In numerous discussions with advisors and physician scientists, the vast majority told me not to try to do postdoctoral research during residency, MD/PhD program directors included.
You need to focus on your clinical skills.
You won't have any time.
What's the rush, you will always have your skill set and can come back to science later.
I simply would not advise it.
Why do so many physician scientists dole out this advice with such certainty?
There is not a control group of physician scientists who tried and failed. There are no patients that have suffered adverse outcomes because a resident was instead working on their research project. Of the residents who are in specific research residency tracks, more about those tracks in this online piece, they seem to have great success in terms continuing their research work.
I think the reason why the idea that research during residency is a bad idea is prevalent is simply because the majority of physician scientists did not do it. But what if they had? And what about all the MD/PhD's who decided not to return to the laboratory because they felt they no longer belonged there after residency training - what if they had too?
Advice from mentors who attribute their success to research during residency
In my time at Harvard, I have met exactly three of such physician scientists. They currently run exciting, productive labs and are role models and mentors. And notably, they they started their labs at the ages of 34, 38 and probably 33 (I can't find exact numbers on the third). In a time when average age of first R01 for MD/PhDs is 44.3 years (NIH Physician Scientist Workforce Working Group Report 2014), that's no small feat. Some trainees see this and feel that those accomplishments are superhuman and cannot serve as a model, but perhaps it was their expeditiousness to embark early on their research career that was the outlier. I have distilled their advice to me into guidelines that serve as my own template:
You need to focus on your clinical skills.
You won't have any time.
What's the rush, you will always have your skill set and can come back to science later.
I simply would not advise it.
Why do so many physician scientists dole out this advice with such certainty?
There is not a control group of physician scientists who tried and failed. There are no patients that have suffered adverse outcomes because a resident was instead working on their research project. Of the residents who are in specific research residency tracks, more about those tracks in this online piece, they seem to have great success in terms continuing their research work.
I think the reason why the idea that research during residency is a bad idea is prevalent is simply because the majority of physician scientists did not do it. But what if they had? And what about all the MD/PhD's who decided not to return to the laboratory because they felt they no longer belonged there after residency training - what if they had too?
Advice from mentors who attribute their success to research during residency
In my time at Harvard, I have met exactly three of such physician scientists. They currently run exciting, productive labs and are role models and mentors. And notably, they they started their labs at the ages of 34, 38 and probably 33 (I can't find exact numbers on the third). In a time when average age of first R01 for MD/PhDs is 44.3 years (NIH Physician Scientist Workforce Working Group Report 2014), that's no small feat. Some trainees see this and feel that those accomplishments are superhuman and cannot serve as a model, but perhaps it was their expeditiousness to embark early on their research career that was the outlier. I have distilled their advice to me into guidelines that serve as my own template:
1. Find a lab before starting residency.
One of these mentors set up postdoctoral interviews alongside residency interviews, and another used a fourth year elective to rotate through a potential lab out of state. Many PIs that you contact for a postdoctoral position at this stage will express a mixture of confusion and skepticism, but those are not the people you want to work with anyway. The key is to define your goals clearly and spell out your timeline for them.
2. Set up realistic short term and long term project goals.
One person set up a bank for samples from patients with dementia, in which he collected samples over his entire residency period and propelled his early work as a PI. Another looked for isolated case studies of a particular phenotype he was interested in that contributed to his larger scientific story. Regardless of the project, the key is to make sure that you see all the pieces fitting in together to craft a cohesive story for your career. For example, I am writing up a case study of an already solved genetic family in the laboratory while also collecting a cohort of patients with a specific phenotype for which I want to understand the genetics. The small successes will keep your momentum going.
3. Find nooks and crannies in your time and make them count.
Compared to a time when they did research without intern work hour restrictions, our current situation is quite cushy. I don't recommend taking tremendous amount of time in addition to the 80 hour workweek, but instead maximize time during the week. One faculty member said he would work on grants during night call if patients weren't getting admitted, and during downtime even if they are. In the afternoons, schedule one phone meeting every week because you can cram the time for your progress notes, the least useful of all, into 30 minutes less time.
4. Get help and collaborate.
Sometimes that means finding multiple collaborators to carry out a few time intensive experiments that you cannot. Sometimes that means finding grant funding for a student or technician, or partially commandeering an existing clinical coordinator. People are more willing to help out than you might think as long as your tasks are carefully planned and don't waste time.
4. Advocate for your own time.
This tidbit is my own addition, and the ways to advocate will depend on your program. For example, my residency program often has research studies about residents which we are expected to go to, but in reality all research studies are voluntary. We have clinics where we shadow specialists and the resident is not involved in patient care - on those days I bow out no later than 5pm regardless of the clinic schedule.
5. Find mentors who believe in you.
How will you know? I know because when I tell them I am a postdoc, the people who believe in me don't try to help me define when and how I should be doing my postdoctoral research, they simply try to help me achieve it.
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