Academic Medicine? Clinical Research?

jhk43

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    I value your opinions here on SDN, so I was wondering if you could share some of your insight. I was on a PHD track in bioengineering (ended with a Masters after 1.5 yrs) and could not envision myself working in that environment for the next 40 yrs. That said, I very much enjoy the pursuit of new knowledge - as long as I have the chance for patient interaction (hence the MD degree - it is this balance that I naively seek)

    I'm gaining an interest in academic medicine, which frankly I dont know much about. The MD scientists I have known seem to largely work in the same environment as that of a PHD, i.e. loners, isolated, pipettes.

    How realistic is a career split 50/50 (or some other proportion) in patient-care and research? Are there some specialties that are more condusive to this balance?

    Where can i find more info on clinical research? Taking a step back, what IS clinical research, besides 1) new data studies (i.e, linking cancer and peanut butter consumption) 2) drug trials 3) new surgical methods.


    thanks!!
     

    Gleevec

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      Originally posted by jhk43
      I value your opinions here on SDN, so I was wondering if you could share some of your insight. I was on a PHD track in bioengineering (ended with a Masters after 1.5 yrs) and could not envision myself working in that environment for the next 40 yrs. That said, I very much enjoy the pursuit of new knowledge - as long as I have the chance for patient interaction (hence the MD degree - it is this balance that I naively seek)

      I'm gaining an interest in academic medicine, which frankly I dont know much about. The MD scientists I have known seem to largely work in the same environment as that of a PHD, i.e. loners, isolated, pipettes.

      How realistic is a career split 50/50 (or some other proportion) in patient-care and research? Are there some specialties that are more condusive to this balance?

      Where can i find more info on clinical research? Taking a step back, what IS clinical research, besides 1) new data studies (i.e, linking cancer and peanut butter consumption) 2) drug trials 3) new surgical methods.


      thanks!!

      While Im still a senior in college, I too am very interested in academia and will share what little I know about it in the hopes that it will be helpful to you:

      A 50/50 career split in patient care and research is quite viable. Academia is structured nowadays such that academics concentrate on 1 or 2 out of patient care, research, and teaching. The triple threat simply doesnt exist in substantial numbers anymore.

      Clinical research is all that you have stated (epidemiology, clinical trials, and new surgeries, though the methodology of reporting new surgical procedures is different and something I dont know much about, so I wont comment on that)

      In terms of specialties that are 50/50 patient care/research, it really depends on what type of research you want to do. If you want to do epidemiology, then something like infectious disease or medical genetics might be worthy of consideration. Clinical trials take place in just about every specialty, as new drugs are being developed for all sorts of diseases, and further discoveries in molecular medicine will trickle down into all fields. Right now, Id say the biggest fields for clinical trials are heme/onc, cards, allergy/immuno, rheum, hormone disorders. But just about every specialty has some clinical trials going on, so just pick a topic youre interested in. In terms of surgical procedures, well, its obvious what specialties youd enter, though i dont know enough to comment about what research in that field is like.

      Salary structure-wise, academics generally begin by generated X revenue towards the university (which pays fixed salary) with tons of patient care. As grants start to come in, doctors can switch to doing more research. Teaching gives you a certain amount of "revenue credit" as well. So depending on how successful a grant-writer you are, you can effectively eliminate patient care altogether (though you, and most people with MDs, wouldnt want to).

      If youre interested, most schools have some kind of research program, either over the summer or over a year. Also, the Clinical Scientist Training Program might be of interest, as well as several of the Howard Hughes sponsored and NIH programs for the specific purpose of training physician-scientists.
       

      carrigallen

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        Originally posted by jhk43

        Where can i find more info on clinical research? Taking a step back, what IS clinical research, besides 1) new data studies (i.e, linking cancer and peanut butter consumption) 2) drug trials 3) new surgical methods.

        thanks!!

        Clinical research is any medical research involving patients.

        Much of clinical research is what you describe...clinical trials, epidemiology, and evaluating the efficacy of procedures/guidelines. For example, is hepatomegaly truly a reliable sign of CHF in newborns?

        Clinical research is designed, above all, to optimize patient outcomes. Since humans are an infinitely more complicated entity than rats, a great deal of manpower (and womanpower) goes into churning out statistically significant results.

        If you look through Pubmed, most of the journal articles are clinical research...check out NEJM for example.
         
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        Padres248

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          i've been doing a ton of clinical research since graduating from college last year and this experience has definitely steered me towards academic medicine. its definitely very possible to be involved in patient care, research and teaching though it will consume your life if you put your heart into it. the doc i work for right now manages to do all three but he's a serious workhorse
           

          oldbearprofessor

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            As noted, the term "clinical research" has a lot of meanings. Although it can certainly include epidemiology, outcomes research, drug trials and the like, it often relates to a combination of more basic sciences and clinical work. For example, those who developed surfactants for use by preterm babies included both basic scientists, those who then tested the surfactants in animal models (sheep mostly), and then the many who conducted bedside trials in babies. There was alot of cross-over in terms of who did which studies. Nutritional studies often involve a mixture of basic and clinical studies. For example, looking at the genetics of obesity requires both a molecular scientific collaboration but also a dedicated clinical component as well.

            With regard to the 50-50 time split, I've seen this issue discussed here before so you might search for it. In general, it has become increasingly difficult to do this type of even split for those who wish to be primary investigators on NIH-funded grants. This usually requires 70-80% research committment. Those who do not have NIH funding often have to do a majority of clinical time even in an academic setting. Anything is possible, though, depending on the institution, the type of practice and (perhaps unfortunately), the details of the research funding.

            Regards

            oldbear professor
             

            efex101

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              From talking to numerous academic physicians the 50/50 is almost impossible. Most spend 80% of their time in research and very little patient contact just FYI.
               

              sandg

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                Gleevac mentioned that academic physicians usually do 1 or 2 of research, patient care, and teaching.
                Is this the teaching of medical students and residents in clinical medicine (i.e. not teaching the first two years of med school)? If so, how do these doctors avoid having to do bench research?
                 

                mosoriire

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                  You know, not all research is benchwork...That's how they get out of doing bench research. If you are a coordinator/PI of an international trial, or you basically abstract info about pateitn care, patient outcomes, etc, your schedule can be as flexible as you want it to be...
                   
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