In this episode of the Neurocritical Care Society Podcast Masterclass series, hosts Stephan Mayer, MD, FCCM, FNCS, and Jon Rosenberg, MD, are joined by Hooman Kamel, MD, MS, professor of neurology at Weill Cornell Medicine, to discuss how clinical trials take shape in practice. Dr. Kamel reflects on his path into research, the importance of strong mentorship and what it takes to grow from early-stage projects to large multicenter trials. Their conversation explores practical aspects of trial design in neurocritical care, including building robust data sets, leveraging EMR-based tools, designing pragmatic studies and fostering collaboration across institutions. They also discuss the Arcadia trial and the broader mindset required to stay engaged in research, even when results do not go as expected. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.