Academic Medicine? No way! (But are you so sure?)

[owlegrad]

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[magicm]

what do people feel is the necessity of a PhD to get into academic medicine. Or is a strong MSc (3-5 first author papers) enough or simply enough publication

 

[Eddie Marcus]

what do people feel is the necessity of a PhD to get into academic medicine. Or is a strong MSc (3-5 first author papers) enough or simply enough publication

I don't think there is any need for a PhD for academic medicine. It is helpful to gain a PhD for all the additional skills. But in fact, I think it is much more important for person to have an MD if they are doing medical research then a PhD. The MD experience provides focus on the why and what and, to some extent the market. I see lots of PhD's (and MD's sometimes to), who go off on tangents like the research is a hobby: They get NIH funding to build a mouse model of a human disease, and then track a series of interacting proteins in the cells of the mouse, and then go check out the transcription and translation and ubiquitinization etc, and find puzzle after puzzle to solve in their mouse model of a disease, and often forget that the mouse wasn't sick before they made it sick, and isn't a human. It is important to try to stay focused on this question: how, exactly how, is my research going to help make a patient better. Knowledge for knowledge's sake has a role, perhaps, but it may also be a narcissistic trap paid for from the public till.

 

[secants]

I really liked the article. Wish my school was more open about the different practice options that are available rather than having us to figure it out by trial and error. Consensus seems to be that most physicians initially go out in community, get a little disgruntled or tired of the word, and nestle back into academia to retire out. I'm thinking of fast tracking straight into academia and being open to moonlighting as needed for extra income; win-win.

 

[Neuronix]

Academic Medicine? No way!

I find the title of this article strange considering that all the medical school and residency applicants that we see filling SDN are constantly talking about the virtues of academic medicine and saying no way to private practice.

what do people feel is the necessity of a PhD to get into academic medicine. Or is a strong MSc (3-5 first author papers) enough or simply enough publication

You don't need an advanced degree to obtain an academic position. The question is what you're doing in the position. If it's just clinical work with a little bit of teaching and clinical research (the vast majority of academic positions), it's common to have an MD only (the vast majority of academicians).

Consensus seems to be that most physicians initially go out in community, get a little disgruntled or tired of the word, and nestle back into academia to retire out. I'm thinking of fast tracking straight into academia and being open to moonlighting as needed for extra income; win-win.

I have seen the opposite, starting in academia and going to private practice, far more frequently than the reverse. Retiring physicians typically want to go part-time which is much easier as a private practice partner or locum tenens physician. Many academic faculty positions, including my institution, do not allow moonlighting.

 

[michaelrack]

I have seen the opposite, starting in academia and going to private practice, far more frequently than the reverse. Retiring physicians typically want to go part-time which is much easier as a private practice partner or locum tenens physician. Many academic faculty positions, including my institution, do not allow moonlighting.

Agree that it is more common to start off in academia (as I did). There are opportunities to reduce hours/ semi-retire for full-professors.

 

[Neuronix]

Agree that it is more common to start off in academia (as I did). There are opportunities to reduce hours/ semi-retire for full-professors.

Agreed, but it's a long, slow, hard-working, non-guaranteed climb to full professor.

 

[michaelrack]

Agreed, but it's a long, slow, hard-working, non-guaranteed climb to full professor.

agreed, that's one of the reasons I left

 

[secants]

I'm curious, couldn't you shuffle how your time is split in acedemia to working less clinical shifts and doing more teaching, admin stuff? Or is that also something that takes time to achieve with rank? Additionally, how common is it to have other avenues to increase your earning potential? Since moonlighting seems to not be allowed, do most academic places compensate you for taking more call, shifts etc?

 

[Eddie Marcus]

I'm curious, couldn't you shuffle how your time is split in acedemia to working less clinical shifts and doing more teaching, admin stuff? Or is that also something that takes time to achieve with rank? Additionally, how common is it to have other avenues to increase your earning potential? Since moonlighting seems to not be allowed, do most academic places compensate you for taking more call, shifts etc?

If you get a chance to read Assume the Physician, it really is a fun way to learn how to see the dark spots in modern medicine and to find the bright spots, and become wise enough to know the difference.

There tends to be less clinical obligations in academia to make room for teaching and research. In my academic career, I generally split my time like this:
80% research, 40% clinical, 15% teaching, 10% admin. Yes those percentages don't add up to 100%, but unlike the administrators of academic centers, who think such should all add up to 100%, the reality is that they don't. I had my salary at 80% research based on my grant funding, but there were patients that needed to be seen that would take more than 20% of my time, and other things to do. You just find ways to do it all, of course. Just like anything in life. Academia can be highly flexible: from 0 percent research to 100% research. A teaching focus, vs a research focus, vs (later) an admin focus. There is now even available a Quality Improvement focus (barf central to me). in all my years in schools of various types, my brain was most stimulated by the people with whom I worked during my medial academic years. It is a great, not well paid, career, IF (and this is the trouble) IF you are creating value, doing good, and expanding the ability of people to pursue happiness. IF, instead, you are leeching off the taxpayer to perform intellectual hobbies, with no thinking at all about how to get the value to the patient (and it is VERY hard to get new devices and drugs to a patient) while you are putting down all industry and corporations and capitalists as evil people (even though they are the ones that get the improvements to the patients, then the life and time in academia will be valueless. I recommend instead that we look at each industry player--are they good or bad? We look at each individual academic player: are they doing good or bad. Treat everyone like an individual, not just as a member of a group. For example, if you might be a supporter of Occupy WallStreet, it is good to note that the 1% aren't all bad, not at all. Some are. What makes some of the 1% bad? The same thing that makes some of the 99% bad: the willingness to use force and fraud against a fellow human.

There are ways to supplement income. You can invent, patent, start "faculty startup companies" consult, do paid talks for industry, etc. There is remarkable flexibility in academia Get bigger grants, make more money. See more patients, make more money. (Doing a better job with each patient, knowing more, having better expertise does NOT make more money in most portions of the health care system, since it is so greatly (insanely?) price controlled.

Academics used to be all about individual faculty empowerment and innovation and voluntary synergistic cooperation to create wonderful new and imminently valuable knowledge, with the administration working for the faculty. It was really wonderful. There has been a shift that you do need to be aware of. Two shifts actually. The first is a strong shift to groupthink. Evidence Based Medicine is a great example of Groupthink. Sometimes useful certainly, often horribly misused. It has infiltrated academic medicine rather thoughtlessly. The second is that there has been a power inversion in academia consistent with the rest of US society: The administrators now are the bosses, and the faculty are employees. Power and control now comes from the top down, reflecting the country as a whole. It is hard to avoid as a Republic slowly converts to more imperial or oligarchical construct, as ours is doing. It is not just the government--it is culture wide, and certainly in medicine. Faculty now seek permission from Administration in ridiculous ways. But we doctors may complain, but don't do much to improve it.

 

[Eddie Marcus]

One of the posters said this "You don't need an advanced degree to obtain an academic position. The question is what you're doing in the position. If it's just clinical work with a little bit of teaching and clinical research (the vast majority of academic positions), it's common to have an MD only (the vast majority of academicians)."

I would say that both MD and PhD are "advanced degrees" or "terminal degrees" in academic speak. Likewise DO is a terminal degree. All of them are appropriate for an academic medical career.. MD/PhD combination has some advantages once achieved, but you definitely do not need to have your own PhD to be a fulltime medical researcher (bench, transitional, clinical research, whatever). If you don't have a PhD and are focused on bench research as an MD, you will benefit greatly from collaborating with PhD's, and they will benefit from collaborating with you. And those collaborations are everpresent in academia.