by Asande Vilane
At the beginning of last year, myself and a number of my 3rd year MBChB peers enrolled into the Molecular Medicine program: an adjunct course which aims to give aspiring clinician-scientists a background in basic science knowledge and techniques. This journey has since taken us into the honors year, and has seen us undertake introductory research courses in fields such as Neuroscience and Physiology, Infectious Diseases and Immunology, Genetics, Bioinformatics, and Molecular Cell Biology. This experience, which has gifted us with experience both in the clinical and lab platforms, has prompted me to continuously revisit and redefine the term ‘clinician-scientist’.
From a distance, it’s easy to define what a clinician-scientist is: a person with training in both the clinical and science-based fields who combines their skills to conduct research in a way that relates to human health and disease. In my late high-school years, this concept seemed flawless. Yes, I wanted to be the person who had seen, firsthand, the clinical problems that I wanted to solve – and I believed was going to seamlessly transition from my patients to the bench every day with the glamour and flair of a reality-tv show main character (also why isn’t this already a show?). As I’ve grown (a little) older and have had the privilege of enrolling in the BMedScHons (infectious Diseases and Immunology) program, parts of my preconceptions have been both reinforced and shattered by my experiences.
Firstly (and I was actually asked this in a casual interview) – what’s the real need for a clinician-scientist? And why do I want to become one? While it’s true that we need people who can speak both languages to bridge the gap between science and medicine, thus driving the creation of valuable translational research, we also need to keep in mind that we have scientists… and we have doctors. And sometimes, with enough continued education, they can indeed speak each other’s language. So what exactly is the need for someone with an all-round training? Where does this person fit in the grand scheme of things – or what exactly is the problem that they are trying to fix? It becomes difficult to answer these questions without all the buzzwords.
Secondly – what is a clinician-scientist in the South African context? Unlike developed countries which have established MD PhD or MBChB PhD tracks which produce graduates that are quickly zapped up into biotech and big pharma – the idea of this joint training is still quite new in South Africa’s history. While there remains space for one to innovate in corporate medicine using these skills from training, one will have to face the inevitable question of how they will spend their time and their skills once they graduate. Are you going to specialize, and sacrifice the time you could have been using for research? See patients full time and treat your lab work as a fever dream? As a person who came into medicine fully convinced that I’d end up as a full-time basic scientist, this question becomes difficult to answer once you get your first taste of the clinical realm.
Lastly, why do I want to become a clinician-scientist? It’s no secret that medical students are notorious careerists – and being forced to truly reflect and ponder on this question while consciously removing that old high-school identity as an ‘achiever’ has been an interesting experience.
I can’t, however, explain this answer without talking about Angela Merkel. Now the former chancellor of Germany, Angela Merkel has a PhD in quantum chemistry – but also succeeded in becoming a leader while campaigning under a conservative party. While I was already reading biotech articles at 4am way back when – Angela convinced me that being a leader and being a thinker and innovator are not and have never been in antithesis to each other. While my greatest aspiration remains to leave a positive impact on our society, I’d be lying if I didn’t mention that this has also been a journey in the exploration of self. Apart from trying to develop myself along the thinkers as leaders paradigm, being a clinician-scientist also seems to be allowing yourself to develop your career on your own terms. While it’s scary that this is a new South African phenomenon, and there’s no telling exactly how you’ll use your skills – it’s also warming to know that this journey is yours to define. That you don’t have to have all the answers just yet, and that it’s enough to follow an urge or a passion. That for now – it’s enough to be an experience experiencing experiences.
The only way I can describe my honours year is a rollercoaster: there have been moments where I’ve strolled into the Institute of Infectious Diseases and Molecular Medicine (aka the IDM) fully convinced that I’m where I’m supposed to be, and feeling refreshed by the change of pace from the medical program.. but there have also been days where, after over a month of repeating the same experiment, I wished I could just go see a patient and give them antibiotics and know that they’d be on the up and up three days from now. These experiences have all been part of the process, and have been instrumental in teaching me to experience things in the moment, to take a critical look at old decisions and preconceptions, and to allow myself to explore a little – regardless of how it will turn out.