Tenture Track

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coarctation

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I have a question about a research career track in rad onc that I would appreciate anyone's input on.

From what I understand, in medicine, for those interested in a research tenure track, there are various young investigator grants for the first 3-5 years that will fund you for 50-75% research, and limit clinical time so you can start your research career. Eventually, the institution wants to see you can fund yourself, but the grace period is provided for those with promise of a successful academic career. This pertains to clinical and bench research.

Is it the same for radonc- or is it similar to surgical specialties where the concept of tenure as it pertains to research is different than other specialties? Surgeons will often get tenure without having major funding. Do you have anyone at your institution that has started out with >50% dedicated time to research, on a tenure track? Are they typically radiobiologists or pure bench guys? How are they being funded? From institutional grants or outside grants?
 
I've had several colleagues go into Rad Onc physician scientist careers. Even if you finish residency with a substantial grant (rare), it will not be enough to fully fund your own lab. Therefore, I've seen two good solutions to surmount this problem:

1. You become a glorified "post-doc" in a senior investigator's lab, which allows you to have strong mentorship and excellent resources to start. The upside is that you can/should be paid a full clinical salary, not a post-doc salary. After a couple of years in this situation, you should be ready to apply for more substantial funding and break off to form your own lab.

2. The department will provide you with sufficient start-up funds (~$1 mil) to start your own lab and hire a research assistant. You will get formal or informal mentoring from other faculty but you have more independence and autonomy than situation #1. Good Chairs will give you three years or so and you should have made substantial progress. You don't necessarily need an R-01 by then, because that's nearly impossible, but you have to show that you are at least capable of being independently funded.
 
In my opinion, the issue is more complex now than it was even 2-3 years ago. Finding a dept willing to give you a startup package is much harder now than it was a few years back. This actually parallels non-clinical departments many of which will really only strongly consider scientists with a K99/R00 or similar grant (~200K/yr x 3 years) and a number of which want you to have an R01 first.

Similarly, the glorified post-doc route carries it's own set of difficulties including the quite real possibility of NOT making a full clinical salary, but something in between and having to secure real funding (not necessarily R01, but more than a post-doc grant) before moving to a "tenure track" position.

Beware of whether your glorified "post-doc" will allow you to apply for post-doc grants and/or junior faculty grants. You may be frozen out of one or both due to a "lack of institutional commitment" which puts you squarely between the proverbial rock and hard place. Nearly all junior faculty grants I've looked at include the criteria "institutional commitment." Having your chair's letter say "we are fully committed to the career development of Dr. X.... We anticipate providing him with XX sq ft and $XXX as he transitions from mentored to independent position after obtaining funding" doesn't actually carry much weight.

Finally, depending on your institution, if you are put on the clinical/non-tenure track with the plan to transition to tenure track after 2-3 years, make sure you ask whether the initial time served is counted towards tenure. This can be quite difficult to find out but is a very appropriate question for the senior associate dean of research or other similar person within the university and/or medical school hierarchy.
 
You have to have good research skills, protects your ideas (don't let them become re-assigned by the "senior facaulty" and/or chair), work late into the night and endure little sleep. Starbucks helps. Motivate your team to be publication productive (buy their coffee). Only hire the most talented who do their own work - not ones who state they will farm it out to "core labs". Balance between holding your research funds tightly and investing in good R01 ideas. It never worked for me to do the co-PI thing on grants. If we won, they would keep all the money even if it was my work.
Good luck - it's worth it! You get to discover the future.
 
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