Is the physician-scientist pathway dead?

[moralis]

Looking around the alumni lists of top MSTP programs, I notice that very few graduates (from relevant time periods, not too long ago) are actually practicing physician-scientists doing significant research.

For example, from the Stanford alumni list, the majority of people I see doing significant research seem to have just done a postdoc after the MD/PhD. This means that they could have saved time by doing the PhD alone...

If your goal is to do significant research, would it be more optimal for you to simply do a standard T5 PhD -> "big lab" postdoc route nowadays?

For people leaning towards research, is the MD/PhD simply a financial safety net/fallback method in case the PhD is not as productive as desired?

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[VaultArmitage]

It's cliche to say but I think those that do MD/PhD for the "right reasons" (not for the free ride, having two degrees, pressure, etc) are those that legitimately feel called to do a research career with patient care. MD/PhD is not the right route for someone who wants to do world-changing research necessarily because your time will be split and you won't be as productive as the postdoc in the lab next door. Personally I love research and want to mainly do it as a career but also couldn't imagine not treating patients with the diseases I research. I want the research training of a PhD but need the MD to treat patients. Just over the weekend I interviewed an MD who is doing a 75/25 research/clinical split. He told me that he wishes he would have gone and done the PhD because it teaches such solid research skills and gives a lot more weight to grant applications. Of course he also cares deeply for his patients hence the need for both degrees.

That was kind of word vomit but overall I think the true Physician-Scientist path is very niche, but the MD/PhD route is the best road to it.

 

[Lucca]

We’ve kind of already had a version of this discussion in the “early career prospects” thread. Science is extremely competitive and highly saturated right now. MD/PhD has advantages and disadvantages to the PhD. If you see practicing clinically as a failure for anyone with a PhD, then you probably shouldn’t bother with the MD to begin with. If you want to do bench science as long as possible you will have options but the trade offs will become increasingly painful compared to full-time clinical practice depending on your specialty / location / success in research.

Maybe the NIH budget will double within the next 10-20 years of training a young trainee on this board will be going through. Maybe everything will get worse forever. I can only answer for myself that I enjoy medicine and science and will let everything else figure itself out along the way. I don’t feel a super strong need to have every single aspect of my life on rails to min/max...what presumably? I can only do my best to be satisfied and happy in what I do / my personal life. I just have the added curse of enjoying science LOL. Would’ve been better off never to try it. Pipetting: not even once.

 

[tortuga87]

No because most MD/PhDs end up doing 50% research (which includes research teaching). It's basically a linear relationship in academia: X % of MD/PhDs do greater than 100-X% of research. See famous fig below from JCI. There's even a guy doing 70% research in private practice.

Your standards will meet reality if you lower them from "80-20 physician scientist" to "a physician who does varying amounts of science from time to time."

 

[dl2dp2]

For example, from the Stanford alumni list, the majority of people I see doing significant research seem to have just done a postdoc after the MD/PhD. This means that they could have saved time by doing the PhD alone...

If your goal is to do significant research, would it be more optimal for you to simply do a standard T5 PhD -> "big lab" postdoc route nowadays?

For people leaning towards research, is the MD/PhD simply a financial safety net/fallback method in case the PhD is not as productive as desired?

Doubt this. Have you scrutinized an equivalent alumni list for Stanford PhD only? The math generally is that MD PhD from the same institution/department has an OR of 3.5-5 over PhD-only in sustaining a substantial long term career in academic research. Much of this is probably a selection effect in that MD PhD is more and increasingly competitive vs. the PhD programs, but your inference is methodologically incorrect and therefore reached an incorrect conclusion.

It's not that easy to get into a "big lab".

The value of MD PhD, in fact, has exponentiated in the last 10 years due to 1) decreasing jobs/funding for PhD-onlys; 2) increasing MD tuition. And this is reflected in the exponentiated admission difficulty in MD PhD. People aren't dumb and vote with their feet.

 

[tr]

Looking around the alumni lists of top MSTP programs, I notice that very few graduates (from relevant time periods, not too long ago) are actually practicing physician-scientists doing significant research.

For example, from the Stanford alumni list, the majority of people I see doing significant research seem to have just done a postdoc after the MD/PhD. This means that they could have saved time by doing the PhD alone...

If your goal is to do significant research, would it be more optimal for you to simply do a standard T5 PhD -> "big lab" postdoc route nowadays?

Wait you don't want to do a postdoc? Everyone does a postdoc. MDs and MD/PhDs combine them with fellowship ('research fellowship'), typically only do *one*, and get to make a little more money than PhDs, who more typically do two or even three postdocs at this point. PhD does *not* save time over MD/PhD. I think time from entry into grad school to first R01 is actually remarkably similar.

If your goal is to run a basic science lab I'm not sure MD/PhD gives much of an edge over PhD (*assuming successful PhD, not a given*). The odds aren't great either way, but also the other outcomes and hence the incentive structures are very different. PhD alternatives are industry or government positions with somewhat better pay (at least in industry) but less autonomy and scientific interest. MD alternatives are either clinical work outside academics for *much* better pay, or remaining in academics with options to engage in research in other capacities besides running a basic science lab. The more appealing alternatives for people with MDs make it difficult to draw direct comparisons with PhD trajectories.

 

[testus_2]

I think it’s hard to directly compare them because MD/PhD’s have stronger backup options.

I also think that MD/PhD’s more frequently end up in “desirable” faculty positions (eg. higher tier R1 institutes) than PhD-only’s

 

[SurfingDoctor]

No, the pathway isn’t dead. And it never will be.

 

[Lucca]

No, the pathway isn’t dead. And it never will be.

 

[SurfingDoctor]

View attachment 327679

Is that GoT? Sorry, never could get past the first episode. It sucked too much.

 

[Lawpy]

The question should really be why MD/PhD over MD, because personally, i honestly believe MDs can do just as great basic science and translational research without the added PhD. I'm not really sure if the PhD adds significant advantage to getting R01s but i'm way too junior on this.

 

[Fencer]

The question should really be why MD/PhD over MD, because personally, i honestly believe MDs can do just as great basic science and translational research without the added PhD. I'm not really sure if the PhD adds significant advantage to getting R01s but i'm way too junior on this.

The age of first R01 awardees who are MD and MD/PhD is the same. MDs need to circle back in fellowship and spend time in the lab earning their stripes. The benefit of the MD/PhD is that if you are certain that research will be part of your career, the MD/PhD path offers stipend, tuition, community, mentoring, legitimacy, and program track record. It makes you eligible for some grants like F30. You insert research at an earlier time in your career span, which might be a disadvantage, potentially disconnecting the effort from research in fellowship as compared to the "late bloomer" path (MD only).

 

[psychacad]

The age of first R01 awardees who are MD and MD/PhD is the same. MDs need to circle back in fellowship and spend time in the lab earning their stripes. The benefit of the MD/PhD is that if you are certain that research will be part of your career, the MD/PhD path offers stipend, tuition, community, mentoring, legitimacy, and program track record. It makes you eligible for some grants like F30. You insert research at an earlier time in your career span, which might be a disadvantage, potentially disconnecting the effort from research in fellowship as compared to the "late bloomer" path (MD only).

Shooting from the hip here a bit, but I also think MD only researchers are also probably less prone to burnout. A lot of the cynical/doomsday commentary here are from MD/PhD students in the midst of trying to complete both degrees. MD only researchers don't have to bounce back and forth between clinical/research training.

 

[agp4]

Shooting from the hip here a bit, but I also think MD only researchers are also probably less prone to burnout. A lot of the cynical/doomsday commentary here are from MD/PhD students in the midst of trying to complete both degrees. MD only researchers don't have to bounce back and forth between clinical/research training.

Respectfully disagree. Once you graduate from fellowship, an MD faculty hire is going to have to deal with all of the vagaries of clinical medicine (maintaining your patient panel, covering the inpatient service, keeping up your RVUs, etc...). Starting a research career during the later stages of MD training ("late bloomer" path) is still going to have a lot of bouncing back and forth. The issues driving the despair and burnout in MD-PhD students are issues with academia as a whole, not from graduate training. So, I think the late bloomers are just as prone to researcher burnout as the MD-PhD students; the late bloomers will just be in a deeper hole, both financially and professionally, when they get confronted by the uglier parts of an academic career.

I second what fencer said - if you know upfront that research is going to be an important part of your career, the MD-PhD path has it's definite advantages.

 

[Lawpy]

Respectfully disagree. Once you graduate from fellowship, an MD faculty hire is going to have to deal with all of the vagaries of clinical medicine (maintaining your patient panel, covering the inpatient service, keeping up your RVUs, etc...). Starting a research career during the later stages of MD training ("late bloomer" path) is still going to have a lot of bouncing back and forth. The issues driving the despair and burnout in MD-PhD students are issues with academia as a whole, not from graduate training. So, I think the late bloomers are just as prone to researcher burnout as the MD-PhD students; the late bloomers will just be in a deeper hole, both financially and professionally, when they get confronted by the uglier parts of an academic career.

I second what fencer said - if you know upfront that research is going to be an important part of your career, the MD-PhD path has it's definite advantages.

I haven't seen any MD researchers being burned out but i have seen many MD/PhD folks transitioning out of research and focusing on clinical medicine and clinical research. It looks like the research postdoc in fellowship seems to be better since there's a lot of clinical context and insights from med school and residency that'll guide the direction of basic science/translational research. I haven't seen MD researchers starting off on an F grant but with good leadership and department support, getting a K grant has been usually achievable.

Also what if someone wants to do only clinical research upfront? Does an MD/PhD have value?

 

[phonyreal98]

I haven't seen any MD researchers being burned out but i have seen many MD/PhD folks transitioning out of research and focusing on clinical medicine and clinical research. It looks like the research postdoc in fellowship seems to be better since there's a lot of clinical context and insights from med school and residency that'll guide the direction of basic science/translational research. I haven't seen MD researchers starting off on an F grant but with good leadership and department support, getting a K grant has been usually achievable.

Also what if someone wants to do only clinical research upfront? Does an MD/PhD have value?

What do you mean by clinical research- RCTs/chart reviews/etc or do you mean all research involving humans?

 

[Lawpy]

What do you mean by clinical research- RCTs/chart reviews/etc or do you mean all research involving humans?

RCTs mainly, with some smaller prospective and retrospective studies on the side.

 

[Fencer]

With all due respect, @Lawpy, RCTs are very expensive to do. In general, at least 10 times more than the average R01 award. You need to build up your credibility to be the PI of a RCT. I know people who got burnout by working hard recruiting as a clinical site PI in 10-20 regulatory trials, and only being recognized as 10th co-author in the manuscripts. Sponsors will not be offering you right away. To be able to lead RCTs as your primary job, it takes a lot of time, dedication, and perhaps even coursework. Clinical trial design, statistics, regulatory, management, ethics, and other subjects are not just greater scale than most wet lab experiments. Many of the NIH funded CTSA/CTSI institutions have created Training in Translational Science at MS and PhD level. While you pursue a wet lab training in a MD/PhD training, you can access some of these courses, or alternatively, go all-in and pursue a PhD in Translational Science. There are some MD/PhD programs open to that possibility...

 

[Lawpy]

With all due respect, @Lawpy, RCTs are very expensive to do. In general, at least 10 times more than the average R01 award. You need to build up your credibility to be the PI of a RCT. I know people who got burnout by working hard recruiting as a clinical site PI in 10-20 regulatory trials, and only being recognized as 10th co-author in the manuscripts. Sponsors will not be offering you right away. To be able to lead RCTs as your primary job, it takes a lot of time, dedication, and perhaps even coursework. Clinical trial design, statistics, regulatory, management, ethics, and other subjects are not just greater scale than most wet lab experiments. Many of the NIH funded CTSA/CTSI institutions have created Training in Translational Science at MS and PhD level. While you pursue a wet lab training in a MD/PhD training, you can access some of these courses, or alternatively, go all-in and pursue a PhD in Translational Science. There are some MD/PhD programs open to that possibility...

Thanks, this is very informative, and i greatly appreciate your and others' thoughts on the topic

 

[Lucca]

I haven't seen any MD researchers being burned out but i have seen many MD/PhD folks transitioning out of research and focusing on clinical medicine and clinical research. It looks like the research postdoc in fellowship seems to be better since there's a lot of clinical context and insights from med school and residency that'll guide the direction of basic science/translational research. I haven't seen MD researchers starting off on an F grant but with good leadership and department support, getting a K grant has been usually achievable.

Also what if someone wants to do only clinical research upfront? Does an MD/PhD have value?

In addition to the other comments, I think you are biasing yourself by comparing MD and MD/PhD researchers Apples to apples. Specifically, survivorship bias. A tiny fraction of MDs are NIH RPG funded PIs. That’s not the only way to have a research career, but it’s certainly one of the main paths ppl have in mind when they set out on “doing research”. Comparatively, somewhere between half to two-thirds of MD/PhD grads have a significant portion of their effort dedicated to research. An MD can be just as productive and impactful a scientist as an MD/PhD, but if you want to talk about career outcomes you have to think about the % going into a path with a career goal compared to the % going out achieving X career metrics.

In MD/PhD it’s very well documented because it’s the public’s money funding this at the end of the day and we want to know if it’s money we’ll spent or not. Even with comparatively very good career outcomes that are mostly in line with the NIHs vision for the program, there’s a lot of handwringing because the pipeline is *still* very leaky even taking the best and the brightest. Data is not as good for MD only although that may soon change with many places starting pipelines and programs to support MDs interested in translational/basic science careers.

What I’m trying to get at is an MD who gave lab research the good old college try for 1-2 years during fellowship and wasn’t able to get the papers / grants to get a faculty job may say “welp, thems the breaks” and not be too burned out on science / research / academia. By the time an MD/PhD is at that same point they’ve invested 3-6 additional years of training to be in the same spot and “failure” becomes a tougher hump to hurdle. But they’re also better positioned to keep trying if they have it in them.

I mean, read my sig lol.

 

[dl2dp2]

The question should really be why MD/PhD over MD, because personally, i honestly believe MDs can do just as great basic science and translational research without the added PhD. I'm not really sure if the PhD adds significant advantage to getting R01s but i'm way too junior on this.

Very few MDs actually do any research. Also, $300k.

 

[Fencer]

Data shows that less than 1% and about 42% of MDs and MD/PhDs do more than 50% research as their primary activity. Just as in my case, only during my 5 years of K08 awardee, I exceeded 50% research in my 25+ years career. Nevertheless, despite 10-50% research time, I continue to publish a couple of manuscripts per year (one clinical and one basic) for the past 7-8 years. In general, we pay for our salary with our effort (i.e.: RVU, admin, grants). NIH PI salary is capped at ~$200K/yr.

 

[tortuga87]

Data shows that less than 1% and about 42% of MDs and MD/PhDs do more than 50% research as their primary activity. Just as in my case, only during my 5 years of K08 awardee, I exceeded 50% research in my 25+ years career. Nevertheless, despite 10-50% research time, I continue to publish a couple of manuscripts per year (one clinical and one basic) for the past 7-8 years. In general, we pay for our salary with our effort (i.e.: RVU, admin, grants). NIH PI salary is capped at ~$200K/yr.

Looking back at your career and also maybe your former classmates or students, is there anything you would have done differently to get more research time earlier on? Outside the box answers also appreciated if you are familiar with any

 

[CheGuevaraMD]

To give a counterpoint, I think this subforum has a blind spot in terms of soft vs. hard money. MDs and MD/PhDs are 100% soft money or clinical revenue, always. PhDs, at least those in tenure track (TT) positions, are not. It is likely that a TT job in biology at Stanford is much better than a MD/PhD "TT" job at Stanford Medicine, because the Stanford main campus prof probably only has to raise half of his/her salary in grants. The rest comes from teaching bio 101 to rich kids who overpay for college. BUT the only way to become a TT prof at Stanford is to get a PhD at Harvard and be extremely lucky.

 

[tr]

To give a counterpoint, I think this subforum has a blind spot in terms of soft vs. hard money. MDs and MD/PhDs are 100% soft money or clinical revenue, always. PhDs, at least those in tenure track (TT) positions, are not. It is likely that a TT job in biology at Stanford is much better than a MD/PhD "TT" job at Stanford Medicine, because the Stanford main campus prof probably only has to raise half of his/her salary in grants. The rest comes from teaching bio 101 to rich kids who overpay for college. BUT the only way to become a TT prof at Stanford is to get a PhD at Harvard and be extremely lucky.

Sorry, junior faculty on both the Med Center Line (tenure track) and Clinician-Educator Line (nontenure track) at Stanford are expected to make their own salaries as well, if not through grants (ideally) then through clinical work. This applies to PhDs also. Really there seems to be little in the way of material differences between the tracks, except a bigger hurdle to promotion to Associate on the MCL track (although failure to promote to Associate on MCL would likely just kick you down to Associate on CE so it's not the most awful loss).

People on the University Tenure Line who don't do clinical work are operating under a different (and generally much more difficult) set of constraints, but it seems very unlikely that someone who wasn't able to cover his salary (and, once through his startup funds, fund his lab as well, which is a vastly larger expense) through grant funding while Assistant would ever make it to Associate. Most people on UTL are not teaching bio 101. They might throw an odd lecture at the med students a couple of times a year.

 

[Lucca]

To give a counterpoint, I think this subforum has a blind spot in terms of soft vs. hard money. MDs and MD/PhDs are 100% soft money or clinical revenue, always. PhDs, at least those in tenure track (TT) positions, are not. It is likely that a TT job in biology at Stanford is much better than a MD/PhD "TT" job at Stanford Medicine, because the Stanford main campus prof probably only has to raise half of his/her salary in grants. The rest comes from teaching bio 101 to rich kids who overpay for college. BUT the only way to become a TT prof at Stanford is to get a PhD at Harvard and be extremely lucky.

this is not fair, faculty at Stanford can also come from Stanford. Maybe even UCSF.

 

[tr]

this is not fair, faculty at Stanford can also come from Stanford. Maybe even UCSF.

Besides being puerile, this fascination with name brand universities is not even accurate. Stanford has tenured star faculty whose degrees are from totally middle-of-the-road places. The older you get the less anyone cares about the name of the institution you graduated from X years ago. It's all about what you, yourself, have achieved most recently.

 

[dl2dp2]

To give a counterpoint, I think this subforum has a blind spot in terms of soft vs. hard money. MDs and MD/PhDs are 100% soft money or clinical revenue, always. PhDs, at least those in tenure track (TT) positions, are not. It is likely that a TT job in biology at Stanford is much better than a MD/PhD "TT" job at Stanford Medicine, because the Stanford main campus prof probably only has to raise half of his/her salary in grants. The rest comes from teaching bio 101 to rich kids who overpay for college. BUT the only way to become a TT prof at Stanford is to get a PhD at Harvard and be extremely lucky.

It's not a "blindspot": hard money TT jobs at Stanford's basic science departments are in general inferior jobs because the total income is lower, sometimes substantially. I know of examples of people who are on the Clinician-Educator track who make a decent amount more than the provost of the university due to clinical practice income generated otherwise. These are just two different types of jobs. TT salaries are clamped by institutional guidelines and in many places, UTL faculty are paid with perks (private school tuition, housing, etc) whereas clinical revenues often aren't, and the need for perk doesn't exist. And while there is institutional hard salary protection, the bottom is typically quite low--if you want to generate a good salary you still have to raise a large portion of your own salary.

Generally speaking, TT jobs are inferior in several dimensions (total comp, team budget, geographical flexibility, leadership potential) and superior on other dimensions (intellectual independence, hour flexibility). The career prospect of your average professor on the UTL is not great in mid-career outside of academia or even laterally--it's not that easy to say to move a UTL from one university to where your spouse is moving to, especially if you don't have active grants. This is actually a major reason for mid-career attrition in women in science. CE tracks don't have this issue--it's very easy to lateral on CE, grants or not.

 

[tortuga87]

Besides being puerile, this fascination with name brand universities is not even accurate. Stanford has tenured star faculty whose degrees are from totally middle-of-the-road places. The older you get the less anyone cares about the name of the institution you graduated from X years ago. It's all about what you, yourself, have achieved most recently.

Yeah the academic community seems to be the last vestige of the mentality that was much more prevalent in the boomer generation - do well in school, get degrees from name brand institutions, get a stable job within a large bureaucracy (e.g., at Stanford). There are still some grandparents (including my own) who cannot fathom someone doing well without a college degree, or physicians who insist on adding an extra degree to work in administration.

In reality, there are capable people everywhere and the above structure just provides artificial barriers to people who can actually do the jobs well. You can learn most things on your own or on the job. The hard part is putting in the effort to find the diamond in the rough rather than just restricting your selection to the waspy dudes from (insert name brand here). Also, increased job stability means lower pay and more bureaucratic restrictions. It's important in life to be comfortable with uncertainty.

 

[kepler16b]

Yeah the academic community seems to be the last vestige of the mentality that was much more prevalent in the boomer generation - do well in school, get degrees from name brand institutions, get a stable job within a large bureaucracy (e.g., at Stanford). There are still some grandparents (including my own) who cannot fathom someone doing well without a college degree, or physicians who insist on adding an extra degree to work in administration.

In reality, there are capable people everywhere and the above structure just provides artificial barriers to people who can actually do the jobs well. You can learn most things on your own or on the job. The hard part is putting in the effort to find the diamond in the rough rather than just restricting your selection to the waspy dudes from (insert name brand here). Also, increased job stability means lower pay and more bureaucratic restrictions. It's important in life to be comfortable with uncertainty.

I was appalled to learn that undergrad reputation still ranks highly on elite med school's metrics for selecting applicants. It's shamelessly classist. "Name brand" academics is a pyramid scheme.

 

[Lucca]

Besides being puerile, this fascination with name brand universities is not even accurate. Stanford has tenured star faculty whose degrees are from totally middle-of-the-road places. The older you get the less anyone cares about the name of the institution you graduated from X years ago. It's all about what you, yourself, have achieved most recently.

this was a very tongue in cheek post I assure u

 

[psychacad]

I was appalled to learn that undergrad reputation still ranks highly on elite med school's metrics for selecting applicants. It's shamelessly classist. "Name brand" academics is a pyramid scheme.

Just remember that it's in their economical advantage for "elite" universities to keep selling their brand as "elite"; hence, they will do their best to keep the prestige system alive.

 

[SurfingDoctor]

Tenure is mostly a joke. The only advantage is 1) typically you have to be on this track to get some sort of start up money and 2) if you make it to tenured professor with an endowed position, the university uses the annual “income” of the endowment to float research assistants. Outside of those two things (which are more rare), tenure is meaningless.

 

[CheGuevaraMD]

Sorry, junior faculty on both the Med Center Line (tenure track) and Clinician-Educator Line (nontenure track) at Stanford are expected to make their own salaries as well, if not through grants (ideally) then through clinical work. This applies to PhDs also. Really there seems to be little in the way of material differences between the tracks, except a bigger hurdle to promotion to Associate on the MCL track (although failure to promote to Associate on MCL would likely just kick you down to Associate on CE so it's not the most awful loss).

People on the University Tenure Line who don't do clinical work are operating under a different (and generally much more difficult) set of constraints, but it seems very unlikely that someone who wasn't able to cover his salary (and, once through his startup funds, fund his lab as well, which is a vastly larger expense) through grant funding while Assistant would ever make it to Associate. Most people on UTL are not teaching bio 101. They might throw an odd lecture at the med students a couple of times a year.

What? No. UTL profs teach, even at Stanford. For example, this new UTL assistant prof has a R01 and still teaches intro to cell bio: Jessica Feldman's Profile | Stanford Profiles

Teaching is highly profitable.

 

[StilgarMD]

Tenure is mostly a joke. The only advantage is 1) typically you have to be on this track to get some sort of start up money and 2) if you make it to tenured professor with an endowed position, the university uses the annual “income” of the endowment to float research assistants. Outside of those two things (which are more rare), tenure is meaningless.

One of the reasons I imagined tenure to be valuable is I get this strong sense that momentum is crucial, and once you 'stop', it becomes harder to restart for every month/year/unit of time that you're out of the game of publishing/presenting, and it becomes harder to secure funds to start back up. Is that the case generally?

 

[SurfingDoctor]

One of the reasons I imagined tenure to be valuable is I get this strong sense that momentum is crucial, and once you 'stop', it becomes harder to restart for every month/year/unit of time that you're out of the game of publishing/presenting, and it becomes harder to secure funds to start back up. Is that the case generally?

Well, tenure track is a clock. There isn’t really starting and stopping. The clock is usually 7 to 9 years from hiring as an assistant professor to make tenured associate. If you stop at any point during that 7 to 9 year period, best just to leave the track. The time between tenured associate and full professor is whatever. There is no clock for that. If you are an MD or MD/PhD, you may be regarding as successful enough to merit a endowed position and generate enough clinical RVUs and just coast on that. If you are a PhD, you need grants even in an endowed position. All tenure really means at that juncture is they can’t fire you. That being said, I know of tenured full professors who were PhD who couldn’t (or didn’t) get grants anymore. The university didn’t fire them, they just reduced their salary significantly and stuck them in the basement next to the boiler. Maybe they were cool with that though? Most of the attrition is during the assistant to associate phase.

 

[StIGMA]

Tenure doesn’t mean you can’t be fired. You can generally have your contract non-renewed which is the same thing. For firing, tenure means the department may have to jump through more hoops (dean, provost) to fire you. in my experience it is more common to just not renew their contract.

tenure doesn’t necessarily mean a whole lot nowadays

 

[dl2dp2]

You can get fired for cause, like having sex with your lab assistant, etc. extremely rare to get fired for lack of grant productivity. However the low # on protected salary is very low (~75k for ivy, ~60k for state school), so yeah tenured faculty still write grants.

Typically though when you get tenured your productivity is usually good enough that you can float for a while, and if you are staying active with research your department would help if it’s a temporary thing. If you aren’t interested in filing grants anymore usually there’s enough sinecure in a department that they can fish out a job for you that pays a little more than the minimum (ie teaching, admin, etc)

I would say tenure is a “perk” that is not very useful for MDPhDs who have active clinical practices. In general it’s much better to make 300k a year without tenure than 75k with tenure. In practice a lot of 75k with tenure people have family money. I wish I’m joking. Lol.

 

[StilgarMD]

I guess that makes the existential dread accompanying fears about not making it in academia a less daunting ordeal... So I guess the major obstacle is getting funds to do the work you want to do if you're insistent on independence, or finding the right lab/co-I to work with.