Clinical vs. research emphasis in academic H/O programs?

[ecogfive]

Hey folks. Before I kick off, I should say that I'm planning to talk to my mentors about this, but also wanted to poll a larger audience.

I'm an IM PGY-2 who is interested in heme/onc; specifically, I have gravitated towards solids. Things that get me jazzed include, but are not limited to, intersections with palliative care and checkpoint inhibitors. I'm having a blast with my little projects and have published x2 in residency, but I will be honest... I am never going to be the guy on the bench. Research, for me, is most exciting when it has a direct application in practice; first and foremost, I want to be a clinician. Dream job is maybe 75%-25%?

But! I also want to stay in academic medicine, mostly because I love working with students/residents/learners.

I'm concerned that, to be competitive for academic positions down the line, I will need to target very research-heavy institutions for fellowship +/- prioritize research in my broader career. I have been told, "Don't mention your interest in teaching; it will put programs off." I can do that, but I find myself wondering: Is there space for me in H/O right now or am I a bad fit for this fellowship? Should I let go of my interest in staying academic? Are there certain academic programs whose goals/values are more aligned with mine? An attending of mine suggested looking to OHSU, for example.

Any thoughts you have would be greatly appreciated!

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[ShuperNewbie]

Hey folks. Before I kick off, I should say that I'm planning to talk to my mentors about this, but also wanted to poll a larger audience.

I'm an IM PGY-2 who is interested in heme/onc; specifically, I have gravitated towards solids. Things that get me jazzed include, but are not limited to, intersections with palliative care and checkpoint inhibitors. I'm having a blast with my little projects and have published x2 in residency, but I will be honest... I am never going to be the guy on the bench. Research, for me, is most exciting when it has a direct application in practice; first and foremost, I want to be a clinician. Dream job is maybe 75%-25%?

But! I also want to stay in academic medicine, mostly because I love working with students/residents/learners.

I'm concerned that, to be competitive for academic positions down the line, I will need to target very research-heavy institutions for fellowship +/- prioritize research in my broader career. I have been told, "Don't mention your interest in teaching; it will put programs off." I can do that, but I find myself wondering: Is there space for me in H/O right now or am I a bad fit for this fellowship? Should I let go of my interest in staying academic? Are there certain academic programs whose goals/values are more aligned with mine? An attending of mine suggested looking to OHSU, for example.

Any thoughts you have would be greatly appreciated!

I honestly feel like you'd be perfect in academic medicine (I believe you when you say you want to be in academics more than I do 50% of other people who say they want to do "academic medicine" but are really just trying to tell programs what they want to hear).

There's PLENTY of space for you to do research and practice in an academic institution. No you don't have to kill yourself to try and publish a ton to be competitive for these positions (when the pay difference between private and academic is sometimes 400k vs 200k, you'd be surprised at how non-competitive some of these positions are). It's more important to create a good story for yourself. If you're into bench (which I know you're not), then maybe you want to do mechanisms research into therapeutic resistances, or maybe you want to do clinical trials, or maybe you want to do disparities research into healthcare delivery models. Regardless of what you're into, just make sure you stay consistent and are able to answer the question of "what do you want to do here" with a clear and concise plan. Saying "I want to do research" is way less convincing than "I want to continue my work in the health disparities field, looking at the differences in outcomes of PSA screening for ethnic men vs. white men, and I want to work with [this specific person] as a mentor and I plan on publishing in [this space] within my first year."

In regards to finding that dream 75-25 job, keep in mind that to get 25% of your clinical time shunted towards research, you either have to (A) bring in that sweet sweet grant money or (B) convince the institution that what you're doing is worth paying for (because the institution will be effectively "buying out your time"). But it's certainly doable. I have a fairly similar gig right now and it's pretty amazing (NGL... I have like... a month and a half of non-clinical time coming up... I have no idea why I'm leaving this job).

Also, as someone who's very interested in teaching and unabashed about it (I talked about it a lot during my interviews), saying something like "don't mention your interest in teaching; it will put programs off" is dumb advice. MOST OF THE ACADEMIC INSTITUTIONS WORTH GOING TO OUT THERE ARE INTERESTED IN TEACHING, THATS WHAT MAKES THEM ACADEMIC INSTITUTIONS. Every place I interviewed at this year was like "Oh nice you're interested in teaching? SO ARE WE! WE TAKE IT VERY SERIOUSLY!" Those that weren't, I didn't even bother applying to, and honestly weren't that reputable to begin with (since people obviously will tend to avoid these programs for the very reason that they're not interested in teaching).

So honestly, you be you. If you've got a passion for something you should be around people that nurture it (as long as it's not a passion for cocaine). I think you're on a great track right now, and there's more than enough space for you to pursue that track in academic heme/onc.

 

[HemeOncHopeful19]

I had a similar story when I applied. I’m from the Southeast but a few of the places that I recall specifically had “clinician educator” tracks were Florida, VCU and Baylor. I would check program websites out and see if they offer one of those.

I’m just a fellow but I certainly think it’s fine to be honest about this interest. I would think when interviewing with academic PDs of all people you are likely to find like-minded individuals, and will probably help you find a good fit.

 

[ecogfive]

Wow, thank you both so much. I feel way less alone and am overall reassured to hear that my interests aren't anathema to a successful career in heme/onc, haha.

@ShuperNewbie -- I really appreciate the detail in your response. This was an extremely helpful way of framing my interest for the purpose of fellowship applications (and also just like... figuring out what I want in my career). I did laugh a little when you said that you believe me; I have a pretty hard time hiding my dorkiness/excitement, so I'm glad that I don't necessarily need to lie about my interest in medical education. Will likely do a chief year, so like... my teaching hype is probably obvious.

Jealous of your 75-25 spot, lol. But since you mentioned that you're moving on, I should also say congrats on the new job!

@HemeOncHopeful19 -- Oh, rad, that's a great tip about looking for a clinician-educator track! I'll keep those names on my list. And good point, lol; the people interviewing me are all going to be involved in program leadership, so if anyone is going to get it, it'll probably be them.