I ch habe deshalb viel zu lernen. (I have so much to learn.) This statement haunts me because it rings true at so many levels. I struggle to learn, but there is always more to know. The trick, it seems, is seeing the similarities between things and making the necessary associations. The connections are there, they're just not always readily apparent.
Since I was a child, I had intended to study medicine. I entered college at the University of Oklahoma  with those intentions and took the required courses, but in my junior year, I decided to study abroad in Austria and ended up with a degree in the German language. It seemed like a tangent, but that's where life took me. I entered medical school at Thomas Jefferson University  in Philadelphia thinking, "I haven't taken organic chemistry in years. What do I remember about science anyway?"
Strangely, just as learning German was based on constructing a grammatical framework and fitting in vocabulary, the same held true for anatomy or pharmacology. You build the basic structure, learn the language, and slot in the details. I discovered a resurgence of enthusiasm and fervor for science and medicine. I was the prodigal child returned home.
Most M.D./Ph.D. students are accepted to medical school already assigned to the dual-degree program. At Thomas Jefferson, students who are in their first 2 years of medical school have the option of applying to the M.D./Ph.D. program. Conceptually, it seemed like an interesting idea to me when I arrived, but I wasn't sure if research was right for me. I had worked in a lab briefly during college, but my experience was limited. So, I put the M.D./Ph.D. idea on a back burner for a while and concentrated on my medical school courses.
I quickly realized during medical school that although I was very proficient at rote memorization, I really am a big-picture thinker. I was capable of memorizing the details of a system or topic in order to jump through that exam hoop, but I really wanted to know more. I often found myself at the end of a class approaching the teacher and asking the same incessant, toddler-type question, "Why?" All sorts of whys. Why did the receptors bind that way? Why were these processes linked? What could we clinically do with this biochemical or molecular knowledge? Why didn't we? Quickly, I realized that the answers to my questions were things that no one definitively knew. It may seem geeky, but I got really excited about taking my understanding to the point where there was no answer. During the process of my education, there was always an answer: fact or opinion, but still an answer. In research science, what you know is neither hard fact nor rule, but the current theory that may be rethought or reworked at any minute. I find this type of problem solving and free thinking very appealing.
I spent a summer in a lab to test if my interest would hold in light of what research really involves. After that summer, I realized that I was still interested in basic and clinical research, but was unwilling to become purely a research scientist. Although limited during the first few years of medical school, patient interaction is what I find most satisfying. As the youngest of six children, I am by nature a social creature. I love people. I love the workings of the human body. Research medicine is applicable to human clinical medicine, but it's often one step away. I want both the innovative and creative aspect of research and the direct and tactile participation in clinical medicine. I want to have my cake and eat it too.
I am now midway through the Ph.D. portion of my education. I successfully completed my first 2 years of medical school and passed my USMLE Step I Boards Exam. Instead of heading into the clinic like the rest of my classmates, I entered the lab. In a little over a year, I will return to the medical school and complete the final two clinical years of school and finish with both an M.D. and a Ph.D. degree. I began my research in the Cell and Tissue Engineering Program at Jefferson, but have recently moved with my adviser to the National Institutes of Health  to complete my research. It's been a wonderful opportunity to see not only the working of academic research, but to see how it is done in the government. The government is a strange and interesting boss, but the resources, in terms of people and equipment, are unbeatable. This is one of the most stimulating environments I have ever been a part of.
The M.D./Ph.D. system has suited my personality very well. The first 2 years of medical school move like an avalanche. Now that I am in the research phase of the program, I am finally able to assimilate some of the knowledge I acquired over the last few years. I see it as a time to use my knowledge in a different way. In research I've found some time to think creatively again, to problem solve, and to think outside of the box. There also is a humbling aspect to research. It's not the same as the classroom where if you study harder, you do better. Sometimes, you work your hardest and you still come away frustrated. I think this is the difficulty, but also the challenge of clinical research. The outcome is based on many different variables, some of which are external to you and your performance. It is a microcosm of life and nature: Sometimes things work out, and sometimes they do not. No one is omnipotent or successful all the time. You have to work around the difficulties and face failure sometimes.
Clinical research is the ultimate marriage of ideas. It exercises one's creativity and logic--and it's the implementation of newly synthesized research concepts translated directly into the setting of patient care and the practice of medicine. We are in a period of exponential growth, where our ability to make new discoveries almost outpaces our ability to know what to do with our new knowledge. I think the field of clinically focused or translational research is and will continue to be one of the most exciting and high-yielding fields of the future. We need people to bridge the gap between a piece of interesting data and a new therapeutic tool. I hope to be one of those people.