Clinician scientists face unique balancing act

Alan B. Dang, MD; Rowena McBeath, MD; Tamara K. Pylawka, MD; and Chadi A. Tannoury, MD, share a common career ambition—finding success as both clinicians and researchers. As participants in the 2009 Clinician Scientist Development Program (CSDP), they took a major step in achieving that goal.

The CSDP—an annual program cosponsored by the AAOS, the Orthopaedic Research and Education Foundation (OREF), and the Orthopaedic Research Society (ORS)—is designed to support and nurture orthopaedic residents interested in pursuing careers as clinician scientists. Sessions focus on topics such as the career timeline, collaboration with scientists, mentorship, academic promotion, grants and funding resources, working with specialty groups, and balancing it all with a fulfilling personal life.

“The CSDP gives participants an unfiltered look at the challenges, obstacles, and rewards in pursuing a career as a clinician scientist,” said Dr. Dang. “I came wanting to learn more about grant writing but gained so much more.”

Dr. Dang, who is applying for a spine fellowship, is interested in focusing his research on computational biomechanics, regenerative medicine, and information science.

Challenges and balancing acts
“The biggest challenge for clinician scientists is time management,” said Dr. Tannoury. “It is about dissecting the time appropriately to fulfill the clinical duties of patient care and execute the scientific hypotheses in the form of projects.”

Of course, there is no simple answer to the question “How can you have it all?” Rather, it is a delicate balance that requires making difficult choices, selecting an academic and a research focus, setting goals, finding the right mentor, and establishing a proper environment. Faculty member Jo A. Hannafin, MD, PhD, shared her insight on balancing responsibilities as a surgeon, a scientist, an educator, a spouse, and a parent.

Noting that several leaders in orthopaedics—including Regis J. O’Keefe, MD, PhD; Scott A. Rodeo, MD; and Constance R. Chu, MD—have had widespread success as clinician scientists, Dr. Hannafin informed the residents it is possible to “have it all.”

Because the successful clinician scientist is different from colleagues—both in the lab and in the operating room—he or she must establish strong support systems at home and at work and must respect the time and needs of others.

“You must be willing to shift and/or modify your focus,” said Dr. Hannafin. “Be realistic in your goals and time frame for success. Above all, have passion for all that you do!”

“I hope to be an excellent clinician and researcher,” said Dr. McBeath. “That will require not only superb training now but also constant vigilance in the future, to stay abreast of emerging ideas and techniques in multiple disciplines related to my field.”

Importance of mentorship
Dr. Chu addressed the residents on the importance of mentor relationships, pointing out that establishing a mentor during the early stages of a career is associated with higher career satisfaction, higher rates of promotion, and enhanced personal growth.

As a core part of the program, the CSDP pairs each resident participant with a faculty mentor(s) and allows time for casual interaction. “I was getting candid advice from the heroes of orthopaedics,” said Dr. Dang. “It was not limited to just one person’s view. The CSDP gave me the opportunity to gain mentors from beyond the institutions where I’ve trained.”

Dr. Tannoury has already worked with several good mentors. “To follow their instructive directions and walk their path is a recipe for success and excellence,” he stated. “[At the CSDP], meeting real clinician scientists, learning from their experiences, and establishing mentorship with them was a huge help with the potential for a remarkably positive impact on my career.”

Mentor relationships established at the CSDP serve as a supportive foundation for the resident participants. “I will look to my mentor for advice concerning all avenues of my research goals—grant applications, pitfalls of grant writing and obtaining funding for my research,” Dr. Pylawka stated. “Through this relationship, I hope to fine tune my ability to become a better teacher, researcher, and future mentor.”

The AAOS and the future
The AAOS/OREF/ORS CSDP is a first step in the career path for many clinician scientists. The program, now in its seventh year, offers the orthopaedic profession a new source of clinician scientists engaged in research with the goal of advancing musculoskeletal medicine.

“The AAOS has been a pioneer in creating opportunities for residents interested in becoming clinician scientists,” explained Dr. Tannoury.

Dr. Pylawka, whose surgical interests include sports, trauma, and the hand, has been researching cartilage regeneration since medical school. “In my future, I see the AAOS as providing a great platform that will aid in my becoming not only a well-rounded clinician and scientist, but also a leader in the orthopaedic field,” she said.

The AAOS/OREF/ORS Clinician Scientist Development Program, held in Chicago June 7–9, 2009, was chaired by Edward Diao, MD. Constance R. Chu, MD, and John H. Healey, MD, FACS, served on the steering committee. The CSDP is overseen by the AAOS Research Development Committee, chaired by Denis R. Clohisy, MD. Links to additional information on the program and future events can be found in the online version of this article, available at www.aaosnow.org

Erin L. Ransford is a research coordinator in the AAOS office of government relations. She can be reached at ransford@aaos.org

Tips on succeeding as a clinician scientist
CSDP participants learned the following lessons during the 2009 program:

Dr. Pylawka—Find an area of research you truly love. Find a program with faculty that share and support your excitement for your research endeavors. Dedicate yourself to becoming a leader in both your research and clinical pursuits.

Dr. Dang—Seek the advice of mentors whenever and wherever you can. Do not limit yourself to just mentors within your intended specialty.

Dr. McBeath—First establish a firm foundation in surgical technique and a deep knowledge of bone and joint anatomy and physiology. Remain scientifically curious—particularly when interacting with patients—and ideas that can be developed in the lab will begin to flow.

Dr. Tannoury—To make a positive difference in other people’s lives, assume a leader’s position; put your dreams and thoughts into projects, and come up with honest conclusions. Leaders are the people who dreamt, thought, and executed their projects to improve the standard of care.