Physician-scientist: Contemplating the complimentary dual challenge

Carina Dehner

Wikipedia defines physician-scientist as “a holder of a degree in medicine and science who invests significant time and professional effort in scientific research and spends correspondingly less time in direct clinical practice compared to other physicians.” As a postdoc (studying autoimmune diseases of the skin) and MD, I am currently trying to determine whether this up-and-coming pathway is one I want to pursue for my own future. While I am currently spending 100 percent of my time on research, I will start residency in 1-2 years, which will be 100 percent clinical involvement for about three years. At that point, I will have to decide what type of career I want to pursue. I’ve outlined below some of the benefits and disadvantages of the uniquely challenging physician-scientist profession. These are factors I’ve weighed, and that I hope will help others contemplating similar career decisions.

As you may know, when conducting human research, it is generally hard to get enough human study materials together. To this end, being involved in clinical life certainly has benefits, as a physician regularly sees patients, and the physician’s field of research is very often directly connected with her or his clinical duties. Additionally, the clinical knowledge itself can help structure research projects—evaluating results and explaining possible outcomes, or even negative findings. Especially since I have studied medicine myself (I recently finished my licensing exams in the United States after graduating from medical school in Germany about a year ago), I can see many benefits for my own research projects. For example, all of my projects involve patient samples, and most often it is me personally who needs to check an antibody titer through chart review, or similar tests and tactics.

Job security is another clear positive point for being a physician-scientist. Being employed by a hospital as a practicing physician provides more stability than being an independent researcher who is responsible for bringing in funds—not to mention that funding institutions’ interests don’t always coincide with a researcher’s own project. Being a physician-scientist doesn’t necessarily guarantee a better salary than choosing just one focused role, but the dual nature of performing both research and direct clinical application is conducive to the scope of important funding institutions.

But, as with most things in life, there are considerable sacrifices and downsides to juxtapose with the benefits. Simultaneously performing the individually arduous jobs of both a physician and a scientist means doubling the amount of time devoted to work, rendering free time very limited. This can make family bonding—or family planning—very difficult, especially for women. And while it is possible to reduce the time spent on either clinical work or research, this may cause the quality of one or the other to suffer, thereby diminishing the upsides of the desired career balance that made this path compelling to begin with.

So, will I pursue the physician-scientist path, remain solely focused on research, or change course and reinvent my career as a practicing physician? I don’t know yet, but I’ll continue weighing the pros and cons of each option—and report back once I’ve done decided “What I want to be when I grow up.” In the meantime, please comment if you have any advice or experience that will help me and others in my shoes make up our minds.

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Carina Dehner

I am a postdoc, currently studying the influence of the microbiome on autoimmune diseases and cancer.

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