Physician-scientist Career Research Articles

A physician-scientist preceptorship in clinical and translational research enhances training and mentorship

BackgroundDual degree program MD/PhD candidates typically train extensively in basic science research and in clinical medicine, but often receive little formal experience or mentorship in clinical and translational research.MethodsTo address this educational and curricular gap, the University of Wisconsin Medical Scientist Training Program partnered with the University of Wisconsin Institute for Clinical and Translational Research to create a new physician-scientist preceptorship in clinical and translational research. This six-week apprentice-style learning experience—guided by a physician-scientist faculty mentor—integrates both clinical work and a translational research project, providing early exposure and hands-on experience with clinically oriented research and the integrated career of a physician-scientist. Five years following implementation, we retrospectively surveyed students and faculty members to determine the outcomes of this preceptorship.ResultsOver five years, 38 students and 36 faculty members participated in the physician-scientist preceptorship. Based on student self-assessments (n = 29, response rate 76%), the course enhanced competency in conducting translational research and understanding regulation of clinical research among other skills. Mentor assessments (n = 17, response rate 47%) supported the value of the preceptorship in these same areas. Based on work during the preceptorship, half of the students produced a peer-reviewed publication or a meeting abstract. At least eleven peer-reviewed manuscripts were generated. The preceptorship also provided a structure for physician-scientist mentorship in the students’ clinical specialty of choice.ConclusionThe physician-scientist preceptorship provides a new curricular model to address the gap of clinical research training and provides for mentorship of physician-scientists during medical school. Future work will assess the long-term impact of this course on physician-scientist career trajectories.

3292 Duke Integrated Physician-Scientist Development

OBJECTIVES/SPECIFIC AIMS: 1.Identify barriers to pursuing research for physician trainees 2.Develop a sustainable pipeline of physician-scientists at Duke 3.Coordinate physician-scientist development programs across the School of Medicine under one central Office 4.Provide infrastructure and resources for all physician-scientists 5.Increase the number of MDs and MD/PhDs who pursue, succeed, and are retained in research METHODS/STUDY POPULATION: To establish a baseline understanding of the needs and concerns of physician-scientist trainees at Duke, we conducted focus groups using a standardized interview guide and thematic analysis. Findings from these focus groups were used to develop a framework for support, leading to the creation of the Office of Physician-Scientist Development (OPSD) housed centrally within the Duke School of Medicine. The OPSD integrates programs and resources for multiple populations including medical students, residents, fellows, junior faculty, and faculty mentors. Pipeline programs will also be developed to enhance research engagement in targeted student populations prior to medical school. RESULTS/ANTICIPATED RESULTS: A total of 45 students and faculty participated in the focus groups and structured interviews (1st year medical student, n=11; 4th year medical students, n=11; residents/fellows, n=13; junior faculty, n=11). While participants raised a number of specific issues, one key message emerged: non-PhD MDs in basic research felt they lacked opportunities for directed training. Moreover, they felt the need to teach themselves many critical skills through trial and error. This has led to perceptions that they cannot compete effectively with PhDs and MD-PhD scientists for research funding and positions. Consensus recommendations included: better guidance in choosing mentors, labs, and projects; central resource for information relevant to physician scientists; training specifically tailored to physician scientists conducting laboratory-based research; improved infrastructure and well-defined training pathways; and assistance with grant preparation. To-date, over 90 students, residents, and fellows have been identified who identify as laboratory-based physician scientists. Additional efforts are underway to identify and characterize the broader range of physician-scientist students and trainees at Duke. DISCUSSION/SIGNIFICANCE OF IMPACT: Our planning study revealed specific steps forward toward developing a robust community of physician-scientists at Duke. As a first step, the Dean of the School of Medicine has appointed an Associate Dean of Physician-Scientist Development to oversee a new Office of Physician-Scientist Development (OPSD) being launched in December of 2018. The OPSD will offer four primary programs. 1) A concierge mentoring program will assist new trainees in identifying research areas of interest and mentors. Trainees will receive periodic contact to provide additional support as needed and promote success. 2) A physician-scientist training program is being created to provide training specific to laboratory research skills as well as career and professional development training to complement existing clinical and translational research programs. 3) Integrated training pathways will provide additional mentored research training for those pursuing research careers. Pathways will capitalize on existing resources from R38 programs, while pursuing additional R38 and R25 support. 4) An MD-Scientist funding program has been developed to provide additional research funding and protected time for students pursuing a second research year. Through the support and programming offered by the OPSD, we anticipate decreased perceptions of barriers to pursuing a physician-scientist career and increased satisfaction with training opportunities. Over time, we expect such support to increase the number of MD students pursuing research as a career and the number of residents, fellows, and MD junior faculty remaining in research careers.

Scientific overview on CSCI-CITAC Annual General Meeting and 2017 Young Investigators' Forum.

The 2017 Annual General Meeting of the Canadian Society of Clinician Investigators (CSCI) and Clinician Investigator Trainee Association of Canada/Association des Cliniciens-Chercheurs en Formation du Canada (CITAC/ACCFC) was a national Annual General Meeting (AGM) held in Toronto, Ontario November 20-22, 2017, in conjunction with the University of Toronto Clinician Investigator Program Research Day. The theme for this year's meeting was "Roll up your sleeves-How to manage your physician scientist career", emphasizing lectures and workshops that were designed to provide tools for being proactive and successful in career planning. The keynote speakers were Dr. Rod McInnes (McGill University and Canadian Institutes of Health Research Acting President), who was the Distinguished Scientist Award recipient, Dr. David Goltzman (McGill University), who was the 2017 Henry Friesen Award recipient, Dr. Gillian Hawker (University of Toronto), Dr. Mike Sapieha (Université de Montréal), who was the 2017 Joe Doupe Award recipient, and Dr. Alex MacKenzie (Children's Hospital of Eastern Ontario Research Institute, University of Ottawa). The workshops, focusing on career development for clinician scientists, were hosted by Dr. Lisa Robinson, Dr. Nicola Jones, Kevin Vuong, Fran Brunelle, Dr. Jason Berman and Dr. Alan Underhill. Further to this, the Young Investigators' Forum encompasses presentations from scientist-clinician trainees from across the country. All scientific abstracts are summarized in this review. There were over 100 abstracts showcased at this year's meeting during the highlighted poster sessions, with six outstanding abstracts selected for oral presentations during the President's Forum.

Physician-Scientist Careers in the Biotechnology and Pharmaceutical Industries.

Many careers are open to physician-scientists in the biotechnology and pharmaceutical sectors. However, research is structured very differently in these environments compared to academic medicine. This article highlights these differences and the reasons for them, then outlines the different career paths available to physician-scientists in the variegated worlds of biotechnology and pharmaceutical companies.

Challenges for the MD Physician-Scientist Upon Entering the Lab: From the Grand to the Practical

Physicians who seek to become laboratory-based physician-scientists, especially those without a PhD degree, face substantial challenges during the critical transition period between clinical and laboratory training. These challenges range from the complex process of adopting new logic structures and standards of proof to the more mundane but important challenges that accompany extending training in a new discipline when other career options are available. Discussion of these challenges can inform individual and institutional strategies to enhance entry and retention of physicians in the physician-scientist career path.

Balancing Research, Teaching, Clinical Care, and Family: Can Physician-Scientists Have it All?

Unprecedented opportunities for research into basic biologic mechanisms, novel diagnostic approaches and therapies, population and outcomes medicine, health policy, and health services now exist, expanding the role of those who understand both patient care and research. Despite this, the total number of physician-scientists in the United States is declining and the average age of physician-scientists increasing. An important cause of the declining physician-scientist workforce is both real and perceived threats to quality of life in choosing this career path. Researchers dually trained in medicine and in the rigors of scientific research have contributed and will undoubtedly continue to contribute substantially to advancing medical care if encouraged to do so. Training programs and workplaces that address threats to quality of life and support strategies that have proven successful in inspiring talented people to pursue the physician-scientist career path are needed to produce, attract, and retain more physician-scientists.

Academic Anesthesiology Career Development: A Mixed-Methods Evaluation of the Role of Foundation for Anesthesiology Education and Research Funding.

In 1986, the American Society of Anesthesiologists created the Foundation for Anesthesiology Education and Research (FAER) to fund young anesthesiology investigators toward the goal of helping launch their academic careers. Determining the impact of the FAER grant program has been of importance. This mixed-methods study included quantitative data collection through a Research Electronic Data Capture survey and curriculum vitae (CV) submission and qualitative interviews. CVs were abstracted for education history, faculty appointment(s), first and last author peer-reviewed publications, grant funding, and leadership positions. Survey nonrespondents were sent up to 3 reminders. Interview questions elicited details about the experience of submitting a FAER grant. Quantitative data were summarized descriptively, and qualitative data were analyzed with NVivo. Of 830 eligible participants, 38.3% (N = 318) completed surveys, 170 submitted CVs, and 21 participated in interviews. Roughly 85% held an academic appointment. Funded applicants were more likely than unfunded applicants to apply for National Institutes of Health funding (60% vs 35%, respectively; P < .01), but the probability of successfully receiving an National Institutes of Health grant did not differ (83% vs 85%, respectively; P = .82). The peer-reviewed publication rate (publications per year since attending medical school) did not differ between funded and unfunded applicants, with an estimated difference in means (95% confidence interval) of 1.3 (-0.3 to 2.9) publications per year. The primary FAER grant mentor for over one-third of interview participants was a nonanesthesiologist. Interview participants commonly discussed the value of having multiple mentors. Key mentor attributes mentioned were availability, guidance, reputation, and history of success. This cross-sectional data demonstrated career success in publications, grants, and leadership positions for faculty who apply for a FAER grant. A FAER grant application may be a marker for an anesthesiologist who is interested in pursuing a physician-scientist career.

Physician-Scientist Career Awards and a Dilemma

Physician-Scientist Career Awards and a Dilemma

The endangered clinician-investigator profession in Saudi Arabia: curricular attention is required

The endangered clinician-investigator profession in Saudi Arabia: curricular attention is required

Impact of elective versus required medical school research experiences on career outcomes

Many US medical schools have added a scholarly or research requirement as a potential intervention to increase the number of medical students choosing to become academic physicians and physician scientists....

Sustaining careers of physician-scientists in neonatology and pediatric critical care medicine: formulating supportive departmental policies.

Understanding mechanisms of childhood disease and development of rational therapeutics are fundamental to progress in pediatric intensive care specialties. However, Division Chiefs and Department Chairs face unique challenges when building effective laboratory-based research programs in Neonatal and Pediatric Intensive Care, owing to high clinical demands necessary to maintain competence as well as financial pressures arising from fund flow models and the current extramural funding climate. Given these factors, the role of institutional support that could facilitate successful transition of promising junior faculty to independent research careers is ever more important. Would standardized guidelines of such support provide greater consistency among institutions? We addressed preliminary questions during a national focus group, a workshop and a survey of junior and senior academicians to solicit recommendations for optimal levels of protected time and resources when starting an independent laboratory. The consensus was that junior faculty should be assigned no more than 8 wk clinical service and should obtain start-up funds of $500K-1M exclusive of a 5-y committed salary support. Senior respondents placed a higher premium on protected time than junior faculty.

An International Summer Biomedical Research Program for Undergraduate Medical Students

Purpose: The declining physician-scientist number is alarming. Therefore, this study is designed to establish early exposure to undergraduate research interest in science careers and generates physician-scientist workforces. Materials and methods: In this paper, we report the experience and student’s perceptions of an innovative summer research program and examine how it could influence students’ interest in research careers. Results: During the summer of 2012, fourteen undergraduate medical students from Alfaisal University, Riyadh, Saudi Arabia, attended a month-long summer biomedical research program at Texas A&M Health Science Center College of Medicine in Temple, Texas, USA. The program was designed to expose students to four domains: 1) an intensive basic science research experience, 2) extraordinary aspects of clinical medicine, 3) collaborative research projects, and 4) social entertaining activities. At the end of the program, a self-administered questionnaire was used to explore participants’ experiences and evaluate the program. Majority of students reported various research skills and knowledge gains, personal and professional gains, negative insights about research and clarifications of a research career. Moreover, majority were satisfied with the overall summer program and recommended it to others. Conclusion: Participation in such scholarly programs enhances research intellectual and practical skills, supports participation in future research activities and increases interest to pursue physician-scientist careers.

Rescuing the physician-scientist workforce: the time for action is now.

The 2014 NIH Physician-Scientist Workforce (PSW) Working Group report identified distressing trends among the small proportion of physicians who consider research to be their primary occupation. If unchecked, these trends will lead to a steep decline in the size of the workforce. They include high rates of attrition among young investigators, failure to maintain a robust and diverse pipeline, and a marked increase in the average age of physician-scientists, as older investigators have chosen to continue working and too few younger investigators have entered the workforce to replace them when they eventually retire. While the policy debates continue, here we propose four actions that can be implemented now. These include applying lessons from the MD-PhD training experience to postgraduate training, shortening the time to independence by at least 5 years, achieving greater diversity and numbers in training programs, and establishing Physician-Scientist Career Development offices at medical centers and universities. Rather than waiting for the federal government to solve our problems, we urge the academic community to address these goals by partnering with the NIH and national clinical specialty and medical organizations.

Challenges facing physician scientist trainees: a survey of trainees in Canada's largest undergraduate and postgraduate programs in a single centre.

A number of indicators suggest that the physician scientist career track is threatened. As such, it is an opportune time to evaluate current training models. Perspectives on physician scientist education and career path were surveyed in trainees at the University of Toronto, home to Canada's longest standing physician scientist training programs. Trainees from the Clinician Investigator Program (CIP) and MD/PhD Program at the University of Toronto were surveyed. Liekert-style closed-ended questions were used to assess future career goals, present and future perspectives and concerns about and beliefs on training. Demographic information was collected regarding year of study, graduate degree program and focus of clinical and health research. Statistical analysis included non-parametric tests for sub-group comparisons. Both groups of trainees were motivated to pursue a career as a physician scientist. While confident in their decision to begin and complete physician scientist training, they expressed concerns about the level of integration between clinical and research training in the current programs. They also expressed concerns about career outlook, including the ability to find stable and sustainable careers in academic medicine. Trainees highlighted a number of factors, including career mentorship, as essential for career success. These findings indicate that while trainees at different stages consistently express career motivation, they identified concerns that are program- and training stage-specific. These concerns mirror those highlighted in the medical education literature regarding threats to the physician scientist career path. Understanding these different and changing perspectives and exploring those differences could form an important basis for trainee program improvements both nationally and internationally.

Perceived barriers to physician–scientist careers among female undergraduate medical students at the College of Medicine – Alfaisal University: A Saudi Arabian perspective

Introduction: At present, only a negligible number of matriculating and graduating female medical students express interest in physician–scientist careers. The aim of this study is to explore the perceived barriers towards pursuing physician–scientist careers by female undergraduate medical students at College of Medicine – Alfaisal University, Saudi Arabia.Methods: An online, anonymous, self-rating survey was administered. The survey assessed students’ perceived barriers towards potential physician–scientist careers by responding to typical 5-point Likert scale statements.Results: One hundred sixteen students (116/171) participated in the survey with a 67.8% response rate. The top three barriers to such physician–scientist careers were greater preference towards patient care than research (75%), lack of conviction as regards merging a fruitful research profession with satisfying motherhood life (52.6%) and paucity of recognizing successful and well-known female physician–scientist role models in the country (48.3%).Discussion: Our results showed that the perceived barriers to physician–scientist careers by College of Medicine – Alfaisal University’s female undergraduate medical students were largely identical to the Western literature with few differences and more influence of cultural reasons. It is crucial for medical educators in Saudi Arabia to work on mechanisms that stimulate female students’ interest in research and resolve all barriers that stand in the face of students towards considering physician–scientist careers.

Career Outcomes of the Graduates of the American Board of Internal Medicine Research Pathway, 1995–2007

In 1995, the American Board of Internal Medicine (ABIM) formalized an integrated residency curriculum including both clinical and research training (the Research Pathway), designed to develop careers of physician-scientists. Individuals who completed Pathway training between 1995 and 2007 were surveyed to determine the extent to which graduates established research-oriented careers. In 2012, the authors used a Web-based, 56-question, multiple-choice electronic survey of 813 participants in Research Pathway programs who completed their residency training between the years of 1995 and 2007. Survey questions addressed source and type of funding, research productivity, and job title/content. Descriptive and inferential analyses were performed. Forty-seven percent of solicited Pathway graduates participated in the survey. Ninety-seven percent of the respondents completed Pathway training. Ninety-one percent reported some research effort, with a group average of 58.6% of total professional effort spent in research. Seventy-two percent currently hold positions in academic medicine; 8.6% in the biomedical industry; and 2.1% in government medical service. Over 85% reported extramural research funding, with 81.4% receiving research support from federal sources. Among the variables positively correlated with the highest level of research engagement were previous graduate-level research training, any first-author publications arising from the Pathway research experience, and the receipt of extramural career development funding supporting the Pathway research. On the basis of a very high level of active research engagement reported by 385 ABIM Research Pathway graduates, this special research training track appears to be effectively meeting its goal of training biomedical scientists.

Congratulations from the IARS!

ON the occasion of its 25th anniversary, the International Anesthesia Research Society (IARS) applauds the Foundation for Anesthesia Education and Research (FAER) for its prodigious contributions to the science of anesthesiology and to the careers of numerous anesthesiology investigators and educators.“IARS joins FAER in redoubling our commitment to the academic future of anesthesiology.…”Founded in 1986, FAER's stated mission is to “advance medicine through education and research in anesthesiology.” Specifically, FAER was started at a time when external metrics indicated that the specialty of anesthesiology was not effectively competing in the arena of biomedical science. Total National Institutes of Health funding to departments of anesthesiology in 1985 was $12.3 million, a mere 0.5% of total expenditures.1FAER wisely targeted the career development of physician-scientists through a program of fellowship and starter grants. These granting mechanisms have successfully bridged trainees from residency to funding as National Institutes of Health investigators. Surveys have demonstrated a huge return on investment from this strategy as measured by extramural grants, publications, and the continued research careers of former grant recipients.2The strategy may also have affected external metrics; by 2003 National Institutes of Health funding to departments of anesthesiology had grown to $97.2 million and 0.9% of total expenditures.Although the eightfold growth in National Institutes of Health research funding to departments of anesthesiology from 1985 to 2003 is a major accomplishment, the fact that funding for anesthesiology departments remains less than 1% of total research funding is an indicator that our specialty is still not achieving its appropriate role in biomedical and clinical research.1Funding levels of less than 1% are not appropriate to our representation in the physician community3or to our potential contributions to improved health outcomes.4FAER has stepped up to the plate to meet this challenge. During the past decade, FAER has increased its research funding nearly fivefold and currently provides approximately $2 million a year in grants to young investigators. Despite this effort, federal research funding for anesthesiology departments has remained nearly constant since 2003, both in total amount and as a percentage of total funding.‡In the increasingly competitive research funding environment, the growing efforts of FAER have helped to maintain the position of our specialty, but this is not enough. The ability of our specialty to thrive is critically dependent on the continued generation of new knowledge. The growth, not just the continuation, of FAER is essential to maintaining the pipeline of talented scholars in anesthesiology.The IARS has also worked hard to support the science of anesthesiology. The IARS is a nonpolitical society founded in 1922 with a mission “to advance and support scientific research and education related to anesthesia and to improve patient care through basic research.” Over the past 20 yr the IARS has funded more than $10 million in research grants and currently provides approximately $750,000 per year in research support. Like FAER, IARS funds starter grants for young investigators, emphasizing clinical research through our Clinical Scholar Research Annoucements. The IARS has also focused on the development of new directions in the specialty through its Frontiers in Anesthesia Research Award, a $750,000, 3-yr grant for novel and innovative projects. Finally, the IARS has worked hard to leverage its funding to solve important anesthesiology-related problems facing the public. The recent evidence that anesthetics administered to neonatal animals causes neuronal death and cognitive impairment5has spawned concern that anesthetics may be neurotoxic in human infants. The IARS has partnered with the U.S. Food and Drug Administration, creating a public-private partnership to raise funds for grants to address this issue in patients. The SmartTots® initiative6,7has just been launched, with contributions from the IARS and philanthropic sources and infrastructure support from the U.S. Food and Drug Administration.§SmartTots® will have its first round of grant funding this year.As with the FAER programs, internal surveys have demonstrated a substantial return on the investment from IARS grant funding, as manifested by the highly successful academic careers of former grantees and their subsequent grant funding from government and foundation sources. The mission of IARS is international and its grants are available to members worldwide. The effect of IARS grant programs has been spread across many nations, particularly in Europe and North America. This international mission complements FAER's focus on anesthesiology research in the United States.It is clear that funding for anesthesiology research will continue to be a scarce resource. FAER deserves tremendous credit for advancing the careers of many anesthesiology physician-scientists and for improving the academic standing of our specialty. The IARS joins FAER in redoubling our commitment to the academic future of anesthesiology in the United States and worldwide. Happy Birthday FAER, and thank you!

The Physician Scientist's Career Guide

The Physician Scientist's Career Guide

Career Development of Physician Scientists: A Survey of Leaders in Academic Medicine

Career Development of Physician Scientists: A Survey of Leaders in Academic Medicine

Thyroid Pathophysiology: Reflections on Physician–Scientist Careers in Thyroidology

ThyroidVol. 20, No. 11 Editorials and CommentaryThyroid Pathophysiology: Reflections on Physician–Scientist Careers in ThyroidologyPaul G. WalfishPaul G. WalfishProfessor Emeritus of Medicine, Pediatrics, Otolaryngology, Pathology & Laboratory Medicine, University of Toronto, Toronto, Canada.Senior Endocrine Consultant, Joseph and Mildred Sonshine Family Centre for Head & Neck Disease, Mount Sinai Hospital, Toronto, Canada.Alex and Simona Shnaider Research Chair in Thyroid Oncology, Mount Sinai Hospital, Toronto, Canada.Search for more papers by this authorPublished Online:9 Nov 2010https://doi.org/10.1089/thy.2010.1661AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetails Volume 20Issue 11Nov 2010 InformationCopyright 2010, Mary Ann Liebert, Inc.To cite this article:Paul G. Walfish.Thyroid Pathophysiology: Reflections on Physician–Scientist Careers in Thyroidology.Thyroid.Nov 2010.1201-1204.http://doi.org/10.1089/thy.2010.1661Published in Volume: 20 Issue 11: November 9, 2010PDF download