How to become a research/academic staff?

[MarsRover]

Maybe the wrong spot to post this, but perhaps medical students are also interested. Further this is the more active section to post. 

I am interested in research, and looking into a two year research fellowship post residency. I am curious though to understand how getting a job as a clinician researcher actually works. If you work clinically 40% of the time and 60% research. Does your salary need to be funded by grants? Does the department help support you? Presumably you likely more significantly more clinically until you have established yourself? It is a very nebulous area, which is funny given research is pushed on essentially every resident and medical student. 

[Edict]

Most of your salary comes from your clinical earnings afaik. Some departments negotiate special contracts that pay everyone in the department a salary or a set rate, which allows more research heavy staff to be paid for their research, but this is department dependent. 

Grants help support research staff and lab costs, but usually your salary doesn't come from grants for most physicians, most of it comes from your clinical work. Mentorship is key in research and academia, so reach out to your mentors who can help you or direct you to someone who can. 

[shikimate]

Dedicated research time is tricky to negotiate in smaller departments. For example, let's say the department has 5 FTE positions funded by AFP arrangement. If two people has 1 day a week of research (0.2FTE x 2), another 2 has 1 day a week off for academic things (0.2 FTE x 2), then technically that's 0.8 FTE, which is almost another hire. The last guy that doesn't get any time off for research or academic stuff will be burdened by a lot more clinical work. If someone wants 2 days a week off for research, then that's an entire 1 FTE lost to research and academic stuff. First and foremost most places need bodies to do the clinical work, plus on call, resident/medical student training etc. So imagine you are the guy that doesn't get time off for these type of things, would you be content?

Also pay can be contentious. FFS is less common in academic departments so AFP is common. Like mentioned above, if you want more time for research, it means everyone else must do more of the clinical work. Well, in most physician's mind, clinical work is what gets the $, so you must make your research "worth" everyone else's increased workload. Having said that, if you do research on your own hours without reducing your clinical workload, then they will be more than happy to accommodate you.

Research is pushed onto medical student and resident because they're cheap labor and some of them actually give a damn about it. You'll find academic staff who just tag onto a 5th author on some paper every couple of years for the sake of it.

[Arztin]

The previous posted answered perfectly.

Now, I'd like you to think about the following. You don't need to type the answer, but rather actually think about the following: why do you want to work in the academic setting instead of the community, and most importantly, do you really want to work in an academic setting.

[Laika]

A different perspective - at large US institutions, grants often cover part of your salary and you are supported by your department. I know this isn't an option for many people, but if the OP is already thinking about doing a research fellowship, it's something to consider.