After his medical residency, Miguel decides to go into academic research.  Although medical school was exciting, and he enjoyed the challenge of applying what he had learned in clinical practice to his specialty area of pain disorders, what he really likes is the idea of working in science. He is especially attracted to the notion of interacting with other researchers in his field, sharing ideas, and benefiting from the intellectual interplay of the research world…brown bag seminars, conferences, internet exchanges, and a helpful mentor.  

Miguel decides that he had better pursue his research interests while he is still young, single, full of new ideas, and brave enough to see if he can become a successful medical researcher. He rationalizes that he can always return to the more secure world of clinical medicine if research doesn’t work out, but that he probably cannot go the other direction–from many years as a clinician to becoming a researcher. His main interest, pain management, is a field that is really taking off, and he has a lot of ideas that he wants to pursue as a researcher.

Miguel receives some startup funds from Dr. Jones, his advisor and clinical liaison, and begins to delve deeply into the literature to formulate his own ideas around some novel uses of a drug that is currently on the market. He writes a complex investigator protocol which he thinks is very good. He asks Dr. Jones and another colleague, Dr. Harpin, to read and critique his full proposal.

A month later, Dr. Harpin, calls Miguel. “Hate to tell you, but Dr. Jones just submitted a research proposal identical to yours as part of a large federal grant that the institution is tendering,” he says. “I know it is yours because I edited it.” Miguel can’t believe his ears. His colleague says, “Unfortunately, I’m afraid the administration will pull your protocol and say it’s in the best interests of the organization to have someone of his stature submit the protocol, not you.”

Miguel is flabbergasted. He’d done all the hard work of devising the protocol, not Dr. Jones. When he tells his friend and junior researcher, Erika, she responds, “Oh, you stupid idiot. Why did you send the entire protocol to anyone?”

Miguel explains that he thought that academic medicine provided a place where he could and should share his ideas. Now he is angry with himself for losing control of his protocol.

At this point, Miguel feels so discouraged, powerless, and defeated that he wishes he were back in clinical practice. He wishes he were anywhere except where he is.

What should Miguel do?

Discussion Questions for the Facilitator

• If Miguel could prove that the work is his, do you think he could recover control of his protocol?
• Who would you discuss the problem with?
• How should Dr. Harpin respond in this matter?
• How might Miguel assess whom in the administration to trust with a complaint about a senior researcher?
• Why might the university prefer to have a senior investigator submit an innovative research proposal instead of a junior investigator?
• What are some subtle take-away lessons gleaned from this case?