The Road to Becoming a Biomedical Physician Scientist

What is a Physician Scientist in Pathology and Laboratory Medicine?

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Avrum I. Gotlieb

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A physician scientist is a unique clinician who is part of a small cadre of physicians who usually work in academic health science centers and have a high impact on health care through discovery, translational and clinical research, and clinical practice. A physician scientist in Pathology and Laboratory Medicine is a laboratory physician who is trained in both scientific biomedical investigation and in pathology and/or laboratory medicine, often with clinical subspecialty training. The reason to train physician scientists is dual. On the one hand, the physician scientist brings the rigors of scientific investigation into the patient care arena and on the other hand, the physician scientist's contact with disease brings clinically relevant questions into the research arena to drive investigations into pathogenesis, prevention, diagnosis, prognosis, and treatment of disease. Physician scientists form a core group who can instill the core values of academic laboratory medicine into medical students and young trainees. In addition, physician scientists are able to provide leadership in communicating information to the public and government on how biomedical science benefits healthcare.

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Who better to study disease than those who know it intimately? Who better to provide clinical care than those who have a facility with problem solving, hypothesis testing, and critical thinking? Both clinical care and research benefit enormously from this cross fertilization of knowledge and critical thinking. In fact, it is not uncommon that normal biological processes become better understood due to the study of the pathobiology of disease. In addition, the physician scientist is perfectly suited to the role of a transmitter of basic and clinical knowledge, especially new and emerging knowledge. The linking of high quality teaching with innovative high impact research is a very powerful educational approach to prepare medical students and residents for self directed learning that will serve them throughout their career.

Health care is undergoing dramatic changes as biomedical research and technology allow us to critically explore prevailing concepts and discover new knowledge to advance new paradigms. The clinical tissue and human biologic material that pathologists and laboratory physicians see on a daily basis in their clinical practice provide intellectual inspiration and direction to investigate mechanisms of human disease in novel and productive ways. In addition, much more consideration is being given to the social, cultural, and outcome parameters of health care delivery. Pathology and laboratory medicine have led the way in the past several years utilizing molecular, genetic and imaging technologies to chart the new frontiers of academic medicine - in teaching, research, and clinical care. In the clinical sphere, advanced laboratory technologies are being developed and adapted to diagnose disease earlier, more accurately and with a greater ability to predict outcomes. Pathology and laboratory medicine are at the forefront of developing the knowledge platforms for personalized medicine.

By being at the crossroads of basic science and clinical medicine, pathologists are in the enviable position of understanding how to develop appropriate in vitro and in vivo models to investigate complex mechanisms of human disease. The phenotypes arising from genetic manipulation are being thoroughly studied, including using imaging methods that effectively combine morphology and molecular biology, a powerful combination to understand genomic and proteomic function. Thus, laboratory physician scientists are in an excellent position to generate and effectively communicate new discoveries and state-of-the-art knowledge to the clinical arena. In fact, it is only through high quality research that health care costs will be controlled and the burden of disease will be reduced in the population.