Concerns about going into research

[Rankik]

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Hey all. First off this site is incredible, with a large amount of information thanks in large part to all of the senior members posting here. I have some questions and concerns which I hope I can get answered.

I had made the decision of wanting to go into research in HIV/AIDS for quite some time now. I had envisioned going into an MD/PhD program, where I would be trained to become a medical scientist and would start doing research in the field after completing the program. I would be able to help find some kind of vaccine/cure to the epidemic due to all this training, or at the very least, help the progress.

And then I came onto this forum and started reading This is my understanding of the process and what it really involves:

7-8 years of MD/PhD program
3-5 years of residency
3~ years of fellowship
Unknown number of years of post Doc until you are able to secure enough funding and/or a position

Am I on the right track about this? From what I understand, one of the biggest issues of becoming a medical scientist is the amount of grants and funding available to do research. Even after completing a "specialized" program, going through a residency, and a fellowship, you still have the task of having to publish yourself several times in order to have a chance of obtaining funding, that are quite limited. And even when you do secure some funding, the odds of doing research you want to do is still against you, depending on where you are and the position you have obtained.

Did I get it right thus far in regards to what it takes to be able to follow a career in research as a medical scientist? I am all for doing research and dedicating myself into it as a lifelong career. However if even going through all these years of training, you are still left with a great amount of uncertainty of even being able to do the research you had planned on doing and potentially having to "settle" on something else, it's a very daunting view, especially considering the number of years you invest. More than anything though, it feels very disappointing to know that the possibility of going into research, in the exact field you wish to follow, is a real gamble.

Aside from all the questions I've had in my text above, I wanted to learn more about what options there are in going through the MD only path. I still want to be able to help contribute into the HIV solution. My guess is that as a physician, the way to do these would be through either clinical trials or serving areas where the epidemic is strong (Sub Saharan Africa for example) for set periods of time.

What I am unsure about is how either of these two (and any other possible ways I would have that I am not aware of) can be done. What paths do you have to take in order to be able to do clinical trials? And if you wanted to help serve areas such as Sub Saharan Africa, how do you go about doing this in a more temporary basis? What I mean by temporary is I don't want to have to live in the area for the rest of my life, but instead would like to be able to go there for a period of say 6 months to a year + and then return to the states. Probably the most ideal scenario would be doing actual clinical research in the area, which again falls back to the need of having to obtain funding, but this seems possible with just an MD.

Any insight on this would be greatly appreciated and again a big thank for all the information on this site. It has really opened my eyes to the reality of the current academic/research situtation.

 

[dl2dp2]

If the training length is the primary issue, you can always contribute to research by being a research assistant.

I think your questions are too complicated for people to address on an online forum. I would suggest that you talk to an MD/PhD faculty member at your local medical school.

And then I came onto this forum and started reading This is my understanding of the process and what it really involves:

 

[Rankik]

Well the training length isn't the main issue, its more of the fact of after having done all the training the chances of obtaining funding is still up in the air due to how limited it is. I understand why it is limited, there is only so much money to go around and not only it it MD/PhD applying for the grants, but also others with PhD's. My question really comes more down to what or how could I contribute with just an MD instead of an MD/PhD in regards to diseases. Obviously I've made it clear that I want to work with HIV, but in a more general sense, how is a physician able to contribute into disease research or helping to alleviate a disease in certain areas? I know peace corp comes to mind when helping very underdeveloped areas, but I really don't know much in that regards.

Oh and I will call the local medical schools on this to find out more on it, thanks! 🙂

 

[mercaptovizadeh]

Short answer: stay tuned for alternative funding mechanisms. In the end, we'll return to the days of gentleman-scientists (Lorenzo de' Medici), government-funded distributed projects (CERN), and patronage (Bill Gates and malaria).

 

[gbwillner]

Your training times are off... MD/PhD times are more like 7-12 years. Also, the remaining times for clinical training vary dependent on your specialty. For example, if you go into medicine, and sub-specialize in infectious disease, that's years residency +3 years fellowship. In top academic centers, that fellowship will include research time, meaning it will be possible for you to get a lab and start-up out of fellowship without a formal post-doc.

Alternatively (keeping in mind your interest in HIV), you could do residency in clinical pathology (3 years) and the a formal post-doc with research in HIV.

There are pros and cons to both approaches. As an internist, you will get fellow salary during your research, although you will still have clinical responsibilities. As a pathologist, you may or may not get resident/fellow salary during your formal post-doc (depending on institution). But you will probably have 100% protected time. This will give you a chance to get published and get grants before testing the free agency market (academics). You have a great chance to be successful in either approach, but NOTHING IS GUARANTEED.

If the times are off-putting, and your primary interest is in HIV research, you should just get a PhD in virology at the best virology department you can find with the best mentor. You can be working on HIV the day you start grad school, then do a post-doc doing HIV research. Again, nothing is guaranteed. But let me tell you- the nest way to be a successful scientist (besides being incredibly smart and motivated) is to surround yourself with other great scientists. The ones already pulling grants. Their name on your CV and grant applications is a HUGE influence.

 

[Rankik]

Your training times are off... MD/PhD times are more like 7-12 years. Also, the remaining times for clinical training vary dependent on your specialty. For example, if you go into medicine, and sub-specialize in infectious disease, that's years residency +3 years fellowship. In top academic centers, that fellowship will include research time, meaning it will be possible for you to get a lab and start-up out of fellowship without a formal post-doc.

Alternatively (keeping in mind your interest in HIV), you could do residency in clinical pathology (3 years) and the a formal post-doc with research in HIV.

There are pros and cons to both approaches. As an internist, you will get fellow salary during your research, although you will still have clinical responsibilities. As a pathologist, you may or may not get resident/fellow salary during your formal post-doc (depending on institution). But you will probably have 100% protected time. This will give you a chance to get published and get grants before testing the free agency market (academics). You have a great chance to be successful in either approach, but NOTHING IS GUARANTEED.

If the times are off-putting, and your primary interest is in HIV research, you should just get a PhD in virology at the best virology department you can find with the best mentor. You can be working on HIV the day you start grad school, then do a post-doc doing HIV research. Again, nothing is guaranteed. But let me tell you- the nest way to be a successful scientist (besides being incredibly smart and motivated) is to surround yourself with other great scientists. The ones already pulling grants. Their name on your CV and grant applications is a HUGE influence.

Okay I see what you are saying. So in one path, I would complete residency years in internal medical followed by a fellowship in infectious disease. At the same time, this runs the risk of having clinical work pushed on me hindering research. Is it correct to assume this approach can be done with just an MD?

While on the other path, I do clinical pathology residency followed by post-doc in HIV, which has a higher chance of protected research time, but potentially a lower pay during said post-doc.

The amount of time in training isn't much of an issue, it's more of the idea of having trained through all this and still being in "limbo" due to being unable to get grant money or a position. You also mentioned there is a good chance of being successful, is this because my area of interest is in HIV and there is more funding available for it?

Also thank you for the advice in regards to the PhD path. It seems in the real world it really does come down to who you know when wanting to advance, no matter what field you are in

 

[gbwillner]

Okay I see what you are saying. So in one path, I would complete residency years in internal medical followed by a fellowship in infectious disease. At the same time, this runs the risk of having clinical work pushed on me hindering research. Is it correct to assume this approach can be done with just an MD?

While on the other path, I do clinical pathology residency followed by post-doc in HIV, which has a higher chance of protected research time, but potentially a lower pay during said post-doc.

The amount of time in training isn't much of an issue, it's more of the idea of having trained through all this and still being in "limbo" due to being unable to get grant money or a position. You also mentioned there is a good chance of being successful, is this because my area of interest is in HIV and there is more funding available for it?

Also thank you for the advice in regards to the PhD path. It seems in the real world it really does come down to who you know when wanting to advance, no matter what field you are in

All of the above COULD be done with just an MD. But you will be at a huge disadvantage, unless the kind of research you are interested is purely clinical (like testing different drugs on a cohort of patients). If you want to develop NEW approaches at the bench, you will greatly benefit from the PhD. First, you will need to learn to do science and get established (the PhD does this), second, you will be better at getting serious commitments from departments with the PhD.

Your chance of being successful can be dependent on how many independent funding opportunities exist for your specific research. Studying sea slugs may get you an NIH grant, but studying cancer can do that, plus there will be lots of independent groups funding that kind of research, like the American Cancer Society. I'm sure HIV will also give you other opportunities.

 

[Rankik]

All of the above COULD be done with just an MD. But you will be at a huge disadvantage, unless the kind of research you are interested is purely clinical (like testing different drugs on a cohort of patients). If you want to develop NEW approaches at the bench, you will greatly benefit from the PhD. First, you will need to learn to do science and get established (the PhD does this), second, you will be better at getting serious commitments from departments with the PhD.

Your chance of being successful can be dependent on how many independent funding opportunities exist for your specific research. Studying sea slugs may get you an NIH grant, but studying cancer can do that, plus there will be lots of independent groups funding that kind of research, like the American Cancer Society. I'm sure HIV will also give you other opportunities.

I see. Hmm in that regard then I will want to be aiming for the dual degree then, as I do want to be apart of the research in making new approaches, but I don't want to be stuck in a lab forever either I would want to not only develop, but also be apart of the clinical process, being apart of the human aspect. I feel that is very important, to me anyway. Thank you for the insight on this.