“Every hour spent in the lab is an hour not spent in the clinic, and vice versa,”

– Arnon Kater, discussing his motivations and choices as a physician scientist and how these relate to the ambitions of ‘Recognition & Rewards’.

An academic career as a physician-scientist requires not only perseverance but also conscious choices, a solid research foundation and a department that genuinely makes room for this. This is evident from the career of Arnon Kater, an internist-hematologist and professor of translational hematology at Amsterdam UMC.

In 1997, Arnon deliberately chose hematology because clinical practice and laboratory research are closely intertwined in that field, and because an interesting transformation was taking place in the discipline at that very time. They were experimenting with the shift from non-specific chemotherapy treatments to biologically driven, targeted therapies. From an early stage, he felt that he did not just want to treat patients, but also wanted to contribute to the medicine of the future. His conviction was clear: “I don’t just want to practice medicine; I also want to shape medicine”. During his training, he therefore combined clinical work with research and wrote his first research proposal, which was funded by the Dutch Cancer Society (KWF). This led to a PhD on new strategies for Chronic Lymphocytic Leukemia (CLL).

Realizing that he needed further research skills to be able to lead a group independently, he subsequently made a conscious decision to spend additional years conducting research. Partly on the basis of a Veni grant, he organized and funded a postdoctoral position in San Diego (UCSD) working alongside leading researchers. There, he learnt about state-of-the-art laboratory techniques, mouse models and international collaboration, and, together with his wife, made new friends for life. He later returned to Amsterdam on a clinical research fellowship to set up his own group as a physician-scientist.

Physician-scientist in practice: dual responsibility

Arnon is now recognized as an expert in the field of CLL. He has established a national CLL biobank network, received several individual research grants including, most recently, an ERC Advanced Grant – and supervises a large group of PhD students, postdocs and clinical trial employees. In addition, he has led various international Phase 1–3-studies that have contributed to changes in the global standard of care for CLL. At the same time, he works as a hematologist, does on-call duties, treats patients with lymph node cancer and holds managerial roles.

That combination is inspiring, but also presents a structural challenge: “Every hour spent in the lab is an hour not spent in the clinic, and vice versa,” says Arnon. For him, this tension is characteristic of the physician-scientist profile. When asked how to deal with this, he advocates clear choices and explicit support.

Differentiation within the department: the key to sustainable profiles

A significant turning point came around 2020 with the reorganization of the Hematology Department as part of the merger between AMC and VUmc. In that sense, this marked a fresh start. Instead of a single standard profile (where everyone does everything: clinical work, research, teaching), a conscious decision was made to introduce differentiation:

a group of physician scientists (clinical work and substantial research),a group of colleagues focusing on teaching/management,a group of primarily clinical experts.

Within this structure, doing on-call duties and night shifts is no longer a ‘chore’ whilst recognition comes solely through publications; each profile is visibly valued for its own core strengths. For Arnon, this meant that his role as a physician scientist was explicitly recognized and supported.

Six practical lessons and tips for a physician-scientist career pathSet aside a period of time exclusively for developing research skills
 If you want to develop into a physician-scientist, ‘a few extra hours a week’ is, according to Arnon, almost never enough. His advice: make research your main focus for a substantial period of time – for example, one to two years – either in the Netherlands or abroad. Use that period to fully master techniques, experimental thinking and international collaboration. His postdoc years in the US were crucial for later writing grants independently and leading a group.Make explicit arrangements for time and cover
Doing less clinical work means that someone else has to take over patients and duties. Help devise ways in which grants and project funding can be used to pay for temporary replacements. Discuss this openly with the department; otherwise, research will end up being done ‘on the side’ without anyone realizing, and quality will suffer in both areas.Schedule dedicated research time in your week
Arnon learnt that doing research ‘in between other tasks’ mainly leads to frustration. His tip: block out periods in your schedule when you are unavailable for routine clinical work (except in genuine emergencies) and communicate this clearly. During those times, you are available to your research team. This gives you peace of mind and provides clarity for your team and colleagues.Have the courage to choose the area in which you truly wish to excel
A physician-scientist cannot be top-of-the-bill in every field (clinical practice, research, teaching, valorization). Arnon advocates honesty: if your profile is primarily clinical/research-based, teaching may be at a more basic level, and vice versa. This is in line with the ‘Recognition & Rewards’ principle, but it also requires that organizational and assessment systems dare to specify what is not required. At present, however, people are often still expected to keep all the balls in the air, which leads to a heavy workload.Find a department that recognizes differences and supports your profile
It only works if department heads and colleagues genuinely recognize the different profiles and do not measure everyone by the same yardstick. Mergers, restructurings or new policies such as ‘Recognition & Rewards’ are good opportunities to review with the department: who is our clinical expert, who is our physician-scientist, and who is our driving force for teaching and valorization?Make use of networks and roles outside your own department
Arnon does not view international collaborations, working groups and administrative roles as separate from his research. On the contrary, they help him to keep abreast of developments in the field, refine research questions and strengthen the link with clinical practice.

For Arnon, the essence of his work lies in that constant link between the laboratory and the clinic: translating insights from research into better – and now often chemotherapy-free – treatments for patients, and formulating new research questions based on clinical practice. This ties in with the motivation that drove him at the start of his career: “I don’t just want to practice medicine, I also want to shape medicine”. Thanks in part to his choice of a clear ‘physician-scientist’ profile and a department that supports this and dares to set itself apart, he is not only able to sustain this dual role, but it is also visibly valued and recognized both nationally and internationally.