surgery & real, good research possible?

[surgeon2b forev]

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What are your thoughts at being a real physician researcher? I mean... whereby physician=surgeon in our case?

AND, have a successful family?


I just spent a couple days at the NIH Year of research grant conference I received for my research year. Anyway, I was really surprised at how much motivation and excitement there are for physician researchs... everyone EXCEPT the surgeons. Whereas the infectious disease breakout room had like 5 students for every faculty, there were literally only two surgeons in our breakout room for about 60 of us. And one of them doesn't even operate anymore!

So is the only research surgeons are worth now a days Outcomes research, and being affiliated with real basic scientists?

thoughts?

 

[mitchconnie]

Some of the old-time surgeons may have done it, and some younger surgeons may claim to do both research and clinical well, but I doubt that it really happens. It's clearly a full-time job to be running a basic science lab and competing for NIH grants, and if you spend that much time running a lab, you won't be able to keep your operative skills sharp and be up-to-date on the latest surgical procedures.

It seems like most academic positions in surgery are either clinical or research track, although everyone is probably involved with a little of both. The clinical guys do most of the cases, write a few clinical papers and participate in clinical trials, while the research people work most of the time in the lab and maybe cover some call or have a niche practice that isn't very intense (like dialysis access).

 

[SocialistMD]

It is possible, but increasingly rare and difficult to do so. As mentioned before, surgeons are competing with medical physicians who only have clinical duties 1-2 months/year or just see patients once a week and PhDs who are in the lab full-time. The schedule of a surgeon does not allow such schedules if you plan to still operate. Most surgeons I have seen who are successful at this endeavour employ a full-time PhD to run their lab and have multiple grad students/residents working in their labs. The amount of research they actually do is (next to) none.

 

[surg]

This is possible, but you do have to make some sacrifices on at least 1 axis. If you want to operate 3 days a week and do the clinics (usually 2 days/wk) required to do that, then it's either research or family IMHO. If you are willinging to cut back your practice to ~1 day/wk clinic and ~1.5 day/wk in the OR, then research becomes possible while still maintaining a life.

A few caveats, if you want to do basic science, partnering with a PhD does make your life a lot easier, but I certainly know surgeons who still go it alone. You are competing on a difficult playing field, so you should play to your strengths. Tie your research to your clinical practice. The advantage that surgeons have is ready access to tissue and patients. The disadvantage is, your schedule is tougher and less predictable. Beyond that, if you choose to go the standard route of looking for NIH funding, the max NIH salary component is based off ~100k (a little higher now I think but still lower than the average surgeon salary). Thus, if you can get NIH to cover 75% of your salary via a grant, the department is actually down money unless you generate a good amount of money in the remaining 25% of your time via good clinical billing, OR your department doesn't care since the NIH is only kicking in ~75k for your 75% effort. This is different from non-surgeons who typically have lower average salaries (with some exceptions), and thus, it is easier to "buy back" their clinical time with research dollars and still get caught up by being efficient with their remaining clinical time.

 

[Pilot Doc]

Beyond that, if you choose to go the standard route of looking for NIH funding, the max NIH salary component is based off ~100k (a little higher now I think but still lower than the average surgeon salary).

Max NIH salary is just under $200K. $189 if I recall correctly. Still less than typical surgery faculty pay, though.

 

[Pilot Doc]

Some useful links




Long-term Outcomes of Performing a Postdoctoral
Research Fellowship During General Surgery Residency
Ann Surg. 2007 April; 245(4): 516–523.
PubMed



Recent trends in National Institutes of Health funding
of surgical research.
Ann Surg. 2002;236:277–286.
Pub Med