EDITORIAL
Degrees of Freedom: Your Future
in Biomedical Research
B
iomedical research has never been so
exciting, and opportunities for interdisci-
plinary and translational research are
unprecedented. However, the percentages of
PhD and MD-PhD scientists transitioning into
sustained careers in academia is at an all-time
low, and funding for basic research is uncer-
tain. With these challenges facing us, how and
by whom do we envision biomedical research
being done in the future? What advice can we
provide early career scientists as they set out to
explore the increasing number of paths available
to them? Two of us, one from the United States
and one from Europe, provide our perspectives
on the current and future state of the biomedical
research enterprise and suggest how best to
prepare oneself for an exhilarating but frequently
challenging career in biomedical research.
During our careers we have witnessed dra-
matic technological and conceptual advances
that have completely resculpted the biomedical
research landscape. Scientic opportunities for
trainees contemplating a career in basic and
translational research are unprecedented. The
ability to transcend disciplinary and geographic
boundaries makes the adventure even more
exciting for those who choose to pursue it. At the
same time, however, data show that prospects for
PhDs looking for faculty positions in the sciences
are bleak, with estimates being that approxi-
mately 15% or less obtain academic positions as
independent investigators in the United States,
with much lower rates in some places in Europe,
such as the United Kingdom at 3.5% (Powell,
2015). In the United States, the average age of
obtaining a rst National Institutes of Health
(NIH) grant for investigators with PhDs is 42
years (NIH, 2012). Research-intensive medical
schools in the United States are faced with
nancial pressures that could eventually limit the
number of PhD scientist positions for which no
hard money support is available were an in-
dividual to lose external sources of support.
Prominent leaders in academia and research
have suggested we are training too many PhDs in
the United States, Europe, and Asia (Alberts et al.,
2014; Cyranoski et al., 2011). However, doing
research as an MD, with all of the associated
Journal of Investigative Dermatology (2016) 136, 1073e1076.
doi:10.1016/j.jid.2016.03.025
2016 The Authors. Published by Elsevier, Inc. on behalf of the Society for Investigative Dermatology.
competing responsibilities, presents its own
challenges.
In light of these uncertainties, how does a
person intent on biomedical research as a career
decide on the best path for achieving this
objective? What degree or degree combination
provides the best opportunities? Will most
biomedical research be done in the private
sector, medical schools, institutes, or univer-
sities? In clinical or basic science departments?
These questions are not easy to answer, because
many unknown variables will factor into deter-
mining where, and by whom, research will be
done in the next several decades. Changes in
federal funding, possible reductions in the size of
graduate programs, the willingness of clinical
departments to hire PhDs, and even the future of
tenure will all have an impact on the research
prole of institutions. Similarly, there is not a
single path to becoming a biomedical researcher.
Indeed, the path is rapidly branching, but you
may have more control over what that path looks
like than you might think.
Before setting out on your journey, understand
yourself
The primary driving force behind our decision to
enter the world of academic research (decades ago)
was the desire to gure out how stuff works. Today,
the tools that are available for scientic exploration
make the road to discovery an even more
compelling and exciting one. The ability to trans-
late these discoveries into clinically useful drugs
and technologies that have impacts on human
health is more possible today than ever before.
However, the road can be challenging and some-
times treacherous. Are you addicted to the rush that
scientic exploration brings? Is your addiction
strong enough to overcome the inevitable setbacks
at the bench and beyond that, in the rat race of
grant writing, mentoring, teaching, and adminis-
tration? If the answer is yes, read on for our tips on
how to shape your own career path in research.
First, what sort of degree or degree
combination is right for you?
Lets take the authors as an example. When we
began our careers, neither of us thought about
whether there would be a glass ceiling of sorts or
a disadvantage to not seeing patients as PhD
researchers. In part this is because neither of us
envisioned ourselves so rmly entrenched at the
www.jidonline.org 1073
 EDITORIAL
interface of science and medicine, but here we nd ourselves.
So, if we could do it over again, what pros and cons would
we see in getting that MD?1
Here are some considerations. First, having a combined
degree gives one a skill set that is highly valued by clinical
departments that engage in research, and the increasing
emphasis on translational science makes MD-PhDs attrac-
tive as candidates for research positions, particularly in clin-
ical departments. For some, the opportunity to be one of the
pioneers who ushers in the golden age of translational
research and a bridge between the sometimes disparate
cultures of clinical and basic science is inspiring. In the
United States in 2013, MD-PhDs fared better at obtaining
highly prized NIH research program grants, with a 24.6%
success rate for this group compared with 21.7% and 21.4%
for single MD and PhD degrees, respectively NIH, 2014).
Balancing the appeal of such a degree, the 8e9 years
required to complete a typical Medical Scientist Training
program poses a major disincentive for some. Then, once one
has secured a faculty position, one must be sure to negotiate
sufcient protected time to establish a robust and sustainable
research program. In addition, there is a danger of being lured
into clinical activities, with the resulting sense of accom-
plishment, at the expense of putting sufcient time into
building a research program.
For those with a desire to focus on basic research without
the distractions of clinical responsibilities, a classic PhD
program holds a lot of appeal. This is the path we chose.
These days it may be considered risky to have a single PhD
degree in the academic setting of a medical school, with very
little in the way of a safety net for those who do not have
clinical credentials. However, in our opinion, the best PhD
scientists have excellent career opportunities, including
academic ones, if they plan smartly, are networked, and
remain open to possibilities. Bipartisan support in the United
States for programs such as Precision Medicine and the
Moon Shot to cure cancer, highlighted in President
Obamas January 2016 State of the Union address, signal
renewed recognition of the importance of basic research as
an investment in our efforts to ameliorate disease (State of the
Union Address, 2016).
For those choosing the PhD-only path, being savvy increases
the chances of a smooth ride
This begins with shaping a research program with the
objective of dening a clear niche for oneself in an area that
attracts sustainable funding. As an example, neither one of us
came into our careers with any idea we would end up
working in the area of skin biology. We both think of our-
selves foremost as cell biologists trying to gure out how cells
function within a tissue. However, it turns out that the skin
offers us an outstanding opportunity to address fundamental
questions in cell biology that are also disease relevant. And
working in an organ system while keeping ones feet rmly
planted in a basic discipline such as cell biology can be an
incredibly exciting way to do science and a good career
1
Note that we will not discuss the single MD degree in this piece. Although it is possible to have a research-intensive career with a single MD degree, in our opinion this
route works for a small group of individuals who obtain extensive research training in other ways, and we do not advise it for most individuals desiring to do research
heavily focused on basic science. We refer the reader to other reviews that provide guidance to this group of individuals (Payne and Brass, 2013).
1074 Journal of Investigative Dermatology (2016), Volume 136
strategy as well. Keeping a toehold in both worlds by main-
taining memberships in general (e.g., the American Society
for Cell biology) and organ-specic (e.g., the Society for
Investigative Dermatology) societies provides one with
insights into both worlds that can be critically important in
establishing transdisciplinary collaborations.
Being both a generalist and a specialist also opens up
additional funding opportunities and a broader scope of
committees in which research projects can be reviewed
As an example, in the United States, NIH applications are
reviewed by one of a large number of study sections (com-
mittees) within the Center for Scientic Review, whose areas
of expertise range from basic mechanisms of cell function to
higher levels of human disease pathophysiology. If one
studies keratinocyte functions in vitro, the investigation may
be reviewed by one of a very few, highly competitive, cell
biology study sections. However, studies of keratinocytes
within their native environment, the skin, may be reviewed
by the Arthritis, Connective Tissue and Skin section or,
depending on the research question, one of several cancer-
related study sections.
On the other hand, the issue of where best to target our
research project applications can be a struggle for us as basic
cell biologists, because we are driven to understand pathways
and mechanisms, which means we are not necessarily wed to
the skin. In fact, studying pathways in multiple tissues, and
comparing and contrasting how these pathways are man-
ifested in disease, can be revealing. One example comes from
cardiocutaneous diseases caused by mutations in desmosome
molecules that give rise to arrhythmogenic cardiomyopathy
and a range of skin disorders. A recent study in the Green lab
(Northwestern University) found that loss of function of one
desmosome model in cardiac myocytes triggered the initia-
tion of a brotic program in this cell type (Dubash et al.,
2016). Although the pathway was intact in keratinocytes,
the brotic program was not initiated because of a difference
in degradation of a key junctional protein in one cell type
versus the other. As cell biologists we are lured into looking at
multiple models, which can lead to important insights but
also comes with its own challenges. These include the
increased cost of doing business and difculty in nding a
home institute (or even study section), because many in-
stitutes focus on specic organs. This is a challenge associ-
ated with the NIH extramural funding system and limits the
insights that could be gained by looking at multiple organ
systems.
For those at the interface of basic science and medicine, is
it a handicap not to have direct clinical involvement with
diseases relevant to ones research focus?
For us, the answer to this question is no. There are
ample opportunities for PhDs to actively participate in
bench-to-bedside sessions and translational activities.
Training programs for PhDs are becoming increasingly
tailored for introducing trainees to translational research and

for bridging the cultural divides that exist between perspec-
tives of the PhD scientist and clinician. At Northwestern
University, a novel Translational Bridge Program pairs
clinicians and researchers in the Robert H. Lurie Compre-
hensive Cancer Center as co-mentors for postdoctoral fellows
to facilitate more rapid movement of basic ndings into
clinical practice. At the University of Cologne, the Cologne
Excellence Cluster on Stress Responses in Aging Associated
Diseases (i.e., CECAD) cooperates with the Clinical Trials
Center (CTC) to provide educational opportunities for PhDs in
translational research. Navigators provided by the CTC
advise basic scientists on how to navigate the process of
translating basic ndings into clinical use.
Although being on the faculty in a clinical department
may offer the advantages of more immediate access to those
colleagues and patient material, this objective can be ach-
ieved in other ways through interdepartmental and center
activities. Being open to a position in both basic and clinical
departments will increase the scope of opportunities avail-
able to you. However, if you choose to take a job in a
clinical department, do your due diligence to ensure that the
position you are considering is tenure track, to determine
policies related to salary support (before and after tenure),
and to determine that you have comparable access to
students and other facilities as the faculty in basic science
departments. In addition, keep in mind that clinical de-
partments are under increasing nancial pressures. This may
affect the number of PhD researchers recruited to clinical
departments in the future and the extent to which back-up
systems and bridge funding support will be available for
research projects.
What are the challenges early-career-stage investigators in
biomedical research will face in the next decade?
What is possible scientically has exploded. This has caused
expectations to rise, including expectations of reviewers of
grant applications and manuscripts. This is happening at a
time when grant budgets are stagnant. To publish their pa-
pers in the highest-impact journals, students and post-
doctoral fellows nd themselves going back to the bench for
sometimes up to a year to address the comments of referees.
Papers take longer to publish, so time to completion of the
PhD degree is longer. This occurs during a time of life when
people want to have families, which has always been an
issue but has reached a crisis level. A 2015 report (Gould,
2015) showed that the number of researchers with biolog-
ical science PhDs going into academic postdoctoral fel-
lowships dropped from 41% to 31% in cohorts surveyed 10
or 5 years after receiving the PhD, with the others going into
business, government, or nonprot positions. These trends
may have broad-ranging impact on who will be doing
biomedical research in the future if we do not address the
problem.
But all is not lost: WE are the reviewers and WE are the
training program directors, and together with YOU, our
trainees and junior colleagues, we have the power to shape
the landscape of the future biomedical research enterprise
We encourage early career investigators not to sit passively
by while their opportunities continue to erode. You can be
activists and advocates who help carve the path that will be
EDITORIAL
the future of biomedical research. Already PhD students
and postdocs are taking the reins into their own hands,
as exemplied by the emergence of student advocacy
groups (e.g., https://orgsync.com/124536/chapter) and na-
tional organizations such as Future of Research, which grew
out of a Future of Science Symposium in Boston (McDowell
et al., 2015). If you do not know where to start, become a
member of your favorite scientic society. Most provide
guidance and opportunities in getting involved in advocacy,
workshops to teach one how to communicate their science in
a two-minute elevator speech (http://www.ascb.org/tag/
elevator-speech-contest/), opportunities to be representatives
on governing boards (American Society for Cell Biology/
Society for Investigative Dermatology), and retreats that
provide career guidance (Society for Investigative Derma-
tology). Take an interest in what is happening at your own
institutions through student and postdoc groups. Lobby for
onsite child care at your institution. Change is slow, but it will
happen.
Finally, be open and flexible as you set out on this greatest
of adventures
If academia does not work out, there are a variety of
directions one can take and have a fullling job in research,
including private industry, private institutes (e.g., the new
Allen Institute for Cell Science, Seattle, Washington), public
policy, and directorship of graduate training programs or
training grant ofces (Ford, 2015). In addition, emphasis on
team science has opened up new opportunities for PhDs with
transdisciplinary experience to engage in program develop-
ment at the institutional and federal levels. Regardless of the
path taken, science is a tremendously gratifying endeavor that
opens up the possibility of creating an international network
of colleagues working together to achieve common goals. We
encourage our trainees to embrace the opportunities that are
available, not fear them.
ORCID
Kathleen J. Green: http://orcid.org/0000-0001-7332-5867
CONFLICT OF INTEREST
The authors state no conict of interest.
ACKNOWLEDGMENTS
We would like to thank Rex Chisholm for comments and suggestions
during the process of writing this editorial. The authors work is supported by
NIH grants R01 AR041836, R37 AR43380, and R01 CA122151 and by the
J. L. Mayberry Endowment (to KJG) and Deutsche Forschungsgemeinschaft
grants SFB 829 A1 and A5 and SPP1782 and by the German Cancer Aid (to
CMN). KJG receives support as Associate Director of Basic Sciences in the
Robert H Lurie Comprehensive Cancer Center of Northwestern University
(P30 CA60553) and is Director of Northwesterns Carcinogenesis Training
Program (T32 CA009560). KJG and CMN also thank the Alexander von
Humboldt Foundation for supporting KJG while she was performing research
at the University of Cologne, during which time the authors wrote this
manuscript.
Kathleen J. Green, PhD1,2,* and Carien M. Niessen, PhD2
1
Northwestern University Feinberg School of Medicine, Departments
of Pathology and Dermatology, the Robert H Lurie Comprehensive
Cancer Center of Northwestern University, 303 East Chicago
Avenue, Chicago, Illinois 60611, USA; and 2University of Cologne,
Department of Dermatology, Cologne Excellence Cluster on Stress
Responses in Aging Associated Diseases (CECAD), Center for
www.jidonline.org 1075
 EDITORIAL
Molecular Medicine Cologne (CMMC) at the CECAD Research
Center, Joseph Stelzmannstrasse 26, 50931, Cologne, Germany
*
Correspondence: Kathleen J. Green, Joseph L. Mayberry Professor,
Departments of Pathology and Dermatology, Northwestern University
Feinberg School of Medicine, 303 East Chicago Avenue, Chicago,
Illinois 60611. E-mail: kgreen@northwestern.edu
REFERENCES
Alberts B, Kirschner MW, Tilghman S, Varmus H. Rescuing US biomedical
research from its systemic aws. Proc Natl Acad Sci USA 2014;111:
5773e7. http://dx.doi.org/10.1073/pnas.1404402111.
Cyranoski D, Gilbert N, Ledford H, Nayar A, Yahia M. Education: the PhD
factory. Nature 2011;472:276e9. http://dx.doi.org/10.1038/472276a.
Dubash AD, Kam CY, Aguado BA, Patel DM, Delmar M, Shea LD, et al.
Plakophilin-2 loss promotes TGF-b1/p38 MAPK-dependent brotic gene
expression in cardiomyocytes. J Cell Biol 2016;212:425e38.
Ford TJ. What the heck do you do with a Ph.D. in the biomedical sciences?
Science in the News, Harvard University. http://sitn.hms.harvard.
edu/ash/2015/what-the-heck-do-you-do-with-a-ph-d-in-the-biomedical-
sciences/; 2015.
1076 Journal of Investigative Dermatology (2016), Volume 136
Gould J. How to build a better Ph.D. Nature 2015;528:22e5. http://dx.doi.
org/10.1038/528022a.
National Institutes of Health. Biomedical Research Workforce Working Group
report. Bethesda, MD: National Institutes of Health; 2012.
National Institutes of Health. Chapter 3: Physician-Scientists with a Medical
Degree. In: Physician-Scientist Workforce Working Group report.
Bethesda, MD: National Institutes of Health; 2014. p. 11e43.
McDowell GS, Gunsalus KTW, MacKellar DC, Mazzilli SA, Pai VP,
Goodwin PR, et al. Shaping the future of research: a perspective from junior
scientists. F1000Research 2015;3:291. http://dx.doi.org/10.12688/f1000
research.5878.2.
Payne AS, Brass S. Finding nirvana: paths to becoming a physician-scientists
[e-pub]. Science Careers 2013. http://www.sciencemag.org/careers/2013/
10/nding-nirvana-paths-becoming-physician-scientist (accessed 8 November
2015).
Powell K. The future of the postdoc. Nature 2015;520:144e7. http://dx.doi.
org/10.1038/520144a.
State of the Union Address. Remarks of President Barack ObamaState of the
Union Address As Delivered. https://www.whitehouse.gov/the-press-
ofce/2016/01/12/remarks-president-barack-obama-%E2%80%93-prepared-
delivery-state-union-address. 13 January 2016.