Normalizing Medical Doctors in Research

Physician-scientist, a dying species?

In November 2023 an article by the American Medical Association headlined “The physician shortage crisis is here”. Not only the US but also Europe experiences a general shortage of qualified doctors. There is a number of job opportunities at home and abroad, an increased mobility and social flexibility of young physicians and a strong demand for a favorable work-life balance. Taken all these factors into account raises the questions of whether the combination of clinic and research is still attractive these days? Is it even possible to do both at the same time at a superb level? Based on my personal experience finding young motivated MDs who just graduated from medical school and who seek to pursue a career as physician-scientists in an academic environment has become more challenging.

At lot has happened since students would voluntarily work as research fellows (sometimes for years) during medical school just to have a better chance to, perhaps one day, get one of those highly competitive positions as residents/clinical fellows at a university hospital. Fortunately, the system has changed and students now apply for fully funded PhD positions at one of many PhD programs and have access to a structured curriculum with seminars, journal clubs and most importantly a network of likeminded peers to engage in scientific exchange. Graduating from such a PhD program usually requires at least one first authorship in a peer-reviewed journal and even though the number of publications does not always correlate with the qualities of a scientist, publications are your business card into the scientific world! It also shows that you are capable of getting your projects over the finish line. A successful completion of a PhD program in combination with your medical training may open doors you might not even think of that early in your career. It could be the ticket into one of the elite universities like Harvard or Stanford if you decide to pursue a Postdoctoral fellowship elsewhere. It could also give you access to the pharmaceutical industry if you find out that patient care is nor your thing after all. It most certainly will help you grow as a physician-scientist, develop your own ideas, question medical problems in your area of expertise and provide you with a toolkit to address those problems. Your research work will also help you better understand certain diseases and the underlying pathophysiological mechanisms. And finally, if you believe in a bigger picture, you may realize that medical/pharmaceutical progress would not exist without scientific research. 

Why does it seem that a career as a physician-scientist has become less attractive?

So why does it seem that it has become less attractive to pursue a career as a physician-scientist? Work-life balance may be one argument. It is true that research does not only happen from “nine to five”. However, during your PhD training you have a lot more flexibility than you will ever experience again as a clinician and ideally you learn how to manage your time better to be more effective. Of course your research work usually does not stop after you finished your PhD training when you enter the clinic but it is normal to scale back to focus more on your clinical training. That is also the reason why I believe it so important to dedicate a certain amount of time exclusively for research - for basic science at least 2-3 years - before starting a clinical fellowship, in order to acquire the technical skill set you will benefit from your entire career. Some might argue they did not study medicine for 6 years in order to “waste” another 3 years before they even start seeing patients. In that case you may be able to choose a clinical research program, that often allows you to perform most of your research work during your patient service e.g. as part of a clinical study.  Another frequently heard argument for choosing a job in the clinic over a research fellowship is the salary. It is correct that a PhD position is not as well paid as a clinical position, however you are not working nightshifts as PhD candidate (at least not officially) and you are formally still a student, so you get paid while you get educated. It is important to understand that your research training is an investment in the future. The opportunities that will provide to you as an experienced physician-scientist, an expert in your field who trained in a competitive academic environment are unparalleled and the financial reward may not come as early but it will come. 

Finally, who if not you, the future generation of doctors should be studying diseases and unsolved clinical problems? This is no disrespect to other scientists who make valuable contributions towards the medical field but understanding the clinical needs of our patients, studying underlying causes of diseases and identifying new therapeutic approaches have always belonged to our responsibilities as medical doctors. I believe a strong scientific training in combination with the clinical experience lay the groundwork for the necessary qualifications to take on these responsibilities

Physician Researcher Pathway of MedUni Vienna

The physician researcher pathway (PRP) is part of MedUni Vienna's ongoing commitment to the promotion of young medical talent in research and medicine.The PRP is a scholarship program that provides physicians with the opportunity to spend a year in research, free from clinical responsibilities. This initiative is designed to facilitate the careers of physician-scientists, thereby promoting groundbreaking research and advancing healthcare.

Applications for the scholarship can be submitted by doctoral students at MedUni Vienna on an annual basis; detailed guidelines and deadlines can be found on the intranet of MedUni Vienna. Physicians interested in medical research and this career path are encouraged to apply and seize this unique opportunity to spend more time in contributing to our scientific discoveries.