Desire to pursue primary care medicine and to conduct research

[jdfamily]

I would like feedback from premedical students, medical students, residents, fellows, physicians, and anyone else on this topic as I think all opinions should be taken into account.

I have always wanted to go into primary care medicine. I have also participated in a variety of research projects and found a strong desire to continue performing research as a medical student and as a physician.

Here are my questions:
1. How common is it for medical students to pursue research and primary care medicine through medical school, residency, and eventually into their careers?
2. For primary care physicians working at hospitals and clinics, how easy or difficult is it for them to have and use resources for conducting research?
3. How do admissions committees view an application with these motives, considering the combination?

I guess I am concerned with appearing 'naive' thinking that I can spend my life in a career of primary medicine with time dedicated to research efforts.

When you post please state whether you are a premed, med, resident, physician, adcom, etc. so that everyone can see what perspective you are coming from. Examples of physicians and students who have pursued this route would be very much appreciated!


Thanks for everyone's feedback.

---

Members don't see this ad.

 

[Mt Kilimanjaro]

What kind of research do you want to do?

 

[jdfamily]

What kind of research do you want to do?

Good question. I have a medical laboratory science background and am interested in pediatrics. I have performed previous research in analyzing laboratory results in liver transplant recipients. As of right now I want to conduct further research in different aspects of the laboratory results, whether it be to analyzing them in new ways, or trying to use results in innovative ways to identity pathologies.

I can also see myself participating in experimental treatments and medications. To be honest, I am not real sure how common that is in primary care, but it interests me nonetheless.

 

[RuralPhysician8]

Have you thought of getting an MPH? You could use it to research "part time". Most med schools will also have specialty departments that are usually open to students for research purposes.

 

[GoPelicans]

I have a similar question. I like adult primary care. I also like doing basic research. I see lots of specialists like cardiologists, pulmonologists, etc doing basic research, but I never see it from a primary care physician... anyone know if primary care physicians can do basic research?

 

[jdfamily]

Have you thought of getting an MPH? You could use it to research "part time". Most med schools will also have specialty departments that are usually open to students for research purposes.

I haven't thought about getting a MPH. I guess I always thought that getting one was more for people looking to working on the administrative side of healthcare. Are you saying that as an administrator one could dedicate time to research and patient care? Because I have not research what the MPH is and how it is used I don't really know what to think of it. Obviously I will take some time to do so, but any input now would be great. Thanks!

 

[RuralPhysician8]

I haven't thought about getting a MPH. I guess I always thought that getting one was more for people looking to working on the administrative side of healthcare. Are you saying that as an administrator one could dedicate time to research and patient care? Because I have not research what the MPH is and how it is used I don't really know what to think of it. Obviously I will take some time to do so, but any input now would be great. Thanks!

I have researched it lightly, because I am somewhat interested in pursuing a MPH in Epidemiology and Biostatistics prior to medical school (I am still in UG so it has not been a comprehensive search) and most legitimate job profiles depict a 40-60 hour week in an office and laboratory setting.

Edit: Perhaps an MS in Clinical Pharmacology and Toxicology would also give you the Lab work you seek. I could see it fitting well into your Liver physiology and pathology studies.

 

[jdfamily]

I have researched it lightly, because I am somewhat interested in pursuing a MPH in Epidemiology and Biostatistics prior to medical school (I am still in UG so it has not been a comprehensive search) and most legitimate job profiles depict a 40-60 hour week in an office and laboratory setting.

Edit: Perhaps an MS in Clinical Pharmacology and Toxicology would also give you the Lab work you seek. I could see it fitting well into your Liver physiology and pathology studies.

I want to practice medicine and do research, what you are saying is that I could do so much more easily with the MPH as a credential? Realistically should I not be able to practice medicine and do research on my own time as a primary care physician without any extra degrees or licensures, even if it is not part of my the position I hold at a particular hospital?

 

[chillaxbro]

Why not try for MD/PhD?

 

[jdfamily]

Why not try for MD/PhD?

Because I don't want to spend the extra year in medical school honestly.

 

[dcamkl1]

Hey OP, pre-med here.

I think if you're in FM, Peds, or IM, you could easily participate in clinical research at an academic institution. In primary care, I'd imagine you would be limited to research in health disparities, risk factors/screening, preventative medicine, and the like.

Having been involved in biomedical research, I have never seen a primary care physician in true basic research. From what I have read, for a non-MD/PhD to be involved in basic research, they must get their research training as a post-doc or as a fellow -- the latter is the easier path because most specialities conveniently require a research component during fellowship, and the pay is better than a post-doc. This is why you see that specialists are the types of doctors involved in basic research, and also for the fact that most primary residencies do not require a significant basic research component.

I, myself, enjoy basic research and primary care, though I have realized that what I truly enjoy is long-term care, which primary care easily provides. There are some specialities that allow you to work with patients in the long-term and have research opportunities (ex: oncology and infectious diseases). Perhaps this can provide more insight for you?

 

[Noggin]

I would like feedback from premedical students, medical students, residents, fellows, physicians, and anyone else on this topic as I think all opinions should be taken into account.

I have always wanted to go into primary care medicine. I have also participated in a variety of research projects and found a strong desire to continue performing research as a medical student and as a physician.

Here are my questions:
1. How common is it for medical students to pursue research and primary care medicine through medical school, residency, and eventually into their careers?
2. For primary care physicians working at hospitals and clinics, how easy or difficult is it for them to have and use resources for conducting research?
3. How do admissions committees view an application with these motives, considering the combination?

I guess I am concerned with appearing 'naive' thinking that I can spend my life in a career of primary medicine with time dedicated to research efforts.

When you post please state whether you are a premed, med, resident, physician, adcom, etc. so that everyone can see what perspective you are coming from. Examples of physicians and students who have pursued this route would be very much appreciated!


Thanks for everyone's feedback.

I don't really have enough information to answer your specific questions, but I'll give you my take on this situation. This thread intrigues me because I am actually in the same position as you. I am applying this cycle. I have a desire to go into primary care, and also have an extensive research background. I really enjoy research, and want to make it part of my career. However, many of the schools that I am applying to are more "primary care" focused and not as big on research (many of these schools also have excellent research programs but don't seem to emphasize it as much as some other schools). What interests me about research is discovering something that has never been known before. I only have experience doing benchwork, but I am open to trying clinical/epidemiology type work. I highly doubt adcoms would be critical of you having research experience and also wanting to go into primary care. In my opinion, that almost makes you more well-rounded. Just speak from your heart, and talk about what you honestly want to pursue in your career in your secondary applications, and you will be fine.

 

[jdfamily]

Hey OP, pre-med here.

I think if you're in FM, Peds, or IM, you could easily participate in clinical research at an academic institution. In primary care, I'd imagine you would be limited to research in health disparities, risk factors/screening, preventative medicine, and the like.

Having been involved in biomedical research, I have never seen a primary care physician in true basic research. From what I have read, for a non-MD/PhD to be involved in basic research, they must get their research training as a post-doc or as a fellow -- the latter is the easier path because most specialities conveniently require a research component during fellowship, and the pay is better than a post-doc. This is why you see that specialists are the types of doctors involved in basic research, and also for the fact that most primary residencies do not require a significant basic research component.

I, myself, enjoy basic research and primary care, though I have realized that what I truly enjoy is long-term care, which primary care easily provides. There are some specialities that allow you to work with patients in the long-term and have research opportunities (ex: oncology and infectious diseases). Perhaps this can provide more insight for you?

Yes that does most definitely. Thank you. If what you say is true, then it is much easier for specialists like ENT's and OBGYN's to participate in research because their fellowship involved a research component, and additionally their positions for employment are more likely to offer research resources rather than needing to work with another institution?

 

[jdfamily]

I don't really have enough information to answer your specific questions, but I'll give you my take on this situation. This thread intrigues me because I am actually in the same position as you. I am applying this cycle. I have a desire to go into primary care, and also have an extensive research background. I really enjoy research, and want to make it part of my career. However, many of the schools that I am applying to are more "primary care" focused and not as big on research (many of these schools also have excellent research programs but don't seem to emphasize it as much as some other schools). What interests me about research is discovering something that has never been known before. I only have experience doing benchwork, but I am open to trying clinical/epidemiology type work. I highly doubt adcoms would be critical of you having research experience and also wanting to go into primary care. In my opinion, that almost makes you more well-rounded. Just speak from your heart, and talk about what you honestly want to pursue in your career in your secondary applications, and you will be fine.

My thoughts exactly thanks. It is good to hear that I am not the only one considering this route. Obviously my preferences will change while in medical school, but this is really how I feel during the application cycle thus far.
Thanks for everyone's feedback so far. Hopefully we get some med students, residents, or adcoms' input soon.

 

[dcamkl1]

Yes that does most definitely. Thank you. If what you say is true, then it is much easier for specialists like ENT's and OBGYN's to participate in research because their fellowship involved a research component, and additionally their positions for employment are more likely to offer research resources rather than needing to work with another institution?

I think if you want to continue to do research (clinical or basic) you would definitely need to be associated with and work at an academic institution to maximize research resources and opportunities, like you said.

You may also need to consider if you want to participate in research as a collaborator or as an independent investigator. If you want to be an independent PI, you will need experience in grant writing--you can get this experience as a fellow or a post-doc. Some doctors with little basic research experience (but want to go into research) use their fellowship time to develop their techniques and skills, so they don't have time during fellowship for grant writing. This is why these doctors may choose to do a post-doc after fellowship to write their first grant and transition into a faculty position.

Definitely check out the physician scientist forum on SDN for more information.

Best of luck!

 

[jdfamily]

I think if you want to continue to do research (clinical or basic) you would definitely need to be associated with and work at an academic institution to maximize research resources and opportunities, like you said.

You may also need to consider if you want to participate in research as a collaborator or as an independent investigator. If you want to be an independent PI, you will need experience in grant writing--you can get this experience as a fellow or a post-doc. Some doctors with little basic research experience (but want to go into research) use their fellowship time to develop their techniques and skills, so they don't have time during fellowship for grant writing. This is why these doctors may choose to do a post-doc after fellowship to write their first grant and transition into a faculty position.

Definitely check out the physician scientist forum on SDN for more information.

Best of luck!

Very helpful thank you!

 

[LizzyM]

General Internal Medicine and General Pediatrics can combine primary care and clinical research, particiularly in the fields of comparative effectiveness, effectiveness of programs to promote health behavior change, strategies for efficient delivery of health services and so forth.

The MPH with a focus in epidemiology (study design) and biostatistics (data analysis) will give you the skills you'll need to do research of this kind. As mentioned, grant writing skills are important too, and they tend to be emphasized in fellowship programs (general pediatrics and general internal medicine are fellowship programs). Graduates of these programs generally go on to careers in academic medicine combining patient care, training/teaching most often in clinical settings, and research as well as an administrative role (hiring new faculty, selecting residents & fellows, management decisions in one's group practice, handling department budget in collaboration with a professional administrator).

 

[sinombre]

Because I don't want to spend the extra year in medical school honestly.

It's actually an extra 3 to 4 years of school... so not wanting to spend the extra time is a pretty legitimate reason.

 

[vc7777]

1. How common is it for medical students to pursue research and primary care medicine through medical school, residency, and eventually into their careers?

How common? Not super common. But not unheard of. For example, my school explicitly recruits candidates interested in combining research and clinical practice. Everyone does meaningful research when they are here (which admittedly is 5 years instead of 4 - but more on that later). Three of our graduating class this year matched into FM (Family Medicine) - out of a class of 32! That's nearly 10%

I know a well-respected Family Medicine practioner who, for example, looked into the questions about whether or not "tubes" should be recommended for children with chronic ear infections to help develop practice guidelines. Another example, I just ran into a full-time Orthopedic surgeon yesterday who is doing cell culture research under his own R01 grant. How about that for "different"? Oh, and I have a classmate dedicating herself to bench molecular biology research, and thinking about unrelated fields including Pathology and Internal Medicine for her future career. I personally used to be a firepower research engineer and now am thinking about surgery as a career path (yeah, yeah, another dime-a-dozen "rocket-surgeon"). In short, it's doable. You just have to work a little harder, and be a little smarter about planning your career and choosing your school.

2. For primary care physicians working at hospitals and clinics, how easy or difficult is it for them to have and use resources for conducting research?

If you go to research-oriented organizations, you will find they have resources already in place to support research endeavors. If you are trained for such a career - you will be attracted (and attractive) to like-minded physicians and groups already doing such work. Now, "easy" is a whole other discussion - since money is scare all around for research.

3. How do admissions committees view an application with these motives, considering the combination?

My admissions committee, in a word, demands an interest in research from our applicants and we obviously produce primary care residents. And we are not the only school.

I guess I am concerned with appearing 'naive' thinking that I can spend my life in a career of primary medicine with time dedicated to research efforts.

When you post please state whether you are a premed, med, resident, physician, adcom, etc. so that everyone can see what perspective you are coming from. Examples of physicians and students who have pursued this route would be very much appreciated!

Thanks for everyone's feedback.

Finally, MD/PhD programs are usually much, much longer than 1 additional year in medical school, as pointed out before. Just remember this will take some additional time.
MS-4 now (yikes) at my school and SDN moderator.
Sorry for the long-winded response. I didn't have time to make it short (to paraphrase Mark Twain).

 

[jdfamily]

Thanks for the replies, I have a better understanding of my options.

 

[Goro]

The vast majority of my students self-select for primary care. That said, plenty of them find time to do research, either during the summer, or even during the year, if they're really good at time mgt.

As a career, they're going to be too busy for research. As a whole, doctors aren't researchers, they're doctors.



1. How common is it for medical students to pursue research and primary care medicine through medical school, residency, and eventually into their careers?

One can always collect clinical data and look for outcomes.

2. For primary care physicians working at hospitals and clinics, how easy or difficult is it for them to have and use resources for conducting research?


At my school, the first question out of our mouths will be "why not just get a PhD"?

3. How do admissions committees view an application with these motives, considering the combination?

You CAN do a research fellowship at NIH or any major research institution, and then settle down to a career in practice.

It could be done with a faculty appointment at a medical school and teach hospital, and my hunch is that you'd probably want to specialize.


I guess I am concerned with appearing 'naive' thinking that I can spend my life in a career of primary medicine with time dedicated to research efforts.

Faculty and adcom member .

 

[jdfamily]

At my school, the first question out of our mouths will be "why not just get a PhD"?

I don't know how bad of a response this would be, but I would not want to go for a PhD because of the extra years of schooling. Like LizzyM described earlier, would not a fellowship with training in grant writing and extra training in biostatistics and other preparatory research activities suffice?

Are there many physicians whose prime focus is practicing medicine receive their PhD's? I guess I view the reason to receive a PhD being if your primary focus is research and/or administrative opportunities at research institutions.

 

[LizzyM]

For health services research within the context of primary care, a PhD is not needed although a physician may collaborate with PhDs, particularly biostatisticians, economists and other investigators. Med school alone will not train you to do research with medical records, electronic medical records, and other data bases or how to collect data directly from subjects. For that you'll need to apprentice to other investigators or learn in a formal program such as a MS in epidemiology, clinical investigation, etc

 

[vc7777]

For health services research within the context of primary care, a PhD is not needed although a physician may collaborate with PhDs, particularly biostatisticians, economists and other investigators. Med school alone will not train you to do research with medical records, electronic medical records, and other data bases or how to collect data directly from subjects. For that you'll need to apprentice to other investigators or learn in a formal program such as a MS in epidemiology, clinical investigation, etc

100% This. To reiterate: no matter how you slice it - you want to train to do two different (albeit related) jobs. This inherently requires you to have additional training. This can be in the form of additional training at almost any stage of the game: medical school, residency, fellowship, on-the-job, but most likely will come from a combination of these.

A final example, my best friend in medical school just started her year of research at the NIH this past week doing primary care research. She is definitely headed towards primary care - no doubt. She can and WILL integrate research into her ultimate career.

Nothing you have said thus far is unattainable.

 

[jdfamily]

Great to know that it is attainable and that it is being done by medical students, residents, and physicians today. Thanks for everyone's input!

 

[ukae]

So is it possible for someone to be in academic medicine + general pediatrics?

 

[LizzyM]

So is it possible for someone to be in academic medicine + general pediatrics?

Absolutely! Most earn an MPH degree during medical school, or during residency or fellowship (yes, there is a general pediatrics fellowship). The combination of population science (study design and statistical analysis for public health research) and public health advocacy is powerful.

 

[ukae]

Absolutely! Most earn an MPH degree during medical school, or during residency or fellowship (yes, there is a general pediatrics fellowship). The combination of population science (study design and statistical analysis for public health research) and public health advocacy is powerful.

Thank you so much! This thread is really helpful.