physician scientist track

[coughlolly]

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hey guys, I'm an MD/PhD trying to plan my next career move.

My current dilemma is trying to have a firm understanding how viable a research career is going down a CP-only physician-scientist track. Note, I'm interested in feedback from people who are already there or are heading in that direction, ie writing papers, grants and trying to start a lab. I understand that CP-only isn't going to prepare me for a role outside of academia, so no need to forewarn me about the lack of jobs!

Also, for the questions below I am referring mainly to top 10 departments with respect to research funding/output.

Specifically,

1/ Do you think its easy to stay on in your department after training. Would your hospital/university support you with funds/space after clinical training?

2/ I know there are several grant mechanisms open to MDs that are not open to PhDs. The K08 is the first that comes to mind. But I think funds like the Burroughs-Wellcome fund also has an MD mechanism. Do you think these are easier to get than the more general K99s?

With regard to the K99s, do you find them easier to obtain vs straight PhDs?

I guess, what I'm saying is does the MD + residency give you a certain cachet that a straight PhD doesn't have?

3/ How much pressure is there for you to cover your salary? My understanding is that usually you need to cover 100% of your salary if you want to start up an independent lab. Say you've finished your residency. How much time do you get to fund yourself with an R01? How generous are startup funds at your institution (a ballpark figure)?

Taking the above into account do you think its enough for you to generate enough results to have a viable lab?

4/ I've been carrying this (mis)conception around that perhaps doing a residency is a more easier path to starting a lab and becoming an independent PI vs postdoc route. I'm under the impression (and feel free to correct me) that many pathologists post-training end up being offered academic posts in the hospital department they trained at (note that I'm referring to top 10 departments). Are there any caveats to this observation?

It just seems very striking to me that my PhD friends are fighting tooth and nail to just find a position (including soft money positions in clinical departments like Psych/Path/Neuro) and it seems that residency offers a very gentle 'in' to academia. Am I missing something here?

5/ One of my mentors has been pushing for me to go down the residency -> PI route. The argument is that you get more respect, more access to funding, and people take you more seriously compared to a straight PhD or even an MD/PhD with no residency training.

Anyway, all feedback / thoughts/ criticisms welcome!

Also, can you please write down what stage of training you are at? Residency/fellowship/instructor/PI. Thx.

 

[deleted314957]

An MD w/o a residency is like kissing your sister, with the possible exception
of an MD/JD going directly into law. You've chosen a tough road that a residency can only help greatly.

 

[LookForZebras]

Practicing physician here. I agree with your mentor that doing a residency really dose legitimize you as an MD. I strongly considered not doing a residency while I was in med school (straight MD, not an MD/PhD program), but ultimately decided to do a residency for this reason. I'm really glad I did. It's really helpful to have an active board certification, or at least to be board eligible. Your PhD will weigh heavily in the research field, but not so much in the clinical realm. Clinically, physicians are generally expected to have formal training in their specific specialty area and, while research experience is an added bonus, is typically doesn't take the place of clinical experience in most people's minds.

So I'd say go ahead a do a residency unless you're sure it would be a dreadful experience for you. It might be a tough several years, but you won't regret it later.

 

[coughlolly]

hey guys, thanks for the feedback so far. I just want clarify, I am intent on doing a residency.

I'm interested in gauging how supportive departments are towards physician-scientist track residencies? Will enough resources be provided to setup a productive and independent lab? Or is there too much pressure to perform clinical duties such that research doesn't quite get off the ground?

 

[LADoc00]

This is such a tough and endless struggle of a career path, I wish you luck. I was not brave enough in the end to do something like this even after all my grad school, endless weekends alone in a neuroscience center feeding rats, writing grants and attending conferences.

Honestly it is very akin to becoming a priest or nun. You give up alot...alot. In fact I was in a relationship once with a UCLA md/phd who broke up with me because she was spiritually married her research and career. She still isnt married to an actual person all these later. (She also probably gets laid now less than an actual priest would sadly...)

Point being, I would do APCP to give yourself options, get boarded fully and then look at your life, take a long trip to Mexico, walk the beach at Playa Del Carmen and ponder how you want to spend your short time on Earth.

Peace.

 

[chooks]

Although there is a recognized PST in the ABP, there is little guidance for programs (as far as I know) as to what this actually means. There are a couple of programs out there where there (appears to be) committment to the level of junior faculty with respect to resources and obtaining funding for someone on the PST track. Last I knew, UCSF and Wash U were two such institutions, although things may have changed and there may be more (or less). Other research-heavy programs (MGH, JHH, etc...) may have nascent PST programs that you may want to talk to the PD about -- some are trying to figure it out and might be willing to talk, depending on your strengths. Just be aware that promises are empty unless written down (and even then, unless you are willing to push the issue).

Few people on this board will argue against an AP/CP to hedge your bets (and future employment). You may be 100% certain of your path now, but as life goes on, the lifestyle differences between academics and non-academics may be increasingly important.

Good luck with your path. May the force be with you, and the odds ever in your favor.

- N

 

[kchan99]

I'm interested in gauging how supportive departments are towards physician-scientist track residencies? Will enough resources be provided to setup a productive and independent lab?

At your interview, you should ask about departmental funding and whether there is a T32 or R25. If you are a MD/PhD student, you will still need a period of mentorship, such as a postdoctoral fellowship, before applying for a K99/R00, K08, or K23. It seems to me that the physician-scientist track replaces a postdoctoral fellowship, and the trainee would not be considered an independent researcher. Nevertheless, for a K08 or K23 (I don't know about K99), a faculty appointment is necessary before applying. I doubt a department would know whether tenure track junior faculty positions would be available in 4 years.
During interviews, it would be helpful to find out from current physician-scientist track residents on whether there is sufficient time to learn research skills and generative preliminary data for future grant applications. Also find out about the outcomes of research-minded residents.

Or is there too much pressure to perform clinical duties such that research doesn't quite get off the ground?

This is a question you should ask at your interview. How much protected time will there be for research and when? How will your time be funded? However, keep in mind that as a resident, you could be asked to rearrange your schedule to cover another resident, who is suddenly ill or has family emergency. In this situation, you would ask for your research time to be "refunded" to you later.

 

[coughlolly]

All very good points. Will definitely draw a list of pertinent questions to ask before committing a place.

@kchan99 My understanding has always been that once residency is complete, physician-scientist tracks provide 2 or 3 years of protected research time where they put you in an instructor role. You apply for the K08 and if successful they 'create' a position in time for your grant to begin.

Also I've been checking out the paylines for K99 vs K08. Do any of you have insight into why the K08 is ~40% while the K99 is ~20%? That's twice as high! I'm guessing its because K99 is open to everyone, while the number of post-residency researchers are much fewer and are sharing a similar funding pie. Nonetheless, superficially it seems that a residency gives a huge boost to obtaining a K award.

Has anyone applied to both a K99 and K08? Any thoughts?

 

[kchan99]

Also I've been checking out the paylines for K99 vs K08. Do any of you have insight into why the K08 is ~40% while the K99 is ~20%? That's twice as high! I'm guessing its because K99 is open to everyone, while the number of post-residency researchers are much fewer and are sharing a similar funding pie.
Has anyone applied to both a K99 and K08? Any thoughts?

K08's and K23's are also restricted to US citizens and green card holders. K99's are open to visa holders as well.