Early Career Blues - Life on a T32 and Thinking of Bailing

[Medstudent9]

Hey all,

I want advice but also maybe just to vent.

My situation: graduated from a top MSTP program, was kinda a middling PhD student (one first author paper, several other author), did residency in a non-traditional MD/PhD field then fellowship, and am now two years into my post-training career.

So, like a good little MSTP grad, I touted my interest in research to my department, which in my field is a somewhat novel thing to have, and was maybe hired partially based on that. Did the first year all-clinical (except for not getting any time in my fellowship area) and then got on a T32. I am about 6 months into a lab that was chosen for me by my department chair...

And, I kinda hate it! I am 5+ years out of research and in a new field so I don't know how to do anything and nothing is working. My "protected" time is frequently pulled and at the last minute. I am not as productive in lab as I want to be/should be, and when I have ideas or early results, my PI gives those aspects of my project to other lab members (postdocs), probably to get results sooner. So it's a poor fit. All I have to show for it so far is one poster presentation.

And, on the clinical time, my department initially promised me I would get my sub-speciality associated time but now I keep hearing "not yet, maybe later" since I am getting this research time. Meanwhile, my clinical days end up being stuck in the assignments no one else wants to do since after all I am only there 1-2 days per week so I should just suck it up.

tl;dr: MSTP graduate, 6 months into T32, hate the lab/unproductive, clinical opportunities I was promised not materializing.

Meanwhile, I have thought about starting to interview for a new job to start after I finish the year. I still have the payback requirement but I am honestly thinking the basic scientist path may not be for me. Possibly I could get a K but I don't know if I have what it takes or the desire to make the R jump. Maybe a clinician educator who does 1 day/week in clinical or translational reseach would be better (though I have not done either before)? I don't think my current academic job would be accommodating to say 20-40% research time plus getting into my subspecialty clinically.

Thoughts? Is it a d**k move to cut and run after a year on a T32 to a more supportive clinical environment (already had one interview on the DL)? Should I suck it up? Try to switch mentors?

I feel too old to be as frustrated again as I was sometimes as a grad student, and I do want to have kids/family in the near future.

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[Fencer]

What kind of PD do you have? Clearly, there is a mismatch between you and their expectations. Talk to your PD, switch labs, discuss expectations quite clearly with your lab mentor and PD. Trying another lab will allow you to know whether you hate this lab/position or you hate doing science. If you go to a more clinical position after doing a 2nd lab, you know that you tried and it wasn't for you anymore. You will walk chin up knowing that it wasn't for you... and that is ok. We need outstanding people who understand science as clinician-educators. Good luck!

 

[Medstudent9]

I don't have a PD because I am a graduate. I am two years into an Instructor position, not in training any longer. My username is from 7 years ago.

So, I have a PI (at the lab) and I have a department chair (my boss), but that's it.

I am on a T32 as young faculty which is done in some fields (whereas in medicine I think you are usually still classified as a fellow).

 

[SurfingDoctor]

I don't have a PD because I am a graduate. I am two years into an Instructor position, not in training any longer. My username is from 7 years ago.

So, I have a PI (at the lab) and I have a department chair (my boss), but that's it.

I am on a T32 as young faculty which is done in some fields (whereas in medicine I think you are usually still classified as a fellow).

So why did your Department Chair pick a lab for you? There must be some background to that because that seems atypical to me. Either way, I personally would have an honest discussion with your Chair about your concerns. It doesn't make sense that they would hire you to go down a physician-scientist track then pull you away from it for clinical duties or not support your research time appropriately, unless they don't have the option because your department or whatever is short staffed and they need warm bodies. If they really want to see you succeed, they should try to accommodate you as best as possible.

Likewise, you must have a mentoring committee for your T32, can you discuss with any of them your issues? Technically, they should be the ones to advocate for you if your not getting protected time or having a PI give away your projects, ie they should help negotiate on your behalf.

I think its okay to move labs if needed, just realizing that you may burn some bridges in leaving the lab without discussing your issues with the mentor. That being said, a good mentor should want to help you, not hinder you by giving your results to others. At this stage, you can take the advice that a once mediocre mentor once gave me "The person most invested in your career is you". If you feel like you aren't meeting your potential in the current environment, you have the most power to do something about it. But I would discuss your concerns with both your research mentor and Chair (and get a sense of their expectations, especially for the latter because they are the ones to help promote you out of an Instructor position) before you jump ship.

 

[dl2dp2]

Thoughts? Is it a d**k move to cut and run after a year on a T32 to a more supportive clinical environment (already had one interview on the DL)? Should I suck it up? Try to switch mentors?

This happens with some frequency. You are not the only one. People on T32 routinely drop out for the greener pasture of private practice. People on Ks routinely drop out. People on R01s frequently drop out.

IMHO your problem is deeper than a mismatch between your lab and your expertise. Frankly, you don't sound like you care about a career in research all that much. The current climate in research is that barriers are sky high every step of the way, and after the T there's K, after K there is R, after R there is R renewal and second R. The process is excruciating. It's really only worth it if you really want to do it because otherwise it has very few advantageous over a clinical career.

Life is too short to blindly persist in something you don't feel strongly about and don't like on a day to day basis. If you feel strongly about a research career and just don't like the day to day maybe you can switch mentor or strategize and tweak it logistically some other way; if you enjoy the day to day but don't feel strongly about the career, I'd say hey why the hell not just cruise and have fun. But if you are neither then you should move on.

 

[Spacedman]

This sounds somewhat familiar - non trad residency for mdphd, getting "assigned " to work areas- if you happen to be in anesthesia, pm me... it's a very small world in academic anesthesia and I may be able to give you concrete advice.

In any event, if your interest in research is truly a novelty in your dept and field, you may best be served by applying to a dept that values research- either you'll find a place that's willing to invest in early career physician scientists (though that will likely involve further investment of time/deferred income from you), or it will give you some leverage to get what you want from your chair, whether that's clinical subspecialty cases or a mentor switch.

This is, of course, assuming you're not burned out on the whole process. I needed almost 4 years of departmental support to get a K, and very nearly got fed up with the whole process. Then again, working 100% clinical would probly make me crazy too. I just like complaining I guess.

As some others have said, I think it's very odd that you have a phd yet your chair chose a mentor for you. That's totally back assward. Either you're not advocating strongly enough for your interests or your chair has a very skewed vision for advancing medical science.


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[gbwillner]

Did your Chairman select the PI for you, or did he/she say "I think this would be a good match for you"? I think probably the latter.

I agree with everything Sloux said above- you just don't seem to be into a job as a physician-scientist. And unless you are 150% committed, you are going down the wrong path. If you just want to dabble in science or clinical research, you can get there far easier by getting a "normal" clinical appointment with 25-50% protected time from clinical duties (for teaching/administrartive, etc), and try to swing that time for research endeavors. Make friends with people who run labs in your field of interest and just get involved. Don't be the PI, be ancillary. If you get your name on their grant, they may pay for your protected time.

You may end up happier that way.

 

[whistleberries]

Did your Chairman select the PI for you, or did he/she say "I think this would be a good match for you"? I think probably the latter.

I agree with everything Sloux said above- you just don't seem to be into a job as a physician-scientist. And unless you are 150% committed, you are going down the wrong path. If you just want to dabble in science or clinical research, you can get there far easier by getting a "normal" clinical appointment with 25-50% protected time from clinical duties (for teaching/administrartive, etc), and try to swing that time for research endeavors. Make friends with people who run labs in your field of interest and just get involved. Don't be the PI, be ancillary. If you get your name on their grant, they may pay for your protected time.

You may end up happier that way.

Sorry to derail, but I need to ask - in what kind of clinical environment would asking for a position like what you described be possible? That sounds like my dream split, so I am wondering how easily getting 25-50% protected time away from clinical duties is. For context, I am an incoming MSTP student.

 

[dl2dp2]

Sorry to derail, but I need to ask - in what kind of clinical environment would asking for a position like what you described be possible? That sounds like my dream split, so I am wondering how easily getting 25-50% protected time away from clinical duties is. For context, I am an incoming MSTP student.

This is easy. You can do it anywhere. The math is the following: suppose your full time clinician salary is 200k. You want to do 50% research. There's no grant support. The department will give you an "instructor" position, pay you 100k, then you can have 50% "protected time" to do research. Once you have secured grant support either as a PI or a Co-I, you can fill the other 50%.

Any clinical job that can be part time would allow this, as long as you don't care about taking a pay cut.

 

[gbwillner]

This is easy. You can do it anywhere. The math is the following: suppose your full time clinician salary is 200k. You want to do 50% research. There's no grant support. The department will give you an "instructor" position, pay you 100k, then you can have 50% "protected time" to do research. Once you have secured grant support either as a PI or a Co-I, you can fill the other 50%.

Any clinical job that can be part time would allow this, as long as you don't care about taking a pay cut.

How you do it depends on your institution and field. I don't think you need to take an instructor position either- I think you would do better to start in a clinical track as Asst Prof. No one does 100% clinical time in academia. You have other responsibilities, like teaching and administrative duties. you could simply squeeze in research during these times, and if you get funding, wiggle out of doing things you don't want to do with your off-service time. Your department WANTS you to do research, they just don't want to pay for it. Ensuring that you don't lose the department revenue is the best way to get what you want.

 

[Neuronix]

How you do it depends on your institution and field. I don't think you need to take an instructor position either- I think you would do better to start in a clinical track as Asst Prof. No one does 100% clinical time in academia. You have other responsibilities, like teaching and administrative duties. you could simply squeeze in research during these times, and if you get funding, wiggle out of doing things you don't want to do with your off-service time. Your department WANTS you to do research, they just don't want to pay for it. Ensuring that you don't lose the department revenue is the best way to get what you want.

This is a chicken and egg problem. How do you get grants funded without preliminary data and startup resources? Anyone who does 75% clinical will tell you it's more like 110% clinical.

I wish so much I could get on a T32. I wrote a solicited industry grant and the whole funding mechanism was withdrawn after I submitted.

 

[tr]

This is a chicken and egg problem. How do you get grants funded without preliminary data and startup resources?

YUP

 

[Medstudent9]

GBWillner has it right. I wasn't "assigned" this lab - my chair said, "I think this will be a good fit for you, he's our favorite researcher/collaborator" (though he's in another closely related dept).

I pretty much said "great!" because it did sound interesting even if it is much more Molecular Bio than I know/knew how to do.

And for a variety of reasons (5 years out of research during residency, brutal residency experience with hazing, limited geographic job search, coming out of fellowship in a bad job market), I did not advocate well for myself. So I took a job that didn't give me my sub-specialty time, and I played up the research to make myself more marketable. I hoped I would be able to get into my sub-specialty eventually which is sort of what I was promised but hasn't materialized...

So now I kinda have two problems:

1) One is that my clinical job is not very satisfying (I get mediocre clinical assignments, not making your career stuff, and nothing in the subspecialty area I trained in), and my dept has a lot of turnover, excessive overtime, bitter coworkers...

2) The other is that the research (which has gotten a bit better over the last few months) is okay but not something I love.

So I interviewed for another job locally that would give me subspecialty time and has a dedicated 1 day a week of academic time (my dept now does not have academic days except for the 3-4 people in the dept on research grants, all of whom are in T/K career stage, not the R range). Since the place I interviewed at is still affiliated with the medical school that administers my T32 though it's a different hospital, I may even be able to transfer the T32 second year funding with the new clinical job. The new place I interviewed at is government, the dept chair expresses an interest in research, but it's a small dept and nobody "does" research there now.

I don't know if I should try to negotiate for a 2nd day of research time to meet my 20 hrs/wk payback commitment and stay in my current lab at a reduced level, maybe using the T32 money? Try to dabble in my current lab for 1 day per week? Try to find another lab/research project at the new hospital that might be amenable to a one day a week project? Stay at my current place of employment and on the T32 and maybe give up on what I went to fellowship for (which is not very employable in my field, at least right now)?

Honestly, I like (not love) research, I like coming up with ideas, I even like the hands- on aspect. I just don't want to spend my life getting grants, I don't want to do it primarily, and I don't see myself being successful in the traditional model of MD/PhD researcher/solo PI running a lab of grad students and postdocs. And I don't want to give up clinical satisfaction and family time to have it either.

It's been said before, but there's not great way to be a basic science research dabbler with a satisfying clinical career... Let alone add having a normal family life too.

@Neuronix - I know you though you may not realize who I am. We were in the same MSTP program.

 

[dl2dp2]

Honestly, I like (not love) research, I like coming up with ideas, I even like the hands- on aspect. I just don't want to spend my life getting grants, I don't want to do it primarily, and I don't see myself being successful in the traditional model of MD/PhD researcher/solo PI running a lab of grad students and postdocs. And I don't want to give up clinical satisfaction and family time to have it either.

It's been said before, but there's not great way to be a basic science research dabbler with a satisfying clinical career... Let alone add having a normal family life too.

You sound like a nice and earnest person and a lot of what you say I think strikes a chord in a lot of us who are at around the same stage or perhaps a few years ahead. I hope you are not taking what me and some of the other people are saying as being too discouraging.

I think your thoughts are bit muddled right now, and you are becoming fixated on small tactical issues and not thinking in a big picture strategic way. Secondly, you sound burnt out and I would encourage you to take some time to try to optimize your mental health. I think I'm not speaking for myself when I say almost every single one of us here feel a lot of exactly what you feel, and very much at times burnt out. This seems to be a natural part of growing up MDPhD these days. The institutional culture in general is hostile, winner takes all, ruthless, so I think as young academic physicians we have to try to support each other as much as possible, because otherwise no one else can.

There is a spectrum of careers of posters here. Regardless of which career you pick, this is pretty much a marathon without shortcuts. One way or the other you have to raise money to do research, and you have to put in your time to become proficient clinically and make money to support your family. But we all know you can do it, whatever it may be, in good time if you have some patience, good mental health, stay positive, etc. there are realistic constraints in terms of financial resources and institutional support, but it's very specific to specific situations and I doubt that the internet can help much there. You need local mentorship. The key is to find out what you like, take some time to assess the possibilities, don't worry about making mistakes, and continue with a positive attitude. HAVE FUN! Your family will thank you for it! Consider all possible strategies and opportunities that might make you happier in the long run.

For example, the idea that you like coming up with ideas but not writing grants: But what is wrting grants but coming up with ideas and writing them down? I actually find writing grants to be the most enjoyable part of doing science. If I could get away with it, I'd rather just write grants all day without doing the actual project, which is often tedious. The chicken and egg problem obviously still applies. The bad part of grant writing isn't the writing itself, which is awesome, but the fact that your salary hinges on it being randomly getting picked. This is where becoming financially independent asap would help a great deal... dabbling is very much feasible as long as you don't need a big personal salary. And this is easily manageable if you are careful with your finances. "Think outside of the box" a little bit and I bet you'll have more interesting ideas than all this drivel of alphabet soup of NIH acronyms. Focus on your science and clinical work. What do you really care about? How can you get that done.

 

[Neuronix]

@Neuronix - I know you though you may not realize who I am. We were in the same MSTP program.

I know who you are now. Did this whole MD/PhD thing work out well for any of us? I don't really keep in touch with anyone

I hope that you're happy in your personal life. I think that's the only way to survive the "academic" life these days.

 

[SurfingDoctor]

Honestly, I like (not love) research, I like coming up with ideas, I even like the hands- on aspect. I just don't want to spend my life getting grants, I don't want to do it primarily, and I don't see myself being successful in the traditional model of MD/PhD researcher/solo PI running a lab of grad students and postdocs. And I don't want to give up clinical satisfaction and family time to have it either.

Well, if that's the way you feel, I say stop. By forcing yourself to go down a path that it sounds like you don't really want (ie, you cannot be on a physician-scientist track and not write grants, you also can't "dabble" successfully in lab work), you are wasting your current time (and also losing money... which is okay to say is important at this stage of your career), when you could pivot to do something more your interests and something that is more fulfilling. Have you ever tried doing clinical research? You can often do retrospective and database analysis with broken up administrative time. Can you stay on the T32 and learn a new skill set such as database analysis or something that you think would be relevant to your perceived career? I'm not sure I have a specific answer for you, but I will say this, you are early enough that if you don't like the career path you are heading, you can still change it.

Again though, as I mentioned before, I would at least have a discussion with a more senior colleague you trust who knows your situation specifically or your immediate supervisor. I think you need to be honest about your concerns so they can help you out. And if they blow you off or are disinterested in your career trajectory... find a new job. The one who has the most to lose on your career is you.

 

[tr]

tl;dr: MSTP graduate, 6 months into T32, hate the lab/unproductive, clinical opportunities I was promised not materializing.

Meanwhile, I have thought about starting to interview for a new job to start after I finish the year. I still have the payback requirement but I am honestly thinking the basic scientist path may not be for me. Possibly I could get a K but I don't know if I have what it takes or the desire to make the R jump. Maybe a clinician educator who does 1 day/week in clinical or translational reseach would be better (though I have not done either before)? I don't think my current academic job would be accommodating to say 20-40% research time plus getting into my subspecialty clinically.

Thoughts? Is it a d**k move to cut and run after a year on a T32 to a more supportive clinical environment (already had one interview on the DL)? Should I suck it up? Try to switch mentors?

I feel too old to be as frustrated again as I was sometimes as a grad student, and I do want to have kids/family in the near future.

It kind of seems like the thing that is restricting your choices is your desire to stay in this apparently low-demand clinical subspecialty. If this is something that there isn't so much need/employability for, that limits your options and your negotiating power.

How important is it to you to stay in this clinical sub-field, vs how important is it to stay in basic science? It seems like trying to do both simultaneously is pretty difficult.

If you really want to stay in your clinical sub-field, I would aim to transition to a clinician-educator position where you have expressly dedicated clinic time in this field, and switch your research focus to clinical research in this area. Taking the new job offer you mentioned sounds like a good option in this case.

If it's more important to stay in basic science, I would try to shed the requirement for certain types of clinical work, and actually just try to minimize clinic time altogether while you are on the T32 and concentrate on being super productive (either in this lab or a different one if you have a clear idea of somewhere you think you would do better) so you will have some prelim data, pubs, etc that will give you the ability to make the next step to a career development award. Clinical time is just deadweight in this context and dwelling on what type of work it is just steals your focus. The point is to do as little of it as you can get away with while you build scientific cred. You are supposed to have 80% protected time on a T32 so if you are working 2 clinical days per week and your department is eating your protected time they are in violation of the terms of the T32 grant and you should call them on it.