High-impact careers in academic medicine

Successful entry to the academic pathway

Common entry routes include:

• Integrated MD/PhD or MB/PhD programs

• Residency or fellowship research tracks

• Postgraduate research degrees after clinical training

In the current highly-competitive research funding environment, specific research training should be considered a major priority to achieve success in this career pathway.

In North America, MD–PhD and clinician scientist training programs provide a clear integrated route. In the UK and Europe, combined programs are fewer (e.g. Cambridge and London) and pathways are often therefore sequential (MB first, then academic training program after, e.g., the National Institute for Health and Care Research in the UK, or Charite, Berlin and Heidelberg University in Germany). Despite different structures, success depends on the same core elements: protected research time, advanced training, and strong mentorship.

Practical tips:

• Protected research time is critical

• Plan for a PhD or a high quality Master’s

• Carefully evaluate potential training programs, not just institutional prestige - connect with current and past students.

Is an Advanced Degree Essential?

Both MD-PhD and MD-only (or MB-only) pathways can lead to academic success. Higher degrees not only provide knowledge and skills, but also important networking opportunities, and deep insight to career options. Time spent on a Master's or PhD is therefore a powerful springboard to academic success.

What kind of research or other academic work?

Research is divided into different tracks:

• Biomedical (Basic Science or “Wet Lab”) (e.g. Katalin Karikó’s work on mRNA technology and the COVID vaccine)

• Clinical Research (e.g. Peter Pronovost’s work on checklists to reduce central line associated blood infections)

• Health Systems and Services (e.g. Agnes Binagwaho’s work on national health system reform)

• Population & Public Health (e.g. Soumya Swaminathan’s public health research on tuberculosis and other infectious diseases)

• Implementation & Knowledge Translation (e.g. Paul Farmer’s work on delivery of high-quality, evidence-based clinical care in severely under-resourced environments)

Important impact can also be achieved through the application of expertise in:

• Education, teaching and performance evaluation

• Quality improvement

• Content relevant to development of government or organizational policies

Building a Highly Impactful Research Program

Successful programs grow and evolve over time when completion of initial smaller studies and collaborations support successful applications for funding, completion of more ambitious studies, and increased levels of responsibility in larger research collaborations.

For high impact, maintain relentless focus on cost-effective solutions to important, solvable, and neglected problems. Centring on experts in the countries impacted by the problem you are working to solve increases relevance and feasibility of implementation.

Impact is achieved through the downstream effects of research, e.g. through creating and implementing guidelines and through influencing policy.

Practical tips:

• Embrace current approaches to re-imagining global health (e.g. as considered in this book and in this interview)

• Maintain focus on impact and effectiveness.

• Position yourself early to contribute to groups involved in guideline development, advocacy, or policy advice.