I press down on the plunger with my thumb, dispensing all the mustard yellow pipette tips into a biohazard waste bag. It’s satisfying when all twelve tips from the multichannel pipette land in the bag; sometimes, one or two stray tips would settle on the biosafety hood counter and roll around. Of course, tips landing perfectly in a bag doesn’t correlate to obtaining clean or favorable experimental data, though it would be kind of nice if it did. 

Collecting precise experimental data – with minimal in-group variation – was something I got to practice this summer. Through a program at my university, I had the opportunity to continue work in a research lab. Since I’ve been working “full time,” (not necessarily the 9-5 grind, because there’s only so much experiment setup that can be done in a day; a big part of research is just reading literature and planning ahead), I get to see experiments run from start to finish – which is difficult during the school year with classes – and troubleshoot assays when they don’t work. 

The research I’m contributing to feels important, since the end goal is to create a therapeutic that solves a problem. In this case, that entails developing nanoparticle formulations to deliver nucleic acids to cells, targeting genetic and immune related diseases. This all feels in line with what I think I want to do with my career, and that’s becoming a physician-scientist. 

Why a Physician-Scientist? 

In my sophomore year of high school, I began to realize that there were a bunch of systemic problems that remained unsolved – namely a lack of translation of lab research and inequities that impede access to the latest medical breakthroughs. 

I thought that becoming a physician-scientist would allow me to develop the mindset to solve both problems; as a researcher, I would develop and scale groundbreaking therapeutics, and as a doctor, I would be at the heart of getting those therapeutics directly to people. I admire the work of Professors Kiran Musunuru, MD, PhD and Rebecca Ahrens-Nicklas, MD, PhD; they created a CRISPR therapeutic to save the life of a baby with a rare metabolic disease they were seeing in the clinic. I aspire to do something similar: solve a problem a patient is facing, and get a solution to them (and eventually to more people with the same problem).   

However, this summer, my perception of research began to change, and that inevitably led to my physician-scientist vision crumbling (spoiler for those who are looking for the outcome of what I’m writing: that vision will piece itself back together, I promise, but just in a slightly different way). 

The Doubts  

I’ve doubted my career-related decisions several times before. I wondered whether I should drop biomedical engineering and study materials science and engineering instead, for example. I also wondered whether it was worth pursuing medicine at all (but maybe that was because I wasn’t doing too good in organic chemistry at the time).  

But now, working in a translational research lab, the thought that continues to linger in the back of my mind is: where does all this end up going? The primary outcome of academia is publishing papers, or sharing information for the sake of sharing information, as my friend puts it – and maybe end up in a high impact journal along the way (mhm, Nature). As for what happens when those papers are churned out – other researchers would read it, cite it, and potentially integrate it into their own work. The process repeats.

I’m not saying that publishing research is a waste of time. Cutting edge therapies, namely CRISPR, have only been made possible due to the fact that scientists working in academia studied defense mechanisms in bacteria. Yet, at the same time, the biology publication space has now become highly saturated, cultivating a culture in academia where scientists either “publish or perish.” For instance, there’s a plethora of articles detailing the key proteins and molecules in biological signaling pathways, which makes me wonder: alright, we conducted experiments to discover this thing, but what’s next?  

Even within translational research, it feels that some of the work is being completed just for the sake of being published or to obtain funding. An example would be studying incremental improvements to existing, well established technologies, such as testing a new nanoparticle formulation with marginally improved therapeutic impact. I want my work to focus on a therapeutic end goal, and believe that pursuing MD-PhD (the classic training for becoming a physician-scientist), would be instrumental in bridging the gap between the bench and the bedside. 

The main thing I’ve realized this summer is that the whole “bench to bedside” ideal doesn’t always play out. Admittedly, I haven’t had a sit-down conversation with someone who’s earned an MD-PhD (though recently I’ve been trying to set up coffee chats with those going down that path). 

So for now, my best shot at answering the question, “What happens after an MD-PhD?” was to scour through alumni lists of MD-PhD programs at prominent institutions, and run Google searches to see where those people are now. For the people I found information on, I noticed a recurring pattern: many of them were now internal medicine doctors (there are exceptions, such as George Yancopoulos who founded Regeneron), and it was unclear whether they were contributing to research outside of the clinical setting. 

The career I had imagined – a blend of medicine and research that aimed to solve a problem in a clinic – felt elusive. My doubts spun into a restless spiral, making me question my long-held interest in healthcare. I thought that bioengineering research wasn’t worth the time, since there’s not always a path for cutting edge advancements to make it to the clinic. I felt regret that I didn’t fully consider or explore enough fields (such as electrical engineering) before deciding to set out on biomedical engineering and medicine. 

For a while, I sought an escape: maybe, I should just abandon this lengthy physician-scientist path altogether and plunge straight into the industry right after graduation (which people pursuing mechanical engineering, computer science, or electrical engineering seem to do) so that I could at least witness the immediate, tangible impact of my work. Why commit myself to a future riddled with uncertainty, one that didn’t guarantee the outcome I wanted? 

The Realizations 

Wrapping my head around all my doubts, one by one, enabled me to emerge from them with more clarity. First, all good things take time and patience. Even on a micro level, achieving reliable experiment data in the lab means incubating cells for 48 hours. On a macro level, getting an innovation from the “bench to the bedside” will take at least a decade. Medicine is a long path, and for a good reason; we would want doctors to be well-trained before they’re in charge of the lives of others. 

Furthermore, I realized that it’s not too late to continue exploring different career paths and opportunities. I’ve always heard that college is the time to take risks, learn, build and fail; but, I don’t think I truly internalized that until this summer. In my quest to weave learning and creativity into each day and carve out an interdisciplinary path that encompasses engineering and medicine, I should venture into areas that pique my interest, regardless of the prior knowledge I have – whether that’s game development, medical robotics, or creative writing. I don’t have to lock myself into any one path right now. 

Lastly, personal growth is not always marked by a dramatic transformation. Rather, it’s about those subtle moments that make me realize I’ve learned more and changed quite a bit. For instance, just a few months ago, planning out my cell plate layout for experiments in the lab felt daunting and calculations were slow. Now, the process is a lot quicker, and the process feels like second nature. 

Likewise, figuring out my career doesn’t mean having all the answers right away. Clarity will gradually unfold with more conversations; recently, I spoke to a PhD student pursuing bioengineering, as well as an alumna of my school who’s now in an MD-PhD program. While they provided helpful insight into what a career encompassing research and medicine can look like, they helped me discover parts about myself that I didn’t notice initially – such as how I would value patient interaction in the clinic more than being the principal investigator of a lab. 

I don’t have to know exactly what a physician-scientist career looks like at this moment. Rather, like designing lab experiments, filling in the details will be a process of iteration with occasional breakthroughs sprinkled throughout. However, I have more trust now than I did a few weeks ago that the pieces will click into place, forming a vision just as fulfilling as the process of getting there.