I've finished my second year of undergrad, and I have seriously been thinking about applying to medical school. Being a doctor has always been a desirable career for me. Recently, I have put more thought into apply to phd/md programs. Research has always interested me, and i started doing work in labs this past semester and this summer. I want to have the opportunity to do research as a physician. The idea of treating patients and having the opportunity to innovate the field I'm working in at the same time excites me. It also makes my job much less monotonous. So I began looking into becoming a physician scientist, and I'm very unsure about it. I've read that physician scientists spend 75% of their time doing research, and 25% of the time working with patients. I am interested in and enjoy research, but I'm unsure if I want to spend such a greater amount of time on research than working with patients. The ideal job for me would be around 60-70% of time spent with patients, and the rest doing research. Is there a job like this that exists? I have heard of physicians doing research along with treating patients, but I haven't been able to find any good information, which is what brings me here. So does the ideal job exist for me, or will I have to choose between being a full time physician and being a physician scientist?
Is the career I desire out there?
- Thread starter qqaazz
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The rule of thumb is if you cannot see yourself doing mostly research (i.e. >75% of your time), then do not pursue an MD/PhD. If you want to mostly see patients and do a little research on the side (the sustainability of that type of program being a topic for another discussion), then an MD-only should suffice. You can get involved in research during med school and potentially during residency and/or fellowship.
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In theory, you could balance it any way you wanted to. In practice, there are several reasons why it can't work that way.
One of the reasons involves funding. It is not too easy to get funding to run a research program. If one spends much of their time seeing patients, one cannot get enough good data or contribute enough time researching and writing to get substantial grant money. There are PhD working on their stuff full time who are more likely to get the research dollars since they are going all in versus someone who is only spending half their time on their research. So for instance, someone who does a lot of psoriasis research may see psoriasis patients (because they are related to the persons research) for a half day or day a week, then work on research/teaching/admin the rest. That way they are spending enough time on the research end to be successful with garnering funding.
It's tough to justify research time if you are not bringing in grant money. Thus, if one wants to do research, but not put in enough time to do the work involved to get a full blown funded research program off the ground, they have to find the time and money some way...and it's usually not enough to get more than about 25% of time (that's probably even generous).
So the two opposing forces: needing to put in enough time to get grants which generally requires lots of research time versus wanting to do research but wanting to see patients more often during the work week (you aren't generating immediate tangible money for your institution when you are doing research so places usually don't allow this type of set up if you aren't bringing in the grant bucks)...it's very hard to hit that 50:50 mark. It's either lots of research or lots of patients....not a medium amount of both.
My job entails seeing patients in my specialty a few days a week, then working in my subspecialty a few days a week. Luckily my subspecialty affords me time to do research...so I do low cost research that fits in with the goals of the department...but I have the time due to the nature of my subspecialty...I don't get designated research time. But that's fine because I only want to do a small amount of research...almost like a work 'hobby'.
On the clinic side, one can work on industry sponsored research, but that will be clinical in nature usually...and again, it will entail seeing patients to get research subjects, but will still mean the majority of time is spent doing that...seeing patients.
Anyway, good luck, you'll figure it out.
One of the reasons involves funding. It is not too easy to get funding to run a research program. If one spends much of their time seeing patients, one cannot get enough good data or contribute enough time researching and writing to get substantial grant money. There are PhD working on their stuff full time who are more likely to get the research dollars since they are going all in versus someone who is only spending half their time on their research. So for instance, someone who does a lot of psoriasis research may see psoriasis patients (because they are related to the persons research) for a half day or day a week, then work on research/teaching/admin the rest. That way they are spending enough time on the research end to be successful with garnering funding.
It's tough to justify research time if you are not bringing in grant money. Thus, if one wants to do research, but not put in enough time to do the work involved to get a full blown funded research program off the ground, they have to find the time and money some way...and it's usually not enough to get more than about 25% of time (that's probably even generous).
So the two opposing forces: needing to put in enough time to get grants which generally requires lots of research time versus wanting to do research but wanting to see patients more often during the work week (you aren't generating immediate tangible money for your institution when you are doing research so places usually don't allow this type of set up if you aren't bringing in the grant bucks)...it's very hard to hit that 50:50 mark. It's either lots of research or lots of patients....not a medium amount of both.
My job entails seeing patients in my specialty a few days a week, then working in my subspecialty a few days a week. Luckily my subspecialty affords me time to do research...so I do low cost research that fits in with the goals of the department...but I have the time due to the nature of my subspecialty...I don't get designated research time. But that's fine because I only want to do a small amount of research...almost like a work 'hobby'.
On the clinic side, one can work on industry sponsored research, but that will be clinical in nature usually...and again, it will entail seeing patients to get research subjects, but will still mean the majority of time is spent doing that...seeing patients.
Anyway, good luck, you'll figure it out.
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You're situation sounds pretty desirable. I just want something extra to have the chance to innovate within a field. Is a phd necessary to have this scenario? Also, what specialty and subspecialty do you work in?
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A PhD is definitely NOT necessary. I did my PhD before med school (I had plans on med school before I even started the PhD...stuff happens, it's all good) and I've always enjoyed research, but I don't want to to to the whole grant rat race thing. I could definitely be doing the research I'm doing without my PhD though.
Anyway, I'm a Dermatologist/Dermatopathologist. Sometimes Pathology departments designate a bit of money for faculty to do a small amount of research. The nature of pathology is that if you have a light or easier day, you can muster up some spare time for other stuff after you get your cases signed out. On the clinical side, I'm booked for patients all day so I don't really have the research time there unless I do a sponsored clinical trial or two (I prefer my dermpath side research because it relates more to my PhD work).
Please don't run out to be a pathologist though, the job market isn't the best. But I'm sure you'll attempt to end up in the field that you actually enjoy the most regardless. Again, best of luck.
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You can still do research with just a MD, the problem will be (as pointed out above) justifying your research to your institution if you want protected research time. If you want protected time per week then generally you will need to bring in money to your institution. Remember it's a business, time that you're not seeing patients means you need to bring in $$$ through other means (indirects from grants) in order to justify your time spent. This will be very hard unless your position is at least 50/50.
Also, keep in mind it's tough to be a successful physician-scientist...it's not cracked up for everyone. My MD/PhD buddy's breakdown is 80 (research)/ 20 (clinical) but it's more like 80% research / 80% clinical. Not sure how he does it.
Also, keep in mind it's tough to be a successful physician-scientist...it's not cracked up for everyone. My MD/PhD buddy's breakdown is 80 (research)/ 20 (clinical) but it's more like 80% research / 80% clinical. Not sure how he does it.
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My very brief 0.02$ since people much more qualified have already answerd:
I worked for an MD/PhD this past year and he was able to split his time about 60/40 patient research. But this is because he basically never slept or saw his family. He was able to crank out enough research to get funded but was in a small field and had a huge number of people working below him to help produce the necessary data and papers.
It's not the life I'd want to live. He basically operated as a nearly full time surgeon, taking a ton of call, and when not on call was researching. He spent about 4 nights a week in the hospital or lab, which just sounds miserable as a 40-something attending. But hey, if you think you'd like it go for it, he sure did.
I worked for an MD/PhD this past year and he was able to split his time about 60/40 patient research. But this is because he basically never slept or saw his family. He was able to crank out enough research to get funded but was in a small field and had a huge number of people working below him to help produce the necessary data and papers.
It's not the life I'd want to live. He basically operated as a nearly full time surgeon, taking a ton of call, and when not on call was researching. He spent about 4 nights a week in the hospital or lab, which just sounds miserable as a 40-something attending. But hey, if you think you'd like it go for it, he sure did.
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You definitely don't need to get a PhD (and from your scenario, probably shouldn't). Many fellowships involve protected research time, but getting your research career off the ground is tough.
I shadowed a maternal-fetal medicine fellow in the last year of her fellowship. We talked a bit about her situation and she said that one of the biggest hurdles is the hospital. Hospitals won't generally give a physician protected research time unless they have a grant (read: they are giving the hospital money for the research), which she couldn't apply for until after she completed her fellowship and was practicing. The trick is that putting together a successful grant requires a heck of a lot of time, which is scarce for a full-time married Ob/Gyn with two children. The alternative was to reduce her working time and pay proportionally: she could apply to reduce her clinical time to 70%, effectively reducing her pay by 30%, for two years. At the end of the two years the hospital would bump her back to 100% if she hadn't secured a grant. She wasn't sure which way she was going to go.
The difficulty seems to vary by field, though. The inpatient internal medicine physicians I shadowed often worked two weeks on/two weeks off for 2-4 months out of the year. The rest was devoted to private practice, research, teaching, etc, which is much more flexible. For some fields (heme/onc, infectious disease), research was almost mandatory.
Long story short, yes, your ideal job is out there, but you may find in actuality that it's less than ideal.
I shadowed a maternal-fetal medicine fellow in the last year of her fellowship. We talked a bit about her situation and she said that one of the biggest hurdles is the hospital. Hospitals won't generally give a physician protected research time unless they have a grant (read: they are giving the hospital money for the research), which she couldn't apply for until after she completed her fellowship and was practicing. The trick is that putting together a successful grant requires a heck of a lot of time, which is scarce for a full-time married Ob/Gyn with two children. The alternative was to reduce her working time and pay proportionally: she could apply to reduce her clinical time to 70%, effectively reducing her pay by 30%, for two years. At the end of the two years the hospital would bump her back to 100% if she hadn't secured a grant. She wasn't sure which way she was going to go.
The difficulty seems to vary by field, though. The inpatient internal medicine physicians I shadowed often worked two weeks on/two weeks off for 2-4 months out of the year. The rest was devoted to private practice, research, teaching, etc, which is much more flexible. For some fields (heme/onc, infectious disease), research was almost mandatory.
Long story short, yes, your ideal job is out there, but you may find in actuality that it's less than ideal.
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