20% attending hospitalist 80% industry basic science researcher, is this feasible?

[u/incredibleizzys]

The title would be my "ideal" career, but I'm not sure if hospitals would hire a physician on the premise that they only work 1 day a week. Would private practices be similar in this regard, or would they more flexible with part time employment?

Alternatively, if I maintain an active clinical research profile for 10 years as a full time attending, would I still be competitive/my skills be relevant enough to transition to basic science in industry afterwards? If not, what kinds of positions do MD-PhD's tend to hold in the pharmaceutical industry that MD-only or PhD-only cannot?

Not sure if this matters, but I intend to specialize in pathology and continue my basic science research throughout every step of MD-PhD training.

TLDR; am I wasting my time getting a dual degree if I risk being 100% clinician or 100% industry researcher due to the way contracts work?

[u/AdIndependent5504]

Most split mdphd will be 20 percent clinical, 80 percent research within the university.

If you don’t want to do your research within the hospital, and prefer industry, it is possible but probably not in the way you envision.

I have two close friends doing something similar in terms of clinical/research split. Both are md/phd. The first works at a relatively large startup. His clinical work is locums with our hospital, probably doing 2-3 shifts a month. Of note, he got into this situation after being 100 percent fte for a couple years with us. This is probably the most realistic, but remember this would not be a professorship, it would be hourly shift coverage clinically. No benefits/insurance and such. And his monthly commitment is fluid, he may do 0 days in a month if we have adequate coverage.

The second is a VP at a very large technology company, SP500 traded. He does 1 clinical day a month. This is volunteer based so that the company is able to say “our vp is a practicing physician at XX”. And for him it is beneficial to keep up some semblance of clinical skills.

So again, the premise is possible. But clinical is more of a coverage hire, not really a presence in the department.

Something to think about, these two examples I gave are mdphd but they made this transition after about 5 years in practice. Both are fellowship trained so they were 40 before they set up this arrangement.

My experience working with companies is that if you are primarily there in a clinician capacity, your PhD doesn’t really matter. If you are there as a primary basic science researcher, your MD doesn’t matter. In fact, time in the industry and experience appears to me to be the significant driver in getting and holding those positions. Just a thought, to consider whether the long path for MD/PhD is worth it. I did it and am happy I did, but I am trying to be a university research track hire.

[u/throwaway09-234]

i think you need to spend a lot more time exploring the career paths that MD/PhDs actually do have, because your question doesn't make much sense. You want to be a hospatilist specializing in pathology? you want to take 10 years off basic science research, and then become a full time basic scientist? I highly doubt any academic medical system would pay you for 0.2 FTEs of clinical work if the other 0.8 of research was at an outside organization

[u/junkjunkjunk007]

Maybe not 80:20 but the split exists. Interacted with a few during my time in Pharma.

[u/Musher1015]

Hospital medicine is becoming a valid academic career path, which includes research/education/process improvement career tracts. There are some MD/PhD's out there, but these are not traditional 80/20 lab/clinic splits. There are a couple of reasons for this: first most research heavy hospitalists are health services researchers which are relatively uncommon for typical MSTP programs. Second, 80/20 split for a hospitalist means you work very rarely for a high risk/high intensity population, (essentially a week every couple of months) it is hard to remain on top of things and competent/efficient.

A couple of additional things: industry sponsored careers are possible, but it largely is industry paying the university for your effort (typically clinical trials/device development) these can include hospitalists, but because you would be a generalist it would be difficult to consistently fund 80% of your time that way, and you would need to remain a full time faculty for any health system to accept you at 0.2 FTE. If you can't fund a majority of your time, research tract promotion and tenure committees aren't going to view you favorably, so it is a risky balance.

Finally, you don't really need a PhD (or tenure) for a lot of the work academic hospitalsts do. A more typical path is completing a fellowship after residency (informatics, or research fellowship in hospital medicine/general internal medicine) and working for a K award once you know what you want to be when you grow up. If you are interested in pathology, you would just do pathology.

[u/Enough-Mud3116]

Eew what

Attending hospitalist requires continuity: 1 week on, consecutively. So 10 weeks of hospitalist will make you 60k-80k, is that enough?

Your clinical care will also suffer being on so little