Research track residency

[wamc2021psych]

MS4, applying into psychiatry. Even after asking around and speaking to senior people in real life, I'm still on the fence about whether to apply to research track or just general adult psychiatry. After my 3rd year of medical school, I realized I really like spending time with patients. However, I still want to do research. At the moment, I just don't want to do the typical 95% research/5% clinical I see out there. It's funny how that number gets more and more skewed the further along in training I get. I remember 80/20 being the model advertised when applying into MSTPs. I don't see anyone in real life doing 80/20. Maybe part of the problem for me is that I also don't know any role models who aren't MSTP->PSTP->post-doc->K award->R01->R renewals. So I guess I have 2 questions:

1) Am I thinking about this all wrong? Should I be choosing whether to apply to research track based solely on my own desired outcome and not whether I think I am a good fit for what I have been told are research tracks' desired outcomes? For example, my background is not in neuroscience; applying psychiatry was purely a clinical decision. I 100% could benefit from protected time and focused mentorship to develop a specific niche in the field.

2) Outside of NIH money, what other funding is out there for (semi)sustained research in the capacity of a principle investigator (not just a clinical collaborator)? Is something outside of 95/5 research/clinical not a possible model?

Thanks in advance for your insights.

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[dl2dp2]

1. I don't really know what you get from not doing research track. Research track is associated with prestige and typically are more competitive and often associated with other perks aside from protected research time. Research track graduates, especially with MD/PhD credentials, are also more likely to get other senior administrative jobs outside of academic research or build more lucrative practices.

In short: there's nothing negative about just going for research track as a default, regardless of your eventual goal.

You also don't know because you don't ask and people don't tell you. Except at very senior levels, it's actually somewhat rare to have 95/5 in psychiatry at "coastal elites". In general people work more hours clinically than they are willing to admit to trainees. Your assumptions are all false.

2. There's a lot out there. There exist clinical researchers who's entire career is funded by pharma/industry sponsored academic research. There are also jobs where it's 50/50 research/clinical, especially jobs associated with VA/state govt, though getting large grants is somewhat unusual, and these jobs are somewhat newer, as clinical psychiatry's demand increased and VA/state govt having problems retaining quality clinicians. People who are qualified to receive large grants, eventually move more towards 80/20. The main issue is if you don't devote a large # of hours to NIH sponsored research, it's difficult to get sustained funding. Perhaps you can clarify as to what kind of model you'd like to have and we can comment on whether such a model is possible or not.

 

[tr]

Trying to draw a distinction between 95/5 and 80/20 is pointless at this stage.

The bottom line is it is difficult to fund time for research but easy and lucrative to do clinical care. No chair is ever going to stop you from doing as much clinical care as you want; rather, you will get pushed to do more and more clinical care, at the expense of research.

The more clinical care you do, the harder it is to generate research productivity and the less likely you are to get more funding. Hence the death spiral of clinical effort over research.

Anyone who is really doing 80/20 (or 95/5) is killing it.

In reality people are doing every split available along the spectrum. No time to find the link right now, will look around later, but there is a very informative MSTP Outcomes pdf that shows a continuum from 0% research to 100% research.

Other sources of PI level funding besides NIH are DoD/VA and NSF (very rare for MD investigators to be substantially supported by NSF though, they have much less money than NIH). Foundation money is out there too but not typically renewable for years and years like NIH money, most foundation grants are one-shot deals. Some people run a very lucrative-looking model of doing drug trials for pharma companies. Less interesting but pays the bills, keeps the shop open when funding for more interesting work is not to be had.

 

[Lucca]

In reality people are doing every split available along the spectrum. No time to find the link right now, will look around later, but there is a very informative MSTP Outcomes pdf that shows a continuum from 0% research to 100% research.

Are these the figures you're referring to?

from JCI 2019, MD/PhD Outcomes

 

[tortuga87]

In general people work more hours clinically than they are willing to admit to trainees.

How much are research people really working clinically? Something like 40 hours research + 30 hours clinic per week? I suspect there is continuum but would like to know what to expect

 

[Fencer]

This is from the MD/PhD survey by Akabas & Brass. For MD/PhD faculty who works in Academic Medicine, what is the FTE proportion of research & clinical activities.

 

[deleted728364]

There's a lot out there. There exist clinical researchers who's entire career is funded by pharma/industry sponsored academic research.

Do industry people ever offer startup funds for early career investigators? I read that most biotech money usually comes from consulting once one is already an established researcher.

If in theory one’s work is valuable to some company, is making a connection for startup funds possible? For some reason I imagine it would only be within reach for those from MIT/harvard/stanford.

 

[dl2dp2]

Do industry people ever offer startup funds for early career investigators? I read that most biotech money usually comes from consulting once one is already an established researcher.

If in theory one’s work is valuable to some company, is making a connection for startup funds possible? For some reason I imagine it would only be within reach for those from MIT/harvard/stanford.

Generally pharma does not make the distinction between early career and later career. And it's not true that money is only from consulting. Most medium to large pharma companies have extramural investigator-initiated grant programs.

E.g.:

Janssen

Investigator Sponsored Studies and Externally Sponsored Collaboration

Independent clinical studies with external promotion to advance disease awareness and treatment development

www.sanofi.com

Brands don't matter much. In particular, MIT is not known to be a big recipient of pharma money, especially in translational science, because they don't work in this space. Harvard/Stanford are also not big recipients if you restrict your scope to the university itself. Stanford is frankly not very strong in pharmaceutical development in general.

 

[wamc2021psych]

In general people work more hours clinically than they are willing to admit to trainees. Your assumptions are all false.

My experience was the opposite. I assumed it would be more clinical, but what they told me amounts to <5% face to face time with patients, which was why I started doubting research track being for me.

The main issue is if you don't devote a large # of hours to NIH sponsored research, it's difficult to get sustained funding.

That's my understanding as well, and the reasoning behind my asking if I shouldn't even bother applying research track if my ideal career likely will not be the ideal outcome in programs' pov.

Perhaps you can clarify as to what kind of model you'd like to have and we can comment on whether such a model is possible or not.

Just something less than 80/20, closer to 50/50. I don't know enough to be more specific as a MS4. I don't even know exactly where my clinical interests lie at the moment. I'm possibly interested in C/L or CAP. I would imagine no academic center would hire a C/L psychiatrist without a large clinical commitment and what I've heard about CAP is that it is the toughest for research track as the flexibility that general adult psychiatry residency has is lost with fast tracking into CAP and most will end up doing a more prolonged research fellowship/post-doc to play catch up.

I really want to know who all those people are in the graphs shared in this thread who are around 50/50 and what they are doing/what kind of funding they have.

 

[tr]

I really want to know who all those people are in the graphs shared in this thread who are around 50/50 and what they are doing/what kind of funding they have.

It's soft money people who don't have the NIH grants that would give them more protected time. This was me last year. I had 3 little peanut non-NIH grants of my own, was coI on someone else's R01, and had a few % institutional protected for teaching and stuff, all together adding up to 50%. It goes up and down depending on available funding. This year I'm 40% research on paper but they keep stuffing patients into what is supposed to be protected time, plus the billing targets are nastier than at my previous institution so it feels like a lot less

Early career researchers who have K awards are 80/20 or more (at least on paper) because the terms of the K guarantee it.

 

[dl2dp2]

My experience was the opposite. I assumed it would be more clinical, but what they told me amounts to <5% face to face time with patients, which was why I started doubting research track being for me.

Why do you trust people? Did you audit their caseload? Did you see their income tax return? #TrustNo1.

That's my understanding as well, and the reasoning behind my asking if I shouldn't even bother applying research track if my ideal career likely will not be the ideal outcome in programs' pov.

I don't get this. Why is this an impediment from even bother applying? Go through the research track, if you are not into research, then go do something else during your "protected research time". Who cares what your ideal career is from the program's POV? Just tell the program what they want to hear and they'll take you, then once they take you you can do whatever you want. Why are you being so forthright with a system that's designed to explicitly exploit junior investigators every step of the way? What you feel empathy towards universities and the NIH that wouldn't give any funding for people until they are 45? You running a personal charity? This should've been already obvious at the MD/PhD level. How many of your MD/PhD classmates end up doing PP derm? Who cares???

Just something less than 80/20, closer to 50/50. I don't know enough to be more specific as a MS4. I don't even know exactly where my clinical interests lie at the moment. I'm possibly interested in C/L or CAP. I would imagine no academic center would hire a C/L psychiatrist without a large clinical commitment and what I've heard about CAP is that it is the toughest for research track as the flexibility that general adult psychiatry residency has is lost with fast tracking into CAP and most will end up doing a more prolonged research fellowship/post-doc to play catch up.

I really want to know who all those people are in the graphs shared in this thread who are around 50/50 and what they are doing/what kind of funding they have.

These jobs exist, as shown by the graph. They aren't easy to get as usually by word of mouth and are very ideal "mommy track" jobs. In general, if you ask people will tell you they don't exist, but they plainly do exist. Try to start by developing relationships with a broad range of people in your network. People who get them are usually muted about them because they are so desirable. I know someone very well who got one of those jobs.

 

[tr]

These jobs exist, as shown by the graph. They aren't easy to get as usually by word of mouth and are very ideal "mommy track" jobs. In general, if you ask people will tell you they don't exist, but they plainly do exist. Try to start by developing relationships with a broad range of people in your network. People who get them are usually muted about them because they are so desirable. I know someone very well who got one of those jobs.

Huh? You can get a job like this any day of the week. Any school of medicine will hire you as an MD with a pulse on the clinician-educator track to see patients for a below-market salary. Then you just go out there and apply for funding. It's no harm no foul from the point of view of the university. If you get your grants, good for all concerned and you can have whatever time you can buy. If you don't get your grants, no skin off their nose, they'll just fill out all your time with patients.

It only works if your research is clinical/translational, not if you're trying to run your own basic science lab. That requires institutional commitment, which is indeed scarce and hard to find; and the time commitment required to keep a basic science lab running precludes you from doing more than a token amount of clinical care.

 

[deleted728364]

It's no harm no foul from the point of view of the university. If you get your grants, good for all concerned and you can have whatever time you can buy. If you don't get your grants, no skin off their nose, they'll just fill out all your time with patients.

My understanding from a recent thread was that med schools/hospitals are averse to their faculty getting K-awards (therefore harder to get an R01) because they’ll generate less $$ compared to being a full-time clinician?

Or that only a challenge for basic science investigators?

 

[Fencer]

While some of the aversion to K's is geographical (worst at coasts), mostly is seen at high revenue specialty departments as compared to traditional IM/Peds/Neuro/Path that value the path for its relative success rate...

Another possibility is consider the VA Medical Centers.... your clinical time is limited, and the VA Merit Awards are a great source of support similar to R01s.

 

[dl2dp2]

Huh? You can get a job like this any day of the week. Any school of medicine will hire you as an MD with a pulse on the clinician-educator track to see patients for a below-market salary. Then you just go out there and apply for funding. It's no harm no foul from the point of view of the university. If you get your grants, good for all concerned and you can have whatever time you can buy. If you don't get your grants, no skin off their nose, they'll just fill out all your time with patients.

Well ... depending on how "below-market" we are talking about lol. I'm talking about a nice little 50% protected research time job that still pays 100% academic clinician level salary (albeit much lower than full-time PP situation), ad infinitum with no contracted obligation of increasing clinical load should you be unsuccessful in attracting your own grants (within any stipulated certain time frame).

These are usually called "hard money" part-time research jobs. I don't think they are easy to find. They exist--usually in VA/State mental health systems, some federal and private hospitals. They also exist in academia but you have to be "tenured", which typically means you will probably bring in enough external grants to cover your salary anyway.

I'm not talking about clinician-educator track where they give you protected research time that is still floated by soft money.

 

[tortuga87]

So the life of a researcher in psychiatry is to essentially work part time private practice (so you can get paid reasonably) and part time grant writing. Waste two years trying to convince a committee of picky old dudes to vote in your favor (instead of actually doing the science) so that one day a grant sticks. You then hire some labor and use their work to try to convince the committee of old dudes again. Repeat. Sounds stupid tbh, but I guess this is modern day science

 

[dl2dp2]

So the life of a researcher in psychiatry is to essentially work part time private practice (so you can get paid reasonably) and part time grant writing. Waste two years trying to convince a committee of picky old dudes to vote in your favor (instead of actually doing the science) so that one day a grant sticks. You then hire some labor and use their work to try to convince the committee of old dudes again. Repeat. Sounds stupid tbh, but I guess this is modern day science

You got it! And one day you'll be one of the old dudes on the committee!

Practice need not be private. Academic medical centers have lots of clinical roles you can pick and choose, if you don't want to manage a business. The process is stupid--the content is generally not. The grants are genuinely very difficult to write without the right mix of knowledge/skills, and this is especially apparent if your research is translational in nature. That said, study sections often have biases AGAINST translational science.

This takes a lot of work--based on cocktail party conversations at conferences, successful MD/PhDs are very often work very very hard post residency (12 hours days 6 days a week). Imagine submitting 3-5 6-12 page grants per year, plus 50 pages of support paperwork (budget, etc), plus 1-3 primary papers, 3-5 collaborative papers, 2 conferences. Your life is basically one of writing and presentation. The rest is managing teams to do the actuals science and administrative work. On a per hour basis the science work really pays paltry vs. PP. It's almost entirely absurd.

Actual scientific skills appear to be a commodity that's easier to buy. The managerial/fundraising aspect seems to be the bottleneck that benefits from the combined degree and subsequent training pathways (i.e. "research track residency")... often deliverables are very explicit in research track programs--i.e. a grant.

 

[deleted728364]

That said, study sections often have biases AGAINST translational science.

Interesting, I assumed that translational science is more valued. After all, you’re showing how insights from basic science can be applied to help patients.

 

[tortuga87]

You got it! And one day you'll be one of the old dudes on the committee!

Practice need not be private. Academic medical centers have lots of clinical roles you can pick and choose, if you don't want to manage a business. The process is stupid--the content is generally not. The grants are genuinely very difficult to write without the right mix of knowledge/skills, and this is especially apparent if your research is translational in nature. That said, study sections often have biases AGAINST translational science.

This takes a lot of work--based on cocktail party conversations at conferences, successful MD/PhDs are very often work very very hard post residency (12 hours days 6 days a week). Imagine submitting 3-5 6-12 page grants per year, plus 50 pages of support paperwork (budget, etc), plus 1-3 primary papers, 3-5 collaborative papers, 2 conferences. Your life is basically one of writing and presentation. The rest is managing teams to do the actuals science and administrative work. On a per hour basis the science work really pays paltry vs. PP. It's almost entirely absurd.

Actual scientific skills appear to be a commodity that's easier to buy. The managerial/fundraising aspect seems to be the bottleneck that benefits from the combined degree and subsequent training pathways (i.e. "research track residency")... often deliverables are very explicit in research track programs--i.e. a grant.

Damn... too much unenjoyable work there. Rather just do private practice and write 1-3 primary papers per year. Good luck for those who want to become research faculty. I think I’ll just do private practice and work as a scientist with a PI, at an institute or in industry at this point.

Probably will have more scientific expertise than the PI plus be buddies with him after several years anyways, so he will likely let me do whatever I wanted within reason so long as productivity didn't stall. Also will work less and make more money than the PI by growing a private practice + investing well.

 

[dl2dp2]

Damn... too much unenjoyable work there. Rather just do private practice and write 1-3 primary papers per year. Good luck for those who want to become research faculty. I think I’ll just do private practice and work as a scientist with a PI, at an institute or in industry at this point.

Probably will have more scientific expertise than the PI plus be buddies with him after several years anyways, so he will likely let me do whatever I wanted within reason so long as productivity didn't stall. Also will work less and make more money than the PI by growing a private practice + investing well.

You are 100% on the ball. This is not uncommon a career pathway in this field, especially for primary childcarer (this may be more relevant to OP), especially if you are willing to work part time as a study physician. You'll likely be able to get put on grants as Co-Is and get paid anywhere between 50-100k for ~50% FTE. It might even come with benefits. It's definitely not enough to fatFIRE, but it's not chump change either. If "your boss" the PhD PI sees that you write things relatively fast, they'll float you. Meanwhile, you grow your practice and 10-15 years out you'll be a million or two wealthier, at a minimum, than "your boss" will ever be, and nobody will know.

 

[CheGuevaraMD]

You are 100% on the ball. This is not uncommon a career pathway in this field, especially for primary childcarer (this may be more relevant to OP), especially if you are willing to work part time as a study physician. You'll likely be able to get put on grants as Co-Is and get paid anywhere between 50-100k for ~50% FTE. It might even come with benefits. It's definitely not enough to fatFIRE, but it's not chump change either. If "your boss" the PhD PI sees that you write things relatively fast, they'll float you. Meanwhile, you grow your practice and 10-15 years out you'll be a million or two wealthier, at a minimum, than "your boss" will ever be, and nobody will know.

I mean...I think this is a bit rosy. Being a successful business owner AND a successful Co-I is pretty hard. I have seen this combination more with employed or associate physicians, especially if the market is competitive.

 

[StilgarMD]

You are 100% on the ball. This is not uncommon a career pathway in this field, especially for primary childcarer (this may be more relevant to OP), especially if you are willing to work part time as a study physician. You'll likely be able to get put on grants as Co-Is and get paid anywhere between 50-100k for ~50% FTE. It might even come with benefits. It's definitely not enough to fatFIRE, but it's not chump change either. If "your boss" the PhD PI sees that you write things relatively fast, they'll float you. Meanwhile, you grow your practice and 10-15 years out you'll be a million or two wealthier, at a minimum, than "your boss" will ever be, and nobody will know.

I always wonder how such things work when it comes to "being the scientist" though. Like are you a senior author on papers? Do you go to conferences and present? Do you "get credit" for the work, and maybe leverage this into running an independent group later? When you're the PI Its clear you're the senior author, you have to get grants/pay the bills, but in the situation @tortuga87 describes, I haven't seen much of that.

 

[tortuga87]

I always wonder how such things work when it comes to "being the scientist" though. Like are you a senior author on papers? Do you go to conferences and present? Do you "get credit" for the work, and maybe leverage this into running an independent group later? When you're the PI Its clear you're the senior author, you have to get grants/pay the bills, but in the situation @tortuga87 describes, I haven't seen much of that.

I reckon it is like a long-term post doc position. You focus mainly on first author papers. You get credit just as you would in a post doc. You switch between PIs over the years according to their lab materials and your expertise. You can go to conferences/present if you want, although I think it is best to minimize this part because it often does not directly lead to discoveries.

A normal PI works say 60 hours per week minimum. Substitute their time spent writing grants + admin stuff + teaching with direct clinical work in your own private practice, preferably cash only with everything as automated as possible. Work 30 hours private practice, the rest do research in the lab. Learn how to passively invest well in the stock market (to beat the S&P500) and real estate to effectively boost your clinic hours to 35 hours. Try to be the best psychiatrist in town so you get good referrals; this means being really good with therapy in addition to medications. Do not live in places like New York, San Francisco or LA with lots of taxes, expenses and/or competition.

 

[dl2dp2]

Do not live in places like New York, San Francisco or LA with lots of taxes, expenses and/or competition.

Not sure if this is true. The ceiling in PP is much higher in larger markets. It's not all that rare to have PP psychiatrist make 1M+ in bigger markets. In that way you'd FIRE much faster than if you went all out to the boonies.

 

[StilgarMD]

I reckon it is like a long-term post doc position. You focus mainly on first author papers. You get credit just as you would in a post doc. You switch between PIs over the years according to their lab materials and your expertise. You can go to conferences/present if you want, although I think it is best to minimize this part because it often does not directly lead to discoveries.

A normal PI works say 60 hours per week minimum. Substitute their time spent writing grants + admin stuff + teaching with direct clinical work in your own private practice, preferably cash only with everything as automated as possible. Work 30 hours private practice, the rest do research in the lab. Learn how to passively invest well in the stock market (to beat the S&P500) and real estate to effectively boost your clinic hours to 35 hours. Try to be the best psychiatrist in town so you get good referrals; this means being really good with therapy in addition to medications. Do not live in places like New York, San Francisco or LA with lots of taxes, expenses and/or competition.

I guess with this elongated post doc you'd be applying for funding until it worked out? So its basically a more financially secure part time post doc? Seems like you'd need air tight time management or a really good lab environment to make it happen while working half the time other post docs are, right?

 

[tortuga87]

I guess with this elongated post doc you'd be applying for funding until it worked out? So its basically a more financially secure part time post doc? Seems like you'd need air tight time management or a really good lab environment to make it happen while working half the time other post docs are, right?

You can, but I don't see a reason why you would want to apply for funding. The only reason I can see the need to become a PI is for a sense of prestige which is immaterial at the end of the day. It seems that being a "forever half post doc" (FHPD) as described above is better if you like clinical work and research because the PI route has many other responsibilities like grant writing, teaching, meetings, etc. If those extra responsibilities are not enjoyable to you, then FHPD seems to be a better way to structure your career assuming compensation for psychiatry does not radically change.

 

[tr]

You can, but I don't see a reason why you would want to apply for funding. The only reason I can see the need to become a PI is for a sense of prestige which is immaterial at the end of the day. It seems that being a "forever half post doc" (FHPD) as described above is better if you like clinical work and research because the PI route has many other responsibilities like grant writing, teaching, meetings, etc. If those extra responsibilities are not enjoyable to you, then FHPD seems to be a better way to structure your career assuming compensation for psychiatry does not radically change.

Separate from the question of whether one would want to be a part-time clinician in private practice while being a part-time permanent postdoc, I don't see why any PI would want a permanent part-time postdoc in their lab. Part-time people are a headache because they cannot maintain projects that require daily oversight (like feeding cell lines, monitoring time points on multi-day experiments, etc), and may end up leaning on others for help with these types of responsibilities. Also PIs are incentivized to mentor future effective scientists so they can expand their network and demonstrate prestige by seeding other successful investigators. Someone who is expressly never going to attempt to move to PI level, and also cannot be a permanent Research Scientist-level uber-tech (because they are only part time, and therefore aren't useful as experienced support people for other lab members), doesn't seem like a good person to have around.

On the part of the FHPD, I think eventually this would seem stifling. Why spend half your time being paid 1/5 the salary you get the rest of the time in order to be a permanent lackey working on someone else's projects? It seems like you would eventually reach the point where you would want to ask your own research questions, or at least you'd get sick of sacrificing so much income to support someone else's research program.

 

[tortuga87]

Separate from the question of whether one would want to be a part-time clinician in private practice while being a part-time permanent postdoc, I don't see why any PI would want a permanent part-time postdoc in their lab. Part-time people are a headache because they cannot maintain projects that require daily oversight (like feeding cell lines, monitoring time points on multi-day experiments, etc), and may end up leaning on others for help with these types of responsibilities. Also PIs are incentivized to mentor future effective scientists so they can expand their network and demonstrate prestige by seeding other successful investigators. Someone who is expressly never going to attempt to move to PI level, and also cannot be a permanent Research Scientist-level uber-tech (because they are only part time, and therefore aren't useful as experienced support people for other lab members), doesn't seem like a good person to have around.

On the part of the FHPD, I think eventually this would seem stifling. Why spend half your time being paid 1/5 the salary you get the rest of the time in order to be a permanent lackey working on someone else's projects? It seems like you would eventually reach the point where you would want to ask your own research questions, or at least you'd get sick of sacrificing so much income to support someone else's research program.

I think the amount of money you would make from a post-doc position would be very little compared to what you make in private practice, so you will essentially work with a PI for free. You get equipment to carry out your ideas and the PI gets publications. Yes, you cannot run those very intensive experiments that require you to monitor things multiple times every day (unless you block out that time when the need arises), but there are still many other experiments that you can run. Keep in mind that by the time you are FHPD, you are far more efficient than any grad student and more efficient than a typical post doc just because you have been at the bench for so long.

As for the second point, I guess some PIs actually work this way, although I have not encountered one. I have never been handed a project because that would be very boring. Usually, I approach a PI who does similar work with a project in mind already, he/she asks if I can really pull it off with his/her resources, and then we do it.

 

[dl2dp2]

On the part of the FHPD, I think eventually this would seem stifling. Why spend half your time being paid 1/5 the salary you get the rest of the time in order to be a permanent lackey working on someone else's projects? It seems like you would eventually reach the point where you would want to ask your own research questions, or at least you'd get sick of sacrificing so much income to support someone else's research program.

LOL, I find it amusing that people would seriously consider doing wet lab science for free. The only thing I like about science is writing grants. I find the actual execution of the science to be, in general, tedious and unfulfilling, and compare poorly with clinical work, which, while can also be repetitive, has a very visceral sort of satisfaction, not to say the $ per hour factor. OTOH, I find the process of writing grants to be similar to writing fiction--you also learn a lot of random junk while you write grants and in some detail, which makes you feel smarter even when you aren't. Writing a paper is somewhat less satisfactory but still better than actually doing the work itself. Process of result accumulation in dry lab/clinical trial are somewhat better than just pure wet lab work, but I still find it way more "stifling" than the presentation and organization of the results and the articulating of a vision.

The unpleasant part of scientific writing has to do with 1. deadlines. 2. people who write faster than you. 3. rejections of various sorts. These things can be made psychologically easier to bear if you make a lot of money otherwise or have a hard money position.

 

[tr]

As for the second point, I guess some PIs actually work this way, although I have not encountered one. I have never been handed a project because that would be very boring. Usually, I approach a PI who does similar work with a project in mind already, he/she asks if I can really pull it off with his/her resources, and then we do it.

Where is your salary coming from?

If you are a postdoc whose salary is paid by the PI, then your salary comes from a particular grant, usually a research project grant, and you need to show progress on whatever that grant was for. If you can do other work on the side that's great, nobody is ever going to tell you to work less vs more.

If you are approaching a PI for collaboration with your own grant in hand and your salary covered, then that definitely gives you more freedom. But if it is a fellowship grant it is time limited, usually max 1-2 years, definitely not something that can be extended for many years.

If it is a research project grant then you are not a postdoc, but a collaborator. At that point it starts to make very little sense to actually do your wet-lab work with your own hands, because your salary is so high that it will overwhelm your grant budget if you try to pay yourself to do such time-intensive work.

 

[tortuga87]

So I guess this FHPD idea is getting ripped apart here. Seems like there is a lot of "but no PI would want you because of X, Y, Z." We should be more open minded about other ways to do science than being a PI. I just want to make money doing clinical work + investments, and make cool discoveries by directly doing science. I do not like writing grants/fiction, managing, teaching or prestige because they suck away time from clinical work + science. I'm sure I'm not the first one to be in this predicament, but it sure seems like I am from Mars!

Psychiatry is special because you can create a profitable private practice much more easily than other specialties. This can provide an income source for science. This is not about FIRE or bathing in dollar bills because I would just shuttle all of the extra money into more science anyways.

What are some "creative" options for being a good scientist while avoiding the politics/bureaucracy of academia? Maybe I'll just make a lab in my basement, but then I'll get the "No, that only worked 100 years ago. People have to collaborate now."

 

[tr]

So I guess this FHPD idea is getting ripped apart here. Seems like there is a lot of "but no PI would want you because of X, Y, Z." We should be more open minded about other ways to do science than being a PI. I just want to make money doing clinical work + investments, and make cool discoveries by directly doing science. I do not like writing grants/fiction, managing, teaching or prestige because they suck away time from clinical work + science. I'm sure I'm not the first one to be in this predicament, but it sure seems like I am from Mars!

Psychiatry is special because you can create a profitable private practice much more easily than other specialties. This can provide an income source for science. This is not about FIRE or bathing in dollar bills because I would just shuttle all of the extra money into more science anyways.

What are some "creative" options for being a good scientist while avoiding the politics/bureaucracy of academia? Maybe I'll just make a lab in my basement, but then I'll get the "No, that only worked 100 years ago. People have to collaborate now."

I think if you want to ditch academia altogether and be an independently funded gentleman scientist, that is actually more practicable than trying to torque the academic-industrial complex to your will. System gonna system; if you want to do something else, I'd suggest you bypass the system completely vs trying to make it fit your needs.

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[dl2dp2]

What are some "creative" options for being a good scientist while avoiding the politics/bureaucracy of academia? Maybe I'll just make a lab in my basement, but then I'll get the "No, that only worked 100 years ago. People have to collaborate now."

The lifestyle you are talking about is potentially doable and as I said above, these jobs, while rare, do exist. They are in this rubric of hard money positions where the hard money is stipulated to "research", but are not allocated to a particular project grant. I'm not as negative as @tr, who may have not seen these jobs. They are often associated with core facilities, VAs, state and municipal salary lines, large non-profits and other "non-traditional" entities. They also exist in universities after tenure in the form of endowed chairs--an example of this would be things like sabbaticals, etc. made famous by people like Sydney Brenner, but obviously you don't want to get to point B from point A, you want to get to point B directly bypassing point A.

I'm assuming that you are not talking about "doing science" in the sense of pipetting like an RA or first year grad student but more like maintaining complex instruments or running and developing complicated protocols and so forth. These things can be feasible as part of someone else's R01 with you as a Co-I, if you tell the PI you'll do X Y Z and they are convinced they can put you in. In one of the previous labs I worked in, there are FHPDs who do this kind of work and seem to be a fixture while the traditional full time postdocs come and go. They also get on papers but not as a first author. On occasion they get a first author method paper if they feel motivated. Is this the model you describe?

Hard core methodologists and engineers eventually get their own R01s and become collaborators rather than employees. This doesn't jive with your "I don't want to write grant" ethos. Some clinical faculty end up becoming very senior without PIing many grants, typically being administrators on U54s and other large cooperative agreements. This doesn't jive with your "I don't want to admin" ethos either....

Still, as good as FHPD might be, there are real limitations when you are just one skilled person. Even if your however low salary is taken care of, there's equipment, support, indirects, blah blah. so even if you lucked into such a position, if you want do take a project from start to finish, you typically still need to file external support. But this you can do at a somewhat leisurely pace.

 

[CheGuevaraMD]

So I guess this FHPD idea is getting ripped apart here. Seems like there is a lot of "but no PI would want you because of X, Y, Z." We should be more open minded about other ways to do science than being a PI. I just want to make money doing clinical work + investments, and make cool discoveries by directly doing science. I do not like writing grants/fiction, managing, teaching or prestige because they suck away time from clinical work + science. I'm sure I'm not the first one to be in this predicament, but it sure seems like I am from Mars!

Psychiatry is special because you can create a profitable private practice much more easily than other specialties. This can provide an income source for science. This is not about FIRE or bathing in dollar bills because I would just shuttle all of the extra money into more science anyways.

What are some "creative" options for being a good scientist while avoiding the politics/bureaucracy of academia? Maybe I'll just make a lab in my basement, but then I'll get the "No, that only worked 100 years ago. People have to collaborate now."

Get into software if at all possible. That's the only field remaining where you can live out your engineering/"science" dream of tinkering by yourself and eventually producing a product that may be of use to people.

Science in a large part is the writing -- you aren't producing a product, but you are documenting your hypothesis (grant writing) and then disseminating your results (publishing in journals). Both activities are heavily peer-reviewed so you can't "do science on your own."

Tinkering isn't science, but sort of amateur-ish engineering. Which is fine, but difficult to do outside of software these days.

 

[tr]

I'm not as negative as @tr, who may have not seen these jobs. They are often associated with core facilities, VAs, state and municipal salary lines, large non-profits and other "non-traditional" entities. They also exist in universities after tenure in the form of endowed chairs

I never said hard money didn't exist. It's hard to get but not non-existent. Obviously the classic University type tenured position is hard money based, though those are much more rare in biomedicine now vs the soft-money model.

But not hard money for permanent postdoctoral positions. That I have not seen. The closest is these Research Scientist type people who make a career out of being right-hand man to a well funded PI. They don't stay postdocs though (I actually think it is expressly disallowed to keep people in training positions forever), and you couldn't do it part time because you just wouldnt be very useful to the lab that way.

Correct me If I'm wrong, but I don't think @tortuga87 was envisioning churning out FACS or GC/MS data or managing neuroimaging data acquisition in a core facility either. It sounded like s/he was interested in asking scientific questions, not assisting others to do so. If that's the case, there's just no way around needing control of a funding stream.

 

[kepler16b]

I never said hard money didn't exist. It's hard to get but not non-existent. Obviously the classic University type tenured position is hard money based, though those are much more rare in biomedicine now vs the soft-money model.

But not hard money for permanent postdoctoral positions. That I have not seen. The closest is these Research Scientist type people who make a career out of being right-hand man to a well funded PI. They don't stay postdocs though (I actually think it is expressly disallowed to keep people in training positions forever), and you couldn't do it part time because you just wouldnt be very useful to the lab that way.

Correct me If I'm wrong, but I don't think @tortuga87 was envisioning churning out FACS or GC/MS data or managing neuroimaging data acquisition in a core facility either. It sounded like s/he was interested in asking scientific questions, not assisting others to do so. If that's the case, there's just no way around needing control of a funding stream.

It would be interesting if there were "research scientist" positions for physician-scientists.

 

[StilgarMD]

Get into software if at all possible. That's the only field remaining where you can live out your engineering/"science" dream of tinkering by yourself and eventually producing a product that may be of use to people.

Science in a large part is the writing -- you aren't producing a product, but you are documenting your hypothesis (grant writing) and then disseminating your results (publishing in journals). Both activities are heavily peer-reviewed so you can't "do science on your own."

Tinkering isn't science, but sort of amateur-ish engineering. Which is fine, but difficult to do outside of software these days.

My hope of even making such a thing possible would be through developing really deep data analysis skills and playing w/ publicly available or otherwise acquired data sets. There is a world of "Neural Data Science" emerging which seems like a much better means of staying "close to the science" without the tedium of actual bench work, but a good deal of excitement and thinking about things. Also if you know how to analyze big Neuroimaging, calcium imaging, or spiking data sets, seems like you'd be useful to many groups in a flexible way where you could be a clinical to cover yourself and do real 'science' on the side. Given I'm really interested in Psych, this is something I'm keeping in mind. but echoing what @tr and @sluox have said, it seems neither desirable nor feasible to just be an research tech for the rest of your scientific career.

@tortuga87 when you say "make cool discoveries by directly doing science", wouldn't something bother you about grinding out a ton of work, keeping up on the literature, and finding something cool only for someone else to go around presenting your findings? The communal aspect of science is essential to my desire to do it, and the idea that I can collaborate closely and train grads/post docs while also thinking about interesting problems is why I'd fight to stay involved at all. I'm a fan of the idea of floating your own salary with clinical work, but I view that as managing the floor (i.e. I can't get eliminated from the game for a bad funding cycle), butI'd still want to have a high ceiling (opportunities to get independent funding, run lean lab setup via studying something relatively cheap to study with open source everything).

 

[dl2dp2]

It sounded like s/he was interested in asking scientific questions, not assisting others to do so. If that's the case, there's just no way around needing control of a funding stream.

You can control by influence. I know of examples where the "research scientist"/"research assistant professor" was never a PI on any grants, but is able to convince the study PI to do research in a certain way, and eventually be main authors on key papers. That can be a path forward, but you are right highly unusual. Salary support is an administrative hurdle that's somewhat orthogonal to the control factor.

My hope of even making such a thing possible would be through developing really deep data analysis skills and playing w/ publicly available or otherwise acquired data sets. There is a world of "Neural Data Science" emerging which seems like a much better means of staying "close to the science" without the tedium of actual bench work, but a good deal of excitement and thinking about things. Also if you know how to analyze big Neuroimaging, calcium imaging, or spiking data sets, seems like you'd be useful to many groups in a flexible way where you could be a clinical to cover yourself and do real 'science' on the side. Given I'm really interested in Psych, this is something I'm keeping in mind. but echoing what @tr and @sluox have said, it seems neither desirable nor feasible to just be an research tech for the rest of your scientific career.

It's not easy to do even for software. There are R01s for secondary analyses of large public datasets, and PIs who occupy those grants will be recognized as experts to do this work. It's also more plausible if you develop a relationship with the consortium that acquires this data in the first place--it'll be difficult for you to even understand the data without input from study investigators. You also don't need to do this work for free. There have always been many active career and project, and even massive center grants and cooperative agreements for methodological development, modeling, etc.. It'll be difficult for you to develop credibility for "data analysis skills" as a "gentleman scientist"--you'll do a lot of work, some of which may even be highly valuable, but it'll not be appropriately recognized. It's also common to "step on people's toes", duplicate effort without coordination. This is why people just constantly judge you based on your biosketch. On the other hand, when you have a relationship, money just pops up without even an explicit application via things like administrative supplements and budget revisions. Do you really think it's hard for senior people to find money for your 50% FTE when the trial costs 50-100M? What is credibility but a bunch of people know who you are and what you do? But in order to develop relationships, you'll soon find that the easiest way is through existing institutional pathways, get a fellowship, write some papers, write a K, declare yourself as an expert in data science of X neural data, then apply for bigger grants, etc. etc. This is what "the system is gonna system" means. If you find this process intolerable, it won't be solved just because you transitioned your science from wet to dry, from animals to humans, or any of that.

Technical skills are a commodity because the training can be scaled. Entry-level data analysis skills are cheaper now, given the millions of coding schools and bootcamps that are popping up, and you are competing with a large pool of new PhD grads in an actual quantitative field, if you don't have that. If you are talking about entry-level technical skills, MD skills are [again] more valuable. Depth, which typically considers both soft and hard skills, cannot be scaled and is what's actually valuable.

It's the same in any industry. In the 80s maybe you can be a high school drop out and sell your software to Microsoft for millions, but these days it's more reliable to be a L7 Amazon engineer for 500k a year. What do you think an L7 at Amazon does? Not writing Python code--it's meetings to write documents similar to an R01 application: product development plan, timelines, aims, milestones, deliverables, budget, blah blah and then MANAGE their coders to actually write the code, once it's shopped by a committee of people in charge of the money. Many such proposals get turned down. What do you think a director of clinical development at a big pharma does? Same thing. Generating documents to be read by people who read documents and make a decision about money, and then do more writing to formalize the process where the CRO does the "on the ground" work for you. LOL I don't know why people are so against being middle management. I think I'm just getting old...

 

[tortuga87]

It'll be difficult for you to develop credibility for "data analysis skills" as a "gentleman scientist"--you'll do a lot of work, some of which may even be highly valuable, but it'll not be appropriately recognized.

when you say "make cool discoveries by directly doing science", wouldn't something bother you about grinding out a ton of work, keeping up on the literature, and finding something cool only for someone else to go around presenting your findings?

I think it's fine to be ignored/devalued/criticized, so long as you are compensated clinically and can publish papers with your name.

I think the main issue with secondary analyses is access to the data. My understanding is that things like the NIMH Data Archive are inaccessible unless you are affiliated with an institution (although I would have to look into the details more carefully). It seems like a gentleman data scientist route would be great, so long as you had access to datasets. The only problem would be how to maintain a weak affiliation for many years which I would probably need to figure out on a case by case basis.

I don't know why people are so against being middle management.

The problem is not with the idea of middle management per se, but just that the job focuses too much on obtaining grants in recent years. PIs used to write grants every now and then for larger scale projects, but they now focus on writing multiple per year, and they are very competitive to get. Most people end up burning out even if they get their first R01. The compensation for clinical work in (most) academic centers is also extremely low. People are overworked with reviewing, administration and teaching such that they have little time to actually carry out the research themselves. The coveted 80-20 does not mean 80 in the lab & 20 in the clinic but rather 10 in the lab, 20 in the clinic & 70 other stuff.

I understand that some people view teaching grad students and obtaining grants as part of research, and it is in a secondary way, but I rather enjoy doing the actual bench work itself. Some PIs also seem to think that bench work is "beneath them" in the sense that it is for grad students and they already know basically everything "about pipetting." The reality is that science is hard all the time, and you gradually get better over many years but never achieve mastery because mother nature does not care what you think.

I just believe it would be better if we could structure say 50 in the lab & 50 in the clinic using an alternative route, instead of being kicked out of research entirely.

 

[dl2dp2]

I think the main issue with secondary analyses is access to the data. My understanding is that things like the NIMH Data Archive are inaccessible unless you are affiliated with an institution (although I would have to look into the details more carefully). It seems like a gentleman data scientist route would be great, so long as you had access to datasets. The only problem would be how to maintain a weak affiliation for many years which I would probably need to figure out on a case by case basis.

Administratively, this is easy to overcome. Many ways to maintain a "weak affiliation" with institutions by volunteering in various ways to locum a small amount. One obvious way to do this is to register your own research institute or find someone else's small research institute and piggy back on that.

Scientifically, if it's only as easy as downloading a bunch of CSV files from the Data Archive. Without domain expertise, it's difficult to understand the data dictionary, let alone the right way to fill missing data, harmonize data, develop new analytic methods, modeling, etc. Existing R01s doing this kind of work have budget comparable to wet lab research. It's like saying oh if I downloaded all the ImageNet I can just run my own Google, because all I need is a $2000 NVidia GPU rather than a $2M two photon microscope. No, people who only worked in wet lab have an unrealistic sense of how dry labs work. For one thing, dry lab labor tends to be 30% more expensive. For another, on a technical level it's actually typically more difficult for wet to dry transition than the other way around--it's difficult for someone, even very smart people, over the age of 30 to re-entry into a career that involves relearning serious mathematics--which means this aspect of the work needs to be hired out. Many personal examples. People who transition successfully typically have reasonable existing formal background during their PhD. MDs who enter wet lab research during residency can be viewed as a form of dry to wet transition, and that happens at some much more frequent basis.

I understand that some people view teaching grad students and obtaining grants as part of research, and it is in a secondary way, but I rather enjoy doing the actual bench work itself. Some PIs also seem to think that bench work is "beneath them" in the sense that it is for grad students and they already know basically everything "about pipetting." The reality is that science is hard all the time, and you gradually get better over many years but never achieve mastery because mother nature does not care what you think.

I don't think your assumptions are correct. It's not hard to get a job to do 50% lab work and get paid some low amount for that work. But you won't have control over the kind of lab work you do. As a PI you can do any amount of lab work you want to do--you have 100% control. The aspect of having control comes, ultimately, from controlling funding streams. What you can't have is having control AND getting paid a low salary doing lab work, because that's viewed as being inefficient in any kind of corporate environment, which academia is just one form thereof. Many people enjoy work that's of lower monetary value and still require a lot of skills (i.e. playing musical instrument, etc) but it's in general not possible to have an arbitrary cut of arrangement of that in a *corporate* environment, except in specific instances (i.e. government, etc.)

Finally, given that you haven't written many grants, it's premature to say that you'll only enjoy doing bench work and not enjoy writing grants. The point of a fellowship is such that you get paid to devote a portion of your life to try to write grants and see if you like it. During my 2nd year of fellowship I wrote 8 grants. The more you do something the better you get and more you'd enjoy it. And while it is true grants are hard to get, if you write 3 NIH grants a year for 5 years and a reasonable mentorship team to shop it it is almost certain that you'll survive in academia. People who work 70 hours a week write WAY more than 3 grants a year and have above average hit rate. It's like baseball--the difference between the very best and average is a small change in hit rate.

 

[tortuga87]

Administratively, this is easy to overcome. Many ways to maintain a "weak affiliation" with institutions by volunteering in various ways to locum a small amount. One obvious way to do this is to register your own research institute or find someone else's small research institute and piggy back on that.

Scientifically, if it's only as easy as downloading a bunch of CSV files from the Data Archive. Without domain expertise, it's difficult to understand the data dictionary, let alone the right way to fill missing data, harmonize data, develop new analytic methods, modeling, etc. Existing R01s doing this kind of work have budget comparable to wet lab research. It's like saying oh if I downloaded all the ImageNet I can just run my own Google, because all I need is a $2000 NVidia GPU rather than a $2M two photon microscope. No, people who only worked in wet lab have an unrealistic sense of how dry labs work. For one thing, dry lab labor tends to be 30% more expensive. For another, on a technical level it's actually typically more difficult for wet to dry transition than the other way around--it's difficult for someone, even very smart people, over the age of 30 to re-entry into a career that involves relearning serious mathematics--which means this aspect of the work needs to be hired out. Many personal examples. People who transition successfully typically have reasonable existing formal background during their PhD. MDs who enter wet lab research during residency can be viewed as a form of dry to wet transition, and that happens at some much more frequent basis.

I don't think your assumptions are correct. It's not hard to get a job to do 50% lab work and get paid some low amount for that work. But you won't have control over the kind of lab work you do. As a PI you can do any amount of lab work you want to do--you have 100% control. The aspect of having control comes, ultimately, from controlling funding streams. What you can't have is having control AND getting paid a low salary doing lab work, because that's viewed as being inefficient in any kind of corporate environment, which academia is just one form thereof. Many people enjoy work that's of lower monetary value and still require a lot of skills (i.e. playing musical instrument, etc) but it's in general not possible to have an arbitrary cut of arrangement of that in a *corporate* environment, except in specific instances (i.e. government, etc.)

Finally, given that you haven't written many grants, it's premature to say that you'll only enjoy doing bench work and not enjoy writing grants. The point of a fellowship is such that you get paid to devote a portion of your life to try to write grants and see if you like it. During my 2nd year of fellowship I wrote 8 grants. The more you do something the better you get and more you'd enjoy it. And while it is true grants are hard to get, if you write 3 NIH grants a year for 5 years and a reasonable mentorship team to shop it it is almost certain that you'll survive in academia. People who work 70 hours a week write WAY more than 3 grants a year and have above average hit rate. It's like baseball--the difference between the very best and average is a small change in hit rate.

Thanks, I did not realize you could set up your own research institute. That's great news.

I do feel for those who are stuck in the same situation but do not have a quantitative background. I fortunately kind of thought of this move and obtained a quantitative/computational PhD partially for this reason. Hopefully this can be visible to MD/PhD students choosing their PhD field.

I still think though that we are optimizing different objective functions. I am trying to maximize (1) money in my pocket + (2) time in the lab. Applying for hundreds of grants is an interesting hustle, but I think it is inefficient at getting money directly in your account because it is not scalable at the PI-level and very time consuming. Spending 2-3 years of your life in fellowship just to test if you enjoy writing grants so much that you can effectively replace (2) with a combination of grant writing, teaching, reviewing, etc. is asking a lot for a recent residency graduate who can otherwise grow his/her business rapidly due to patient demand. I mean... this tortuga87 guy is basically asking if there is a way he can work as a post-doc for free. That means he enjoys doing science a lot for the sake of science - i.e., living a 7 year old's idea of a scientist. Is grant writing really going to be that much funner? Unlikely. And worth 2-3 years on top of that? Even less likely.

 

[dl2dp2]

I still think though that we are optimizing different objective functions. I am trying to maximize (1) money in my pocket + (2) time in the lab.

It sounds like you are someone who is very keen on control. You want so much control that you'd be willing for free if you can control 100% the kind of work you do. You may enjoy private practice more--this really allows for 100% control, and practice has an element of trial and error, which feels a lot of times like working at the bench. Institutional work of any kinds requires losing control, being told what to do to extract value, etc. A decent number of psychiatry MD PhDs exiting at various stages of career go into full time PP with excellent results--sort of a rad onc for psych situation. There's also this "f u all, I'm gonna go and make f u money" thing going, which is understandable. This is actually somewhat less common with straight MD/T32 grads, who are more willing to take facility jobs.