Preparing Students for Careers as Physician-Scientists

Introduction

While all physicians receive training in medical science, physician-scientists are trained for careers conducting independent scientific investigation in the laboratory, clinic, or other research setting. Since a physician-scientist possesses in-depth knowledge of human health and disease, the additional investigative and analytic skills they have acquired make them uniquely qualified to contribute to medical knowledge. Examples include characterizing the symptoms and causes of diseases; detecting new threats to human health; developing new therapies, treatments, or means of prevention; providing leadership at the interface of science and medicine for organizations; and guiding public policy decisions, such as new prescription drug approval.

Time and again, physician-scientists changed the history of medicine by identifying a clinical problem at the bedside and then exploring the issue in the laboratory or clinical setting:

• •

  While serving in the Royal Army Medical Corps during World War I, Alexander Fleming watched men die of sepsis. His laboratory research efforts after the war prepared him to appreciate the significance of a mold contaminating his bacterial cultures, an observation that led to the discovery of a new bacterial-killing agent, penicillin.

• •

  Helen Brooke Taussig’s early training focused on caring for babies with serious congenital heart defects. She helped establish the field of pediatric cardiology by developing a new surgical procedure to correct the four different heart defects present in infants with “blue baby syndrome.”

• •

  The interest of Charles Richard Drew in transfusion medicine began during his surgical training while seeking ways to treat shock with fluid replacement. During World War II, he went on to break barriers in a racially divided America to pioneer methods to preserve and administer blood plasma.

• •

  More recently, in the 1970s, physicians Michael Brown and Joseph Goldstein were puzzled that a young child’s arteries could be as clogged as those of an overweight, 70-year-old patient. This question inspired by their clinical work eventually led to the discovery of LDL-cholesterol receptors and paved the way for development of statin drugs, now taken by more than 200 million people worldwide.

Many of these early pioneers in medical science often relied on their innate intellectual curiosity and modest, informal scientific training. However, many prominent medical leaders over the past 50 years have questioned whether any individual is still capable of mastering the ever-growing complexities of both medicine and science. Answering today's important clinical questions usually requires sophisticated laboratory procedures, scientific instrumentation, and high-powered analytical skills, most individuals preparing for a career as a physician-scientist today prepare themselves by completing formal, research-intensive scientific training in addition to their medical education. It has become clear that a physician who possesses both clinical and scientific expertise is better prepared to make important contributions to biomedical science and to serve as effective communicators between the clinical and basic science communities. This chapter provides an introduction to the various pathways leading to research-intensive medical careers and to approaches that will help prepare pre-medical advisors to guide their students into this demanding, yet exciting, field.