mudphudder

Or can you? 

So every clinical department at academic medical centers around the country wants to hire physician-scientists.  Physician-scientist?  You do research?  Hired.  And that’s great–could be much worse–as the job market is quite good for any physician who also wants to do research.  But, there are still a lot of obstacles in the way of becoming a successful physician-scientist, most notably: funding and how to balance clinical vs. research time in order to generate one’s salary.  One complaint I’ve heard from almost every academic physician who also does research is regarding the departmental pressure to increase clinical responsibilities.  This is particularly true in clinical departments whose physicians usually generate a lot of revenue (e.g. some surgical fields, dermatology, radiation oncology) through clinical practice.  Often, junior faculty are hired as “physician-scientists” with a favorable research to clinical time split (e.g. 80:20%) but are very quickly sucked into increasing clinical activities from various soures of departmental pressure.  The problem is that whenever money is involved in the equation, it will usually be at the expense of research since clinical work is much more likely to bring in the $$$ than a research grant.  Sure everyone comes in with “protected time” but soon the phone calls start coming in from colleagues who want X, Y, or Z, including taking on new patients and of course all of the follow-up that comes with them as well.  This scenario seems to be particularly true for physician-scientists in the surgical fields who may feel a lot of pressure up-front to take as many surgical cases as possible. 

As I am just now starting to think about choosing jobs and balancing clinical with research responsibilities, many established people in my field have been warning me of the difficulty in getting significant research done.  With calls coming in to see this patient or that one and your department chair on top of it all pushing you to bring in revenue for the department, I’ve been told that it is near impossible to have substantial research time.  Now obviously, this is true to varying degrees depending on what field of medicine you practice.  But for me, these pressures are particularly true. 

So as I sit for my residency interviews and get some love for being a mudphudder and for having a research track record, in light of everything I’ve heard from practicing physician-scientists I can’t help but wonder what it is that clinical departments really want.  Actually, no–I think I do know what they want–they want it all–a physician who brings in tons of clinical volume and revenue and at the same does important research too–regardless of whether it is realistic or not. 

Which is why I offer this reality check to the ones on top–you can’t have it all. 

Being a successful physician-scientist (not just publishing a lot of case reports and review articles) is hard (I can probably count on one hand the number of practicing physicians who are either in HHMI or the NAS) and requires not only a lot of luck but also finding the right balance of clinical:research responsibilities that is independent of the agendas of others. 

So to those of you who are going through this right now, I say good luck.  And for those of you who have gone through it and/or have insight into the process (e.g. avoiding common pitfalls), please share this insight with us!

January 10th, 2009 | Tags: academics | Category: md / medical student stuff, md / phd student stuff, personal | Subscribe to comments | Leave a comment | Trackback URL