Physician-Scientists: bridging research and medicine

Though they occupy an uncommon niche, physician-scientists are critical contributors to the field of biomedical research. This workforce consists of individuals who operate at the interface of clinical medicine and science, and despite only accounting for 1.5% of the physician workforce today, physician-scientists make up an enduring group of science trailblazers [1]. In fact, physician-scientists account for nearly 40% of Nobel Prizes in Physiology or Medicine and are responsible for landmark discoveries including DNA’s genetic role, antibiotics like penicillin, and induced pluripotent stem cells [2][6]. The label physician-scientist may lead some to assume that these individuals simply spend half of their time in either the research lab or the clinic; however, the reality is that a physician-scientist’s work is founded on the symbiotic relationship between both realms. Trained in both scientific research and medical science, physician-scientists have the tools, experience, and knowledge to take on diverse roles. For example, some may utilize their clinical knowledge to initiate projects investigating clinical mysteries, in turn developing new therapies and treatments, or optimizing existing diagnostic tools [3]. Others may take on unique roles such as advising scientific and research teams, organizations, and even policymakers [7].

For the physician-scientist in training, there are a myriad of career paths that exist. For instance, physician-scientists in academic research often lead self-sufficient research groups consisting of graduate students and postdoctoral fellows. In this line of work, specific qualities that might help a physician-scientist to succeed include leadership as well as originality and creativity when approaching projects [3]. Outside of academia, some physician-scientists may engage in industrial research. This line of work generally entails building a target product profile, which identifies a drug’s properties such as the disease states it treats or the route by which it should be administered [3]. Though physician-scientists in industry can take on a multitude of different roles, most will enter a firm as a clinical investigator with a primary focus of collaborating within clinical development teams. Their day-to-day role can vary depending on the stage of the project, ranging from basic scientific and preclinical advising, leading the selection of chemical compounds for clinical trials, providing counsel to teams designing the clinical trial, and bridging communication between laboratory scientists and clinicians [3]. From there, physician-scientists commonly take on major leadership roles, making up as many as 70% of chief scientific officers for pharmaceutical companies [2]. Outside of industrial research, which tends to emphasize commercial outcomes, academic research is much more concerned with discovery. As such, the biomedical research physician-scientists pursue is diverse, encompassing basic, translational, and clinical research. Furthermore, some will even branch out into non-biomedical research fields like epidemiology and health services, looking into the impact of healthcare on patient outcomes [4].

Following the countless and ever-growing career opportunities for physician-scientists, there are numerous different training paths a physician-scientist might undergo. The most common training path by far, however, is the MD-PhD dual degree program which is specially designed for those looking to become physician-scientists. Trainees on this track typically undergo eight years of comprehensive training in both medicine and research, working towards a medical degree (MD) and a doctoral degree (PhD) [5]. For the budding physician-scientist, there are many benefits to this training path: an integrated curriculum, a streamlined training path, the ability to build a network of mentors and future collaborators, and the waived medical and graduate school tuition (plus an additional stipend depending on the program). Nevertheless, while this training path is highly recommended for individuals interested in a future career as a physician-scientist, it is not the only possible path. Physician-scientists may instead choose to obtain a master's degree or participate in non-degree-awarding research during or after their medical training [4]. Historically, the latter option entailed undergoing postdoctoral training as a research fellow for an extended period. More recently, however, resident training programs have sprung up, such as the UCSF Resident Research Training Program (RRTP) and the Yale Research-in-Residency Program (RIR), offering a synchronous research training program for residents interested in expanding their research careers.

Ultimately, the profession of physician-scientist encompasses a diverse range of career paths within the medical and biomedical research fields. The expanding possibilities for nontraditional training programs for physicians aspiring to do work in research are leading to an ever-growing variety of different professional careers. As the healthcare field continues to be driven by greater innovation and discovery, this group maintains a critical role in bridging science with clinical medicine and patient care. With this, the increasing accessibility of training and career trajectories is a reason for excitement as more individuals will be encouraged to enter the physician-scientist career pipeline.

References

1. Schwartz D. A. (2012). Physician-scientists: the bridge between medicine and science. American journal of respiratory and critical care medicine, 185(6), 595–596. https://doi.org/10.1164/rccm.201110-1806ED

2. Rao, R. C., Dlouhy, B. J., Capell, B. C., & Akeju, O. (2021). The endangered physician-scientist and COVID-19. Cell reports. Medicine, 2(2), 100190. https://doi.org/10.1016/j.xcrm.2021.100190

3. Ganem, D. (2018). Physician-Scientist Careers in the Biotechnology and Pharmaceutical Industries. The Journal of infectious diseases, 218(suppl_1), S20–S24. https://doi.org/10.1093/infdis/jiy308

4. Payne, A. S., & Brass, S. (2013, October 16). Finding Nirvana: Paths to becoming a physician-scientist. Science. Retrieved October 28, 2022, from https://www.science.org/content/article/finding-nirvana-paths-becoming-physician-scientist

5. Brass L. F. (2018). Is an MD/PhD program right for me? Advice on becoming a physician-scientist. Molecular biology of the cell, 29(8), 881–885. https://doi.org/10.1091/mbc.E17-12-0721

6. All Nobel prizes in physiology or medicine. NobelPrize.org. (n.d.). https://www.nobelprize.org/prizes/lists/all-nobel-laureates-in-physiology-or-medicine/

7. Physician-scientists. AAMC. (n.d.). https://www.aamc.org/what-we-do/mission-areas/medical-research/physician-scientist