Physician-scientist

Last updated

A physician-scientist is traditionally a holder of a medical degree and a doctor of philosophy also known as an MD-PhD. Compared to other clinicians, physician-scientists invest significant time and professional effort in scientific research and spend correspondingly less time in direct clinical practice with ratios of research to clinical time ranging from 50/50 to 80/20. Physician-scientists are often employed by academic or research institutions where they drive innovation across a wide range of medical specialties and may also use their extensive training to focus their clinical practices on specialized patient populations, such as those with rare genetic diseases or cancers. Although they are a minority of both practicing physicians and active research scientists, physician-scientists are often cited as playing a critical role in translational medicine and clinical research by adapting biomedical research findings to health care applications. [1] [2] Over time, the term physician scientist has expanded to holders of other clinical degrees—such as nurses, dentists, and veterinarians— who are also included by the United States National Institutes of Health in its studies of the physician-scientist workforce (PSW). [3]

Contents

History

The concept of the physician-scientist is often attributed to Samuel Meltzer's work in the early 1900s. [1] Concern has often been displayed at declining interest or participation in the field, with James Wyngaarden—who would later go on to become the director of the NIH—describing physician-scientists as an "endangered species" in 1979. [4] Among U.S. biomedical researchers, physician-scientists have declined over time as a share of the total researcher population since the 1970s. [2]

Education

Physician-scientists by definition hold terminal degrees in medicine and/or biomedical science. In the United States and Canada, some universities run specialized dual degree MD-PhD programs, and a small number of D.O.-granting institutions also offer dual degree options as D.O.-Ph.D. [5] In the United States the NIH supports competitive university programs called Medical Scientist Training Programs that aim to train physician-scientists, originally established in 1964 and present at 45 institutions as of 2015. [6] Similar programs were established in the United Kingdom in the 1980s, although with relatively less funding support. [7] There are 3000-5000 trainees in this early-career pool based on the number of MD/PhD trainees in the country and number of medical trainees intending research intense careers . [8] [9] Although this dual-degree pathway is not necessary to establish a physician-scientist career, most do receive some form of explicit research training in addition to their clinical education. [10]

Impact

Physician-scientists are a particularly productive research cohort contributing to biomedical innovation, discovering life saving therapies, and developing disease prevention strategies. [11] Physician-scientists only make up 1.5% of the biomedical workforce, yet according to the PSW, they account for 37% of Nobel Laureates in Physiology or Medicine from 1990 to 2014, and over the last 30 years of the Lasker Awards, 41% of the Basic Awards and 65% of the Clinical Awards have gone to physician-scientists. [12] [13]

Career and Workforce

Most physician-scientists are employed by universities and medical schools, or by research institutions such as the National Institutes of Health. [1] [14] As of 2014, the NIH counted around 9,000 NIH-funded physician-scientists; this count does not include those whose work is funded by sources other than the NIH—typically meaning those who work in industry, such as at pharmaceutical companies or medical device companies. [3]

At many medical schools, physician-scientist faculty are expected to obtain significant fractions of their nominal salary in the form of competitive research grants, which are also requirements for the award of tenure. This "up or out" system has been described as developed for a primarily male workforce with homemaker wives, incompatible with the work-life balance needs of the current workforce. [4] Uncertainty about stable careers in academic medicine and the long initial training phase are often cited as concerns by aspiring entrants to the field. [15] [16] Data from the NIH on physician-scientist grant awardees suggests that women and minorities are often underrepresented in the population, even in fields like veterinary science where the majority of students are women. [3]

The American Physician Scientists Association (APSA) is a professional association dedicated to physician-scientists, founded in 2003. [17] APSA has worked to identify and remove barriers thus improving the retention of physician-scientists in academic research. [18] [19] Transitioning through early career stages of resident to fellow to junior faculty is the leakiest part of the physician-scientist pathway. The major reasons for leaving research include the inability to obtain research funding, disparities in salaries between research track physician-scientists and full-time clinicians, and increased financial obligations during this time of life. Therefore, early career awards are the best target for new funding opportunities.

During the COVID-19 pandemic, there has been an unprecedented delay and drop in research productivity due to halted studies, reduction of research time to prioritize COVID-19 related clinical duties and diminished funding opportunities by private foundations as a result of revenue loss due to the pandemic. [20] [21] These challenges have weakened the physician-scientist workforce further.

The American Society for Clinical Investigation introduced Young Physician-Scientist Awards in 2013 to support productive early-career researchers. [22] [3]

Related Research Articles

<span class="mw-page-title-main">Albert Einstein College of Medicine</span> Private medical school in New York City, New York

The Albert Einstein College of Medicine is a private, nonprofit, research-intensive medical school in the Morris Park neighborhood of the Bronx, New York City, United States. Founded in 1953, Einstein operates as an independent degree-granting institution as part of the integrated health care Montefiore Health System and also has affiliation with Jacobi Medical Center.

<span class="mw-page-title-main">Baylor College of Medicine</span> Medical school in Houston, Texas

Baylor College of Medicine (BCM) is a medical school and research center in Houston, Texas, within the Texas Medical Center, the world's largest medical center. BCM is composed of four academic components: the School of Medicine, the Graduate School of Biomedical Sciences; the School of Health Professions, and the National School of Tropical Medicine.

<span class="mw-page-title-main">Medical research</span> Wide array of research

Medical research, also known as experimental medicine, encompasses a wide array of research, extending from "basic research", – involving fundamental scientific principles that may apply to a preclinical understanding – to clinical research, which involves studies of people who may be subjects in clinical trials. Within this spectrum is applied research, or translational research, conducted to expand knowledge in the field of medicine.

The Medical Scientist Training Programs (MSTPs) are dual-degree training programs that streamline the education towards both clinical and research doctoral degrees. MSTPs are offered by some United States medical schools, who are awarded financial support from the National Institute of General Medical Sciences, a branch of the National Institutes of Health (NIH). The goal of these training programs is to produce physician scientists who can translate laboratory discoveries into effective treatments for patients.

The Doctorate of Medicine and of Philosophy (MD–PhD) is a dual doctoral degree for physician–scientists, combining the professional training of the Doctor of Medicine degree with the research expertise of the Doctor of Philosophy degree; the Ph.D. is the most advanced credential in the United States. Other dual degree programs exist, such as the joint MD–JD degree; both the JD professional degree and the MD are not universally recognized internationally, however. The National Institutes of Health currently provides 50 medical schools with Medical Scientist Training Program grants that support the training of students in MD–PhD programs at these institutions through tuition and stipend allowances. These programs are often competitive, with some admitting as few as two students per academic year. The MCAT score and GPA of MD–PhD matriculants are often higher than MD only matriculants.

Translational medicine develops the clinical practice applications of the basic science aspects of the biomedical sciences; that is, it translates basic science to applied science in medical practice. It is defined by the European Society for Translational Medicine as "an interdisciplinary branch of the biomedical field supported by three main pillars: benchside, bedside, and community". The goal of translational medicine is to combine disciplines, resources, expertise, and techniques within these pillars to promote enhancements in prevention, diagnosis, and therapies. Accordingly, translational medicine is a highly interdisciplinary field, the primary goal of which is to coalesce assets of various natures within the individual pillars in order to improve the global healthcare system significantly.

The Academy of Medical Sciences is an organisation established in the UK in 1998. It is one of the four UK National Academies, the others being the British Academy, the Royal Academy of Engineering and the Royal Society.

<span class="mw-page-title-main">Mayo Clinic College of Medicine and Science</span> Private nonprofit university focused on biomedical research and graduate-level education.

The Mayo Clinic College of Medicine and Science (MCCMS), formerly known as Mayo Clinic College of Medicine (MCCM), is a private postgraduate-only research university based in Rochester, Minnesota that trains physicians, scientists, and allied health professionals. The college is part of the Mayo Clinic academic medical center and is accredited by the Higher Learning Commission (HLC). MCCMS consists of five schools that offer M.D., Ph.D., and other degrees, as well as medical residencies, fellowships, and continuing medical education (CME).

<span class="mw-page-title-main">Eva Feldman</span> American neurologist

Eva Lucille Feldman, M.D., Ph.D., F.A.A.N., F.A.N.A. is an American physician-scientist and one of the world’s leading authorities on neurodegenerative disease. Currently, she serves as the Russell N. DeJong Professor of Neurology at the University of Michigan, as well as Director of the NeuroNetwork for Emerging Therapies and ALS Center of Excellence at Michigan Medicine. She was also recently named the James W. Albers Distinguished University Professor of Neurology.

<span class="mw-page-title-main">Yves A. Lussier</span>

Yves A. Lussier is a physician-scientist conducting research in Precision medicine, Translational bioinformatics and Personal Genomics. As a co-founder of Purkinje, he pioneered the commercial use of controlled medical vocabulary organized as directed semantic networks in electronic medical records, as well as Pen computing for clinicians.

Translational research is research aimed at translating (converting) results in basic research into results that directly benefit humans. The term is used in science and technology, especially in biology and medical science. As such, translational research forms a subset of applied research.

<span class="mw-page-title-main">American Physician Scientists Association</span>

The American Physician Scientists Association (APSA) is dedicated to career development and community building among physician-scientists in training.

Joe G. N. "Skip" Garcia is an American pulmonary scientist, physician and academician.

<span class="mw-page-title-main">Jeffrey Flier</span> American physician

JeffreyFlier is an American physician, endocrinologist, widely cited scientist, Higginson Professor of Medicine and Physiology, and Harvard University Distinguished Service Professor at Harvard Medical School. He was the 21st Dean of the Faculty of Medicine at Harvard University from 2007 to 2016.

<span class="mw-page-title-main">Renaissance School of Medicine at Stony Brook University</span> Medical school of Stony Brook University

The Renaissance School of Medicine (RSOM) is the graduate medical school of Stony Brook University located in the hamlet of Stony Brook on Long Island, New York. Founded in 1971, RSOM is consistently ranked the top public medical school in New York according to U.S. News & World Report. RSOM is one of the five Health Sciences schools under the Stony Brook Medicine healthcare system.

Ronald Jonathan Falk, MD, FACP, FASN is the Nan and Hugh Cullman Eminent Professor and Chair of the Department of Medicine at the University of North Carolina-Chapel Hill (UNC). He is a clinical nephrologist and internationally recognized expert in anti-neutrophil cytoplasmic autoantibody (ANCA)-induced vasculitis and autoimmune kidney disease. His career as a translational physician-scientist spans more than three decades. His clinical practice and translational research focus on characterizing the cell, tissue and physiologic changes in the development of specific autoimmune kidney diseases and developing new approaches for studying autoimmunity, inflammation and basic neutrophil/monocyte biology. He was Chief of the UNC Division of Nephrology and Hypertension from 1993-2015. He co-founded the UNC Kidney Center in 2005 and continues as Co-Director. Falk is a Past-President of the American Society of Nephrology (ASN). Since 2015, he has served as Chair of the Department of Medicine at UNC.

Translational bioinformatics (TBI) is a field that emerged in the 2010s to study health informatics, focused on the convergence of molecular bioinformatics, biostatistics, statistical genetics and clinical informatics. Its focus is on applying informatics methodology to the increasing amount of biomedical and genomic data to formulate knowledge and medical tools, which can be utilized by scientists, clinicians, and patients. Furthermore, it involves applying biomedical research to improve human health through the use of computer-based information system. TBI employs data mining and analyzing biomedical informatics in order to generate clinical knowledge for application. Clinical knowledge includes finding similarities in patient populations, interpreting biological information to suggest therapy treatments and predict health outcomes.

<span class="mw-page-title-main">Foundation for the National Institutes of Health</span>

The Foundation for the National Institutes of Health (FNIH) is a not-for-profit, 501(c)(3) charitable organization established by the US Congress in 1990. Located in North Bethesda, MD, the FNIH raises private-sector funds, and creates and manages alliances with public and private institutions in support of the mission of the National Institutes of Health (NIH).

Joan Y. Reede is an American physician. She is Harvard Medical School's inaugural dean for diversity and community partnership, and a member of the National Academy of Medicine. She is known for creating programs that mentor and support minority physicians and female physicians. Alumni of her programs have created a 501(c)(3) organization called The Reede Scholars in her honor.

Scott A. Waldman is an MD and biomedical scientist at Sidney Kimmel Medical College of Thomas Jefferson University, where he is the Samuel M.V. Hamilton Professor of Medicine, and also tenured professor and chair of the Department of Pharmacology & Experimental Therapeutics. He is author of a pharmacology textbook, and former chief editor of Clinical Pharmacology & Therapeutics. He is known for his work in atrial natriuretic factor intracellular signaling through guanylate cyclase (GC), and the relation of Guanylyl cyclase C (GC-C) to the pathogenesis of colorectal cancer. Also for his hypotheses concerning the roles of intestinal paracrine hormones in satiety, obesity and cancer risk. Waldman also holds a concurrent position as adjunct professor at the University of Delaware, School of Health Sciences.

References

  1. 1 2 3 Daye D, Patel CB, Ahn J, Nguyen FT (March 2015). "Challenges and opportunities for reinvigorating the physician-scientist pipeline". The Journal of Clinical Investigation. 125 (3): 883–7. doi:10.1172/JCI80933. PMC   4362227 . PMID   25689260.
  2. 1 2 Ley TJ, Rosenberg LE (September 2005). "The physician-scientist career pipeline in 2005: build it, and they will come". JAMA. 294 (11): 1343–51. doi: 10.1001/jama.294.11.1343 . PMID   16174692.
  3. 1 2 3 4 "Physician-Scientist Workforce (PSW) Report 2014". NIH RePORT. National Institutes of Health. Retrieved 12 October 2015.
  4. 1 2 Schafer AI (January 2010). "The vanishing physician-scientist?". Translational Research. 155 (1): 1–2. doi:10.1016/j.trsl.2009.09.006. PMC   2796254 . PMID   20004354.
  5. ↑ "Do/PhD Programs". American Physician Scientists Association. Retrieved 13 October 2015.
  6. ↑ "Medical Scientist Training Program". National Institute of General Medical Sciences. National Institutes of Health. Retrieved 13 October 2015.
  7. ↑ Lemoine NR (July–August 2008). "The clinician-scientist: a rare breed under threat in a hostile environment". Disease Models & Mechanisms. 1 (1): 12–4. doi:10.1242/dmm.000752. PMC   2561982 . PMID   19048043.
  8. ↑ "2020 FACTS: Enrollment, Graduates, and MD-PhD Data". AAMC. Retrieved 2021-07-20.
  9. ↑ Kwan JM, Toubat O, Harrison AM, Riddle M, Wu B, Kim H, et al. (March 2020). "A nationwide assessment of perceptions of research-intense academic careers among predoctoral MD and MD-PhD trainees". Journal of Clinical and Translational Science. 4 (4): 307–316. doi:10.1017/cts.2020.18. PMC   7681110 . PMID   33244411.
  10. ↑ Eisenberg MJ (2011). "Is a Physician-Scientist Career Right for You?". The physician scientist's career guide. New York: Springer. ISBN   9781603279079.
  11. ↑ Sarma GP, Levey A, Faundez V (2019). "Re-examining physician-scientist training through the prism of the discovery-invention cycle". F1000Research. 8: 2123. doi:10.12688/f1000research.21448.1. PMC   7014578 . PMID   32089830.
  12. ↑ Jain MK, Cheung VG, Utz PJ, Kobilka BK, Yamada T, Lefkowitz R (August 2019). "Saving the Endangered Physician-Scientist - A Plan for Accelerating Medical Breakthroughs". The New England Journal of Medicine. 381 (5): 399–402. doi:10.1056/NEJMp1904482. PMID   31365796.
  13. ↑ "NIH RePORT - Physician Scientist-Workforce Report 2014". report.nih.gov. Retrieved 2021-07-20.
  14. ↑ Payne AS, Brass S (16 October 2013). "Finding Nirvana: Paths to Becoming a Physician-Scientist". Science. doi:10.1126/science.caredit.a1300227.
  15. ↑ Ballios BG, Rosenblum ND (October 2014). "Challenges facing physician scientist trainees: a survey of trainees in Canada's largest undergraduate and postgraduate programs in a single centre". Clinical and Investigative Medicine. 37 (5): E268-83. doi: 10.25011/cim.v37i5.22008 . PMID   25282134.
  16. ↑ Morel PA, Ross G (December 2014). "The physician scientist: balancing clinical and research duties". Nature Immunology. 15 (12): 1092–4. doi:10.1038/ni.3010. PMID   25396341. S2CID   29132886.
  17. ↑ "About APSA". American Physician Scientists Association. Retrieved 12 October 2015.
  18. ↑ Kwan JM, Daye D, Schmidt ML, Conlon CM, Kim H, Gaonkar B, et al. (July 2017). "Exploring intentions of physician-scientist trainees: factors influencing MD and MD/PhD interest in research careers". BMC Medical Education. 17 (1): 115. doi:10.1186/s12909-017-0954-8. PMC   5505137 . PMID   28697782.
  19. ↑ Kwan JM, Toubat O, Harrison AM, Riddle M, Wu B, Kim H, et al. (March 2020). "A nationwide assessment of perceptions of research-intense academic careers among predoctoral MD and MD-PhD trainees". Journal of Clinical and Translational Science. 4 (4): 307–316. doi:10.1017/cts.2020.18. PMC   7681110 . PMID   33244411.
  20. ↑ Wade C (January 2021). "Physician-Scientists in the Era of COVID-19: Gone but Not Forgotten". Academic Medicine. 96 (1): e5–e6. doi:10.1097/ACM.0000000000003771. PMC   7543910 . PMID   32991352.
  21. ↑ Levine RL, Rathmell WK (July 2020). "COVID-19 impact on early career investigators: a call for action". Nature Reviews. Cancer. 20 (7): 357–358. doi:10.1038/s41568-020-0279-5. PMC   7273376 . PMID   32503987.
  22. ↑ "Young Physician-Scientist Awards". The American Society for Clinical Investigation. Retrieved 13 October 2015.

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.