Challenges in Early Career Research
Early career cardiologists are defined as those who are within the 10-year time frame of completion of a cardiology fellowship training program. Many early career cardiologists view a career in academics as a research opportunity to make discoveries that may lead to new therapies or influence clinical practice in substantive ways. Others view it as an opportunity to educate and train the next generation of providers. Unfortunately, some challenges and current uncertainties regarding the viability of research in an academic career are driving many early career cardiologists away. In light of these developments, the Early Career Professional Section of the ACC, along with senior leadership and mentors, are working hard to address some of the many research challenges that exist for early career cardiologists.
- Sources of funding, budget and industry: The federal government is the single largest source of financial support for academic life-sciences research in the United States. The second major source of support is industry makers of medical devices, pharmaceuticals and biotechnology products, which primarily fund clinical trials and other late-stage clinical research. The third major source of support is nonprofit foundations associated with companies, disease specific advocacy groups and individual families. In addition to the decreases in total funding amount and award success and research spending for new cardiovascular therapies, the K-grants are grouped together and awarded by their priority score without regard to subcategories (i.e., K01, K02, K08, K12, K23, K24, K25, K99/R00). Consequently, early career cardiologists compete with more established applicants (e.g., mid-career K02). With institutional indirect rates for federally funded research continuing to rise, it often makes research impractical from a financial standpoint. Meanwhile, increasing numbers of early career cardiologists and those with doctoral degrees at academic centers are competing for smaller available funding pools.
- Trends in medicine and academia: There is reduced available time for investigator-initiated academic pursuits. Progressive limitations on house staff, in turn, lead to work being shifted increasingly to cardiology faculty. Explosive growth of complex regulatory compliance requirements adds administrative burdens (e.g., Institutional Review Board, Institutional Biological Safety Committee, Institutional Animal Use and Care Committee, Institutional Office of Compliance, Research Admin Offices and Environmental Health Safety) leave researchers less time and resources to pursue the actual scientific questions. Compliance translates to hours of work attempting to adhere to all the regulatory guidelines, including strict deadlines for increased documentation, training and the need for assistance from specialized research staff.
- Lack of communication from supervisors: While the official relationship may be over, some early career cardiologists will continue to maintain the informal connection with their mentors. However, one often hears about a mismatch of expectations and misguided, if well-intentioned, advice. Some mentors manage to secure their academic roles in a much friendlier economic climate and do not understand the harsh reality faced by current early career cardiologists attempting to find academic jobs.
- Lack of access to resources: It is quite a sad paradox that very often early career cardiologists find themselves disconnected from sources of support networking, professional development or career advice at a time when they need these most.
- Challenges in writing productivity: The ability to produce academic publications will make or break somebody's career, plain and simple. At the same time, this is possibly one of the most challenging aspects of being an academic. Clinical duties and responsibilities often compete for time needed to conduct clinical research and produce manuscripts. Although not pleasant to mention, sometimes internal politics dictate the success (or lack thereof) of leadership in manuscript writing. Often, those who contribute the most work get the least credit. This can be viewed as part of the "growth process" in becoming proficient in research, but often leads to untimely delays in becoming first author or in simply receiving the credit that is well deserved when a manuscript gets accepted for publication.
- Data Integrity: Considering the many unethical incidents which have transpired in the research arena, there is an ever-increasing pressure to produce clean, reproducible and robust data. Toward this end, it is important to employ the services of experienced statisticians with transparent methodologies. This can be cost prohibitive, as well, for a project. Equally important is the use of reliable software programs and measurement tools for analysis.
No potential conflict of interest relevant to this article was reported.
This article was authored by Fawaz Alenezi, MD, Fellow in Training (FIT) at Duke University, and Muath Alanbaei, MB, BCh, FACC, cardiologist in the Department of Medicine at Kuwait University.