The environmental needs of clinician-scientists in ophthalmology.

Nurturing environments play an instrumental role in building a useful and successful career of a Surgeon-Scientist. There is an increasing need for supportive and not merely permissive environments. Three important cornerstones that define a nurturing environment include

Dedicated resources

Dedicated time and

Dedicated mentors and colleagues.

Resource dedication in terms of laboratory space and finances are very crucial to kick-start the career of a clinician-scientist.1, 2, 3, 4 Resources also need to be allocated for the basic science training of the clinicians. Institutional emphasis on primary care rather than focused sub specialization has been recognized as one of the major deterrents for focused research.

Dedicated time simply means the time free of any clinical obligations. The length of this time is controversial but 30% of the total time is usually considered ideal. Once the dedicated time is decided, it must be fiercely protected by an institutional commitment and on ground by the respective departmental heads.

It is useful to have dedicated mentors who themselves are successful in clinical and research areas. Apart from scientific guidance, they can pave way for acquisition of early career grants like the National Clinician Scientist scheme in the United Kingdom. Institutions can hire clinicians who can shoulder additional clinical responsibilities. High-quality colleagues within the subspecialties with expertise beyond the dedicated area of the Surgeon-Scientist would help greatly. This would enable the researchers cum surgeons to refer clinical cases beyond their core area of competence.

There is a need for Ophthalmology institutions to value their clinician-scientists, the distinctive set of skills that these individuals can provide and their critical roles in translational medicine. Few institutes balance all these components and we are fortunate to be a part of them!