What do I do if I want to be a research psychiatrist?

[luckrules]

And what is this life like?

MS3 here, 90% sure I'm applying into psychiatry, been interested for a while. Like most, I came to this field for the opportunity to get to know people at a vulnerable point in their life, hear their story, and make a positive impact. However, the further I get into my learning, the more turned on I am by learning about the brain, basic science, and pharmacology that goes into it. The more I get into the clinical realm, the more excited I am about different treatment models, the nosology of psychiatric diagnoses, the opportunities to make an impact on a population level with community interventions.

I love psychiatry, I love psychiatric patients, and I love the science behind the field. But the idea of doing even 6 hours a day of therapy and med management seems dull (for me). I spoke with a researcher at my institution who works in brain imaging and treatment resistant depression, but also sees patients a couple hours a week. To me that seemed like the ideal job - getting to scratch both of my itches simultaneously. Insulated a bit from the hustle and bustle of patient's immediate needs, but not divorced from the drama and intimacy of clinical care. I don't yet have a specific research interest carved out, and I'm aware from the above paragraph that my interests span to broadly, from the molecular to the population level. But I guess it seems VERY exciting to me to be a part of advancing the science of mental illness.

I'm wondering how one actually goes about building a career like this, and how realistic it is. This researcher I spoke of earlier mentioned something called a K award, this is an early career grant that aspiring researchers apply for from the NIH. Obviously NIH funding is extremely competitive. If I am an MS3 now, when do I gain the actual concrete tools and experience to do this? Is there time built into residency, or can you create it? Fellowship? Do you do it after fellowship? When do you actually get paid (not trying to bring the level down, just being a real!)?

Anyway, just looking for some insight to see if this is possible. Appreciate the comments in advance.

---

Members don't see this ad.

 

[Bartelby]

An MD/PhD would have set you up best for success, but you could still make it happen without one. I would recommend getting involved in research during your MS-4 year, learning the basics and trying to do something you can publish. If you still are interested in a research career after that, choose a residency program that provides access to researchers and (ideally) protected time to conduct research. Start early with a close mentor, and be willing to put in substantial night/weekend work to build skills and a research portfolio. From there, you may be able to position yourself to win grants, which is what sustains tenure track researchers.

I should mention that I am not a researcher, so you should probably talk with those who are at your medical school in order to see how realistic such a route might be.

 

[luckrules]

An MD/PhD would have set you up best for success, but you could still make it happen without one. I would recommend getting involved in research during your MS-4 year, learning the basics and trying to do something you can publish. If you still are interested in a research career after that, choose a residency program that provides access to researchers and (ideally) protected time to conduct research. Start early with a close mentor, and be willing to put in substantial night/weekend work to build skills and a research portfolio. From there, you may be able to position yourself to win grants, which is what sustains tenure track researchers.

I should mention that I am not a researcher, so you should probably talk with those who are at your medical school in order to see how realistic such a route might be.

Is it fairly common for psych residencies to have protected research time, and does this add time to training? For instance I know that surgery programs often have an additional 2 years for research, but then you are training for 7 years. I guess I'm wondering whats common.

 

[Armadillos]

Several (many?) programs have research tracks with significant research time available Pgy3/4. I would look into those programs.

 

[splik]

There are multiple points where one can develop such a career but the sooner the better is the answer. It would be nigh impossible for someone without a PhD to do basic science research in this day and age so you will have to do a PhD at some point if you really want to succeed as a basic scientist. That might also be true for translational research. If you want to do clinical research then it is not necessary to have done a PhD though many have.

As mentioned above research can be classified as basic, translational or clinical. The three main sciences in psychiatry are neuroscience (imaging), genetics, and epidemiology. Within these fields there are other specialized areas too. Then there are some other less well traversed areas related to immunology, proteomics, social science, history,!ethics and philosophy too.

One can start getting involved in research before med school, during the first 2 years of med school, in the summers in preclinical years or extend between 3rd and 4th year to do research, do an MPH in biostats/epi etc or do an MS in neuroscience, translational research etc etc. there are some research fellowships at the school, state and national level available for med students to be funded. The NIH has small grants for students to do mentored research and there are some other competitive fellowships likeDoris Duke, Howard Hughes etc available but people who already have a significant track record would be in a better position. It is also possible to extend after 4th yr continuing in med student status but doing research before residency.

At the residency levels all major academic medical centers will encourage residents to be involved in research. Many have established research tracks that protect about 15mobths of time and fund your research endeavors. These may be through the match or you may apply once you match into your program to participate. Many good but less competitive research tracks go unfilled entirely every year (for example I don't think Wisconsin has EVER got a single person into their research track though they have great opportunities). The top programs may be highly competitive and would rather go unfilled than match someone not up to their standards in their research track.

You may also have the opportunity todo a PhD during residency. Mt Sinai has a specific program for this but a handful of residents elsewhere will opt to do a PhD. Bear in mind you need to apply separately to the PhD program and gain admission.

Following residency you can do a 1-3 yr research fellowship that maybe NIHT32 funded. They are usually not terribly competitive to get as few people end up going into research. There are other research fellowships nationally or with local funding available too.

One can also do a PhD following residency and start o the research track that way. This is fairly uncommon but not unheard of - the current UCSF psych chair did that and managed to become a successful psychiatric geneticist despite a late start.

Some academic departments may also allow you some protected time for research when starting off as clinical faculty and you can have a day a week to prepare for your Kaward as long as you are successful within a year or do. MIRECC VAs will also often allow protected time for research for you to apply for VA grants.

Bear in mind that most people who start down the academic route fail. They either tire of it or don't have what it takes. Given how anti science our current administration is expect funding to get even more difficult to get and the demise of medical research. Also bear in mindasjunior faxulty you will be often making MUCH less than if you did clinical work until you get funded and in general academics make less than their clinical colleagues. If you are highly successful, or become a dept chair, dean, administrator, are a successful grantsman or discover something than can be patented and marketed you can potentially make quite a bit (I.e. >500k) but expect to work for it and remember fewer than 1% of academics will be this successful not including the majority who fail before they get there.

You need an autistic focus on your interests in order to succeed and to put ina lot of work including weekends, evenings, sleepless nights etc particularly early on in your career in order to succeed allfor less pay (possibly substantially so) than being a clinician. But for those who have what it takes it can be a highly rewarding career pathway being at the forefront of science, being highly respected by your peers, and offers much narcissistic supply when your papers and grants apps get accepted, you are solicited for your expert opinion, when you win prestigious awards, are headhunted by institutions wanting to recruit you, serve as advisors on national and international task forces etc etc. You still have to navigate the toxic environment, petulant colleagues, professional jealousy and people out to ruin you (including potentially your own mentors). Lots of fragile egos coalesce in academia too

 

[luckrules]

There are multiple points where one can develop such a career but the sooner the better is the answer. It would be nigh impossible for someone without a PhD to do basic science research in this day and age so you will have to do a PhD at some point if you really want to succeed as a basic scientist. That might also be true for translational research. If you want to do clinical research then it is not necessary to have done a PhD though many have.

As mentioned above research can be classified as basic, translational or clinical. The three main sciences in psychiatry are neuroscience (imaging), genetics, and epidemiology. Within these fields there are other specialized areas too. Then there are some other less well traversed areas related to immunology, proteomics, social science, history,!ethics and philosophy too.

One can start getting involved in research before med school, during the first 2 years of med school, in the summers in preclinical years or extend between 3rd and 4th year to do research, do an MPH in biostats/epi etc or do an MS in neuroscience, translational research etc etc. there are some research fellowships at the school, state and national level available for med students to be funded. The NIH has small grants for students to do mentored research and there are some other competitive fellowships likeDoris Duke, Howard Hughes etc available but people who already have a significant track record would be in a better position. It is also possible to extend after 4th yr continuing in med student status but doing research before residency.

At the residency levels all major academic medical centers will encourage residents to be involved in research. Many have established research tracks that protect about 15mobths of time and fund your research endeavors. These may be through the match or you may apply once you match into your program to participate. Many good but less competitive research tracks go unfilled entirely every year (for example I don't think Wisconsin has EVER got a single person into their research track though they have great opportunities). The top programs may be highly competitive and would rather go unfilled than match someone not up to their standards in their research track.

You may also have the opportunity todo a PhD during residency. Mt Sinai has a specific program for this but a handful of residents elsewhere will opt to do a PhD. Bear in mind you need to apply separately to the PhD program and gain admission.

Following residency you can do a 1-3 yr research fellowship that maybe NIHT32 funded. They are usually not terribly competitive to get as few people end up going into research. There are other research fellowships nationally or with local funding available too.

One can also do a PhD following residency and start o the research track that way. This is fairly uncommon but not unheard of - the current UCSF psych chair did that and managed to become a successful psychiatric geneticist despite a late start.

Some academic departments may also allow you some protected time for research when starting off as clinical faculty and you can have a day a week to prepare for your Kaward as long as you are successful within a year or do. MIRECC VAs will also often allow protected time for research for you to apply for VA grants.

Bear in mind that most people who start down the academic route fail. They either tire of it or don't have what it takes. Given how anti science our current administration is expect funding to get even more difficult to get and the demise of medical research. Also bear in mindasjunior faxulty you will be often making MUCH less than if you did clinical work until you get funded and in general academics make less than their clinical colleagues. If you are highly successful, or become a dept chair, dean, administrator, are a successful grantsman or discover something than can be patented and marketed you can potentially make quite a bit (I.e. >500k) but expect to work for it and remember fewer than 1% of academics will be this successful not including the majority who fail before they get there.

You need an autistic focus on your interests in order to succeed and to put ina lot of work including weekends, evenings, sleepless nights etc particularly early on in your career in order to succeed allfor less pay (possibly substantially so) than being a clinician. But for those who have what it takes it can be a highly rewarding career pathway being at the forefront of science, being highly respected by your peers, and offers much narcissistic supply when your papers and grants apps get accepted, you are solicited for your expert opinion, when you win prestigious awards, are headhunted by institutions wanting to recruit you, serve as advisors on national and international task forces etc etc. You still have to navigate the toxic environment, petulant colleagues, professional jealousy and people out to ruin you (including potentially your own mentors). Lots of fragile egos coalesce in academia too

Thanks so much for the thorough response. Really appreciate the insight. TBH the most unalluring aspect sounds like the toxic environment and petulant colleagues. Do you think there are any potential research avenues that might have a less toxic environment? For instance, might epidemiology be more toxic than imaging or vice versa?

 

[splik]

Thanks so much for the thorough response. Really appreciate the insight. TBH the most unalluring aspect sounds like the toxic environment and petulant colleagues. Do you think there are any potential research avenues that might have a less toxic environment? For instance, might epidemiology be more toxic than imaging or vice versa?

I think it's entirely dependent on the environment of the work place. As you can imagine some places might be great others less so. Some of it might come down to individual colleagues. But it can be a very competitive environment which when taken to its conclusion is too much. I think medium sized departments might be the way to go, and places away from the coasts or not the most prestigious may be more supportive environments. But there's a lot of variation right down to the lab or group you're working with

 

[deleted343839]

I'm wondering how one actually goes about building a career like this, and how realistic it is. This researcher I spoke of earlier mentioned something called a K award, this is an early career grant that aspiring researchers apply for from the NIH. Obviously NIH funding is extremely competitive. If I am an MS3 now, when do I gain the actual concrete tools and experience to do this? Is there time built into residency, or can you create it? Fellowship? Do you do it after fellowship? When do you actually get paid (not trying to bring the level down, just being a real!)?

This is a model that I've seen work well for emerging physician-scientists not coming in with a PhD:

(1) Get a fellowship at an institution that has a large training grant (T32/K12)
(2) Work your *** off and publish; define a specific research area for yourself; attach yourself to a senior mentor's grant as a co-I
(3) Get a faculty job
(4) Get a career development award (K23, foundation, etc.)

 

[tr]

I don't think you need a PhD to establish a research career. What you need is to attach yourself to a really powerful and well-known scientific mentor who can shepherd you through the transition to independence.
MamaPhD's model is good, but a little short on detail for your current stage. A career development/K award is way down the road and not something you need to worry about right now.

(As an aside, @MamaPhD, that's interesting that you are seeing people get their K award *after* their faculty job. I am mostly seeing K awards as a *prerequisite* for a faculty job, at least for a research position.)

For an MS3, important steps are

- Get involved in research in some way right now. Maybe line up some research electives for your fourth year. Try to get a publication or two. Reviews can be gotten out faster than data papers generally, and at the moment all you need is some stuff on your CV to demonstrate you have an interest in research psychiatry.

- Find yourself a residency program that will nurture your interest in research. Definitely make sure it has a training grant: I'd say look more for a T32 (group training grant to the institution) rather than people holding individual grants like F32/K12 actually. And ask if there is time for research built into the regular residency program. Many programs have dedicated time for a scholarly project for all residents, so this would be time you could use to publish more and pad the research portion of your CV. Keep in mind that it is easier to keep your research momentum going if you don't switch institutions, so pick a place you could see yourself staying for more than just the four years of residency.

- After you finish the clinical portion of your residency you can go on the T32 training grant (either as a PGY4 or as a fellow). This gets you more protected time for research. You should pick a mentor for this training time who is a really big cheese and has lots of NIH funding. Keep publishing and start applying for funding at this stage.

 

[deleted343839]

Find yourself a residency program that will nurture your interest in research. Definitely make sure it has a training grant: I'd say look more for a T32 (group training grant to the institution) rather than people holding individual grants like F32/K12 actually. And ask if there is time for research built into the regular residency program. Many programs have dedicated time for a scholarly project for all residents, so this would be time you could use to publish more and pad the research portion of your CV. Keep in mind that it is easier to keep your research momentum going if you don't switch institutions, so pick a place you could see yourself staying for more than just the four years of residency.

MamaPhD's model is good, but a little short on detail for your current stage. A career development/K award is way down the road and not something you need to worry about right now.

Good point! I got ahead of myself - what I wrote is mainly applicable to fellowship/post-residency. However, it's a good idea when applying to residency to find out which sites have training grants and which ones steer some of their residents into these externally funded fellowships. Not uncommonly, these fellowships turn into job opportunities. But for now, I agree it would be most helpful to match to a residency with protected time for research AND a contingent of externally funded faculty who have a good track record of helping trainees up the research career ladder.

 

[splik]

NIH training grants for residency research tracks etc are called R25s. programs that have this usually boast about it in trying to sell themselves to applicants so you should be able to easily figure out which programs have R25s by looking at their website. These provide funding to protect time for research, and for some costs associated with projects, as well as conference/travel expenses etc. Some programs have other sources of funding for their research tracks

 

[dl2dp2]

If I am an MS3 now, when do I gain the actual concrete tools and experience to do this? Is there time built into residency, or can you create it? Fellowship? Do you do it after fellowship? When do you actually get paid (not trying to bring the level down, just being a real!)?

Don't want to sound discouraging...you sound a bit...too idealistic...

You don't ever really get "paid" very well doing research, since the salary is blocked out by the NIH grant structure. I hope you don't have a lot of debt. 500k is a tall order. From the grapevine, I hear chairs at major depts cap out around 400k, though there might be other opportunities to make money (i.e. consulting, etc.)

This is a very long conversation and an ongoing process. I think the next concrete step for you to do is to identify a faculty mentor in your home department of psychiatry, if it's a decent academic department. And if not, identify someone at a local medical school that has a sizable faculty of academic researchers. Problem is, likely when you go make appointments and meet, they will either 1) want you to work for them 2) be fairly dismissive. You will probably need to meet with a handful of people before you get any semblance of "mentorship".

 

[deleted736562]

I don't think you need a PhD to establish a research career. What you need is to attach yourself to a really powerful and well-known scientific mentor who can shepherd you through the transition to independence.
MamaPhD's model is good, but a little short on detail for your current stage. A career development/K award is way down the road and not something you need to worry about right now.

.

This.

No one cares if you have a PhD or not. What matters are publications, with who and where. Politics is 50% of the battle at least and that's why working with a big name is so important in establishing a research career.

 

[HarryMTieboutMD]

And what is this life like?

MS3 here, 90% sure I'm applying into psychiatry, been interested for a while. Like most, I came to this field for the opportunity to get to know people at a vulnerable point in their life, hear their story, and make a positive impact. However, the further I get into my learning, the more turned on I am by learning about the brain, basic science, and pharmacology that goes into it. The more I get into the clinical realm, the more excited I am about different treatment models, the nosology of psychiatric diagnoses, the opportunities to make an impact on a population level with community interventions.

I love psychiatry, I love psychiatric patients, and I love the science behind the field. But the idea of doing even 6 hours a day of therapy and med management seems dull (for me). I spoke with a researcher at my institution who works in brain imaging and treatment resistant depression, but also sees patients a couple hours a week. To me that seemed like the ideal job - getting to scratch both of my itches simultaneously. Insulated a bit from the hustle and bustle of patient's immediate needs, but not divorced from the drama and intimacy of clinical care. I don't yet have a specific research interest carved out, and I'm aware from the above paragraph that my interests span to broadly, from the molecular to the population level. But I guess it seems VERY exciting to me to be a part of advancing the science of mental illness.

I'm wondering how one actually goes about building a career like this, and how realistic it is. This researcher I spoke of earlier mentioned something called a K award, this is an early career grant that aspiring researchers apply for from the NIH. Obviously NIH funding is extremely competitive. If I am an MS3 now, when do I gain the actual concrete tools and experience to do this? Is there time built into residency, or can you create it? Fellowship? Do you do it after fellowship? When do you actually get paid (not trying to bring the level down, just being a real!)?

Anyway, just looking for some insight to see if this is possible. Appreciate the comments in advance.

As you have seen from the responses, there are a variety of opinions on this issue, and I don't think anyone is necessarily right or wrong, but going through this myself and talking to MANY mentors, etc who help train clinician scientists, this is what I think (some of it is parroting from people who have more experience than me)

1. You do not need to commit to anything now, but at the same time plan ahead. Residency is A LOT different from medical school, and similarly unless you have done a PhD actually doing research is much different than being a tagalong on some project as an undergrad/med student. The doris duke fellowships are nice but not sufficient for actual research training, though it's becoming increasingly common for people to take 1-2 years to do "research." (one NSG intern I know did a gap year in a productive lab and got his name on like 8 papers). Basically what you should be doing as a med student is padding your CV.

2. In your later years of residency, especially as you become mature in your clinical skillset and your clinical responsibilities ease (eg, most places have purely outpatient PGY3 years with no call or weekends) you should find a strong mentor and do research. If your department has an R25 and will pay for you to take classes in statistics, study design, epidemiology etc then you should do this too. The most important thing is mentorship because there is a formula to the T-K-R pathway.

3. If you want to do basic science (meaning, wet lab research) you do not necessarily need a PhD but you have to have the drive, focus, dedication, passion and intelligence. And you have to have a great PI+post docs willing to teach. Also plan on spending lots of non clinical hours in the lab. Two of our residents, one who graduated last year and one who will graduate this year are great clinicians but during PGY3 year were working in a VERY well funded optogenetics lab and are doing some pretty amazing research. Neither has a PhD but both are brilliant and driven.

4. After residency, possibly starting in your 4th year, you should be looking into T32 fellowships (there are a lot). Even though the current administration wants to gut the NIH it has traditionally received bipartisan support (incl a $2 billion dollar increase), which *should* continue. You want a place (it might be your own program) with great mentorship (meaning big names with a lot of funding who have track records of successful mentorship) whose graduates get K level funding. You should also be willing to have as minimal clinical duties as possible- this will be a financial hit especially if you want to moonlight, but this is your REAL research training.

5. 80% research/20% clinical is what most physician scientists who are active in both do. This can obviously change with gaining/losing grant funding, but it's a ballpark figure.

 

[Armadillos]

Do the post residency research fellowships pay better than an ACGME fellowship? (salaries obviously vary somewhat by program)

 

[splik]

Do the post residency research fellowships pay better than an ACGME fellowship? (salaries obviously vary somewhat by program)

they usually pay the same, or worse depending on whether they are on the institutions or NIH payscale (NIH pays less, sometimes the depts supplement this, or require you to do a bit of clinical work in order to earn your keep). OTOH research fellowships are stipends, not salaries, so you don't pay FICA on this income unlike normal residency/fellowship income

 

[Armadillos]

they usually pay the same, or worse depending on whether they are on the institutions or NIH payscale (NIH pays less, sometimes the depts supplement this, or require you to do a bit of clinical work in order to earn your keep). OTOH research fellowships are stipends, not salaries, so you don't pay FICA on this income unlike normal residency/fellowship income

wow that sucks, no wonder they are saying its tough to get MDs into research careers. If someone's going that route how long after residency should they expect it to be until they hit 150-170 a year? Decades???

 

[HarryMTieboutMD]

wow that sucks, no wonder they are saying its tough to get MDs into research careers. If someone's going that route how long after residency should they expect it to be until they hit 150-170 a year? Decades???

It can vary but probably about 10 years. 2-3 years for postdoc then most academic starting salaries are in the 120-140 range for an assistant professor. (higher at less well regarded places). Assuming he or she continues to publish and gets promoted, associate might be 150-180 or so

 

[splik]

wow that sucks, no wonder they are saying its tough to get MDs into research careers. If someone's going that route how long after residency should they expect it to be until they hit 150-170 a year? Decades???

well some people get K-awards straight out of residency so can start at a reasonable salary and most places circumvent the NIH caps on pay - on the west coast it would be normal for an assistant professor in psychiatry to making at least 150k and I know several who are starting out on 170-180k. There are of course variations in how much you get paid depending on location, private or public, the prestige of the institution, the nature of the research, and how much promise you show, along with how much clinical work you do. 80/20 is standard, but 75/25 happens too etc. Also the VA may be a good bet if someone's research interests aligns with the kinds of things they are into (PTSD, TBI, dementia, schizophrenia/psychosocial rehabilitation etc) and you will probably get paid quite a bit more earlier on.

BTW its not uncommon for people to moonlight during their fellowship assuming their mentor allows it (red flag if they don't). I think it's much harder if you are doing basic science vs. clinical research because lab-based work can often require you to be there all the time, depending on the nature of it. I know quite a few people who moonlighted quite a bit during their T32s (including during the week). In some places (read: NYC) it is typical for fellows to have a small cash practice too.

But nobody goes into research for the money. While academics at the top of their game will earn substantially more than clinical psychiatrists, the vast majority who set out to have an academic career fail, and only a tiny minority of those who make it rise to the top. Most research goes nowhere. But all those dead ends are important too.

 

[HarryMTieboutMD]

well some people get K-awards straight out of residency so can start at a reasonable salary and most places circumvent the NIH caps on pay - on the west coast it would be normal for an assistant professor in psychiatry to making at least 150k and I know several who are starting out on 170-180k. There are of course variations in how much you get paid depending on location, private or public, the prestige of the institution, the nature of the research, and how much promise you show, along with how much clinical work you do. 80/20 is standard, but 75/25 happens too etc. Also the VA may be a good bet if someone's research interests aligns with the kinds of things they are into (PTSD, TBI, dementia, schizophrenia/psychosocial rehabilitation etc) and you will probably get paid quite a bit more earlier on.

BTW its not uncommon for people to moonlight during their fellowship assuming their mentor allows it (red flag if they don't). I think it's much harder if you are doing basic science vs. clinical research because lab-based work can often require you to be there all the time, depending on the nature of it. I know quite a few people who moonlighted quite a bit during their T32s (including during the week). In some places (read: NYC) it is typical for fellows to have a small cash practice too.

But nobody goes into research for the money. While academics at the top of their game will earn substantially more than clinical psychiatrists, the vast majority who set out to have an academic career fail, and only a tiny minority of those who make it rise to the top. Most research goes nowhere. But all those dead ends are important too.

Are these offers at tier 2 places, though? I thought UCSF, Stanford, UCLA, etc financially exploited junior faculty vis-a-vis base salary simply because they can (and is the practice on the east coast and the better places in the midwest). I thought most extra cash comes from moonlighting, pvt practice, etc

 

[splik]

west coast is not like the east coast - the institutions own you so you aren't allowed to have your own private practice somewhere, and you cant work for anyone else so no moonlighting allowed(which i think is standard everywhere). also no one wants you sacrificing your commitment to your research by doing additional clinical work (and the terms of your grant may expressly say no more than x% of time is spent doing clinical work). UCLA is notoriously awful at treating their junior faculty like scum but I dont know if that translates into as awful py as you seem to think. but I think that UCSF and Stanford are somewhat sensitive to the high costs of living and no one is going to take a job that isn't paying at least 150k there. UW pays quite reasonable for junior faculty the snag is you will not be tenured (ever). I believe UCSD also pays quite reasonable (i.e. compared to the terrible figures you were floating) for junior faculty. This is contingent of course on you generating your salary through grants and clinical revenue. one thing the university of california does is they only offer tenure track positions to a small proportion of faculty (they have an "in residence" series), and only a small proportion of your salary is pensionable or payable for sabbatical/professional leave or time off. So many of these public institutions offer little in the way of public funds which is how they can offer higher salaries, but at a cost...

 

[luckrules]

Thanks everyone for the insight. Really appreciate it.

 

[dl2dp2]

west coast is not like the east coast - the institutions own you so you aren't allowed to have your own private practice somewhere...

This is not entirely accurate. I know for a fact that some faculty at UCLA have private practices. It depends on where your primary salary comes from and whether you have to participate in specific faculty practice plans. For example, if your salary mainly comes from the VA or the state, you can circumvent this issue.

There's this standard line that academic medical centers "exploit" researchers. I'm not sure if that's entirely accurate. It's not exactly exploitation if the revenue generated doesn't meet the salary demands. Your research time, in the end, is entirely driven by external funds raised, of which federal agencies typically have a salary cap. In theory you can raise other types of funding to improve your salary. The main issue is that there's not enough money in the system, private or public, when clinical reimbursements are higher and therefore academic facilities can't keep people who are opportunity cost insensitive. It's not like academic medical centers have an especially high profit margin and you have these capitalists on the top who's "exploiting"...in another word, the reason academic salaries are low is because research doesn't pay, not someone on top is extracting excess value.

That said, unless you are the accountant of these academics, you don't know exactly how much money they are making. Many of them are already wealthy. Some of them have highly lucrative practice/consultant work. The only public information is the admitted low salary the facilities are paying and reporting. This is why I think if you want any semblance of real information you have to go talk to an actual person instead of listening to hearsay on SDN. The main issue here IMHO isn't the low salary per se, since you can always move to a different job and make a lot more money. The main issue is that it differentially penalizes women and minorities (and perhaps most especially minority women who are primary bread winners), in that the fiscally disadvantaged are the ones who will care the most and drop out most quickly with such imbalanced supply and demand. The main pitfall of academia isn't that they are "exploitative", which compared to most of corporate America they clearly are not especially, but that they are fake. They try to articulate an artifice of equal opportunity but in the end perpetuate, just like everyone else, a system that favors those who are already advantaged.