Best steps to take now to become a physician scientists?

[Alexxxxx]

I am finishing up my 1st year of medical school at a mid-tier USMD, and I am wanting to become a physician-scientist doing research in dementia/similar aging-related processes of the brain. Long story short, I realized I wanted to do this too late and did not apply to MD/PhD programs and can't transfer into my own school's MD/PhD program. I did some basic science research in undergrad, and in my gap year I was full-time in another basic science lab doing research on Alzheimer's Disease which is when I realized that I want to do this as part of my career. I have looked at "research-track" neurology residencies, which for the most part only give ~6 months or so of protected research time during the 4 years, save for a few that are very competitive and I cannot bank on getting into (i.e. Stanford). Fellowships in geriatric neurology seem to have more flexibility with this, though, and more protected research time/opportunities to take additional years for research, so as far as after graduating medical school, it would seem that getting into a residency that allows research time at an institution with a lot of resources and the same for fellowship would be best for me. I am also doing research currently in a basic science lab studying demyelinating diseases, because I am interested in it and also I think it will make my application look more compelling at research track residencies/fellowships. I also have 1 publication from my gap year lab. Does anyone have any recommendations for additional things I can do to improve my odds down the line, or corrections to things that I have already stated to better my understanding? Thanks 🙂

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[Telamir]

Dementia fellowships are pretty research heavy, and you can extend an extra year doing mainly research.

 

[DrSatan]

Lots of academic movement disorders programs have their fellows do a 2nd year dedicated to research. Could be a good segue. During medical school you'll just need to reach out to research neurologists to see if you can help with publications. IMO you won't ever become a true research scientist without the PhD.

 

[Thama]

Lots of academic movement disorders programs have their fellows do a 2nd year dedicated to research. Could be a good segue. During medical school you'll just need to reach out to research neurologists to see if you can help with publications. IMO you won't ever become a true research scientist without the PhD.

I guess I should inform the NIH that I and most of my research mentors over the years aren't true research scientists and thus we will be giving back our grants.

 

[Alexxxxx]

Dementia fellowships are pretty research heavy, and you can extend an extra year doing mainly research.

I wonder what training opportunities will exist for me beyond fellowship though. 1 or 2 consecutive years obviously won't be enough to adequately learn what I need to be a scientist and get grant support - maybe some programs would let me do a PhD during a prolonged fellowship? It would probably be a case by case thing. Alternatively, I know there are a few residency + PhD programs, such as at Mt. Sinai SOM.

 

[neuroneuro123]

I guess I should inform the NIH that I and most of my research mentors over the years aren't true research scientists and thus we will be giving back our grants.

Can I ask what kind of research you do without the PhD? Are you doing basic science bench work? Or more clinical research / human subjects work?

 

[Thama]

I do human subjects neuroimaging work (i.e. functional connectivity) but I've done small animal work previously. There are tons of straight MDs with basic science labs throughout the top neurology departments. A PhD is helpful but by no means necessary, and I have known many MD/PhDs who decide never to go back to science after residency. The single most successful physician-scientist I've ever worked with is a straight MD from a middling state school - nobody cares about that part of your CV from the moment you land your first real grant. A fellowship that gives you dedicated opportunity (time, mentorship, resources) to build a research career is vastly more important than whether you have a PhD.

 

[Alexxxxx]

I do human subjects neuroimaging work (i.e. functional connectivity) but I've done small animal work previously. There are tons of straight MDs with basic science labs throughout the top neurology departments. A PhD is helpful but by no means necessary, and I have known many MD/PhDs who decide never to go back to science after residency. The single most successful physician-scientist I've ever worked with is a straight MD from a middling state school - nobody cares about that part of your CV from the moment you land your first real grant. A fellowship that gives you dedicated opportunity (time, mentorship, resources) to build a research career is vastly more important than whether you have a PhD.

That's awesome! I would love to do that kind of research, maybe even a combo of running clinical trials and a translational lab studying the same disease. I just hope that the research training I get during the end of residency/throughout fellowship will be sufficient to be able to have that kind of thing. A lot of fellowships I have looked at will fund 2-3 years of research after finishing the clinical portion, which if productive enough, may be able to get me my first early career grant? Unlikely still I know, but possible.

 

[Thama]

That's awesome! I would love to do that kind of research, maybe even a combo of running clinical trials and a translational lab studying the same disease. I just hope that the research training I get during the end of residency/throughout fellowship will be sufficient to be able to have that kind of thing. A lot of fellowships I have looked at will fund 2-3 years of research after finishing the clinical portion, which if productive enough, may be able to get me my first early career grant? Unlikely still I know, but possible.

If you land in the right environment and bust your ass, then its possible to be ready to apply for a K or equivalent in that kind of timeframe. The more you stay in one place with the same mentors, the better your chances, which means you need to apply to a residency program where you will have strong potential research mentors that you can carry from PGY4 all the way through junior faculty stages. Doing some productive research as a med student will improve your chances of being taken seriously by that kind of residency program.

It's really kind of the opposite advice that is commonly given around here for residency selection - if your goal is to be a well-trained clinician and practice neurology, then there are a lot of programs that will get you there and research really doesn't matter for getting into most of them. But if you want to be a NIH-funded physician-scientist, then where you do residency and fellowship is massive, and you do need research to be competitive at places that will give you the best chance at this trajectory.

 

[Alexxxxx]

If you land in the right environment and bust your ass, then its possible to be ready to apply for a K or equivalent in that kind of timeframe. The more you stay in one place with the same mentors, the better your chances, which means you need to apply to a residency program where you will have strong potential research mentors that you can carry from PGY4 all the way through junior faculty stages. Doing some productive research as a med student will improve your chances of being taken seriously by that kind of residency program.

It's really kind of the opposite advice that is commonly given around here for residency selection - if your goal is to be a well-trained clinician and practice neurology, then there are a lot of programs that will get you there and research really doesn't matter for getting into most of them. But if you want to be a NIH-funded physician-scientist, then where you do residency and fellowship is massive, and you do need research to be competitive at places that will give you the best chance at this trajectory.

Thank you! I have 1 more question if you don't mind. Would it be best to do solely basic research, clinical research, or a mix of both at this stage? Currently, I am doing work in a basic science lab and doing a little side project with an epilepsy doctor on telehealth/patient satisfaction. I was thinking to do some clinical research/healthcare delivery stuff to fluff my CV a little bit, but commit most of my effort to the lab that I am in since that is what I am more interested in.

 

[Thama]

Probably better to get your feet wet with basic research. It's a lot easier to get a project started and carry to completion as a student including publication in cell culture or animal work compared with all the regulation and recruitment involved with human subjects. You might run into someone who already has human data that just needs analyzing/writing which can also be a way to gain experience but you won't learn as much doing that as the bulk of the work was done by someone else.

 

[Alexxxxx]

Probably better to get your feet wet with basic research. It's a lot easier to get a project started and carry to completion as a student including publication in cell culture or animal work compared with all the regulation and recruitment involved with human subjects. You might run into someone who already has human data that just needs analyzing/writing which can also be a way to gain experience but you won't learn as much doing that as the bulk of the work was done by someone else.

Thank you! Have a great rest of your week and thanks for all of the advice 🙂