Medical

A Med Student’s Guide to Becoming a Physician-Scientist

When medical students start to think about areas of practice to specialize in once they graduate, the area of medical research can sometimes be overlooked in favor of more traditional practice areas such as internal medicine or surgery. However, for some doctors-to-be, the pull towards such research is strong and it is an important part of the healthcare system, as the discoveries that such scientists make can have an impact on techniques used to improve patient care and outcomes.
This article covers the work and scope of physician-scientists as well as educational pathways these professionals pursue in order to undertake their important work.
What is a Physician-Scientist?
According to MJ Eisenberg in his book The Physician Scientist Career Guide, the physician-scientist is a clinician who spends the majority of his/her professional life engaged in research in order to generate or discover new medical knowledge which can then be translated into new treatments and techniques that doctors can use in real-life situations to improve patient care and outcomes. Oftentimes, these physicians will work in academic medical centers, though some work for branches of the government such as the National Institutes of Health (NIH).
Eisenberg also notes that these physician-scientists can be engaged in a number of different kinds of research, including the following:
• Basic scientific research which looks at the functions of the body in both sickness and in health
• Translational research which seeks to apply new scientific knowledge to procedures or treatments that will be useful in a clinical setting
• Clinical research, which can take the form of cross-sectional, cohort, case-control studies, meta-analyses of other studies or clinical trials with human subjects
• Population research, which seeks to gain new medical knowledge through the study of large groups of people
According to Science Magazine, the scope of research for physician-scientists is broad and can relate to any endeavor which seeks to increase knowledge of the human body or improve human health. Apart from the research itself, part of the duties of a physician-scientist may also involve education, direct patient care/clinical work, and administrative duties as well as work like the writing of grants for research funding. In short, a wide set of skills is required to be successful at this particular kind of healthcare work.
Educating the Physician Scientist
There are multiple paths to becoming a physician scientist and the pathway you choose might well be determined by the stage in your education in which you decide you want to go into research. Eisenberg calls these “early bloomers”, “late bloomers” and “very late bloomers”.
Early Bloomers
This refers to students who develop an interest in medical research even before medical students (usually this happens sometime in their undergraduate years). For these students, one popular route is the combined MD/PhD program. While such programs can vary, many work by allowing students to complete their first two years of medical school then go on to complete their PhD in a research area of their choice before completing the third and fourth years of their medical education.
An example of this kind of program is the MTSP at the Perelman School of Medicine. This program was founded in 1958 and is specifically designed to train students for a career as physician-researchers; the program puts a strong emphasis on training to gain research experience, access to faculty to be mentors, integration of graduate and medical school to help with the transition from one to the other, career guidance and a community of sharing with fellow MTSP students.
Late Bloomers
“Late bloomers” refer to students who do not discover an interest/aptitude for medical research until they are actually in medical school. For these students, Eisenberg notes that medical schools will often make research programs available that fit into a student’s summer or winter break. Other schools will allow for part-time research while a student is still in medical school or even allow for students to take a year off to gain research experience.
Some students who become interested in research during medical school itself can gain valuable experience through the NIH’s Medical Research Scholar Program (MRSP). This is a year-long research program which takes place on the NIH’s campus in Bethesda, Maryland, and allows medical, dental and veterinary students to practice their skills in basic, clinical and translational research. Science Magazine notes that the MRSP is not just about gaining research experience, either: graduates from this program have an edge when it comes to receiving NIH post-doctoral grants as well as medical school faculty appointments for positions involving research.
Very Late Bloomers
“Very late bloomers” refer to those who are out of medical school and perhaps even established physicians before they realize their calling to go into research. Often, these professionals will take time off to get other degrees (either at the Master’s or PhD level) that will allow them to begin their research careers. Science Magazine notes that getting a PhD separately from an MD can cost more both in terms of money and time, but may be the only viable option for those who discover their interest in research later in life.
In brief, then, there are several paths to choose from to become a physician-scientist and these options are often dictated by how early or late in one’s educational training a student makes the decision to go into medical research.
Career Options
There are several pathways that physician researchers can pursue as they finish their education and begin their careers.
Although more physician-researchers go into academia or into private sector jobs (such as in the pharmaceutical industry), some people will find their niche in government work such as with the NIH, which offers a wide variety of careers in laboratory and clinical research, science research administration and science/research policy, among other specialty areas.
Private work in the areas like the pharmaceutical industry are another significant source of employment for physician-researchers. In this case, their work focuses in on the design of new drugs, their formulation into capsules and tablets, and tests to discover the effect that the new drugs and their metabolites have upon the body and upon specific disease processes.
If such researchers are interested in entering into academia, Science Magazine reports that there are two main tracks they can follow:
• Tenure-track positions. Those pursuing tenure-track positions in this field will expect to spend around three-quarters of their time doing research and they are expected to find funding for their salaries as well as research money from sources such as grants. It is expected that tenure will be achieved within 6-10 years after being hired and is awarded on the basis of things like the number of papers published, the reputation the researcher has built and, of course, the amount of funding they have managed to garner. This kind of position is ideal for those who want to become lead investigators and develop their own research programs.
• Clinician-scholar positions. Those pursuing this kind of position do research as well as clinical work, though there may or may not be “protected time” in their professional schedules in which to pursue research goals. This kind of position is ideal for a doctor who is interested both in research and clinical practice and is not intending to become a lead investigator for clinical studies.
Potential Difficulties
Of course, as with any profession, there are potential difficulties that students should be aware of before embarking on this career path.
For one thing, while still comprising a small slice of the medical education in this country, the slots for MD/PhD programs are few and the competition to attain them is fierce: it is estimated that there are about 1,800 applicants competing for around 600 slots. Also, there are some disadvantages to such a program, namely that the first two years and second two years of medical school might have quite a gap of time between them and some students find that transition difficult.
According to Science Magazine, research scientists pursuing a tenure-track position, many find themselves with 6-10 years to gain tenure or be asked to leave the faculty and there can be a great deal of pressure to “publish or perish” and to be able to fund research through grants (which can be difficult to come by).
While all these difficulties might not be enough to deter those with a passion for research, they are certainly important points to be aware of before making a decision to pursue this particular career.
To sum up, becoming a physician-scientist might not be what medical students have in mind while pursuing their studies. But for those who have an aptitude for medical research would do well to consider this kind of career pathway. While intellectually strenuous, it offers a high degree of job satisfaction and is an important part of modern healthcare delivery as the knowledge produced by such researchers can guide new treatments, procedures and plans of care that can have a direct impact on patient outcomes and quality of life.

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Brian Wu graduated from the University of Maryland with a Bachelor’s of Science in Physiology and Neurobiology, and graduated from the Keck School o...