Challenges Facing Early Career Academic Cardiologists

Tong, Carl W.; Ahmad, Tariq; Brittain, Evan L.; Bunch, T. Jared; Damp, Julie B.; Dardas, Todd; Hijar, Amalea; Hill, Joseph A.; Hilliard, Anthony; Houser, Steven R.; Jahangir, Eiman; Kates, Andrew M.; Kim, Darlene; Lindman, Brian R.; Ryan, John; Rzeszut, Anne; Sivaram, Chittur A.; Valente, Anne Marie; Freeman, Andrew M.

doi:10.1016/j.jacc.2014.03.011

Cited by 50 publications

(44 citation statements)

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“…As our final action item, we urge the establishment of institutional physicianscientist career development offices specifically tasked to oversee career development programs for physician-scientists to help overcome their major barriers at various stages of training -barriers that include funding, uneven departmental or divisional support, and insufficient mentorship (25,26). Leaders of such offices should have sufficient executive authority to coordinate the breadth of physician-scientist training activities within the institution.…”

Section: Resultsmentioning

confidence: 99%

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

Milewicz

Lorenz

Dermody

et al. 2015

Journal of Clinical Investigation

182

152

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In June 2014, the NIH Physician-Scientist Workforce (PSW) Working Group completed a year of data collection and deliberation, and released a report about the status of the PSW (1). The report is a combination of good news and bad news. The good news is that, despite the decline in the NIH budget, the size of the PSW has remained relatively stable. The bad news is that the current demographics, diversity, and career progression of this workforce raise concerns about the future. For a start, although apparently stable in size, the PSW is even smaller than many of us realized, and the apparent stability has hidden important demographic trends. In American Medical Association surveys of the nearly 1 million (and rising) MD physicians in the United States, only 14,000 (1.5%) consider research to be their primary focus (1). Even fewer have NIH grant support; only 8,200 physicians are principal investigators on NIH grants, split evenly between MDs and MD-PhDs (1). The number of extramural NIH-funded physician-scientists with research program (R series) awards has been essentially constant for the past 20 years, while the number of nonphysician (PhD) NIH-funded investigators has increased by half over the same period, reaching 19,400 in 2012 (1). As a result, the percentage of NIH awardees who are physicians has fallen to 30%. Although public policies have encouraged an increase in the number of medical schools and medical students in the US, and medical school admission policies have placed value on undergraduate research, the percentage of physicians focused on research has fallen.At the same time that the PSW has remained stable in size, data in the report show that the average age of the workforce is rising, as older investigators remain employed and younger investigators have not emerged in sufficient numbers. The average age at which a physician-scientist received his or her first NIH R01 grant in 2011 was 44 years for MD-PhDs and 45 years for MDs: approximately 10 years older than in 1980 (2). R01-funded investigators (physicians and nonphysicians) younger than 37 years have all but disappeared, and the time from graduating medical school to obtaining a first faculty position has increased to over 10 years for MD-PhDs and even longer for MDs without a PhD. Women and minorities are underrepresented, having opted not to enter or remain in the workforce. Thus, gathering places for physician-scientists look mostly like clubs for older white men. Without corrective action, the PSW appears headed for a population crash as older investigators retire. We recognize that younger physician-scientists have not entirely disappeared; they just take longer to obtain faculty appointments and independent NIH grants. This situation creates an extended waiting period that we call the holding zone, which contributes to the disturbing demographics (Figure 1). Enough talk, let's do somethingThe NIH advisory group noted these trends and made recommendations that should be considered (1). Rather than repeating them here, we would like t...

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Section: Resultsmentioning

confidence: 99%

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

Milewicz

Lorenz

Dermody

et al. 2015

Journal of Clinical Investigation

182

152

View full text Add to dashboard Cite

show abstract

“…American Heart Association: When applying for American Heart Association postdoctoral fellowships, physician-scientists in training are forced to compete against a growing number of PhDs. 4 Physician-scientists have a natural disadvantage by the fact that time spent in clinical training and duties restricts the amount of preliminary data and participation in research projects that would provide support to their application. b.…”

Section: Fundingmentioning

confidence: 99%

“…A recent review of top reasons from National Institutes of Health Official for K-Grant failure is lack of appropriate preparation or commitment of the applicant or mentor and poorly designed career development plan and research proposal. 4 All of these could be reduced with appropriate protected time and support systems as described above. However, more incentives to physician-scientists from National Institutes of Health would be welcomed.…”

Section: Fundingmentioning

confidence: 99%

“…In a recent survey, 49% of early career cardiologists reported a reduction in potential earnings >$75 000 per year when accepting a position in academic medicine. 4 It is hard to expect someone to invest more years in training beyond residency/fellowship or earn a fraction of the potential salary they could, without more incentives than love for science. I strongly believe that a scientist needs to be driven by passion.…”

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Shine on, Young Physician-Scientist

Davogustto

2017

Circulation Research

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“…Nevertheless, the challenge as we transition from trainees, where time and resources to build upon this passion are more readily available, to attending physicians, is how to incorporate clinical research into one's early career. Although incorporating clinical research into a traditional academic career is generally straightforward, this pathway is not without challenges [1,2]. Incorporating clinical research into a non-traditional environment is a far more daunting.…”

mentioning

confidence: 99%

Incorporating Clinical Research into a Career in Gastroenterology and Hepatology

Wong

2016

Dig Dis Sci

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Challenges Facing Early Career Academic Cardiologists

Cited by 50 publications

References 24 publications

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

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

Shine on, Young Physician-Scientist

Incorporating Clinical Research into a Career in Gastroenterology and Hepatology

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