Medical doctors who do research could be a dying breed

The road from disease research to disease cure isn't usually a smooth one. One role which bridges the laboratory and the clinic is that of the "clinician-scientist" – a doctor who understands disease both in the patient and in the Petri dish. Yet an editorial published in Disease Models & Mechanisms (DMM), http://dmm.biologists.org, contends that clinician-scientists in the UK and elsewhere are not prospering, but rather are "under threat in a hostile environment".

The editorial author, Dr Nick Lemoine, Director of the Cancer Research UK Clinical Centre and a clinician-scientist himself, believes that a lack of career support is partially to blame. Contrasting UK training programs to similar programs in the United States, he discusses how Britain's prospective doctors have fewer research training opportunities than their American counterparts. US dual-degree programs for a combined MD/PhD are comparatively well-funded. Additionally, follow-up studies show that graduates from US Medical Scientist Training Programs are successful in developing well-funded research careers. Clinician-scientists in the UK, however, lack a clear career structure, and are at a disadvantage compared to doctors who opt for traditional specialist training and seek out National Health Service posts.

Lemoine also calls attention to the major financial disadvantage of medical scientists in both countries. Pursuing an untraditional academic route adds a risk which is exacerbated by significant medical school debts. "Setting out on an academic path at qualification with a cloud of debt overhead is a brave move," Lemoine wrote, "and one that a diminishing proportion of graduates have been prepared to make."

However, the clinician-scientist environment might be changing in the UK, Lemoine observes. New funding is being allocated from both public organizations and private charities, and these sponsors are also developing mentorship programs to track participants in clinician-scientist training and monitor quality of their research.

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August 7, 2008