations with a group of individuals who are going through some of the same struggles or challenges that you might be having as a junior faculty member because they can give you a lot of advice and can help share how they're solving their problems or how they're moving their career forward. Certainly you want to have a mentor who is well established, who will work with you, who will help you set your goals, who will help you achieve your goals, and who can be an advisor to you as you move up your academic career. It's always great to have someone who's in your field, who's a urogynecologist, who understands the academic part of your journey, who can be your research mentor. But you can also, it's wonderful to have those who are outside of your field as your mentor. So ideally I think you should have a team around you. I hope that where you are, that they have worked to establish a launch team for you because it's really important, I think, to have someone who can help you with your clinical work to understand the best epic things to do and how to build your practice, how to work with nurse practitioners or physician extenders, how to manage the patient care part of your practice. It's important to have someone who can be your mentor for research and that's important to someone who can help you become a leader and to understand the many trials and tribulations of building your career. So a strong proponent, I really push to have a team around our junior faculty so that they have many different viewpoints and that are invested in you. There's certainly, there's counselors where you go to periodically, someone who's sage to give you some advice. You can pay a consultant to help you to be your, as a coach when you need it. Certainly coaches we'll talk a little bit more about in terms of quite a variety. You can have a long-term coach, you can have a coach for a certain situation, you can have a coach to get you launched at a new position. And as I mentioned before, I underline colleagues and friends because I think that's very important that you have someone who you can go to that's safe and that's so important as you begin your career. So rule number one is you really do, you need a team to support you and this team will change as you go through your career. You'll have some mentors, you'll have some counselors, you may have a coach that lasts for a long time, but in general you'll have people who come and go as you need to help you as you advance your career. There's some distinctions between what is a coach, a consultant, a mentor and who will they be. A coach really is focused on the development and growth of an individual to support them to achieve a specific goal. And so that's what I say frequently a coach is someone that as you enter a new position that you will hire them, you'll have some goal that you want to meet and they will help you to basically achieve whatever goal that might be. That might be establishing yourself as a junior faculty member, it might be to help you through, if you've been hired to develop the research program that might help you outline that. But a coach really is a partnership and learning and so coaches are certified, they go through training and when you pick a coach you really should interview several different coaches. You should find someone that feels right for you. It may be that your chair, your division director assigns you a coach but ideally you should be able to look around and to find someone that matches your personality and you think that you can work with. A consultant or advisor again that's someone who's going to tell you. So that's a little, it's a different, a coach is not supposed to tell you what to do, they're supposed to help guide you to help you figure it out for yourself. And so if you want someone to tell you what to do, then you want a consultant or advisor if that's a specific situation and not a long-term relationship. A mentor then is someone who's experienced, who can offer wisdom, life lessons, can act as a sounding board, it's going to be a sharing relationship so that there should be a give and take with a mentor. A counselor is then someone who we tend to think more in terms of trained mental health professional who is someone who as many especially right now it's been a very difficult year in medicine and it's fine to say you know what I need a counselor to work through some of the issues I might be facing right now. Finally I'm going to then say a sponsor. You know and a sponsor is someone that promotes you and your career. And so as someone when someone asked me hey do you know someone who's ready to be a division director or we're looking for a junior person to be on this committee for AUGS or ABOG or PUCOG or whatever organization. And so you know I have a list of faculty all across the country that I say you know this sounds like a great opportunity for X. And so as someone's sponsor you know I help to promote them and to recommend them to give a grand rounds, to be a book editor, whatever it might be. And so that's what a sponsor does. And it's fine to go up and say Dr. Finner will you be my sponsor and to sit down and I would handle that and say sure well what are your goals and spend some time and say yeah absolutely if the next time the opportunity arises and I think it's a good good match with you I'd be happy to recommend you. So don't be afraid to go up it's intimidating. Certainly your mentors and you know your division directors they should be your sponsor as well. And that is something that you know it's okay to say and it's okay to ask. So about coaching I'll just want to go into that a little bit more in terms of because that seems to be something that a lot of the junior faculty I think is very important. Many departments as I say give people coaches when they take on a new position. And so you know coaching is there's different types of coaching. What types of coaching do you see yourself? As I said there's coaching to develop your future progression. There's coaching to address or correct a derailing issue. Sometimes coaching can be offered as I won't say necessarily as not as a negative thing but it's like you know you know how someone maybe interacted or they worked in a situation. We need someone to spend time with you for you to figure out that maybe that wasn't the right way to perform or how to solve that problem. Let's get you a coach for a while. And so it's an opportunity to grow personally and professionally you know and really they can help as in position. So many chairs many division directors will get a coach as you move into a new role. It's sort of the sounding board to help you you know throw out ideas and to work through things with someone who is non-critical. Someone who is trained to help you really work through your own issues or help you solve your own problems or help you get the team together. But it is again it's not someone who gives you advice like a mentor would but there's again different types of coaching. So when you think about a coach you should really again think about what's the purpose for you in your position and then what's the right person the type of coach who specializes in the area that you want to work on and what do you need. My second rule is written goals and I say every year and I think it's really important that you sit down and you think about this before you go into your annual evaluation whether with your division chief or your chair that you you think about what are your professional goals and what are your personal goals and do those match. One year it may be that your professional goal is going to really take precedent as you want to make sure that you submit your R01 or that you're going to complete writing up your thesis project get that submitted to a publication your goal might be to present at augs etc and you may have many of those professional goals. You want to line up your personal goals it may be that your goal is to you know take an extended vacation to visit family or to do something that you haven't had the opportunity to do during your long years of training you may want to have talk about a paternity leave and thinking about how that is going to be your goal and how bad is your highest priority and so there's just it's really important to think without setting goals you know they're only dreams and so it's important for you to know what you want and then it's important for you to communicate that to your your mentorship team so they can help you and to whether your division director to your chair so that they are fully of where aware of where you are and also to ensure that your goals are aligned with their goals for you for the next year and that you come together so that you all can be rowing in the same direction. So again I think you know you may want to say every year review your five-year goals and say but I'm always a big believer in this year what are we going to achieve and then in the coming years you know what's the ultimate goal down the road in terms of success both again professionally and personally. So rule number three does the position match your goals? This is where I see really the most discontent I think with the junior faculty whether in my department or as my fellows leave and go to other institutions and frequently you know we might make a decision about a position because it's in the right location or where you want to be and or other intangibles but the reason you you've accepted that position may may not match with your professional goals. So what I mean is that someone may you may want to be a more of a researcher the position is posted more as a clinician with some research support but when you get there you know you're you're seeing patients two or three days a week and operating two or three days a week and you have no time to do your research and so your your desires did not match the position and so it's so important when you go for a job when you accept the position to to really make sure that you're aligned because that mismatch rarely ever can be corrected. In addition you want to think about who will determine if you are successful and that's really important and the fact that again some of this match meaning if you think your success is going to be when you have two first author publications and you've submitted an r01 and in fact the division director of the chair sees you as the number one clinical surgeon and all they care about is your rvu production that is not again aligned with what you want and so the performance is being measured against something that is really not your desire and so it's really important as I say this is again when you go out and look for a position and once you're in the position to be sure that if your if your desires if your goals change do they continue to match the position that you're in and to make sure you have that alignment. Misalignment is I think very common and so it really takes ongoing discussions to make sure that you're moving forward in sync with your division director with your chair as you move up the academic ladder. I think one of the other things that there are lots of opportunities now that are not of the traditional I'm going to be move up the ladder I'm going to be a division director then someday I'm going to be a chair. There's so much more that you can do and so many more positions in the hospital in terms of being part of a quality improvement team, having leadership in a clinic, being on the operation side for either the in the hospital or running the clinic. There's just a lot of different I think positions that we never really thought about certainly when I was in a junior faculty. So make sure you know what you know what do you want to do and does that position is it going to allow you to grow and to be successful in matching with your goals. Certainly if there was someone you're taking a job that someone has left you really want to make sure you do your homework, talk to that person to try to understand what went wrong. If someone has left the position, what's the last person that was hired. So really understand the history of that job. So the fourth rule is it's not all about the money. So often when I review contracts, when I talk to my residents and fellows and the junior faculty going out and thinking about their jobs. This gets back to setting your goals, not just for professional goals, but your personal goals. And the idea of about what's going to make you happy. Certainly if what is going to make you happy is making a salary, then understanding what it's going to take for you to be able to sustain that salary. Frequently, the signing salary is guaranteed for several years, but you really need to understand when that goes away, what kind of productivity are you going to need to sustain to keep that salary? And is that matching with the type of lifestyle that you want to leave? So I've enlisted a few things there that I think that are equally or more important than the money. And one of the things is time. So you need to really think about, I don't want to say how hard you want to work. It's not a value judgment or that she works hard or he doesn't work hard or et cetera. It's really about a conscious decision about how you want to spend your time. How many days you would ideally want to be in a clinic, how much OR that's going to provide for you, how much call, how many days you would like to have for research because that all matches up with the salary. And so it's again, it's that being in sync with what you want to do to achieve those goals. And does that match up with the amount of revenue that that's going to produce to match your salary? And so those should be really honest and open discussions. And to understand that time is money. So as a chair, every time I give you protected time, I still have to pay for that time. And I think that's one of the hardest concepts for people to get. So that you're essentially, every day, five days a week, we're paying you. And if you're not generating revenue, which in many cases, I don't want you to generate revenue, I want you to do your research, I want you to do your teaching and to do other academic things, but I still have to come up with the money to pay for that. And so it's that balance of trying to make sure that you're given the adequate time that you're needed to be successful. In addition to time, you need support. And so if someone, if you're in a position and they say, you know what, I want you to develop a research team here, well, that's going to take support. You can't do that alone. It's not just an admin assistant who can make appointments for you or manage your calendar. You need a project manager, you need someone who can do things for you and to help do the work. And so, so often I see where people are, you know, you're supposed to come here and build clinical trials. Well, if you aren't given the nursing support to do that, if you're not giving the team around you to help build that, you're not going to be successful. So some of that shame on me as a chair for having expectations that aren't reasonable from the resources that I've given you, but then it becomes shame on you for not checking and understanding what it's going to take for you to be successful. So this is where it's really important again, to rely on your mentors and to look around and to make sure that you're given what you need to be successful. And again, it certainly is, it's not all about the money. Finally, I want to say, how can you be successful? How can you make your chair or your division chief love you? How can you be the one that gets all the favors because you're the person that when you come to the boss, with your clinic manager, your research mentor with a problem, you have a solution. So that's one lesson I learned a long time ago and from one of my mentors, Tim Johnson, who was the chair here at Michigan before I was. And it was like, don't bring me a problem unless you have a solution. It was great because he was very much a yes person. So anything you brought to him, he would say, yes. My faculty would say, no, I'm not so nice. But basically though, I'm just saying, if you have a problem, have the solution ready. Think about it before you go and bring up the issue. Obviously, there's lots of things that can be fixed in those academic medical centers between the clinical operations and the research support and on and on. And so, think about a solution, find out what needs to be done before you bring it to the person who has the power, the authority to correct the problem. You will be much, much more successful and you'll find that people will begin to look to you as a problem solver, not a problem complainer and your career will be much more successful. So be innovative and certainly don't suffer in silence. I think the worst thing is when one of my faculty comes to me and says, I'm so unhappy or why didn't you fix this? And I have no idea. I have 90 faculty members and over 20 fellows and 24 residents and all of the staff to support that team. And so, it's impossible for me to know all the problems and it's impossible for me to know, certainly every individual faculty member's problems. I certainly care, I wish I did, but unless you speak up again with the proper information and with the goal of solving the problem, it's not gonna be a successful. And so, don't suffer in silence, come forward with a solution, be an innovator and you'll do very, very well. Finally, I wanna say, be true to yourself. I see again where the problem, the decisions get made and I think, again, I will say, I think your generation is much, much better at this than my generation where we felt like there was only one path to be successful or that we never wanted to disappoint. And I don't mean that. I think that, so I think in a negative sense, I think it's a very positive thing that you be true to yourself. Do not give that power to anyone else. So, do not let anyone, don't be, just because someone else gets disappointed in you, if you're going to change career paths or you've decided you're more interested in being a fabulous clinician surgeon and that research is not the pathway despite your training, if that's your choice to make. So, don't give anyone else that power. I've seen a lot of people suffer and not wanna stay in a position, but they're embarrassed to tell their mentor or they're afraid of disappointing someone besides themself. So, I will tell you, be selfish on this one. Make yourself happy. Certainly fulfill your obligations and do your job. But if you change, if you're not happy, nothing is permanent and life is short. So, there's many, many ways to define success and you must decide yours. Don't let anyone else decide that for you. And so, I think one of the most important things is to be true to yourself and to make sure that this is a very fluid process. And again, what your goals and your desires were five years ago, life changes. So, nothing has to be permanent. So, be thoughtful, move forward and continue to define what success is to you. So, I think that, let's go, I'm gonna stop sharing and I'm ready to answer any questions or clarify anything that might've been confusing. Thank you so much, Dr. Funner. I neglected to say this beforehand, but if the audience, if you guys have any questions, please feel free to type them into the Q&A, little box down there and we will answer them as they come in. I have a couple of questions for you. If you could go back, Dee, and imagine yourself as an early career physician, what's one thing you would have done differently? Or something that you see early career folks do well. Early career, I think one is I was a fail, I was somewhat afraid of failure. And so, I had a hard time sharing a paper or sharing a grant for someone else to see because I didn't, I wasn't confident enough to accept someone's critique. So, that is one thing I think for me, I would have had a stronger mentorship team where I felt safe to do that. Some of that perhaps for the circumstances and some of lack of senior people around. So, you have to remember, there wasn't a three or four year old gynecologist in every academic department at the time. We were sort of few and far between. So, a little bit was that. So, I would say one thing is don't be afraid of, I won't say a failure, don't let that bother you. Just move forward. Now, my paper gets rejected or my grant doesn't, that rolls off of me pretty easily. But those first rejections were pretty hard. Well, in this day and age where there's so much talk about injustice and equality and the focus on diversity, equity and inclusion, do you have any advice for early career faculty that perhaps are in an underrepresented minority group or even just female physicians? We know that the gender pay gap is real and you were probably the first one that pointed that out to me. So, how do we best navigate that in these large academic centers where you know, like for example, where I practice, the amount of RBUs that urology gets for doing the same procedures that we get is different and better than what we get. Yeah, so there's a lot to that question. I would say certainly, you know, we should all hope to be creating a better place for everyone to have more opportunities. And so I certainly, I believe that as we can all rise together in terms of supporting each other. And so, you know, for our underrepresented minorities and for everyone, you know, that should be a question. If they're interviewing somewhere and they don't talk about the diversity, equity, inclusion work in their department, in their institution, if that's not part of their interviewing process where they state that in their core values of their department, if it's not, you know, apparent that they are focusing and trying to improve the role of underrepresented minorities, including women in medicine, that should be a red flag. So first of all, so in terms of salaries, you know, I'm a big believer in that the salaries should be standardized in departments and that they should be, you know, so that, you know, again, there shouldn't be the age where if someone's the head of the household, they get paid more than if someone has a dual household. So that was the common in my department for many years. So that there were different salaries based on how much the spouse made. And so, or their, you know, or their partners. And so those days should be gone, but they're still out there. And so it should be very transparent and open. Again, that's part of the values of the department. And if that's not apparent during your discussions, then that's a problem. You know, I think, again, it's trying, as you're interviewing for the positions and, you know, just seeing, are these things talked about? And that is, I think, is a very telltale sign. Well, speaking of interviewing in this day and age, two separate people from around the country just texted me questions. I don't know if the chat box is working. So for graduating fellows looking for a job right now, what advice do you have in terms of working with mentors, sponsors, coaches during this process? Yeah, you know, I think it's tough. I mean, you know, we're trying to, you know, the first round or two of interviews are on Zoom. And so that's a little bit. So, you know, I think, oops, don't reboot my computer. That would be bad. Okay. I think, you know, again, I think it's figuring out what kind of job do you want? And so what is it, what's your ideal, you know? So I'll tell you some of my interview questions, you know, I will say, what's your ideal work week look like? I expect that the applicant has thought about that, that they have seen, you know, they've seen what a clinically focused person or a research focused person at their institution or during their fellowship, or they've, you know, and they have an idea of what they think their life should be and what they want to be. So I think those are, that's, again, going in prepared to that interview. I think if, you know, for my fellows coming out, thinking about, you know, again, it's making that priority list, your job goals and your personal goals. And so if you're, you know, if your number one goal in life is to move back to North Carolina, then that has to be your number one goal. And you may have to sacrifice some other things. You know, if your number one goal is to be in an environment where there's a well-established NIH grant funding or a mentor that you know is going to help you to have a very successful academic career, then those are the positions you need to look for. And I think that coming out of COVID, you know, last year, I think it was a very, very difficult year, but I think there are going to be a lot more positions opening up this summer and this fall. So hopefully that will make it easier for folks. The next question is sort of near and dear to my heart just because I'll be up for professor next year. And the question is, when do you know it's time to become a sponsor yourself, that you're ready to turn things over? And when is it too soon? Yeah, I don't want to say you'll know, but, you know, I think that, again, wherever you are, first of all, you need to know what are the criteria for promotion at your institution. And so, you know, going from a certainly assistant to associate professor, in most places will require somewhat of a regional, if not national reputation. And then going from associate to professor requires really a national presentation of presence of significance. So, you know, once you've achieved that level, then certainly yes, then become a sponsor and help support others to those positions. So once you've done something, if you get asked to do it again, you know, pass it along. I think that's the message I would say. You know, I think that if, you know, we have to help everyone coming along and so you should be very open. So I don't know, I mean, I think for even a junior person, if you get asked to do something and you can't do it, it's quite fine to, you know, go ahead and pass it along even if you're junior. But certainly as you become an associate or professor level, you don't need those opportunities. So for me, you know, I think at some point, you know, it has to be something really amazing to say yes to just because of a time commitment and things. So at some point that becomes a lot easier. And that's why I'll be an editor of a book. Thank you, Dr. Fetter. So another question, is it common to receive a stipend for a division director or another titled role? And where do you recommend finding out the information for a reasonable stipend if this is a thing? I feel like I've heard male division directors receive stipends at my institution, but when I was offered the position, even though I was a recent grad from a fellowship, I was basically told, quote, you can't get any stipends for X number of years here. So, first of all, that's illegal. Let me just say what you just wrote in terms of, so it's illegal to have the same job and pay someone else more differently, quite frankly. So wherever your institution, you should go to your provost office. And I know that you're probably very vulnerable, but quite frankly, that's not allowed. So you need to find a senior, I'm looking, a senior person who you can go to, whether that's in your associate dean for faculty or the provost or who's someone at your institution. And discuss this. Or even like a Title IX person, maybe. Like a Title IX. I mean, this is just, it's not, it's illegal. And so stipends shouldn't be based on number of years. A stipend, it goes along with a position. So if someone is a division director, so institutions, so my division directors don't get a stipend, they get protected time to be the division director. And then they get somewhat of a lump sum at the end of the year for that position. So I guess you would call that a stipend. So, but it's primarily more of giving effort so that they buy out their clinical time and have the position. But all institutions do it differently, but they should be able to pick and choose who they give the stipend to. So if you're being given a job that someone else is getting a stipend for, again, it's illegal. You need to take it to whoever in your institution you feel safe that you can take it to, but you shouldn't have to settle for that. Well, I just got another question. How can I work for Dr. Fenner? Oh. I can take that one offline. If there's not any more questions. Oh, hold on. Here's another question that just popped up. Thank you, Dr. Fenner and Dr. Legegout for an informative session. I'm currently a PGY-2 OB-GYN resident interested in pursuing a career in urogyne, academia, global health. And I would like to know, are there any foreseeable changes you anticipate taking place in the field of FPMRS? Thank you in advance. Oh, taking place in the field. I don't know in terms of in the next couple of years. I think that, you know, there's post COVID, there's certainly changes, I think, you know, that are happening across healthcare, virtual health, everyone is adapting, which I think is good. Our field, you know, I think there's some areas that works well and others where that might be challenging, but certainly, you know, managing medications and et cetera, work well with virtual care. I think that's a big change in medicine. I think that in terms of the use everywhere, I see the expansion of the mid-level provider as part of a practice models. And I think that such that, you know, we see patients primarily that just need surgery. And then for having mid-level providers manage other chronic disease models within urogynecology. I think academic medical centers are consolidating around the country. So I think that is, will be interesting to see. I also think that there's perhaps less money. And so as we look around, I think that, I think research will be more and more threatened during the fellowship years and during the, during the practice years. And so I think that the importance of philanthropy and other financials, dollars other than non-clinical dollars to support research and non-NIH dollars will be increasing. And so what that does, I think it narrows the places that have large philanthropic endowments and potential will be the centers where you'll see more research. So I think those would be the things in terms of other major. I hope we continue to have better outcomes from our surgical care and that we figure out ways of minimally invasively caring for prolapse that's sustainable. But I've been hoping now for 25 years, so we'll see. I have another text question. Clearly everyone on the country knows my cell phone number. I was gonna say, golly, Christina. Okay, I'm very liberal with it. So what are some strategies to advocate for yourself when looking for a starting job? How much should you be willing to compromise on your priority list? Hmm, strategies to advocate for yourself. So again, I think this was, is clearly knowing what you want to do and knowing what kind of job you want to have. And so when you come in and you, you know, so that's again, what type of person am I looking for as a chair? You know, do I want a primary clinical person? Do I want a research person? Do I want a bland? Can someone come in and convince me to take them even though, I mean, there are a few people, yes, who have wowed me to a point of saying, okay, you maybe aren't the right phenotype, but you're amazing and I want you anyway. I think that, you know, being genuine, authentic, excelling yourself, knowing what you want. And I will say, you know, make and showing that, that you have the conviction and the drive to be successful. I think also, you know, people want team players. They want someone who's not, who's going to, you know, who wants to be at the institution. So those are things that can help sell you to wherever you're looking for a job. So, you know, I think that, you know, how much did you compromise? You know, no job is going to be perfect. Don't be afraid to ask though, because that's one thing I, you know, I do a lecture for all the fellows, talk about how to negotiate their jobs, but then I tell them, don't come back and use it on me. And that's the thing is, if you don't ask for something that that person says no to, I always say, you haven't asked enough. So you need to ask, you need, so don't, and this is frequently in OBGYN as I'm negotiating with women, I really tell them, don't, you know, don't think that just because I tell you no, that I think that's a bad thing. It means that you were smart enough to ask for more than I could give you, and that should be a good thing, right? So don't, you know, I know someone lived in New Jersey, they wanted her in New York City. She negotiated to drive her, take her to work every day because they wanted her that bad. You know, I moved here from Seattle. I always managed to move at the high peaks of the market. I shouldn't be moving now, right? But, and I knew I was gonna lose money. I negotiated that if I lost money, they were gonna make up on my house. I said, if you want me here, you're gonna have to make it up so I don't lose money. Fortunately for Michigan, we didn't lose money, so they didn't have to pay out. But, you know, I just think those are unusual things, but compromise, I mean, you gotta know where your line is. And, you know, look deep in your soul so that you know, can you still be happy and make that compromise? And don't think that it's gonna change once you get there. So along those really insightful and deep comments, we have an anonymous question saying, at what point did you realize what you wanted to be happy and successful? It's like a fireside chat now. I know. I love it. Oh, you know, I think I always thought I wanted to be a chair. And that was from early, probably when I was a chief resident, I don't know, maybe because, you know, it was hubris that I just thought I would be a good leader. But anyway, yeah, you know, I think that, you know, most of my research is clinical research, certainly not a basic scientist, you know, a good collaborator, but I was really more an operations person and a educator and a good facilitator and problem solver. And so I won't say what Christina used to say about me, but I will just say that. We still say it about you at Northwestern because there's so many of you. I know, so anyway, but I, so, you know, and I think for me, it was realizing that was really gonna be successful that, but it was, you know, that again, that I didn't have to have TNRO ones to be successful and defining that myself. And it took a few years for that to happen. So I think we have time for one more question slash comment. How could we not? It's from Cheryl, Dr. Iglesias. Love you, Dr. D. Fenner. You're an inspiration to many. You taught me how to negotiate. Can you share best resources for business skills, websites, articles, et cetera, and coaching resources? I don't know if you know any on the top of your head, D, but otherwise maybe we could email them to the attendees. There's a book called The Wisdom of Teens. It's an old book, but I still think that can be really helpful on some basic leadership and management. There's also a book, very simple, old book, probably you've listened to it on the way to work, called The One Minute Manager. It's a very simple, but how to decide, is it the person or is it the system that's broken and thinking and acting accordingly that I think is good. In terms of other resources, websites, gosh, there's an article I use, it's from a Harvard business. I think it's Wanting A and Rewarding B, that I think is a very good article that just, again, talks about making sure what is valued is going to, what is the same, is alignment there. It's again, thinking about how you're gonna be rewarded and does it match what the institution's gonna reward. So that I think is a good article. In terms of how to negotiate, guys, Sherelle, you can type in something yourself here. I guess one of the other things that I'll just add is when I decided I was gonna, did wanna stay in academic medicine and I wanted to move up into a leadership, I took courses. I did, I was fortunate enough, I did a course at Harvard for two weeks. I did a course at Wharton for two weeks and then eventually, then I did ELAM. But, so I will tell you, learning to do these things, they are learned. No one really is a good negotiator. I think the question, are leaders born or leaders developed? I think it's a combination of things, but it's, there are skills and there's knowledge. There are ways you learn to solve problems, you know, how you approach things, you know, you establish your principles, figure out your goals, you think about your strategy, most importantly, how much is it gonna cost? And so there's, you know, there's frameworks that you can learn. And so I would tell you to, to, you know, to take some courses. I also tell you, great experience of being on OGS committees, SGS, APCO, other opportunities where you can learn leadership outside of your institution, where I'm gonna say, maybe it's a little safer for you, but take advantage of those opportunities as well because you can help gain skills and watch people. I had as many negative mentors, if you will, or negative examples of leadership where along the way, where I would be, I'm not gonna do it that way, or, oh my God, I can't believe this is how this person is leading this meeting or trying to lead this team. So I will say, be very observant and you can learn a lot. So since we're at the conclusion of the hour, I want to, on behalf of OGS, thank you so much, Dr. Fenner and everyone for joining us today. The webinar was recorded and then live streamed and it should live on the OGS website for quite some time. And for a complete webinar series schedule, please visit the OGS website and sign up like you guys did tonight. And again, Dee, thank you so much, both personally and on behalf of OGS. This was wonderful. Oh, thanks. And if any of, if you're looking for a job or you have a question, I'm always happy to help a junior faculty or follow along the way. So if you'd like to schedule some one-on-one time, I would certainly try to do that. So my email is very simple. It's def at med.umich.edu. So if something comes up or you have a question, I'd be happy to help. And for those of you that don't know Dr. Fenner personally, she really actually means that, despite how busy she is, she means that and she will do it. So, all right. Thanks again, everybody. Great to see you, Christina. Thank you so much. Okay. Good night, everyone.

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