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Waning Ranks of Physician-Scientists

A National Institutes of Health working group warns that the number of clinicians trained as researchers could soon dwindle.

By | June 9, 2014

FLICKR, ALEX PRIOMOSThe number of physicians who are also trained as research scientists in the U.S. may drop precipitously in coming years, according to a report published last week (June 6) from the National Institutes of Health’s (NIH) Physician-Scientist Workforce Working Group. According to the report, the current physician-scientist workforce is aging, and fewer young investigators are joining their ranks.

The group found the number of physician-scientists age 60 and older is growing. “We’re being sustained by this aging group,” coauthor David Ginsburg of the University of Michigan, Ann Arbor, told ScienceInsider.

Ginsburg said that his group’s primary concern is that as older physician-scientists retire, there won’t be enough researchers to replace them from the younger cohort. He and his colleagues recommended that the NIH increase training opportunities and make changes to grant programs to support younger researchers. “All the NIH can do is call attention to these problems and how important this group of individuals is to the future of biomedical research,” Ginsburg told ScienceInsider.

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Avatar of: drsax

drsax

Posts: 1

June 10, 2014

There are 2 big issues in a lot of mid-level institutions like mine that are exacerbating this problem (State University  in the Midwest).  First, is a leadership that focused on turning academic medical centers in to health care businesses where the primary concern is generating income from the clinical enterprise.  Lip service is given to recruiting clinician scientists, but they are not given the time, support and resources that are necessary to develop an independent research program.  The leadership conveys a view that research is a 'hobby' that they allow potential physician scientists a few hours a week at best.  In most of the successful top tier institutions, research is recognized as a primary function, and supported with sufficient protected time and effective institutional support.  The second issue is that many mid level institutions hire  new physician  faculty with insufficient research training in their residencies.  The result is predictable, they are tasked to start a lab  and write competitive research proposals without sufficient scientific training.  After a few years they either leave the system in frustration or remain essentially as clinicians with 80 to 90% of their time spent in the clinic/hospital and teaching (another important endeavor).  Those of us who recognize this deficiency have been struggling with our academic leadership for the last 30 years with little success.  I hate to be a pessimist, but I don't see this trend in loss of physician scientists reversing wtihout an academic medical center leadership that understands and is committed to developing the research enterprise, and concerted efforts to train physcian scientists to be successful.  At the very least, that means having them do a minimum of 2 years working as postdoctoral research scientists, similar to training provided to Ph.D. postdoctoral fellows.  This can include the final year of fellowship and additional year(s) as a postdoctoral research fellow with minimal clinical duties.  I have several colleagues who trained as physician scientists in this manner in the 80's at UCSF who have gone on to have successful research carreers.  The keys to their success was being trained as a scientist prior to being burdened with expectations to perform as a scientist, and being fortunate enough to obtain a position in an institution that provided a supportive environment for physician scientists.  I also have a number of colleagues who were not successful as scientists and ended up leaving academia or switching to primarily clinical work.  The common factor for all who were not successful was not being provided with sufficient time and support to develop a research program.  At my institution this is not a new struggle and we have lost several potential physician scientists due to lack of protected time and support.

Avatar of: Paul Stein

Paul Stein

Posts: 121

June 10, 2014

drsax provides the most realistic coverage I have ever seen regarding the basic, basic cause of the dwindling research work of the physician scientist. The NIH report, unfortunately, doesn't take this post-training reality too seriously when it provides the number one solution: train more M. D.- Ph. D.'s. This simply will not work when these people run into drsax's institutional economic buzz saw. Within a very short period of time, that Ph. D. training will become viewed as a waste of time by both the hospital and the doctor.

 

This entire physician-scientist problem isn't new. It was heavily discussed in Science magazine in the early 1980's when I was doing my postdoctoral training. But, it is surprising how all the rest of the NIH "solutions" are pretty much the exact same ones tossed around for the last three decades and continually ignore the realities outside NIH's ivory tower. The nuturing of scientists, physician or not, begins and ends with the economics of the individual institution.  Year after year, the truth that dollars brought in by patients are oh so much easier to get than grant funding becomes more and more recognized by more and more institutions.

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