American Society of Hematology

From Bench to Bedside and Back: Challenges and Solutions to the Physician-Scientist Track During Hematology Fellowship

Shyam A. Patel, MD, PhD Stanford University, Stanford, CA

Hematology trainees on the physician-scientist track know quite well the challenges to navigating a career in science and medicine. The physician-scientist track is filled with transitions from the bench to bedside and back. In some phases, bench and clinical work are simultaneous, requiring a trainee to “switch hats” on a daily/weekly basis. This article presents some key elements that may help one steer smoothly on this path.

Establish clear goals and expectations. The first step for any physician-scientist trainee is to set goals and expectations. These goals may involve a laboratory-based career, a clinically oriented career, or a combination. It is important to clarify expectations with one’s mentor(s) while on clinical rotations, as research output may be limited during this time. Any available free time during clinical rotations may be better devoted to activities that do not require multiple consecutive hours, such as writing a research proposal. Upon entering the research phase, focus your efforts toward a project that already has been well designed.

Identify research and clinical mentors. Mentorship is the cornerstone for academic success in the physician-scientist pathway; optimal mentorship might include mentors from diverse disciplines. Your choice of mentors should reflect your career goals, and your primary mentor should be a person whose position the you can imagine yourself filling in the future. Open communication on a regular basis will help foster an optimal mentor-mentee relationship that benefits both parties. In some cases, the research mentor can be the same person as the clinical mentor.

Adopt an integrative mindset. Many trainees feel that clinical work and laboratory research do not sync during training. This is commonly due to the dichotomy of work colleagues in each setting: colleagues in the lab (e.g., graduate students and postdocs) and colleagues in the clinic (e.g., medical students and house staff) are frequently mutually exclusive. The return to the bench after many years of clinical training can be particularly challenging, especially when it comes to applying for funding. Appropriate and prospective planning is highly important. It is ideal to have your laboratory research focus coincide with your clinical interest. This would provide the added benefit of clinical perspective that pure laboratory scientists may lack, and such a dual perspective is highly valued by funding agencies.

Construct a timeline. In science, research findings can be unpredictable. Some trainees may invest months to establish grounds, or build a model, for their research, while others may stumble across a highly impactful finding early on with less effort. Most trainees encounter a path somewhere in between, with the gradual acquisition of promising data through trial and error, and perseverance. Although these trajectories are largely dependent on the biology of the disease under investigation, there are important factors trainees can control. Early planning, for example, will enhance the likelihood of a well-designed research trajectory.

Concluding remarks. Prospective planning during hematology fellowship can increase a trainee’s chance of achieving high productivity in both research and clinical efforts. Although it can be challenging to “switch hats” from the bench to bedside and back, there are many strategies that can be undertaken to ensure success.

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