Possible to have less hours as a physician-scientist at a smaller university?

[todds]

I understand that most physician scientist work long hours to essentially do two jobs at the same time.

However, most of these scientists I often hear about are at larger, more prestigious institutions.

If I like to do a good amount of patient care and tag it along with teaching and research, is it even at all possible to fit into a reasonable work week of ~50 hours? I understand this is likely not possible at prestigious places like the Harvards and Hopkins of the country, however what about smaller institutions?

Are there the same pressures to publish, get grants at less prestigious places? I would really like to have enough time to spend with family and I just wanted to know if this is realistic to balance being a physician-scientist and family at smaller place. Furthermore, are there any specialites/subspecialties that would be more conducive for a lifestyle friendly physician-scientist route?

I don't really care to be HHMI investigator or have multiple Nature publications, rather just be involved in science with small lab, some teaching and patient care.

Any input would be appreciated.

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[GliaGirl]

I am not 100% sure, but I think that specialties like anesthesiology and emergency medicine are pretty good in the time department.

As for not being able to work as hard, why go for the MD/PhD then? You can be a doctor who does research on the side with just an MD. Why waste 4 years of your life if you're only peripherally interested in research?

 

[Neuronix]

Seconding what GliaGirl said. The MD/PhD is intended to be a research degree. Being "involved" with research is not the goal. You being the PI of NIH grants, and hence running your own lab 100% of the time is the goal. Teaching and clinical work is relatively secondary, and can add whatever percentage of time to your responsibilities above the time it takes to be a PI.

In other words, don't choose this path if you aren't willing to sacrifice your personal life for it. That somewhat goes for medicine as well, but it's simply not as bad in clinical medicine. The training for MD/PhD is harder and longer than MD training, since you do everything an MD does AND tack on several years of training and additional duties to just having one career. i.e. typically having a clinical hand when a researcher AND have a research hand when a clinician. Thus the hours are almost always worse than your MD counterparts, except some of the hardcore specialties, which you could also choose as an MD/PhD. For all this you can expect less vacation and less pay. If this doesn't appeal to you, go MD. GG is right--there are many gigs within many lifestyle specialties you can do if you don't want to work too hard.

Of course you can take your MD/PhD degree and do whatever you want with it. But, you going and doing mostly clinical medicine, which is almost always the easier pathway, is going to be the lifestyle friendly one. That's not what the MD/PhD was intended for. The only exception to what I'm saying about lifestyle is if you wait until you are well established as a researcher and cut back as far as you can on your clinical duties (or go 100% research), but even this is a long and delayed gratification (mid to late 40s or maybe 50s before you have this opportunity). Where you do all this work (small vs. large place) is kind of irrelevant. It's a national competition for grants. But when you finish grad school you realize that to get grants at 10% funding rates, it's not possible to dabble in research and be a PI nor is it possible to a lot of clinical, research, and teaching without being there 60, but more like 80 hours a week.

 

[itsallthesame]

there is a shortage of docs and a shortage of doc-scientists. therefore, i personally feel that if you are going to take a seat in the school from someone who'd be busting their arse to get as much done as possible until the day when the average doc can work 35 hours a week, be rich and everyone gets seen as much as needed.

that said, if you don't care about making the big bucks... plenty of decent name psych departments happily hire clinical phds who split time with teaching/practice 50/50. as an md/phd + shrink residency, you'd presumably have no problem. probably not ideal for bench work, but fine for psych/clinical research. you could probably swing one GS and a couple undergrads in the lab. since you won't have ms debt, who cares if you only make ~60-70k? wanna spend most of your time in the lab but still see patients every now and then? volunteer at the associated medical school's free clinic.

if money isn't a conern, there are always options. heck, you can become a surgeon and work 7-14 hours a week if you don't mind covering nigh shifts and only making ~50-70k/yr.

 

[Neuronix]

there is a shortage of R01 funded doc-scientists.

Fixed that for you.

You can always get hired to teach. Teaching doesn't pay anything. Nobody pays you to teach clinical subjects or graduate school classes. If you want to spend 50% of your time practicing clinically and spend 50% of your time teaching and make half your normal salary, departments will love you for it. You'll never have any shot at "tenure" (does it exist anyways?) or the big academic ranks like professor (professor=research), but you'll be in high demand. Any department will say: we get a highly qualified teacher for free? Sign us up. That is if you're willing to go from 120k to 60k so you can teach 50% of the time. Who's willing to do that? You might think you are as an undergrad with no family and no real bills to pay. It's extremely unlikely when you're done.

Of course this scenario continues to be unlikely given the high fixed costs of practice--office space, support staff, malpractice insurance, etc... The truth is that these costs are all roughly fixed, and then once you work a certain amount, you are then paying yourself. Thus, just to practice at all you need to maintain a certain amount of activity in most specialties. The reason why physician-scientists can get away with what they do? They bring in big research grants. If they don't, they get told to do clinical work or get fired.

you could probably swing one GS and a couple undergrads in the lab.

Who's going to pay for them? This has nothing to do with how many hours you want to work or money you want to make. This has to do with a competitive national competition for money to pay these people. You think your department is just going to pay for grad students and undergrads? Are they just going to walk through the door in droves and ask to work for you and not to be paid? How are you going to pay for the research they're doing? Getting sizeable research grants to do serious research is a full-time enterprise. If you're just doing minor clinical research that doesn't take much time you're not going to have grad students, and what students you do have you're going to have find some way to pay the $12 an hour or whatever to do chart reviews.

if money isn't a conern, there are always options. heck, you can become a surgeon and work 7-14 hours a week if you don't mind covering nigh shifts and only making ~50-70k/yr.

I also find this quite naive. Surgeons have to pay malpractice and other overhead costs I mentioned earlier (support staff, billing, etc). They have to practice frequently to keep their skills up. This is all assuming you could even find such a position in the first place. No hospital is going to hire you to operate once or twice a week. They want a full-time surgeon who is going to keep their mortality and morbidity low so it looks good for the hospital, keeps their liability low, and covers their services very frequently. Who's going to support those patients you operated on anyways after you operate on them while they're still in the hospital for a few days? Who's going to get the phone calls from the patients you operated on? If you don't do all of these things, you're not getting hired.

This is neglecting the fact that you have to spend AT LEAST 5 years in a brutal surgery residency working >80 hours a week (and the 80 hour work rule is a joke).

Could you probably find a job as a "part-time" surgeon? Sure. It's going to pay about as much as you listed, but part-time in surgery is really 30 hours a week or more. Full-time in surgery is 60 hours a week or more. If you want to talk about Emergency, where nobody cares if you work say 3 12 hour shifts a week, then it's a different story. But even then trying to find someone who's going to pay you to work much less than that is very difficult, unless you're doing something else for them.

 

[Vader]

Yes, this is possible, depending on many factors that involve how your schedule is arranged, including:

1) Type and extent of research: clinical vs. basic, bench vs. non-bench (i.e. computational, epidemiologic), pace and timing of experiments, type and extent of collaborations, how your lab is set up and managed (techs, postdocs, grad students, undergrads), how much direct involvement you have with projects/data, etc. Obviously, here the more you put in, the more you get out.

2) Type and extent of clinical work: Specialty (perhaps the largest factor)? 1 day a week clinic with 2-4 weeks attending on wards (the "typical" distrubtion)? How well integrated is the clinical work with the research you do?

3) Other responsibilities: administrative (meetings, committees, conferences, mentoring, etc). This stuff can take up a large amount of time, which is to the surprise of many students.

Obviously, there are only 24 hrs in a day, so the name of the game is figuring out the best way to straddle all your responsibilities. It is entirely possible to run a lab without the goal of publishing in Nature, Science, Cell, winning a Nobel prize, etc. I would say the primary motivation ought to not be these things, but out of a genuine interest in solving problems that are hopefully clinically meaningful, thereby ultimately benefiting patients and society. However, the reality is that you still must be able to fund your lab to do the things you want to do. And much of the sparse grant funding is given to people who do work extremely hard. Therefore, to be competitive often requires that you work equally as hard, which most often translates to more hours. That is why most people who are unable/unwilling to commit or whose heart is not truly in it, find other career paths.

Given all that, it is still certainly possible to balance career and life. You have to be (or learn to be) particularly adroit with time management skills. And it definitely helps to have support from all sides (dept chair, mentors, collaborators, clinic coordinators, administrative folks, family, etc). It truly takes a village to raise an MD/PhD. 😀

 

[Vader]

By the way, I agree with everything Neuronix and GliaGirl have to say. 😀

 

[Neuronix]

And much of the sparse grant funding is given to people who do work extremely hard. Therefore, to be competitive often requires that you work equally as hard, which most often translates to more hours. That is why most people who are unable/unwilling to commit or whose heart is not truly in it, find other career paths.

Given all that, it is still certainly possible to balance career and life. You have to be (or learn to be) particularly adroit with time management skills. And it definitely helps to have support from all sides (dept chair, mentors, collaborators, clinic coordinators, administrative folks, family, etc). It truly takes a village to raise an MD/PhD. 😀

I find these two paragraphs to be mutually exclusive. First you say you must work extremely hard to get grants. As hard as everyone else applying for those grants, which are typically PhDs working very hard to keep their own jobs. But this is on top of all the other things you already mentioned in your previous paragraphs. So is this at all possible on the op's suggested 50 hours a week? Well maybe, but probably not doing 80% research (+/- 20%), which is what we're supposedly being trained for.

But, in the very next paragraph you say that it's still possible to balance career and life. How? I guess it all depends on what your definition of having a good life outside of work is. Is anyone going to come after you as an MD/PhD and say DO MORE RESEARCH PUNK! No, of course not. But the MD/PhD program is there to train us to be majority researchers. If someone is looking up at MD/PhD rather than looking around, I think we owe it to them to say--this is a 60-80 hour a week profession, worse than just doing MD alone, get used to it or don't do it. It's better for them and better for the community than them finding out their "heart is not in it" down the road.

But sure, I guess you can balance if you don't sleep. The rumors are the chair of a certain department at a certain school sleeps 3-5 hours a night, so he's able to work hard hours and see his family quite a bit. I also ran into him a lot leaving the lab at 4AM when he was coming in.

 

[itsallthesame]

I can think of two hospitals off the top of my head that pay ~500-1000 for an overnight surgical shifts. Yes, the training is absolutely brutal. There are hospitals owned by say insurance companies or without full residency programs that hire people to cover acute care surgery, where an attending would be called in if a difficult case presented. I am currently living with someone applying for one of these jobs.

Yes, teaching doesn't pay. But if you get a job teaching UGrads at a school with money, they may give out grants to ugrads. my school was liberal with them and i got one. i then worked during the school year for credit: thats one way to get cheap/free labor. yes, grad students are expensive and that would probably require money. however, i know of at least two psych depts that i have been or nearly been affiliated with that offer direct money to their PIs for materials. Grad students can be paid using departmental money with TAships.

No this is not ideal and will never get you rich. You'll "waste" a lot of time with med school and residency for a job that you could get with a PhD and time in PhD for a job you could get likely with clinical training only. However, a two income family with a child might just be OK, you won't have debt, AND if it's what you absolutely MUST do and nothing else could make you happy...

 

[Vader]

I find these two paragraphs to be mutually exclusive. First you say you must work extremely hard to get grants. As hard as everyone else applying for those grants, which are typically PhDs working very hard to keep their own jobs. But this is on top of all the other things you already mentioned in your previous paragraphs. So is this at all possible on the op's suggested 50 hours a week? Well maybe, but probably not doing 80% research (+/- 20%), which is what we're supposedly being trained for.

But, in the very next paragraph you say that it's still possible to balance career and life. How? I guess it all depends on what your definition of having a good life outside of work is. Is anyone going to come after you as an MD/PhD and say DO MORE RESEARCH PUNK! No, of course not. But the MD/PhD program is there to train us to be majority researchers. If someone is looking up at MD/PhD rather than looking around, I think we owe it to them to say--this is a 60-80 hour a week profession, worse than just doing MD alone, get used to it or don't do it. It's better for them and better for the community than them finding out their "heart is not in it" down the road.

But sure, I guess you can balance if you don't sleep. The rumors are the chair of a certain department at a certain school sleeps 3-5 hours a night, so he's able to work hard hours and see his family quite a bit. I also ran into him a lot leaving the lab at 4AM when he was coming in.

I'm not saying it isn't difficult to balance career and life. I think you are correct in suggesting that finding a balance is partly about expectations. But it also involves increasing efficiency, being comfortable wearing different hats, realizing one's own limitations, and having a great deal of support both directly in your career and in your life.

There is no pre-set, proscribed balance here, so anyone looking for a cookie-cutter approach to an MD/PhD career pathway will be searching for quite some time (that hasn't stopped me from starting to write a guidebook though!). Finding a balance is all about thinking long and hard about one's career goals, making tough choices, and gathering sufficient support in one's efforts. For different people, the balance will necessarily be different.

My advice would be to find people who do this successfully (they can be hard to find sometimes), talk to them, and try to incorporate some of those aspects of what make them successful into your own life. If you don't think it is possible for you to strike the balance you are looking for by choosing a specific career pathway, then by all means look for alternatives.

 

[smq123]

if money isn't a conern, there are always options. heck, you can become a surgeon and work 7-14 hours a week if you don't mind covering nigh shifts and only making ~50-70k/yr.

I can think of two hospitals off the top of my head that pay ~500-1000 for an overnight surgical shifts. Yes, the training is absolutely brutal. There are hospitals owned by say insurance companies or without full residency programs that hire people to cover acute care surgery, where an attending would be called in if a difficult case presented. I am currently living with someone applying for one of these jobs.

So, wait.

- Working 7-14 hours per week is enough to cover the ED? To cover any and all traumas, any and all late-night trachs/PEGs/J-Tubes/G-tubes that need to be done, see these patients as clinic followup, AND round on them as inpatients?

- Working 7-14 hours per week is also enough to generate enough money to cover your malpractice insurance? Or does this job expect you to work "naked" (i.e. uninsured)?

- Working 7-14 hours per week is enough to keep your surgical skills up so that you can competently take care of the "difficult cases" that present?

In what fantasy world is THIS a good idea??

I am sorry if that sounds harsh, but I would NOT want such a surgeon to do my stat ex-lap, my stat SBR, or (God forbid) my stat thoracotomy. 7-14 hours per week is not enough to keep your surgical skills up. Unless the person who is doing this job is a) a general surgeon during the day who operates at least 3 days a week, or b) a retired surgeon who has 25 years experience as an attending, that just sounds plain frightening.

Furthermore, if you want to do minimal clinical stuff to leave time for research, most likely you want to tie your clinical stuff to your research. What kind of research could 7-14 hours of surgical duty per week possibly generate? Even a lot of the new trauma research coming out now (for instance, there have been some interesting studies about how much FFP vs. PRBCs to give in traumas) are coming from trauma surgeons who are working their tails off - many of them are currently in Iraq or Afghanistan. Trust me, the people generating this kind of research aren't noodling round in the OR for <60 hours per month.

Yes, teaching doesn't pay. But if you get a job teaching UGrads at a school with money, they may give out grants to ugrads. my school was liberal with them and i got one. i then worked during the school year for credit: thats one way to get cheap/free labor. yes, grad students are expensive and that would probably require money. however, i know of at least two psych depts that i have been or nearly been affiliated with that offer direct money to their PIs for materials. Grad students can be paid using departmental money with TAships.

If you end up teaching at an undergrad with money, and IF those undergrads get a undergraduate grant, and IF the department is willing to pay the grad student for a TA spot, and IF the grad student can somehow scrounge up the money to pay for THEIR experiments....

If, if, if. How often do all those "ifs" line up?

I'm not saying it isn't difficult to balance career and life. I think you are correct in suggesting that finding a balance is partly about expectations. But it also involves increasing efficiency, being comfortable wearing different hats, realizing one's own limitations, and having a great deal of support both directly in your career and in your life.

There is no pre-set, proscribed balance here, so anyone looking for a cookie-cutter approach to an MD/PhD career pathway will be searching for quite some time (that hasn't stopped me from starting to write a guidebook though!). Finding a balance is all about thinking long and hard about one's career goals, making tough choices, and gathering sufficient support in one's efforts. For different people, the balance will necessarily be different.

My advice would be to find people who do this successfully (they can be hard to find sometimes), talk to them, and try to incorporate some of those aspects of what make them successful into your own life. If you don't think it is possible for you to strike the balance you are looking for by choosing a specific career pathway, then by all means look for alternatives.

That brightly chirpy post was nice, but essentially doesn't say anything useful.

The OP's question was NOT, "Can I find balance?" The question WAS, "Can I do both clinical and research in ~ 50 hours a week"? You didn't quite answer the specifics of that question.

The problem with talking to people who did this "successfully," is a) they are often rare exceptions to the rule, and b) their definition of balance is frequently different from yours.

What often happens is that someone interested in medical oncology or pediatric surgery asks their mentor, "Can I do this very intense specialty and still lead a balanced life?" The mentor usually replies as you did, by saying, "Yes, with good time management, you can have time for your family too!" The student then goes into this field and is disillusioned, because their idea of a balanced life is having the majority of weekends completely off, being able to go to every ballet recital or soccer game, and eating dinner with the kids at least 4 nights a week....but quickly realize that their mentor's idea of a "balanced life" was very different.

So, do YOU think that the OP can do both in less than FIFTY hours per week? I doubt it.

 

[itsallthesame]

7-14 was a typo and should have been 12-24 (eg 1-2 12 hour night calls/week).

The answer is that these people never follow patients. If you need an ed thorachotomy, you're going to be thankful that it's not a PA doing it (I have a friend who does these on the regular at a less than great hospital). Also, chances are good that you're going to get taken to a trauma center and not the type of hospital i'm referring to. Generally these potions are filled by part timers/moon lighting residents who are simply there to triage and perform relatively straightforward procedures (appendectomy, etc), watch post-ops overnight, stabilize patients until the morning when the full time staff shows up, or call in the real deal. I live in a big city. These jobs are real. If you don't want your doc to be someone like that, pay for good insurance and stay away from public/ghetto hospitals.

 

[todds]

Thanks for all the responses. I guess the answer to my question is NO. Im not in the MD/PhD program. I'm in medical school thinking about adding fellowship research later after residency.

Well, to add a second question, is it possible to be involved in collaborative projects with PhD PI's where I can help in interpreting data/grant writing but NOT be the PI? Would that be a way some MDs can be involved in basic science without the publishing/grant pressure?

Is this type of collaboration looked down upon by most departments?

 

[smq123]

I live in a big city.

That's nice. So do I - I go to med school in Philadelphia. What's your point?

The answer is that these people never follow patients. If you need an ed thorachotomy, you're going to be thankful that it's not a PA doing it (I have a friend who does these on the regular at a less than great hospital). Also, chances are good that you're going to get taken to a trauma center and not the type of hospital i'm referring to. Generally these potions are filled by part timers/moon lighting residents who are simply there to triage and perform relatively straightforward procedures (appendectomy, etc), watch post-ops overnight, stabilize patients until the morning when the full time staff shows up, or call in the real deal. I live in a big city. These jobs are real. If you don't want your doc to be someone like that, pay for good insurance and stay away from public/ghetto hospitals.

🙄 You've missed my point entirely. My point is not that these jobs don't exist, or that NO ONE would ever want to take these jobs.

But FOR A POSITION LIKE THE OP WAS DESCRIBING, it's simply not a good suggestion. Those types of jobs should NOT be your only source of clinical experience, especially if you're an unseasoned attending. They're usually for people who, having either had an extensive clinical background or othe clinical duties, are just looking for a way to supplement their income. And for the OP, who was hoping to integrate a research career into that, it'd be incredibly unfulfilling all around.

I know that those jobs exist. I've talked to residents who have considered those. And they sound great - if I ever get to a point where I have enough money and seniority to do so, I'd take a job like that, and spend 2-3 days each week doing pro-bono charity work in a free clinic somewhere in the city. Put in a 50 hour work week, and let that be the end of it. But for the OP? Those jobs are not a good idea.

Well, to add a second question, is it possible to be involved in collaborative projects with PhD PI's where I can help in interpreting data/grant writing but NOT be the PI? Would that be a way some MDs can be involved in basic science without the publishing/grant pressure?

Is this type of collaboration looked down upon by most departments?

No, actually. You can be quite heavily involved in research as a plain old MD. It's not the same intensity as an MD/PhD, but it's certainly done.

For instance, PhDs who do cancer research can do the bench work and interpret data, but they can't obtain tissue samples very easily. It's helpful to them to team up with a group of surgeons who can't do bench work, but CAN generate tissue samples from the patients that they operate on. Then the surgeons and the PhDs collaborate on data interpretation (the PhDs providing the science, the surgeons providing the clinical meaning of that data), and collaborate on writing the grants and the papers. I'm not sure if this is entirely what you mean, but yes, this type of collaboration is an option.

 

[Vader]

That brightly chirpy post was nice, but essentially doesn't say anything useful.

The OP's question was NOT, "Can I find balance?" The question WAS, "Can I do both clinical and research in ~ 50 hours a week"? You didn't quite answer the specifics of that question.

The problem with talking to people who did this "successfully," is a) they are often rare exceptions to the rule, and b) their definition of balance is frequently different from yours.

What often happens is that someone interested in medical oncology or pediatric surgery asks their mentor, "Can I do this very intense specialty and still lead a balanced life?" The mentor usually replies as you did, by saying, "Yes, with good time management, you can have time for your family too!" The student then goes into this field and is disillusioned, because their idea of a balanced life is having the majority of weekends completely off, being able to go to every ballet recital or soccer game, and eating dinner with the kids at least 4 nights a week....but quickly realize that their mentor's idea of a "balanced life" was very different.

So, do YOU think that the OP can do both in less than FIFTY hours per week? I doubt it.

You need to re-read the OP's question and also my initial response. Then re-think your hostile tone. As an assistant moderator, IMO you should have more of a filter and be more constructive/helpful in your posts.

 

[greg12345]

I think 50h/wk is highly unrealistic from what I have seen, but may be possible if you are 90-95% time in the lab AND once you are established in your career. With an 80%/20% split and as junior faculty 70-80h/wk is probably more realistic.

 

[smq123]

You need to re-read the OP's question and also my initial response. Then re-think your hostile tone. As an assistant moderator, IMO you should have more of a filter and be more constructive/helpful in your posts.

I apologize if it came off as hostile, but I don't apologize for my post. I simply felt that you were offering advice that said absolutely nothing concrete, but instead hid behind vague promises of "Things will work out," or "Well, anything is possible."

Moderator or not, I still have the right to express my opinions within the TOS, whether or not you "approve."

The idea of having both a fulfilling research career AND a fulfilling clinical career, all within ~50 hours per week is a daunting one - so daunting that it deserves SPECIFIC answers, not sweeping generalizations that "time management is key," and things like that. I understand that you feel like your response was adequate, but, to me, it did nothing to answer the details of a very specific question.

If your response had been along the lines of this....

I think 50h/wk is highly unrealistic from what I have seen, but may be possible if you are 90-95% time in the lab AND once you are established in your career. With an 80%/20% split and as junior faculty 70-80h/wk is probably more realistic.

that would have helped. Even now, re-reading your post, you say that it's possible....but is it rely on cliches such as "Yes, this is possible, depending on many factors" or "Given all that, it is still certainly possible to balance career and life. You have to be (or learn to be) particularly adroit with time management skills." But you still did not address the OP's question within the parameters that the OP had set out.

Offering up vague promises of "Anything's possible" doesn't do the OP (or other SDN readers) any favors.

 

[Neuronix]

Ohhhh controversy in the MD/PhD forum I didn't cause! It's a new day, it's a new dawn!

 

[mercaptovizadeh]

My opinion based on limited experience:

1.) excellent clinical career

2.) excellent research career

3.) rich family life

It IS possible to have 1&2 or 1&3 or 2&3 but not 1&2&3. On top of that, you must be efficient and organized in what you do.

We have only one life to live. Make sure that at the end of a long life (if you enjoy that privilege) you don't reflect and remord.

 

[Vader]

I apologize if it came off as hostile, but I don't apologize for my post. I simply felt that you were offering advice that said absolutely nothing concrete, but instead hid behind vague promises of "Things will work out," or "Well, anything is possible."

Moderator or not, I still have the right to express my opinions within the TOS, whether or not you "approve."

The idea of having both a fulfilling research career AND a fulfilling clinical career, all within ~50 hours per week is a daunting one - so daunting that it deserves SPECIFIC answers, not sweeping generalizations that "time management is key," and things like that. I understand that you feel like your response was adequate, but, to me, it did nothing to answer the details of a very specific question.

If your response had been along the lines of this....



that would have helped. Even now, re-reading your post, you say that it's possible....but is it rely on cliches such as "Yes, this is possible, depending on many factors" or "Given all that, it is still certainly possible to balance career and life. You have to be (or learn to be) particularly adroit with time management skills." But you still did not address the OP's question within the parameters that the OP had set out.

Offering up vague promises of "Anything's possible" doesn't do the OP (or other SDN readers) any favors.

Please don't quote me on things I did not type. If you do not like or agree with the content of my post that is fine. But don't mischaracterize or insert your own impression of my post as quotations.

Again, re-read the original post. I'm not sure why I must spell this out for you, but the OP's title of the thread is "Possible to have less hours as a physician-scientist at a smaller university?" The OP asked "If I like to do a good amount of patient care and tag it along with teaching and research, is it even at all possible to fit into a reasonable work week of ~50 hours?" and "I would really like to have enough time to spend with family and I just wanted to know if this is realistic to balance being a physician-scientist and family at smaller place."

I responded directly to some of the questions the OP asked. Other posters on this thread made some excellent suggestions and gave insightful opinions that cover the other questions that the OP had. Without knowledge of the OP's specific interests, it is impossible to say for sure whether 50 hrs per week is reasonable. I agree with the other posters that for many fields this is not reasonable. However, I have seen it done, even at high-caliber places. I agree with the other posters that ~60 hrs/wk is more typical, and does vary with progression in one's career.

Suggesting that my responses are non-concrete and worthless only serves to anger a senior MD/PhD student who frequents this board and attempts to offer useful advice.

 

[todds]

Please don't quote me on things I did not type. If you do not like or agree with the content of my post that is fine. But don't mischaracterize or insert your own impression of my post as quotations.

Again, re-read the original post. I'm not sure why I must spell this out for you, but the OP's title of the thread is "Possible to have less hours as a physician-scientist at a smaller university?" The OP asked "If I like to do a good amount of patient care and tag it along with teaching and research, is it even at all possible to fit into a reasonable work week of ~50 hours?" and "I would really like to have enough time to spend with family and I just wanted to know if this is realistic to balance being a physician-scientist and family at smaller place."

I responded directly to some of the questions the OP asked. Other posters on this thread made some excellent suggestions and gave insightful opinions that cover the other questions that the OP had. Without knowledge of the OP's specific interests, it is impossible to say for sure whether 50 hrs per week is reasonable. I agree with the other posters that for many fields this is not reasonable. However, I have seen it done, even at high-caliber places. I agree with the other posters that ~60 hrs/wk is more typical, and does vary with progression in one's career.

Suggesting that my responses are non-concrete and worthless only serves to anger a senior MD/PhD student who frequents this board and attempts to offer useful advice.

Of the people you've seen do a 50 hr/week, what type of specialty were they in? What type of research were they doing?

Not doubting you, I'm just interested to know the factors that allow for them to be the exceptions

 

[Tradewind]

60/h per week, then yes. 50/h wk is pushing it.

Larger academic programs are often more research friendly in the first couple of years of attendingship, as some chairs (especially if they know you) will provide for you ample protected time for research. I've seen young attendings abuse this extra time, by working 6 hour days and growing lazy. This of course upsets the chairmen, who have dished out roughly $100K annually for nonproductive researchers. After 3-5 years, if the attendings still don't have much to show (papers and grants), then their chairmen place progressively more and more clinical duties on them. Eventually, the clinical work becomes so heavy that the attending has little time for research, and ends up taking the clinical associate route or private practice. Also, if the attending is productive, then the attending feels obligated to stay at the same institution (and will get intense pressure to do so), since the chair will be thinking "but I just funded you as an attending for 3 years and gave you all that time to research!"

At smaller programs, chairmen are less likely to give free protected research time early on. Perhaps this is due to a different devotion placed upon research and/or academia. ?? In the first years of attendinghood, you can count on your fair share of clinical duties, until you have grant money to bargain otherwise. How you find the time to get basic science NIH funding when you're spending >50% of your time doing clinical work is beyond me. Wiser to go for a fellowship, apply for a grant, then bring in the dough.

Further down the road (eg associate professor or professor), I would like to think you could balance both clinical work and research more readily in smaller university departments... But perhaps that is wishful thinking on my part. I know R01's are competitive whereever you are.

In summary, as pedantic as it sounds, a lot of this boils down to money. Your salary has to come from your NIH grant or your Chair. (Other sources of funding are rarely sufficient) So, if you don't have substantial NIH funding, talk with the potential Chair and probe him/her on these issues.

 

[Vader]

Of the people you've seen do a 50 hr/week, what type of specialty were they in? What type of research were they doing?

Not doubting you, I'm just interested to know the factors that allow for them to be the exceptions

I have seen junior people in psychiatry and neurology do more like 60 hrs/wk initially. They run basic research laboratories at prestigious institutions and have been successful in getting R01s. They did have to make some sacrifices (occasional weekend days at work, some late nights in the lab), particularly at the beginning stages when things were just getting up and running and they hadn't hired very many people yet. Buying equipment, hiring people, and getting things up-and-running takes some serious time investment. From what I have seen, there are more up-front hours that are required (i.e. in the ballpark of ~60 hrs/wk) and much stress involved between initial hiring/startup and until one gets his/her first R01. The people I am thinking of also had some clinical responsibilities, but distributed their time to about 80% research and 20% clinical time, which is pretty standard for physician-scientists.

The above of course is a depiction of independent investigators. It is also possible to do research in collaboration with a group as part of a program project grant. I know several clinician-scientists that do this who work less than 50 hrs/wk. They happen to be MDs and MD/PhDs in neurology who do more clinically-focused or translational research.

There are other specialties that can meld well with a career in research such as any of the medical and pediatric subspecialties, pathology, dermatology, radiology, ophthalmology and anesthesia. The surgical subspecialties tend to be more clinically time-intensive and it would be difficult to work less than 50 hours a week and be productive clinically and research-wise.

Hope this helps!

 

[dl2dp2]

Just want to make a couple of points.

(1) hours as a physician scientist is in general BETTER than private practice doc. If you don't have enough wherewithal to be a regular doctor, then...

(2) i agree that a full time surgeon is probably better than a part time surgeon. However, I want my oncologist and neurologist to be physician scientist. Why? They are more likely to be involved in clinical trials, more likely be up to date with the newest stuff, more likely to in a large support network. If I'm gonna die anyway of a painful and slow death, I want my ass enrolled in a trial. I think in cognitive specialties, the best clinicians tend to be also researchers/academics.

(3) you can work 60 hrs a week and still go to piano recitals and have dinner four nights a week with your kids, as long as you don't watch football or play video games. This is especially possible if you are a physician scientist, cause much of the work can be done from home, so you can babysit while reading a paper. It's good for your soul anyway cause you can take a break from time to time.


At the end of the day, nobody (except may surgeons in certain specialties) work THAT hard. The war stories of crazy hours are mostly blown out of reality, in my opinion.