The search for fundamental knowledge, or basic research, is motivated by curiosity and seeks answers to a wide variety of scientific challenges by slowly adding pieces to life's complex puzzle. In basic biomedical research, experiments are designed to answer specific questions, with the goal of translating research results to the clinical setting as quickly as possible. Scientists realize that in order to attack major diseases such as cancer, heart disease, stroke, and AIDS, they need a broad knowledge base. They know that it is critical to understand more about the specific cellular and molecular changes involved in the development of these conditions in order to find options for treatment and prevention. Researchers are also aware that it takes time to see significant advances and that the long-term relevance of new discoveries to treating human disease is often hard to see.
When the pieces of the puzzle come together and a potentially clinically relevant advance or breakthrough is made, clinical investigators take the information gathered by basic researchers and develop systematic ways to approach the problems presented by a particular disease. Therefore, clinical research is the means by which scientific developments are tested and translated into effective medical practice.
As doctoral students and postdoctoral fellows in the biosciences, we are generally trained to work as independent research scientists with academia or industry in mind. Clinical research is seldom considered a career option, even though there are a growing number of opportunities for Ph.D.s in this field because of increases in the number of clinical trials being conducted both nationally and abroad. An M.D. degree is not required to do clinical research. Ph.D.s in psychology, biostatistics, structural and functional imaging, cognitive neuroscience, diagnosis and phenomenology, genetics, pharmacology, and many other fields are often involved in clinical research. Although usually not knowledgeable about medical management, Ph.D.s come to the clinical arena with considerable experience and training in scientific methods and research.
There are, however, other requirements that need to be met in order to pursue a career in clinical research. First, the individual needs to have a basic understanding of disease processes and a good understanding of medical terminology. This is critical because patients will often ask one's advice on medical issues. Patients will also report various symptoms, and it is important to understand which ones should be rapidly passed along to a physician.
Second, excellent communication skills are essential. When involved in clinical research, one must be comfortable in a hospital and/or clinic setting and must enjoy speaking with patients and their families. One needs to accurately and clearly explain the risks and benefits of participation in the clinical research study, as well as ensuring informed consent. Having self-confidence and being persuasive is key because one is essentially selling the research study to the patient and his or her family. As a clinical researcher, one also needs to be willing to answer phone calls from patients and family members and to be compassionate and comforting.
The ability to communicate with other medical professionals is also critical, because they need to understand that the research will not interfere with patient care. In the hospital setting, nurses are the primary caregivers, and they may be concerned that the study might hinder patient care. Nurses could also be worried that they will be asked to do more work than is normally required, such as transportation to radiologic tests, additional blood draws, additional checking of vital signs, etc. It is the clinical investigator's responsibility to get the medical staff interested in and excited about the research by explaining how the study may have potential benefits to the patient.
Finally, when doing clinical research, one needs to be willing to handle large volumes of paperwork. This involves case report forms and regulatory documents for the government and human subjects committees. In clinical studies, large amounts of data are collected that need to be diligently recorded on the case report forms.
The job requirements mentioned above are particularly relevant if one is working as a clinical research coordinator in the academic setting or in a large group practice. However, there are also many opportunities through the National Institutes of Health and even more through biotechnology and pharmaceutical companies. Furthermore, there are Clinical Research Organizations (CROs) that monitor clinical trials. CROs hire nurses and Ph.D.s, who are responsible for monitoring sites, reviewing documentation, and assuring compliance with clinical protocols. These individuals go through the case report forms and match the information to that in the patient's medical record, so that they can identify and report protocol violations.
In general, the financial compensation in industry is greater than in academia, and the growth potential is considerably greater. In academic health sciences centers or in private practice, the salaries are comparable to those of basic scientists at the junior faculty level. On an hourly basis, clinical research is compensated at a considerably higher rate than is basic research. However, an advantage of the laboratory setting is that one gets to choose the area of one's research and the direction it will take. In clinical research, one is often following previously established guidelines and protocols, although the possibility of being involved in protocol design is often available once one has reached the appropriate level of experience.
So, whatever your choice may be, keep in mind that both basic and clinical research are essential for making progress in the prevention and treatment of disease. Both provide the foundation for developing new therapeutic strategies that advance patient care, and both can offer very fulfilling careers.