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I am shocked to hear how this recent CMAJ article lists research as a nonclinical career.<1> As the Royal College of Physicians and Surgeons clearly states in the CanMEDS framework, physicians must “contribute to the work of a research program.”<2> Does conducting “clinical” research mean choosing a “nonclinical” career?
In fairness to the CMAJ article, people often misunderstand the role of clinician-researchers. Even in academic institutions, some physicians could see their clinical research colleagues as non-clinicians and question these colleagues' clinical competency.<3> The skepticism on clinician-researcher sound like an insult to the clinician-investigator programs, which are available in many universities across Canada to develop residents’ research skills.<4>
We know that research influences guidelines, and guidelines influence our practice, all of which require clinical interpretation. Do these critics assume all research studies are conducted by non-clinicians? This prejudicial assumption is obviously detrimental to the development of medical students and residents. Why do we need physicians to enroll in clinician-investigator and research fellowship programs then? Are they meant to simply deter a physician's clinical knowledge and skill development? It is ironic how physicians often claim to make evidence-based decisions but could suddenly use a non-evidence-based approach to judge their colleagues.
In my humble opinion, staff physicians who practice research are not choosing nonclinical careers. Indeed, they are expanding their scope of clinical practice. You would not call subspecialty physicians nonclinical. Why would you make this assumption about physicians who want to pursue a clinician-researcher career?
References:
1. Glauser W. More doctors talking about nonclinical careers, but challenges remain. CMAJ. 2018;190(32):E969-E970.
2. Scholar. Ottawa, Canada: Royal College of Physicians and Surgeons of Canada; 2015; cited [2018 Jul 29]. Available from: http://www.royalcollege.ca/rcsite/canmeds/framework/canmeds-role-scholar-e.
3. St George I, Kaigas T, McAvoy P. Assessing the competence of practicing physicians in New Zealand, Canada, and the United Kingdom: progress and problems. Fam Med. 2004;36(3):172-177.
4. Special program training requirements for the clinician investigator program (CIP). Ottawa, Canada: Royal College of Physicians and Surgeons of Canada; 2015; cited [2018 Jul 29]. Available from: http://www.royalcollege.ca/cs/groups/public/documents/document/mdaw/mdg4....