A physician-scientist student and his mentor discuss the challenges of running a research lab while delivering uncompromising patient care.
Elias Wisdom
Vice President, American Physician Scientists Association; M.D.-Ph.D. Student, Oregon Health & Science University
As a current M.D.-Ph.D. student, I’m navigating the unique challenges and rewards of becoming a physician-scientist and envisioning what my career trajectory includes. The journey requires not just completing both my M.D. and Ph.D. degrees (7-8 years of school) and medical residency and fellowship thereafter (5-6 years for neurology and dementia, my desired specialty) but a deep commitment to merging both patient care and scientific discovery. Physician-scientists bridge the gap between clinical care and fundamental biological discovery, driving innovations to create new therapies and transform healthcare. To better understand this career and what it takes to be successful, I sat down with Dr. Miranda Lim, a physician-scientist at Oregon Health & Science University, as well as a mentor of mine, to learn from her experiences and gain insight into how she’s managed to lead both a research lab focused on neurodegenerative diseases and care for current patients with these conditions
Elias Wisdom: Dr. Lim, you’ve had such an interesting and diverse journey navigating a career at the interface of science and medicine. What initially inspired you to pursue a career as a physician-scientist?
Miranda Lim: I was hooked by a psychobiology class at the University of Southern California that explored how the brain controls behavior. It was transformative. I became fascinated by the intersection of science and human behavior — complex things like language, social behavior, and relationships. For me, a career as a physician-scientist felt like the perfect way to dive into these areas, combining hard science and the humanities under one umbrella.
EW: That’s fascinating. You had such a specific vision early on! Where did you do your physician-scientist training, and how did that shape your journey?
ML: I trained in a combined M.D.-Ph.D. program at Emory University in Atlanta from 1998 to 2006. I went into it with a strong desire to research non-human primates, so I applied only to programs affiliated with National Primate Centers. However, when I arrived at Emory, I discovered prairie voles. Their social bonds and behaviors became the focus of my Ph.D. research, and my love for them hasn’t faded since. I still have a prairie vole colony in my lab! After my 8-year M.D.-Ph.D. training, I completed my neurology residency training at Washington University in St. Louis. The institution was incredibly supportive, giving me dedicated research time, which was pivotal to my discovery linking sleep with amyloid pathogenesis in Alzheimer’s disease. That discovery was one of the key turning points in my career.
EW: You mention the importance of dedicated research time during residency, which can be challenging for many physician-scientist trainees. How did you balance the demands of clinical training with research during your residency?
ML: I had the luxury of flexible research time during my residency, which allowed me to spend nearly a year working in the lab. I think it’s key for anyone pursuing this path to stay focused on the bigger picture and the end goal of simultaneously doing research and caring for patients. Time management is crucial, and I found that the more overlap I could have between my clinical work and research, the more seamless it became. For instance, my clinical care for patients with REM sleep behavior disorder (RBD) now informs the research questions I pursue in the lab and vice versa.
EW: That overlap between clinical work and research is so inspiring. What distinguishes the M.D.-Ph.D. path from pursuing medical school or a Ph.D. in science alone?
ML: For me, the M.D.-Ph.D. path is all about translation. As a physician-scientist, you get to work on the front lines of patient care while thinking deeply about how research can solve real-world problems. It’s not just about science for science’s sake — it’s about improving lives. That dual training lets you ask clinical questions that matter and seek answers in the lab. Without the M.D. component, I would never have been as deeply connected to the diseases I study. Similarly, without the Ph.D., I would lack the tools to investigate complex scientific questions.
EW: That sense of connection keeps me motivated, especially amidst the challenges of medical school and my current Ph.D. thesis work. I know this career isn’t always linear, and the challenges are endless. Was there a moment in your career when you faced an unexpected challenge?
ML: Absolutely. I’ve had personal and health challenges that tested my resilience. One particularly difficult time was when my partner and I divorced at the end of residency. I moved to Philadelphia for a fellowship at the University of Pennsylvania, and it was a very raw time for me emotionally. But Penn was incredibly supportive during that transition. I also went on to meet my now-husband there, so that chapter ended up bringing wonderful new beginnings. More recently, I was diagnosed with breast cancer and underwent a double mastectomy. It’s been a difficult experience, but it has also helped me connect with patients in a new way. I’ve come to appreciate even more what it’s like to be on the other side of the doctor-patient relationship. That perspective has reaffirmed my love for this work and inspired me to simplify and prioritize what brings me joy.
EW: I can only imagine how challenging those times must have been, both personally and professionally. How are you able to balance the demands of research, patient care, and personal life as a physician-scientist?
ML: Efficiency is critical. It’s a zero-sum game when it comes to time. If your research is closely aligned with your clinical practice, it becomes easier to stay focused. For instance, my clinic work at the Portland VA, which specializes in RBD, directly informs the research I do on neurodegenerative diseases. That overlap helps me maintain a strong sense of purpose and makes both aspects of my work feel more integrated. On a personal level, I’ve learned to embrace what brings me joy — whether that’s spending time with my family or reflecting on the amazing collaborations I’ve had with colleagues. I also think it’s important to recognize that there are seasons of life — some busier than others — and to give yourself grace during those times.
EW: I’m inspired by your approach to work-life balance, especially given such profound challenges. For students like myself who are pursuing a career as a physician-scientist, what would you say is the most rewarding part of this career?
ML: There are so many rewarding aspects, but I think the most fulfilling moments come from seeing your research directly benefit patients. In addition, working in this field offers incredible variety — no two days are alike. You’re constantly evolving as a scientist and a clinician, and that keeps things exciting. Then there’s the joy of collaborating with talented people who bring new ideas and energy to the table. Those moments of synergy, when everything aligns, are magical.
EW: It sounds like the variety and impact of your work are incredibly motivating. As someone currently in training, I, too, have those moments where I witness research directly benefiting patients. Those keep me motivated. What would you recommend to students pursuing the physician-scientist path?
ML: If you’re passionate about both science and patient care, the M.D.-Ph.D. path offers a unique opportunity to make a real difference. However, it’s not for everyone — it requires a lot of time and commitment. You need to be driven by curiosity and the desire to solve real-world problems. Stay focused on your long-term goals, even if the path sometimes seems uncertain. Importantly, find mentors who can guide you along the way — those relationships can be invaluable.
Dr. Lim’s experiences as a physician-scientist underscore this career’s immense potential and distinguish its uniqueness amongst similar healthcare careers. The ability to simultaneously engage in patient care as a doctor and contribute to transformative scientific discoveries as a well-trained scientist offers an unparalleled opportunity to shape the future of medicine and human knowledge. As I continue the long and arduous training path, Dr. Lim’s dedication, resilience, and research discoveries that directly improve patient care inspire me. For those considering this path, the dual role of clinician and scientist can truly impact individual lives and the healthcare field.
For those interested in becoming a physician-scientist, I encourage you to check out the resources we’ve been developing at the American Physician Scientists Association (APSA), which are geared toward recruiting and mentoring motivated students into this amazing career pathway.
