When I started in the MD/PhD program at a prestigious university in southern California, I was a 22-year-old straight out of college with few commitments. I was a single guy, and everything I owned fit in the backseat of my car. Graduating from medical school, running my own lab, and becoming a “real doctor” felt like an eternity away.
But graduation and real life snuck up quickly. While I was in medical school, I got married; when I was an intern, our first child was born. Life changed, and so did my expectations and priorities.
In academic medicine, those priorities didn’t always align with the pressures of trying to be a “triple threat,” or someone who sees patients, runs a research laboratory, and teaches students, residents, and fellows – and excels in each area. That is a demanding and time-consuming endeavor; excelling at all three is nearly impossible.
I began my career in academic medicine in 2004, when I returned from fellowship to join the division of hematology at my medical alma mater. As an assistant professor, I was chasing that goal, and my activities included teaching, caring for patients with leukemia, and doing laboratory-based translational research. While externally it may have appeared that I was achieving one of my dreams from training (running my own lab and conducting research to help patients with cancer), I was so busy with patient care, grant-writing, and academic duties that I spent little time in the lab. About five years into my career in academic medicine, I started seriously thinking about other options that would give me more work-life balance and still allow me to do what I loved: the science.
The Five-Year Itch
As a clinician-researcher, I collaborated with pharmaceutical companies and, witnessing the abundant resources and exciting scientific advances happening on the other side, transitioning to industry seemed like an attractive option. Still, I was hesitant to take the leap. After investing so much time and effort into my academic career, I wondered, “How can I give it all up?”
A few factors helped convince me to give it a try. First, I was “recruited” by someone I knew from my MD/PhD program who was working at a large biotech company in southern California. When I started seriously thinking about making the switch, he proved to be a great resource for answering all my questions. Coming from the foreign land of academic medicine, my first question was, “What do you do all day?” He pulled up his calendar and walked me through the meetings and tasks that made up his work day, and it seemed enticing.
Second, the position didn’t require relocating my family, which was a major concern, since we had two young children (a 9- and 5-year-old) at the time. As a result, my career switch was practically invisible to my family, except for a much-improved work schedule.
Third, I did my own research comparing the sizes and operating budgets of my academic institution and the pharmaceutical company I was thinking of joining. Though the institutions were roughly the same size in terms of number of employees, a side-by-side comparison revealed that the operating budget for the pharmaceutical company was about 16-fold higher. As a data-driven person, putting these numbers in perspective set me at ease.
And, as a naturally curious person, I wanted to know where that money was going.
A Shock to the System
Academia was all I knew for 14 years, so when I came to industry, I spent my first year acclimating to the new environment. My priority was learning the ropes of industry-sponsored research, which is subject to greater regulatory and external stakeholder constraints.
At first, I missed the intellectual freedom academic medicine offered. As a lab director, I was responsible for the research we produced; as a medical director in industry, I exert some influence, but ultimately, our research focus is dictated by the company’s objectives. The tradeoff, though, is in the resources that are directed toward that research. As one of my mentors in industry told me, “If we like an idea and think it could change how medicine is done, we can put a thousand people on that problem tomorrow. If we think an idea has failed, we can take those people off the project the next day.”
Learning industry protocols was an adjustment, but I was also surprised at how similar the two settings are. My focus is still on delivering what is best for patients. As one example, even now, my day is basically the same: I do everything I did as an academic physician, except patient care and applying for research funding. That time is now devoted to thinking about clinical trials, collaborating with colleagues on new investigative questions, reading medical literature, and digging deeper into scientific ideas that could eventually translate to improved treatment options.
Climbing Down From the Ivory Tower
When I left academia, I expected that people would treat me a bit differently. We all know the negative perception people have of industry. Academic physicians are believed to hold the moral high ground, working with the pure motivation of helping patients, while industry physicians are thought to be driven by revenue and beholden to their company and shareholders.
To me, that doesn’t mean that we don’t also care about patients. In my experience, the revenue of a company and patient benefit are well aligned; if we deliver products that benefit patients, the products will deliver revenue for the company. At my employer, it is important to put patients first. If I’m involved in developing a product, my starting question is, “How would I use this product to benefit patients?”
Without my experiences in the clinic, I’m not sure I would be able to answer that question fully. Having spent five years in academic medicine and 10 years in industry, I look back with no regrets. I have the utmost respect and admiration for the sacrifices that “triple threats” make. I loved caring for patients, but I also love how much time I can now spend with my family.
I’m fortunate to have struck a balance in my career that allows me to help patients indirectly and – perhaps most importantly – devote time to my priorities outside of medicine. If someone asked me about the most important thing I did in my first year out of academia, I’d have to answer honestly: “I finally had enough time to coach my son’s hockey team.”