Heme/Onc Research during residency/fellowship

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Hi,

I am an MS3 who has a strong interest in oncology and oncology research. I have carried out basic research in cancer starting from my sophomore year in high school and have done other basic science projects in UG/MS.

I would like to pursue a primarily research based career in academics with some clinical. (the 80:20 model)

Are IM residencies/heme-onc fellowships generally good for those who want to do research for most of their career (i.e. do they provide protected research time)? And are there any programs I should be considering?

I am not interested in doing MD/PhD because of the time length and other factors.

Thank you

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[carrigallen]

I pm'ed you.

 

[gutonc]

Hi,

I am an MS3 who has a strong interest in oncology and oncology research. I have carried out basic research in cancer starting from my sophomore year in high school and have done other basic science projects in UG/MS.

I would like to pursue a primarily research based career in academics with some clinical. (the 80:20 model)

Are IM residencies/heme-onc fellowships generally good for those who want to do research for most of their career (i.e. do they provide protected research time)? And are there any programs I should be considering?

I am not interested in doing MD/PhD because of the time length and other factors.

Thank you

Look into the ABIM Research Pathway. Many programs have it and advertise it. Many others have it but don't advertise it so you have to ask. Some programs are linked (you apply/interview/rank once - U Chicago, Cornell/MSK were the ones I remember well) while others require you to re-apply for fellowship (which sucks but is what I did).

You will do 2 years of IM and 4-4.5 years of fellowship (depending on single or double boarding). You will have 3 years of completely protected research time (I do 1 half day of clinic a week and take weekend call ~3 times a year, in larger programs you won't have this because the senior fellows don't take call). PIs will beg to have you in their lab because you are free to them (the division/dept will pay your salary and/or you'll be on a training grant) and in many cases (mine at least) bring a unique dimension to the lab (since I joined the lab, 5 other MDs have spent 1-2 years here).

 

[Brachyury]

Hi,

I am an MS3 who has a strong interest in oncology and oncology research. I have carried out basic research in cancer starting from my sophomore year in high school and have done other basic science projects in UG/MS.

I would like to pursue a primarily research based career in academics with some clinical. (the 80:20 model)

Are IM residencies/heme-onc fellowships generally good for those who want to do research for most of their career (i.e. do they provide protected research time)? And are there any programs I should be considering?

I am not interested in doing MD/PhD because of the time length and other factors.

Thank you

I am in the same boat as you, however, I'm interested in malignant heme, not onc. Do any of you have any recommendations for which IM/fellowship programs are strong in benign and malignant heme, particularly for someone interested in a mixed clinical-research career?

 

[gutonc]

I am in the same boat as you, however, I'm interested in malignant heme, not onc. Do any of you have any recommendations for which IM/fellowship programs are strong in benign and malignant heme, particularly for someone interested in a mixed clinical-research career?

I was searching for the exact opposite experience but I know a little bit. Out on the West Coast, UW, OHSU and Stanford all have strong heme programs. UMinn is also hard to beat (they pioneered BMT there). MDACC has strong malignant heme (not benign) as well. Cornell is pretty solid (moreso than MSK) as well.

 

[Topspinner]

Thanks Gutonc and carrigallen for your helpful responses. The ABIM pathway sounds great- I will definitely keep my eyes peeled for it and remember to inquire about it. 3 years of protected research time sounds incredible. @carrigallen, I will also remember to look for good mentors/examine grant outcomes - I have seen from my experience in labs that both are instrumental for jumpstarting a career.
I really appreciate the advice you both have given to me and I will be sure to return if I have any more questions!

Merry Christmas/ Happy Hannukkah/ Kwanza/ Holidays and a great new year to all of you .

 

[Brachyury]

I was searching for the exact opposite experience but I know a little bit. Out on the West Coast, UW, OHSU and Stanford all have strong heme programs. UMinn is also hard to beat (they pioneered BMT there). MDACC has strong malignant heme (not benign) as well. Cornell is pretty solid (moreso than MSK) as well.

Thank you for the response. I was at ASH earlier this month, and it seemed like the majority of basic research talks came from folks at Harvard affiliates, Columbia/Cornell/MSK, and Washington/FH, but there were also a few talks from UNC and UMich people.

For me, what's been difficult is that my heme research/clinical mentors specialize in benign heme (hemophilia and sickle cell), so getting dirt on the strengths and weaknesses of heme programs has been difficult because they are only familiar with people in their sub-sub-specialties. Additionally, since not all medical centers have large sickle cell programs (UCSF, OHSU, Washington) and since usually only one academic hospital in a metro area will have a hemophilia treatment centers (i.e. JHU does but Maryland doesn't, or Northwestern does but UChicago doesn't), this limits the number of programs they are familiar with. I guess I will need to thoroughly stalk heme divisions this summer as I make my list of IM programs I plan to apply to

 

[McPoyle]

That research pathway sounds really interesting, what would be the potential downside to a pathway like that? Are you limited at all in what your practice might look like? For instance, I could see incorporating a large amount of basic science research into my career, though 80/20 seems like too much. Would this pathway be as appealing for someone interested in more like 60/40 or 50/50?

 

[gutonc]

That research pathway sounds really interesting, what would be the potential downside to a pathway like that? Are you limited at all in what your practice might look like? For instance, I could see incorporating a large amount of basic science research into my career, though 80/20 seems like too much. Would this pathway be as appealing for someone interested in more like 60/40 or 50/50?

There is no such thing as a 50/50 split for someone who does basic science research. You will fail completely as a PI with that split. You might be able to pull that off as a junior investigator (like a permanent post-doc) in somebody else's lab but not on your own. I'm currently 90/10 as a senior fellow and wishing I could have more time in the lab. Even the 80/20 folks will sometimes have a tough time of it if they have a heavy clinical load (note that what you think of 20% of your time may be very different from what your boss thinks 20% of your time is). You can create a 50/50 clinical research career, primarily because the clinic is your lab.

As to whether the research pathway limits your career in any way, I don't really think so. That said, most of us who do it intend to go into academia. But there are plenty of people who have taken that route who ultimately went into PP.

The only potential downside (and this is largely theoretical) is that many research pathway programs will only allow you to single-board (usually in onc). As such, you may be slightly less attractive to a PP group. That said, according to my friends in PP, the amount of benign heme a typical PP doc sees is pretty small (<10%) and anything really complicated winds up getting referred out to an academic benign hematologist anyway.

 

[McPoyle]

There is no such thing as a 50/50 split for someone who does basic science research. You will fail completely as a PI with that split. You might be able to pull that off as a junior investigator (like a permanent post-doc) in somebody else's lab but not on your own. I'm currently 90/10 as a senior fellow and wishing I could have more time in the lab. Even the 80/20 folks will sometimes have a tough time of it if they have a heavy clinical load (note that what you think of 20% of your time may be very different from what your boss thinks 20% of your time is). You can create a 50/50 clinical research career, primarily because the clinic is your lab.

As to whether the research pathway limits your career in any way, I don't really think so. That said, most of us who do it intend to go into academia. But there are plenty of people who have taken that route who ultimately went into PP.

The only potential downside (and this is largely theoretical) is that many research pathway programs will only allow you to single-board (usually in onc). As such, you may be slightly less attractive to a PP group. That said, according to my friends in PP, the amount of benign heme a typical PP doc sees is pretty small (<10%) and anything really complicated winds up getting referred out to an academic benign hematologist anyway.

Cool, thanks for your insight! My goal is academics, I say basic science, because that is all I have exposure to.

 

[threecoins]

I heard this phrase numerous times, namely that for a clinical researcher " the clinic is your lab" but I am not sure what that actually means.I assume it means that if you are an active clinical researcher you will spend time in the clinic recruiting patients for clinical trials . My understanding is that to be a successful clinical investigator though you need to be the PI who designs the trials, be on the steering committee etc and these are all activities that require non-clinical time, in other words the clinic can be viewed as much of a diversion from "research" for a clinical researcher as much as it is for a basic scientist. Can you please shed some light on that?

 

[gutonc]

I heard this phrase numerous times, namely that for a clinical researcher " the clinic is your lab" but I am not sure what that actually means.I assume it means that if you are an active clinical researcher you will spend time in the clinic recruiting patients for clinical trials . My understanding is that to be a successful clinical investigator though you need to be the PI who designs the trials, be on the steering committee etc and these are all activities that require non-clinical time, in other words the clinic can be viewed as much of a diversion from "research" for a clinical researcher as much as it is for a basic scientist. Can you please shed some light on that?

Yes, these things all require non-clinical time which is why a clinical research career is a 50/50 thing, not a 20/80 (research/clinical) split. Most serious clinical researchers will spend ~2 days/wk in clinic, the rest of their time will be spent doing all that other stuff...that's why doing serious clinical research in PP isn't really tenable.

But to be a successful basic scientist you really need to spend 40+ hrs/week in the lab. On top of that you need to spend time reading, writing grants and papers and then, on top of that, doing your clinical work (which is likely 1 full day/wk). FWIW, many of us also spend time designing and writing clinical trials and serving on the IRB and other committees (at least I do...and I'm not even faculty yet).

I don't think that successful basic science researchers spend more time working each week than do successful clinical researchers (or vice versa), but where they spend that time is different.

Also, FWIW, the "clinic is lab" thing is something I first heard from one of our faculty members who, in addition to running a half dozen investigator-initiated trials of his own is currently the national PI on 4 different SWOG trials which is why I'm willing to quote it as gospel.

 

[threecoins]

Thanks Gutonc for the clarification. Speaking of 50/50, is that a viable " start up package" for junior faculty hired to do clinical research? will recruiting institutions buy into that model ?

 

[gutonc]

Thanks Gutonc for the clarification. Speaking of 50/50, is that a viable " start up package" for junior faculty hired to do clinical research? will recruiting institutions buy into that model ?

If they're recruiting you as a researcher then it's to be expected. Less than that won't be enough to get any significant work done.