Podcast – Leaving Home for Science: The Migration of Minds

Voice Over:

The Dementia Researcher Podcast, talking careers, research, conference highlights and so much more.

Dr Francesca Farina:

This special podcast was recorded in front of a live audience at Trinity College Dublin for the AAIC Neuroscience Next: Ireland Hub on the 23rd of April. We hope you enjoy the discussion.

Hello to everyone here at Trinity College Dublin, and another big hello to everyone who's listening or watching this online. This is a special recording for the Dementia Researcher Podcast. My name is Francesca Farina. I'm a senior fellow with the Global Brain Health Institute at Trinity College in Dublin, and I'm also a research assistant professor in the University of Chicago.

I'm delighted to be joined by three other people on stage here who like me, at some point in their careers, have left their home for the work that they do, and that's the topic that we're going to be talking about. Our title for this podcast is Leaving Home for Science: Migration of Minds. We think there's going to be a lot to discuss here, so I'm going to jump in by starting to introduce my guests. We're joined by Elul Lakew, Claudia Suemoto, and Muireann Irish. Thank you for joining us.

Elul is a clinical psychologist and mental health advocate. She set up her own practice after obtaining her master's in clinical psychology from Addis Ababa University College of Health Science. She also hosts radio and television programs on the issue of mental health, and she uses social media platforms to discuss brain health and raise awareness of dementia. Elul left Ethiopia last year to join us here at Trinity College as an Atlantic Fellow for Equity in Brain Health with GBHI. So welcome, Elul.

Elul Lakew:

Thank you.

Dr Francesca Farina:

Claudia is an associate professor of geriatrics at the University of Sao Paulo Medical School in Brazil. She obtained her PhD at the same institution, exploring the association between dementia and atherosclerosis using morphometric measures in autopsy samples. She also has a master's in epidemiology and a post-doctoral fellowship from Harvard T.H Chan School of Public Health in the US. And amongst the other things that she does, she's currently one of the coordinators for the brain bank of the Brazilian ageing brain study group. Welcome, Claudia.

Dr Claudia Suemoto:

Thank you so much.

Dr Francesca Farina:

And finally, Muireann completed her PhD here at Trinity College and is now professor of cognitive neuroscience at the University of Sydney. She works on the loss of empathy during dementia. Her career has explored how memory and imagination are changed during neurological conditions including Alzheimer's disease, and it's this work that took her from Dublin to Australia. She's also an advocate for diversity in science, and in particular, retention of women in science. So, let's welcome our guests.

Thank you. The question, as I mentioned is we want to address today, is really around what's called the academic brain drain by a lot of people. Questions around is moving necessary to become successful in the work that you do. Why do we move? Would we be better staying in one place? What policies are stopping us or encouraging us to go? And who gets to move or who gets to stay? I'm going to start by giving each of our guests just a couple of minutes to share their overarching thoughts on this theme, and maybe what inspired them to move from where they grew up and their general thoughts on the topic.

So, I'm going to go to you first, Claudia.

Dr Claudia Suemoto:

Thank you. I would start saying that I finished medical school in one institution, did my residence and then did my PhD in the same institution. And after I finished, I became a professor. Everything was super fast. And once you become a professor in my institution, you're a professor until you're 70 years old. So, for me, I didn't have to change if I didn't want to.

But what happened is that during my PhD, I really fell in love with statistics. I tried to learn everything that I could from my institution, and I reached a wall. I could not learn anything different from there, so I started doing an online course from Harvard. And from there, I finished the course and I say, "I want more." And then I asked the instructor, "What could I do?"

He said, "Oh, you can come to Harvard and try our master here." He wrote me a lovely letter of recommendation and it worked out; I went there. And I think it was the most transformative experience that I have in my life. Totally changed the level of research that I do nowadays. That's something that we didn't have time to discuss with the early career investigators, but learning statistics and epidemiology is really life-changing for us in research because we can put our own impressions and work in the data in our way.

So, for me, it was life-changing, and I had the opportunity to come back to Brazil three years later a totally different woman. It was really nice for my family, too. At the time, I had a, I still have, a daughter. She was there and I then came back. And I think the good thing about coming back, maybe jumping to the next question, is that I could transform the environment that I'm in right now than I was before. And it has been very impactful for the research that we do in the brain bank and also in the epidemiological studies.

Dr Francesca Farina:

That's great. Elul, I'm going to come to you next. Just what Claudia said there about bringing knowledge back, I guess that's one of the aims of GBHI and the GBHI Fellowship. So presumably, one of the reasons you've come here is to bring knowledge back to your home country. You're not a researcher. You're a clinician and advocate. So, can you tell us a little bit about your experience?

Elul Lakew:

Yes. For me, it's my first time moving out from Ethiopia for an academic purpose. And as you said, one of the things that motivated me to move abroad was I was one of the lucky 12 fellows to join the GBHI community as a fellow. And for me, joining GBHI is an opportunity, a chance to contribute to the international dialogue, and to join the efforts that everyone is doing to address the public concern we are having, which is dementia.

Talking about brain drain and how it affects my country, Ethiopia, first of all, in the healthcare system, we already have a big, big, big demand. We have challenges in resource and qualified personnel, and you can imagine how brain drain or brain migration affects or exacerbates the already existing situation in the healthcare system. And another thing will be in the higher education system, in institutions, the same problem exists. In Ethiopia, higher education, and institutions, they do lack qualified faculty members. This is also another challenge because the coming generation is not getting quality education. And of course, this is a very big problem in one's country's development.

Another issue will be maybe economic development. When people migrate, especially the most skilled ones, the most productive ones, when they migrate, they take the potential and their contribution with them away. So, this might be a great challenge, especially in the case of developing countries like Ethiopia.

Dr Francesca Farina:

Yeah, absolutely. Lots to follow up on there. We're going to go to Muireann next. So, it's been a few years since you moved to Sydney, would you say?

Professor Muireann Irish:

It's been a while, but I was very young when I moved. So, I did my PhD and undergrad here at Trinity, and I took a year off after I had finished my PhD because I really had no plan and I had been in formal education for so long. So, I worked as a statistician actually at a marketing consultancy and just started saving up money to go travelling because I hadn't done any of that before. You'll find out pretty quickly I'm a bit of a maverick. I had no plan. And so, I went off gallivanting around Southeast Asia and Borneo. Went to see orangutans, went to New Zealand, did all of this. Arrived in Melbourne with the intention of staying there for a year. And at the same time, the global financial crisis had just happened, and my parents basically said, "Do not come back here. There is nothing here for you. You have to stay."

And so, it was quite the opposite of anything that's been discussed here. It was more, "I have to now start from scratch. I had nothing." I was trying to find jobs, I didn't have the right visa, I didn't have the right skillset, I couldn't come in as a skilled migrant. So, I ended up working in part-time jobs just trying to make ends meet, and then started sending out emails to researchers that were in either Sydney, Melbourne, Queensland. I was scrambling. And just serendipitously, I sent an email to a person called John Hodges, who I had no idea how eminent this person was. It was just kind of like, "Hey, I heard you do dementia research. Here's my CV. It's really bad."

And he just emailed straight back and said, "I'll fly you to Sydney. Do you want to come and do an interview for a postdoc?"

And I was just like, "Oh, thank goodness." So, I had to claw my way back in basically. I'd been out of the system at that point for three years and then was trying to find my feet in a new system. I didn't understand how the funding worked. I wasn't eligible for any of the grants. And it's been a real sort of like... I'm very scrappy. It's been a real like, "I am not getting kicked out again." So, I was staying in and trying to make it work. And yeah, it's worked out thankfully, but it was very difficult at the start.

Dr Francesca Farina:

I guess that's one of the questions I was thinking about as well, "What would you wish you had known?" So, I moved to Chicago nearly two years ago, and now I think I would know what I'm letting myself in for, but I don't think I did at the time. Culturally or financially or anything like that. So, is there anything that jumps to mind when you think about what you would advise somebody else or what you wish you had known at the time?

Muireann, I'll start with you just because you've already touched on that.

Professor Muireann Irish:

I just feel like just don't do what I did just to-

Dr Francesca Farina:

So, professor [inaudible 00:11:07].

Professor Muireann Irish:

... take my story. Yeah, I think in hindsight, it worked out just because of the way I am. I'm a very determined person. I work very, very hard. But the first, maybe three years, were extremely difficult. I had no social network; I didn't know anybody. We had no furniture in our apartment. We were just literally looking for jobs. Didn't have the right visa, anything like that. So, I think in hindsight, I would always advise that people would have a look at the actual landscape that you're moving to, maybe you have an idea or set up your connections before you go. None of it had been planned. I never planned to move to Australia. It's just that it was kind of foisted on me.

But I think now that I'm there, I've been very, very lucky in that this person that I mentioned, John Hodges, just elevated my career. He saw something and he just decided he was going to mentor me, and he's the person that made it possible for me to rise. And that's been the thing I've probably taken the most from the move, is that that I want to be the mentor that he was to me. And so, I think it's more about seeing the talent in somebody, giving them a chance, and getting them in from when they're not able to advocate for themselves or get funding. For example, I've paid for the funding for three or four students now from India, China, and other countries that aren't able to have the same opportunities. I try and sponsor them in a way that John did for me so they can rise up and have the same opportunities.

Dr Francesca Farina:

It touches back on something that you said about your mentor, Claudia, writing that letter for you that got you to Harvard.

Dr Claudia Suemoto:

Yeah.

Dr Francesca Farina:

Is this kind of mentorship resonating with you? Having these people?

Dr Claudia Suemoto:

Yeah, it's super important because when you see, from the outside years later, you see how important this kind of help is for younger investigators, for early career researchers. And at that time, it's funny because he's at Harvard, he's a full professor, got a presidential medal, very successful, but at the time, he's just one year older than me at medical school and he was my friend. So then, it was something that was not super vertical at that time. It's a little bit different, I knew him before, but it was so impactful for me at that time because the letter was super strong. I think everything that was written there is true, but at the same time, it's such an important process.

And just jumping in a little bit in these other questions, I think what resonates with all of us is that we don't think too much when we move to another place. Otherwise, if you put everything like pros and cons, you don't do it. I have this impression because it's always overwhelming. Even if you want to go there a lot to learn new things, it's always overwhelming because the culture is different. But at the same time, I think for sure, part of the beauty of changing cultures is this shock. Now I can say that even I came back almost 10 years; I still have friends from that time. They come to Brazil, I come to Canada or other countries. And it has been really great, this exchange. Some of them are research collaborators until now, some of my school friends.

So yeah, it was really transformative as I said before.

Elul Lakew:

So, speaking from my experience, when I got accepted to be a fellow at GBHI, all I experienced was excitement. I was just super excited. To the limit, I wasn't even prepared for the challenges. So sometimes when you're overexcited, we don't have the space to think through and to do our research to see what the challenges are, and to try and picture ourselves in a different culture. Especially coming from Africa, it's actually different. It's really different. So, for me, after coming here, I was excited. I meet everyone. Everyone was friendly. But it's still a challenge to fit in. Coming from Ethiopia and meeting people from every side of the corner, every side of the globe, it was exciting in a way, but it was somehow frustrating. And especially in GBHI, everyone has a different background, and you might not have same language, same communication level.

I would say, be prepared for the challenges. Be mentally prepared, emotionally prepared, and use every opportunity, every challenge as a stepping stone. Because if we become more discouraged... There are times I get really lost. When I was very lost, I didn't understand what people were saying, but I kept on going and I'm here. I'm happy now. So yeah, don't give up. Just use every opportunity and it will be rewarding, I would say.

Dr Francesca Farina:

So, resilience, really-

Elul Lakew:

Yeah, resilience.

Dr Francesca Farina:

... and having a little bit of a support network around you and having people that you can turn to. Mentors, peers. And for the GBHI experience, was it helpful to have 11 other people who came from all different parts of the world? Has there been that sense of community in a way, that nobody's used to Ireland in that sense?

Elul Lakew:

Yes. Most of us were new to Ireland, so most of us had the same issues, the same challenges. Looking for a house, registering, getting into the system. So even that sort of challenge, it helped us to connect with each other and learn from one another. And it's always exciting to know about somebody, to learn about their culture, where they're from, because it's new.

Dr Francesca Farina:

It sounds or seems to me that this is becoming inevitable. At least in Ireland now, we're going through another stage, another wave of emigration. I don't know what one you were on, but I'm on the most recent one now. People are leaving again. Do you think that this international mobility is the future of research, of clinical research advocacy, whatever you want to call it? Are we only going to get more and more mobility, do you think? Or do you think it's more waves, like peaks and troughs?

Dr Claudia Suemoto:

First of all, it really surprised me that this happens here in a high-income country, so I'm totally surprised by this movement. But I think nowadays, there are so much collaboration. COVID was bad in many ways but put us together through Zoom and other platforms. So, I think the need for mobility now, it's less, but it's still some kind of training I could not get in Brazil, for sure. And it's not only about learning how to do epidemiology or statistics like how I use [inaudible 00:18:45] or [inaudible 00:18:46]. It's not about only the hard skills, it's always also about soft skills. Because when you go to a place that is way above the place that you were before... So, for example, at Harvard, there is no limit. It's only the sky. There is no glass ceiling, right? And there's a lot of glass ceiling in my country. So, we start thinking that you can do different stuff than you are used before.

And I think that was one of the most important things that I learned outside my country, that we can do big stuff. It's the same work, almost. Do small stuff, insignificant, and do wow things. You have to dream about it. And this kind of training, you don't get in average places. You have to go to a very different place. So, I think there is a space still for mobility, but at the same time, we are living in a country that is... In a world that is very connected. So, we may still collaborate even if you're here in Ireland and I'm in Brazil. While you're in the city, you can only find a good time of the day that we can connect, and you can collaborate. I think that's a wonderful time that we're living now regarding this aspect.

Dr Francesca Farina:

So, how did they get you to come back to Brazil?

Dr Claudia Suemoto:

Oh, it's a super personal story. I don't know if...

Dr Francesca Farina:

That's fine. My broader question is, how do countries retain their talents? So, if you have people who go and learn these amazing skills and do these fellowships, how do you get people... How can countries make sure that they get their talent back? What can they do?

Professor Muireann Irish:

I know... Sorry. In the Australian system at least, they have mobility built into some of the prestigious fellowships. And so, you do two years overseas, but you have to come back, and do the rest of the fellowship then back in your home institute or somewhere else. And it's to build that capacity, ensure that the skills that you are developing while you're on the overseas component is being brought back. And that's a big part of those schemes. I'm assuming it's something similar for...

Dr Claudia Suemoto:

Yeah. So, I stay in the US with a fellowship from the Brazilian government. If I wanted to stay there, I had to give the money back, and I didn't have at that time. That was one of the reasons that I came back. But at the time, I got divorced and I went to the US. That's why I said it's personal. And then, I got a boyfriend in the United States. I came back but I was going to get married and come back to the United States, but in the end, the thing fell apart. I think it was good. I didn't have any personal reasons to come back to the US anymore. And after some years, I think we are discussing this the other time, we still do... I would be one more person in the US, I think sometimes, because there's so many bright people depending on the institution that you are in.

But I think if you get good training, you can make a difference in your own environment. It's really easy to see the difference in certain settings because there is so much scarcity, and you can see the difference. So, what I can say, for example after I came back, it has been almost 10 years. I have students that were early career investigators for the American Heart Association that I think is totally awesome. I could never imagine that a Brazilian could get this award, or we got fellow awards regarding this in the Neuropsychology Society for... The Alzheimer's Association got something, too.

So, it's been transformative, I think, not only in my group but other groups in Brazil, too. When people come back, they come back different, and they bring some of the spirit that they learn outside.

Elul Lakew:

I think my experience might be different because I believe the moving will continue or even be more, because the more there is war in different parts of the globe, the more there is economic instability in different parts of the world. Especially, for example in my country, Ethiopia. In different parts of Ethiopia, in different regions, what is going on still now. So, whenever I talk to my sisters, my younger siblings, they always ask me. They always ask me for guidance, "I want to go out and study this. I want to go out and do this." So, I feel like every time I speak with them... They're very young. And every time I talk to them, I feel like they're losing hope in their country, they're losing hope in studying there, serving their community, helping other people.

So, I believe that this moving will continue, especially in the parts of the world where economics, instability, and what is happening. But another thing I would mention on your last question, countries, they need to give value to educated people, qualified people. They need to be motivated. They need to be encouraged to do more. Unless and otherwise, we are all human beings, we always want something better. We always want something good. So, yeah.

Dr Francesca Farina:

Incentives, yep.

Elul Lakew:

Yep.

Dr Francesca Farina:

Stability. Money helps, yeah.

Elul Lakew:

Yeah, money.

Dr Francesca Farina:

Okay, I'm conscious of the time. I think it's about that time to open it up to questions. I'm sure there are people sitting here who are from somewhere different or have moved. So, anybody who has questions for the panel?

So, the question, I remember to repeat it, is what do you lose when you're open to change and when you make these changes, these moves?

Dr Claudia Suemoto:

It's such a hard question.

Dr Francesca Farina:

It's a hard question?

Dr Claudia Suemoto:

I think we lose the counter fact of it. There is always a price. I'm a very optimistic person. I try to see the glass-half-full. But of course, I stay three years out of my clinical practise, I lose some patients physically. I also lose some opportunities there. But in the end, I think for me at least, the benefits were so large compared to what I lose. And also, I had my daughter with me. You had to. So, they learned to live in a different perspective of a global perspective. She's very respective and respectful to other cultures. I think that's something that she learned that I didn't have to explain. She just noticed.

So, I don't know. I think you lose the other things that stay behind you. You don't come back the same person too, right? Yeah. But I have good feelings about this. I don't know.

Elul Lakew:

I would say for me, family, because of course, I'm lucky enough to come here with my husband. But since I had a very deep connection with my parents and siblings, and moving... I have never been away for this long. So, for me, being away from family, my friends, my relatives, being away from that beautiful culture, that beautiful coffee ceremony, I really do miss it. It was a challenge. It is still a challenge.

Professor Muireann Irish:

Yeah, I would say the same thing. I've missed out on so much in terms of my two brothers, they are getting married, having children. I don't get to see my nieces growing up. That's a decision I made, but I think there's always a part of you that has you foots in both camps. And I always have wondered, like when times were bad in the early days, I'd always think, "Oh, what have I done? I could have gone back." And then I'd have my former supervisor, Shane O'Mara sending me emails going, "When are you coming back? Have you looked at this opportunity?"

And I'm like, "Oh, should I?" And just that uncertainty in not knowing am I doing the right thing. And the thing that flipped that over for me was then when things started going well. And so, I got a fellowship, then I got another fellowship, then I got a permanent position and got promoted. Just the momentum started building. And I think the opportunities that I've had, given to me, it's very symptomatic of the Australian culture. They'll give you a go and it's like, "We'll give you a go, mate." And it's like if you want it, they'll give it to you, and they'll give you the opportunity and you can rise really quickly. And that became quite intoxicating.

And so, everything's going really, really well careerwise, but there's always this lingering thing of, "I'm not actually in my place." Like you said, it's like I miss those cultural things. Christmas is one of the worst times because it's so hot and nobody has a cooked dinner. They all eat salads and seafood. And I'm like, "What is this place?" [inaudible 00:28:13] Yeah.

So, I think it's knowing that you have everything that you dreamed of careerwise, and I'm giving a very good life to my two children, Fiona and Oisin. Hi guys, you're now on the air. But also knowing that I've sacrificed relationships with my family and my friends. And you can't have it all. That's the worst part.

Speaker 6:

For sure. That's life.

Professor Muireann Irish:

Yeah.

Dr Francesca Farina:

The question is, if you had to move to somewhere else again, where would you move to and why?

Professor Muireann Irish:

Bali.

Dr Francesca Farina:

Bali? Yeah.

Dr Claudia Suemoto:

This is easy for me because I thought about it. I studied epidemiology. UK is the place where epidemiology happens. I thought about London, but I don't know. It has to be, I think for a period, and learn a new thing that I don't know yet. There's a lot of things that I don't know. So, it's not going to be that difficult.

Elul Lakew:

For me, I don't know. I honestly don't know. But wherever my heart takes me, wherever I can be useful, wherever I can contribute, and wherever there is an opportunity for me, I would say that.

Professor Muireann Irish:

Yeah. So, I did court a few options probably five, six years ago, and I was thinking about moving to the UK. I don't know, I think I still felt that pull to be back. And I thought, "That's close enough." And then, at least, I'd be in the same country as one of my brothers. I'd be close enough to home. But I think as well, it's not just me anymore. I'd be moving with two small children who have their own networks and have a lot of opportunity and are doing really well. And I think, yeah, I don't think I could do another move unless someone airlifted everything that I haven't put it in for me. I think I just... Yeah, I've put my roots down now.

Dr Francesca Farina:

Your kids are proper Australians now?

Professor Muireann Irish:

They are proper Aussies with the most Irish names you can get though, so yeah.

Dr Francesca Farina:

Any other questions? I can't see at the back.

"Is the move an advantage?" I like your first question, "Is the move essential?"

Professor Muireann Irish:

I wouldn't like to say essential because some people can't do it, and I think there are ways to make these things work. Like you said, we're more connected now post-COVID, and there are people who have young children or for financial reasons just can't do it. But I think it is definitely transformative. I think you said that, Claudia. I wouldn't be the researcher I am today if I had stayed, and that's nothing to do with where I was. It's more just what I've been exposed to and my own kind of personal growth. I've had to be more resilient, more determined, problem-solve, keep applying for the grants, make sure I've got my visa. I've just had to do it all.

And I think that makes me less scared of problems in research. I'm like, "Oh, that's grand. We'll just keep going." It's made me more resilient across the board and more appreciative, I think, of what I have managed to carve out for myself. And then, wanting to pay that forward. I just don't know if I would be the same person if I had stayed, and I think I'm really grateful that I've had that opportunity. As tough as it was, it's been amazing.

Elul Lakew:

I totally agree. I don't have anything to add. Yeah, true.

Dr Francesca Farina:

Kevin? That actually brings a really interesting question, I think Kevin, around visas and the visas challenges of who can get a visa to leave. Some people, it's easier to travel to get to... We have people in GBHI I know who go to conferences, who want to go to conferences, and it's always challenging. I think that's just an important point to bring up, that you really need that support network. Somebody who can help you with these things in the host country that you're going to. I think from my perspective anyway, that it helps to know someone who knows these things, and that it's not as easy for everybody.

Anne Marie, how did you re-adapt to your own home culture after being away?

Dr Francesca Farina:

And how did they adapt to you?

Dr Claudia Suemoto:

That's so interesting. I will try to make it short, but it's a whole podcast. I think, first of all, Americans are very direct. They don't like... Brazilians never say no. You try to please all the time. So, every meeting, Brazil lasts at least one hour. Maybe two hours, maybe three. So, it's crazy. So, when I came back, I was really impatient with all the [inaudible 00:33:15], and it was a problem when I come back. And at the same, time people saw me more... This is a problem of female researchers, I think. They call me aggressive because I was too direct. I became more direct. So, I think people say, "Oh my God." And this happens, I think, two weeks ago. We are in a conference. I organised a conference. And one of my old mentors said that I became different when after I came back from the US, and I got more aggressive.

He used that word, [inaudible 00:33:47], because I became too direct for my culture. And another thing that changed me very quick is that there is abundance in the US. I think there is here, too. There is no... In most low-income, middle-income countries, there is scarcity. So, we live in this mindset of scarcity. Funny stories that [inaudible 00:34:07], we need a grant for... Very small money, but I said, "I've going to put whatever I can, the maximum that I can, of funding. And if they don't like, they just cut it." They put me out of the competition because I put the wrong numbers. So, I didn't have the chance to try to get that grant because they are still working in the scarcity mindset. That's one of the problems that I face when I come back.

Dr Francesca Farina:

Great. I think we're going to have to wrap up there. So, it's a really complex issue, leaving home for work, for science, for advocacy. I think we've heard a lot about mentorship, about collaboration, cooperation, but ultimately, just being open and willing to take a leap of faith. Super complex issue. Thank you all. Please thank our guests, Elul, Claudia and Muireann.

And the very last thing, thank you all for being genuinely a really incredible audience after a very packed and long day, and for joining us as part of the AAIC Neuroscience Next conference here in Dublin. I'm Francesca Farina, live from Trinity College. And you have been listening to and watching a special live recording of the Dementia Researcher Podcast. Thank you.

Voice Over:

The Dementia Researcher Podcast was brought to you by University College London with generous funding from the UK National Institute for Health Research, Alzheimer's Research UK, Alzheimer's Society, Alzheimer's Association, and Race Against Dementia. Please subscribe, leave as a review, and register on our website for full access to all our great resources. Dementiaresearcher.nihr.ac.uk.