"Welcome, Yumi. Please call me Marian, not Dr. Young. We use first names here." Thus my first day in the US as a research fellow at the National Institutes of Health (NIH) started with a greeting remarkably different from what I was used to in the highly hierarchical society of Japan. In a time when one in five researchers in biomedical sciences in the US is an immigrant (1), I hope that sharing my experience of becoming a physician-scientist will highlight the strengths of the US biomedical research community in nurturing scientists from various backgrounds and creating diversity and dynamism in the field.
Coming to the US
After graduating from the Tohoku University School of Medicine in Sendai, Japan, I completed five years of clinical training in internal medicine and endocrinology at Toranomon Hospital in Tokyo, Japan, before coming to the US with little research experience. I received my first full-time training as a research fellow at the NIH for five years and then completed a three-year postdoctoral fellowship at the University of North Carolina at Chapel Hill. Then, I went back to clinical training and completed an internship and residency in internal medicine at the Interfaith Medical Center in Brooklyn, New York, followed by a fellowship in endocrinology, diabetes, and metabolism at the University of Pennsylvania, where I started my path as a physician-scientist and developed my research interest in [beta] cell dysfunction. I obtained my first faculty position at Eastern Virginia Medical School and rose to the rank of Associate Professor and Division Director. I am now at the University of Iowa's Carver College of Medicine, where I have an endowed professorship in diabetes research. In short, I spent 18 years in training, twice as long as the average time to fully train to be a physician-scientist in the US. This occurred largely because of differences between the education systems in Japan and the US and restrictions imposed by immigration and regulatory agencies.
What is a physician-scientist?
This is not a philosophical question. This was indeed a very simple question that I asked myself during my early days in the US. This career path was unknown to me until I had the opportunity to observe and interact with physician-scientists at the NIH. In Japan, the percentage of physicians holding a PhD degree is high and is over 60% in my generation. Japanese MDs pursue a PhD after completing residency training and before moving on to clinical practice for the rest of their career. In Japan, most individuals with MD and PhD degrees in my generation received PhD training without much opportunity to continue research, with the exception of a few who were chosen by their professors to remain in academia. This system is very different from that in the US, where students have the option to enroll in combined MD/PhD programs that foster...