Research or patient care: what should you do with a Biomedical degree?

BY STELLA LIU — DIRECTOR OF COMMUNITY ENGAGEMENT

Biomedical research is a high-impact field with large returns to society that merits consideration as a career pathway. Biomedical researchers endeavour to improve health by investigating how the human body works. Those who pursue this career pathway can find themselves in academia, where they improve tools and techniques, study healthy biological processes, and interrogate the causes and progression of disease. Others land roles in industry, which generally involves generating and evaluating treatments for human diseases and disorders, for commercial applications. Although the road to becoming a biomedical researcher is long and arduous, it is incredibly fulfilling and offers highly interesting work for the intellectually curious.

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What is Biomedical Research?

Biomedical research can broadly be divided into several categories:

Improving tools and techniques

• The process of conducting research is the crux of a biomedical research career, wherein there is a consistent need to improve current tools and techniques or develop new ways to understand biological processes. A notable example of this is CRISPR gene editing, for which Emmanuelle Charpentier and Jennifer Doudna were awarded the Nobel Prize in Chemistry in 2020. CRISPR is now commonly used to generate genetically accurate mouse models of disease, which has direct treatment applications.

Studying healthy biological processes

• Knowledge of the most basic human processes, such as how cells function or how the immune system operates, is critical to the progress of biomedical research. University of Melbourne alumni Macfarlane Burnet is considered a scientific hero in this area. He developed the theory of clonal selection, which continues to serve as the foundation of immunology research. However, funding and support for this avenue of research is difficult due to ambiguous real-world applications.

Studying diseases and conditions of interest

• Biomedical research primarily involves studying a particular disease/condition and the mechanics behind disease progression. This includes research to discover the causes of disease (e.g. bacteria, genetic mutation). Studying the interplay between diseases or conditions of interest and normal biological processes is crucial to determining treatment options.

Generating possible treatments

• Knowing the cause of a particular disease/condition doesn’t guarantee that we will find an effective treatment. Generating treatment options can be based on knowledge of the disease/condition, but it can also rely on trial and error. For example, a promising approach to developing a new COVID-19 vaccine involves screening tens of hundreds of nanobodies to find one which can block SARS-CoV-2.

Preliminary evaluation of possible treatments (preclinical research)

• Potential treatments are first examined “in vitro” outside of living organisms. This is an isolated environment which does not represent the complex interactions of a living being. Treatment options can then progress to the “in vivo” stage where tests are conducted on laboratory animals such as mice. This can recapitulate complex human biology, which gives valuable information about the effectiveness of a treatment before it progresses to clinical trial.

Clinical trials

• Highly rigorous treatment studies are conducted in humans before a treatment can become widely available. Clinical trials come in different phases, with early phases being focussed on safety and later stages on the efficacy of the treatment. The goal of biomedical research is to generate information from the above categories and bring treatment options to clinical trials.

Why Biomedical Research?

Beyond the processes themselves, biomedical research offers the chance to make a tangible impact on society. Through research, we can offer significant improvements to health with a comparatively small investment of resources (time, money, effort etc). For example, it is estimated that reducing cancer deaths by 1% will save the US an estimated $500 billion. We are commonly exposed to organisations or events promoting support for biomedical research, such as Daffodil Day or MS Walk, but this can skew public perception of how research works. Research that involves studying foundational biology or improving research techniques is essential to treating these highly popularised diseases, but it can often be underfunded or understaffed. These “neglected research areas” have the capacity to offer massive returns in the form of quality adjusted life years (QALYs). For example, anti-aging research tackles issues such as cancer, neurodegenerative disease and cardiovascular disease from the foundation and aims to increase healthy lifespan. This is a far better approach to solving age-related deaths compared to mainstream research which typically promotes prolonging unhealthy lifespan. However, this is not as attractive for public funding or well-intentioned individuals who enter research to “cure cancer”.

Being a biomedical researcher is extremely satisfying, especially for anyone with a curious mind who is up for an intellectual challenge. Biomedical researchers spend most of their career doing self-directed work. Researchers, as early as Honours students, have the opportunity to work and direct their own project. They maintain their independence, creatively develop their own unique experiments and have substantial input on what they do. Furthermore, every day presents a new opportunity to satiate curiosity, whether that be investigating a new question, using different techniques or technologies, or collaborating with researchers across the world from different disciplines. The most successful researchers have intense intellectual curiosity, but also display high levels of resilience. Academia is highly competitive, and researchers must overcome setbacks, which can include a failed experiment or a rejected paper. A good researcher is also able to position themselves to build strong professional relationships and collaborations, which will help with securing funding, publishing ground-breaking papers in top journals, or working in the most prestigious labs. Although intelligence is important in a multitude of careers, it is particularly crucial for success in the interdisciplinary and complex field of biomedical research.

Good researchers are hard to come by, but without dedicated scientists and innovative minds, no amount of funding will solve the world’s most pressing biomedical issues.

Seeing as biomedical researchers often come from science or biomedicine degrees, medicine can be seen as an attractive career alternative which offers a similar intellectual challenge and a general sense of helping society. However, whilst doctors create a tangible impact in the lives of the patients they treat, they are limited in their ability to scale up their impact to match that of research breakthroughs or major policy changes. It is widely accepted that the “social determinants of health” (e.g. education, social-economic status) plays a far greater role in health outcomes than medical professionals do. Furthermore, doctors and health resources tend to be concentrated in areas of least need, a concept summarised by the “inverse care law”. As such, the incremental addition of an extra clinician into an oversaturated field has diminishing marginal returns. Shockingly, Dr Gregory Lewis from Cambridge estimates that an additional doctor will only add 4 QALYs for every year that they work, an impact which can be matched 30 fold by simply donating 10% of their salary to effective organisations that fight global poverty.

People likely to succeed in medical school have the potential to make a far greater impact outside medicine. 80,000 hours — an organisation which researches careers with the largest positive social impact — recommends that for those interested in medicine, the highest impact opportunities can be found in biomedical research. Good researchers are hard to come by, but without dedicated scientists and innovative minds, no amount of funding will solve the world’s most pressing biomedical issues. Dr John Todd, a Professor of Medical Genetics at Cambridge believes that “The best people are the biggest struggle. The funding isn’t a problem. It’s getting really special people” and would rather turn down substantial funds in exchange for a good researcher for his lab. This suggests that large grant options are still unable to attract top researchers, and that top researchers are more valuable than any state-of-the-art lab equipment purchased with grants. If you have the potential to succeed in biomedical research, this is a highly effective career pathway where you will likely have more impact than alternative pathways with the same degree. ●