A thought on science/research

[mercaptovizadeh]

I've been thinking about research, the PhD, and future career plans, and I can't help but believe that the chances of my research work doing anything to either help us understand the world better or improve the human condition, are vanishingly small. Does anyone else feel like this? I think I have an occasional decent idea, but it seems that anything expansive or ambitious is crushed under the tedious weight of "stay focused" enforced by the PhD system, the funding system, and the publishing system. Getting to a position where your ideas can be rather more freely tested requires years and years of mindlessly "focused" work which amounts to not seeing the forest for the trees. And after the extensive training and publish-or-perish period you must fight for funding by continuing with the same inane micro-minded projects. In the end, you have a few pieces that don't amount to much and that's a career and a lifetime. It seems that many of the great world-changing discoveries of science (and especially biology) arose more by chance and haphazard discovery rather than force of effort and intellectual genius. So maybe science is a bit like playing a lottery?

Have people here considered (or actually followed through with) quitting a research career for this reason? Oftentimes people will drift into private practice because of the better compensation and more structured format, but how many people leave "science" (even if they could do it well) because it was not fulfilling? I suspect not a few. It's said that you must be curious to do science, but how does one keep alive the curiosity about some obscure biochemical pathway or protein structure when the world is so much bigger than all this?

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[ecoli]

I work on a pathway like that. The cool part is that I'm the only person (that I know of) that is currently working on the assembly mechanism for the protein systems.
I just think of it like I'm a 'world expert' on it, and that's motivation enough for me.

The more obscure the nerdier it is!

That may make it harder to get funding, in the long run, but it keeps your curious about it.

I guess that's how I can stand at looking at gel and gel just waiting for that magic band to appear.

 

[Vader]

First, there are many types of research: basic, disease-oriented basic, patient-oriented, clinical, epidemiology, etc. Designing and undertaking clinical trials for example can directly affect patient care. Preclinical studies can open up new avenues of investigation into disease. For example, studying the genetic or proteomic makeup of tumors as a means of understanding the biology and identifying potential targets for drug development. Or studying mouse models of Alzheimer's disease to identify disease-modifying genes/new targets for therapy. Or studying how one might image plaques in the coronary vessels using
non-invasive techniques for improved diagnosis of unstable plaques and more targeted treatment.

I think it is important for MD/PhDs to not lose sight of the forest. In having patient contact and an in-depth understanding of disease, MD/PhDs have a real advantage over PhDs. Having the know-how of the scientific method is a real advantage over MDs. Thus, there is a niche that is perfect for MD/PhDs to inhabit, which is disease-oriented basic research.

If you try to hang out in more basic science land, my sense is that you will be essentially leaving the MD/PhD niche and trying to compete with PhDs who can spend 100% of their time focusing on research. This is possible and many MD/PhDs do it successfully. However, most do not see patients, or if they do the patient care often is seen as detracting from the research.

Science is definitely not a field for those who are easily discouraged or who cannot deal with rejection, especially in today's world. I encourage you to talk with MD/PhDs who have been successful at doing both research and medicine, and see what keeps their interest alive.

 

[dl2dp2]

Dear OP,
Don't know where your training level is, but don't fret. The kind of things going through your mind is pretty common, esp. if you are like me, who's almost done with PhD and considering the next career step.

I'll admit back in the days I was so touched by Rockefeller Univ's motto "Science for the benefit of humanity". When I was in Cambridge, UK, I visited Cavendish Laboratory. It was a quiet afternoon and nobody was there--it looked quite industrial actually. But just thinking about the drama of discovery of DNA almost brought me tears.

Then comes the PhD...I had ok advisers and it was fairly painless in all honesty. My issue had to do with my field, which turns out to be very competitive and full of collaborators who on the surface are nice and friendly but deep down think your project is crap and you should go to hell. Fight, fight fight till you die. Outright rejection, like a grant, is easier to bare. It is hardest when you talk to some leading figure in the field, and seek desperately for his/her approval, only to get nothing more than a scathing critique. Let me tell you, every time that happens it makes me want to quit science.

Regarding disease oriented research, a very senior researcher of very high caliber told me that he thinks it almost never goes far enough. I take his opinion very seriously. I think he is absloutely right. There IS a branch point here. If you do disease oriented research, the most you'll get is Marshall and Warren H. Pylori kind of discovery, you'll never get Watson and Crick kind of discovery. Is MD/PhD sufficient training for Watson/Crick? Yes. But forget about residency, just do a postdoc. Say bye-bye to medicine. Go on that narrow dangerous but rewarding (however rare) road of basic science and buy that lottery ticket. You only have one life.

On the other hand, if you want to do disease oriented research, see some patients etc., the information I gathered makes it seem as if the future is relatively bright, and you shan't worry too much, just go with your gut. This area is lacking in man power, as MDs do clinical research, PhDs do basic science. Jobs are aplenty, grants are *relatively* easier to get. I am leaning in this direction. I think my goal post has dropped down to H. pylori.

There is a third option. There are certain specialties in medicine, commonly known as "lifestyle" specialties. The salary is about 2-3x that of a researcher in a cognitive specialty, and the hours are very favorable. A PhD makes it much easier to get into these programs and stay where you want to stay. Recent data indicates that MANY (if not MOST, even) MSTP grads go on to one of these specialties. Even if you do stay in academia in this case, you do mostly clinical work and still command a large salary. For instance, the quotes I got from the radiation oncology residents is that starting salary in academia is 200k-250k with a 40 hrs work week. I haven't yet ruled this option out.

I used to despise people who "sell out". I stopped doing that about 3 yrs ago. To be totally honest, I am jealous of the scientists who in the end made it and are successful, because they always seem very happy. But there are just so many, esp. earlier career scientists, who are miserable. We all have to do a lot of soul searching at the end of the day. It is a very personal decision, and don't let anyone's judgment influence your independent thought.

 

[RxnMan]

For every field:

Meat and potatoes = boring, makes up 90% of the work, but keeps the lights on.

Fun stuff = rare, rarely will you get paid much for it, but fun.

Everyone does the former for the opportunity to do the latter.

 

[blazinfury]

"There is a third option. There are certain specialties in medicine, commonly known as "lifestyle" specialties. The salary is about 2-3x that of a researcher in a cognitive specialty, and the hours are very favorable."

sloux, can you elaborate on what other career paths, besides rad onc fit this?

I have heard that an avg MD/PhD makes around 150-200k. However, are these figures for ppl who do an 80/20 or 90/10 split or those who devote more time to clinical?

I personally feel that clinical is a vital aspect b/c it prevents an MD/PhD from losing sight of his/her ultimate goal. Sure there plenty of failures along the way, but it just takes that one second and one patient who's health was improved to make all of those sacrifices worthwhile-- no matter how infrequently this may occur.

Also is sloux trying to say that disease research should only be bench and not involve clinical all that much? Isn't clinical research vital for the whole-world understanding of the disease?

 

[RxnMan]

sloux, can you elaborate on what other career paths, besides rad onc fit this?...

The ROAD to success is paved by Rads, Optho, Anes, and Derm. These specialities often have easier hours and, depending on the field, good -> better money.

...I have heard that an avg MD/PhD makes around 150-200k. However, are these figures for ppl who do an 80/20 or 90/10 split or those who devote more time to clinical?...

The splits you're talking about aren't very different - both would get you ~$180k in academia. The straight clinical folks (i.e. clinical teaching faculty) get somewhat less. Moving the meat pays the bills, so you will be pressed to make that 80/20 -> 50/50, especially in the surgical fields.

 

[blazinfury]

What about something like cardiology? Is an MD/Phd difficult to incorporate in this field? What about ppl who specialzie in like interventional or electrocardiology? Yet I do not see how anesthesiologists could do research since they are in the OR nearly all day, unless they spend this time writing grants, which is a beneficial aspect of the field.

 

[Spacedman]

"There is a third option. There are certain specialties in medicine, commonly known as "lifestyle" specialties. The salary is about 2-3x that of a researcher in a cognitive specialty, and the hours are very favorable."

sloux, can you elaborate on what other career paths, besides rad onc fit this?

I have heard that an avg MD/PhD makes around 150-200k. However, are these figures for ppl who do an 80/20 or 90/10 split or those who devote more time to clinical?

hi blazinfury,
i'm applying for residency this fall (defended last year), so i've been talking to some MDPhDs who are junior and tenured faculty. maybe some of this will be helpful-

first, an "average" salary for MD/PhDs is not very meaningful as some MD/PhDs do IM/research and others do ortho-spine private practice. that basically covers the 100K - 1M range.

that aside, for those who are pursuing 80/20-type careers, the kind of deal you get seems to depend heavily on a) how committed the department is to research and b) whether you are funded with an NIH grant. you can get a sense for "a" by whether the department is largely supported by clinical revenue or NIH grants. if, with a lot of luck and determination, you can successfully apply for a grant (like a K08) in your final year of residency, you have serious bargaining power for your salary.

for example: you are finishing residency/fellowship and you just got a k08. this grant, in principle, covers 80% of your salary, and you are supposed to devote 80% of your time to research over the next 5 years. unfortunately, according to the NIH, 80% of your salary is ~85K. the neurology department hiring you gives you a sweet deal, asks for 20% of your time in the clinic, but pays you the same as other attendings - let's say 125K. that's quite generous, btw. i.e. they're heavily subsidizing your research time by not requiring you to generate the salary gap with clinical duties. i think this is as good as it gets until you get an R01 grant (best case, at the end of your 5 year K08).

if you do a "lifestyle" specialty, (i've heard "ADORE" for anesth, derm, ophtho, radiology/rad-onc, ENT), the picture is a bit different. these departments are almost always supported by clinical >>> NIH $. there's a lot more pressure to do clinical work. i talked to a chairman for one of these specialties in NYC, and his take was that if you work 1 day a week in clinic, you get 1/5 of the salary for a full time clinical attending. now, if the avg salary is 350K (not a stretch), your K08 + clinic ~150K. you're making a lot less than your peers, which may be psychologically difficult for some people, and you definitely take a hit in your clinical skill working one day a week. (to me, it sounds like plenty, but i'm dirt poor now). i talked to one faculty who got paid more on par with other clinical faculty, with 4 days of protected research time- he was a pretty well established researcher when he negotiated that, though.

if anyone (faculty?) has something to add/correct--

 

[GWD]

OP: I'm not sure what sort of lab you work in, but I think one of the keys to staying focused it to work on highly translational projects.

Our lab currently has work going on along all levels (basic, pre-clinical, as well as clinical trials).

I think such an approach really helps one to recognize the fruits of their labor, and keep on track.

 

[ecoli]

h
that aside, for those who are pursuing 80/20-type careers, the kind of deal you get seems to depend heavily on a) how committed the department is to research and b) whether you are funded with an NIH grant. you can get a sense for "a" by whether the department is largely supported by clinical revenue or NIH grants. if, with a lot of luck and determination, you can successfully apply for a grant (like a K08) in your final year of residency, you have serious bargaining power for your salary.

What about the field I'm interested in; infectious diseases?

 

[mercaptovizadeh]

What about the field I'm interested in; infectious diseases?

ID is not a particularly high paying specialty. Considering that it's 5 years of training and that they're among the best diagnosticians, it's a shame they don't earn more. Given that, there's probably not as huge a pay cut going to 80% research as you would have with, for example, radiology. Also, there's still a great many problems to be solved in the field of ID which could have an impact on vast numbers of people (HIV, malaria, TB etc.), so it's ripe for research.

 

[ecoli]

ID is not a particularly high paying specialty. Considering that it's 5 years of training and that they're among the best diagnosticians, it's a shame they don't earn more. Given that, there's probably not as huge a pay cut going to 80% research as you would have with, for example, radiology. Also, there's still a great many problems to be solved in the field of ID which could have an impact on vast numbers of people (HIV, malaria, TB etc.), so it's ripe for research.

is that 5 years of residency + fellowship, after a residency in internal medicine? I assume they'll be opportunities to conduct research in that time, though, right?

 

[mercaptovizadeh]

is that 5 years of residency + fellowship, after a residency in internal medicine? I assume they'll be opportunities to conduct research in that time, though, right?

No, total. IM is 3 years and ID is usually 2 years but I think some 3 yr fellowships allow protected research time.

 

[ecoli]

ok, thank you.

 

[Doodledog]

for example: you are finishing residency/fellowship and you just got a k08. this grant, in principle, covers 80% of your salary, and you are supposed to devote 80% of your time to research over the next 5 years. unfortunately, according to the NIH, 80% of your salary is ~85K. the neurology department hiring you gives you a sweet deal, asks for 20% of your time in the clinic, but pays you the same as other attendings - let's say 125K. that's quite generous, btw. i.e. they're heavily subsidizing your research time by not requiring you to generate the salary gap with clinical duties.

The finances are a lot more complex than this and there are more perks for the department/med school when a new faculty has a K08 or equivalent type of award. Although it's true that the 80% won't really be 80% of your salary, the gap is well covered by the indirect costs the NIH gives to the school with the grant, even after sharing between the school and department. Also, although you are only working 20% time, depending on the field you're likely doing a lot more than that as your work so that the 20% likely underestimates your actual contribution to the department's income. For example, you may be doing night-call or weekend coverage, emergency back-up, etc. Finally, a lot of departments are "rated" in various ways by the amount of NIH support they get and your K08 counts. Not as much as an R01, but it counts.

The bottom line is that hiring faculty who hold K08's is a good financial deal for almost any department unless they pay you an amount that they aren't going to pay OR they have to excessively support the costs of your research with start-up funds (remember the K08 gives little to actually fund your research). However, it is true that the real benefit for the department comes if you can turn the K08 into an R01 or similar award. Then not only is the direct cost greater, but the indirects are proportionally greater.

 

[Spacedman]

The finances are a lot more complex than this and there are more perks for the department/med school when a new faculty has a K08 or equivalent type of award. Although it's true that the 80% won't really be 80% of your salary, the gap is well covered by the indirect costs the NIH gives to the school with the grant, even after sharing between the school and department. Also, although you are only working 20% time, depending on the field you're likely doing a lot more than that as your work so that the 20% likely underestimates your actual contribution to the department's income. For example, you may be doing night-call or weekend coverage, emergency back-up, etc. Finally, a lot of departments are "rated" in various ways by the amount of NIH support they get and your K08 counts. Not as much as an R01, but it counts.

The bottom line is that hiring faculty who hold K08's is a good financial deal for almost any department unless they pay you an amount that they aren't going to pay OR they have to excessively support the costs of your research with start-up funds (remember the K08 gives little to actually fund your research). However, it is true that the real benefit for the department comes if you can turn the K08 into an R01 or similar award. Then not only is the direct cost greater, but the indirects are proportionally greater.

hi tildy,
thanks for filling in some much needed detail. i've found it difficult even to know _what_ to ask when seeking advice. i also see you've posted extensively on this and related topics-

http://forums.studentdoctor.net/showthread.php?t=392633

i didn't know about that forum, so hopefully others will benefit from the link too.

i guess what i'm learning is "follow the $$$ trail", because the financial health of an academic department seems to be, far and away, the best indicator of what's in store for you. am i far off the mark?

 

[Fencer]

.... However, it is true that the real benefit for the department comes if you can turn the K08 into an R01 or similar award. Then not only is the direct cost greater, but the indirects are proportionally greater.

One issue is whether indirects go back to your department or not. In some places, they don't and are kept at the Dean's office for "strategic development". Then, you might be a burden to your department...

Furthermore, the indirects of a K08 are minimal, but a R-01 or other awards, it could be an additional 40-70%. That is the benefit to the institution and your dept. might get 10-25% of those funds for infrastructure.