Mar 2022

When I was a premedical student in college, I had a very one-dimensional view of what research meant: sitting at a lab benchtop with a pipette in hand or culture dishes scattered in front of me. I didn’t come from a family with backgrounds in research or medicine; even my dad, although he is an engineer, specialized in construction science and civil engineering—very practical, just do-it types of science. Even though I had amazing resources, in hindsight, I was completely overwhelmed at how to tap into resources to navigate the research world and even apply to medical school. Through college, I better learned how to ask for help and utilize resources plus, clearly based on my MD degree, I figured out the medical school piece. But believe it or not, I didn’t figure out how to navigate the research world until I was nearly complete with my PhD.

I did not approach research in a traditional sense. At a baseline, I have always been inquisitive. This trait, combined with a basic knowledge of evidence-based medicine while in medical school, made me just dangerous enough to want to keep asking questions. I did not have significant research experiences prior to medical school, but I was fortunate enough to be at a medical school with NIH funding for students like myself. Our Anatomy and Cell Biology division had a grant that could support medical students to complete a one-year Master’s degree, which seemed perfect for me as a means to start learning research basics and even complete a project. While the project where I landed was not anticipated, it turned out to be a great fit that I switched to a PhD track instead. I worked in biotribology, which is understanding how biological systems are impacted by wear and lubrication (tribology). In particular, our lab developed an in vitro model of joint motion that could take biologically-relevant joint motion, including cartilage articulating on cartilage or biomaterials articulating on cartilage, and apply additional stress to the tissue to determine the biological response of the cartilage. I worked very closely with mechanical engineers as we modified and troubleshot our machine and with the biochemists for our different assays and PCRS. In short, I spent a lot of time at a lab bench top with either broken machine parts in front of me or pipettes in hand for assays; yes, I understand the irony of my PhD!

Now my story may give you the thought that you can jump into it. I was very fortunate to have opportunities align along the way, but it cannot be planned for as a guarantee. I had a very supportive educational and lab environment, but there were still many question marks. So I encourage you to be as prepared for this process as possible. Here are my tips for thinking about a physician-scientist career and how to find a starting position for you.

1. Know yourself: I’m borrowing this verbatim from myself in a previous blog post on Mentorship 101 from April 2021, so (Trevino, 2021). “Before entering a professional relationship, you should think about your professional needs. This can include your goals but also a reflection on your areas of strength and weakness. This can give some framework to a mentor about your individual needs. For your goals, you may think about them based on time, such short term (<1 year), intermediate (1-5 years), and long term (>5 years), or based on topics, such as personal, clinical, academic, and leadership. Sometimes, tools such as the individual development plan from the American Association for the Advancement of Science (https://myidp.sciencecareers.org).”
2. Do not enter into this lightly: I tell trainees that to have a positive experience, even if the science fails, needs three parts, and it’s still not a guarantee: a) a principal investigator (PI) invested in you, b) a topic that connects to a personal experience or interest, and c) the extras from the lab/ university. In my case, I knew my PI was interested in my success because I would end up being one of the few MD-PhD trainees he had, but he had many years of work invested in this model. I was lucky because even though cartilage biology would not have been top on my list, I was very intrigued with the unique model and approach (that was my connection). And lastly, my PI is a mechanical engineer; we had to utilize collaborators and other labs to do the biological investigations. And because of it, I presented at both engineering and biologic conferences, getting a chance to meet many cool scientists along the way. At the end of the day, I am a big proponent of positive experiences, even if you realize this isn’t a career path for you. I hate seeing people get turned off research or even questioning evidence-based practice in medicine because of bad experiences and lack of skills.
3. Use the networks: You’ve taken science classes as a student, and some may have teaching assistants. This is an excellent first step to just seeing what work is being done around you. From there, there are so many great resources. As a starting point for general research experiences or networking, look into organizations such as your SHPEP site, the National Research Mentoring Network (NRMN), Annual Biomedical Research Conference for Minority Students (ABRCMS), Society for Advancement of Chicanos/ Hispanics and Native Americans in Science (SACNAS), and even American Physician Scientist Association (APSA). All of these groups have ways to start networking in virtual spaces. They’ve also had conferences such that you can search past years to see where students were doing research and who the PI might have been. Then when you see a project topic that fits an interest, as you contact the student and PI, you can share that you saw their work in a poster from Conference X in Year Y. This goes to support your interest! Also, groups like APSA have mentor networks between undergraduate students interested in physician-scientist careers and MD-DO/PhD students in training. APSA also started a summer training program that supported students in finding virtual placements for underrepresented in medicine backgrounds. Other networks that can be important are based on specialty interests. For instance, with a student membership to the American Academy of Pediatrics (AAP), there is a mentorship network that can be used to find pediatricians conducting research in your area of interest.
4. Physician-scientist knowledge: For an MD-PhD view, please look into lists provided by the Association of American Medical Colleges (AAMC) (MD-PhD Dual Degree Training | AAMC & Applying to MD-PhD Programs | AAMC). For DO-PhD, please look into lists provided by the American Association of Colleges of Osteopathic Medicine (AACOM) (Considering Medical School? Become A Doctor of Osteopathic Medicine (choosedo.org) and search for “combined DO/PhD”; there are eight schools currently). This is important to know the landscape because there are many different funding structures available, and I want you to have the best information possible. AAMC also has information about biomedical PhD programs (PhD in Biomedical Science | AAMC & Applying to PhD Programs | AAMC). Because my background is from a physician-scientist lens, this is the specialty -research combination I know best. For others, start looking into your major professional organization for support when balancing clinical and research interests.

If you are still reading, you know I gave you insight into my journey to being a pediatrician-scientist, which was very untraditional with some very risky steps where I did get lucky. I want you to think about your interests and time commitments beforehand and use that as a guide to looking into experiences. Using your immediate networks is a great start, but so is reaching out to national groups. Once you have done that part, you have just enough knowledge to start reaching out to labs to see what is available. There may be many no’s in the form of “lack of funding,” “no current projects,” don’t work with undergraduate students,” etc. The reasons may be broad and numerous, but this is a time when perseverance can help pay off. Getting a first lab experience can often open things up if you work hard. Not every experience ends with presentations or publications; sometimes, the science experiences are enough to help find the next lab. Sometimes, relationships with mentors have a shelf-life, which means needing to find a new experience. At the end of this though, you’ll start to develop a skill set for yourself and discover niche interests that can lead you to the next lab and project. And it may even lead you to a dual degree. Hopefully, it will not be as uncharted for you as for me. Still, I would not trade my pediatrician-scientist skillset and interest for anything as it is a significant driver for my career aspirations.