Physician-scientists: vanishing?

Biomedical research needs practicing physicians -- understanding the issues that arise in the clinic is arguably one of the best ways to inform the work done in the lab. But recently, there is evidence to suggest the numbers of physician-scientists -- MDs who dedicate a significant amount of their time to medical research -- may be dwindling, argues researcher and hematologist linkurl:Andrew Schafer;http://www.med.cornell.edu/research/aischafer/biography.html of Weill Cornell Medical College and

Feb 26, 2010
Jef Akst
Biomedical research needs practicing physicians -- understanding the issues that arise in the clinic is arguably one of the best ways to inform the work done in the lab. But recently, there is evidence to suggest the numbers of physician-scientists -- MDs who dedicate a significant amount of their time to medical research -- may be dwindling, argues researcher and hematologist linkurl:Andrew Schafer;http://www.med.cornell.edu/research/aischafer/biography.html of Weill Cornell Medical College and New York-Presbyterian Hospital/Weill Cornell Medical Center.
Andrew Schafer
Image: Weill Cornell Medical College
Schafer expressed his concerns about this "disturbing" trend to The Scientist, described in a new book he edited, linkurl:The Vanishing Physician-Scientist?.;http://www.cornellpress.cornell.edu/cup_detail.taf?ti_id=5493 TS: We do not have statistics on the numbers of physician-scientists so what makes you think that their role in the biomedical research community may be changing? AS: There are several very disturbing trends that indicate that the career path of the physician-scientist really is in trouble. First, NIH grant applications have more than doubled in the past 15 years, but it turns out that virtually all of that doubling is attributable to PhD medical scientists. The number of pure MDs who are applying for NIH grants has been really flat for 20 or 30 years. [Additionally], physicians drop out of research careers relatively early. At every point in the early life cycle of NIH funding, physician-scientists are more likely than PhD biomedical scientists to leave the NIH grant applicant pool. [This] is, to me, the most disturbing of all because it indicates that it's not [just] that the so called pipeline of physician scientists hasn't been expanding, but that this pipeline is actually leaking very badly. TS: Why do you think there has been this shift? AS: I think there are several things at play. First of all, I think that there are diminishing numbers of successful and happy physician-scientist role models and mentors, which one always needs to sustain one's career. Secondly, if you're an MD [who's] started an academic career, there tend to be too many distractions that are competing with one's full emersion into research -- clinical responsibilities, increasing administrative responsibilities, teaching responsibilities, and all the other things that go along with the typical academic physician. And then probably the most important factor for the dropout is the increasing unpredictability of grant support. Now, with this roller coaster, boom-or-bust erratic cycling of NIH funding, physician-scientists are leaving the research arena because they do have other career options to make a living. TS: What are the consequences if we continue in this direction? AS: Physician-scientists [are] completely indispensible to the medical research enterprise because they bring to medical research the unique perspective of asking scientific questions based on their direct experience with patients. So I don't think our society can afford to lose physician-scientists. TS: So what is the future of physician-scientists? AS: The message I [and other authors] try to convey is [that it's] not as grim as this sounds. I don't think they are vanishing. What is vanishing is our current or our old concepts of what a physician-scientist should look like. In the old days, we had the so-called triple-threat physician-scientists, who could allegedly, on any given day, move between the laboratory and the clinic and the classroom. That, if it ever existed, is definitely disappearing, if it hasn't already disappeared. But in a different form, especially in the form of teams, I think the physician-scientist does have a very bright future.
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[February 2010]*linkurl:UK to boost clinical trial participation;http://www.the-scientist.com/blog/display/54769/
[25th June 2008]*linkurl:Translational Disconnect;http://www.the-scientist.com/article/display/54321/
[March 2008]