Professional Identity Formation and the Clinician–Scientist: A Paradigm for a Clinical Career Combining Two Distinct Disciplines

Abstract

The clinician-scientist role is critical to the future of health care, and in 2010, the Carnegie Report on Educating Physicians focused attention on the professional identity of practicing clinicians. Although limited in number, published studies on the topic suggest that professional identity is likely a critical factor that determines career sustainability. In contrast to clinicians with a singular focus on clinical practice, clinician-scientists combine two major disciplines, clinical medicine and scientific research, to bridge discovery and clinical care. Despite its importance to advancing medical practice, the clinician-scientist career faced a variety of threats, which have been identified recently by the 2014 National Institutes of Health Physician Scientist Workforce. Yet, professional identity development in this career pathway is poorly understood. This Perspective focuses on the challenges to the clinician-scientist's professional identity and its development. First, the authors identify the particular challenges that arise from the different cultures of clinical care and science and the implications for clinician-scientist professional identity formation. Next, the authors synthesize insights about professional identity development within a dual-discipline career and apply their analysis to a discussion about the implications for clinician-scientist identity formation. Although not purposely developed to address identity formation, the authors highlight those elements within clinician-scientist training and career development programs that may implicitly support identity development. Finally, the authors highlight a need to identify empirically the elements that compose and determine clinician-scientist professional identity and the processes that shape its formation and sustainability.

The Highly Structured Physician Scientist Training Program (PSTP) for Medical Students at the University of Pittsburgh

“…Early training for physician–scientists must not only develop trainees’ foundational knowledge, investigative skills, and the ability to publish and write grants but must also give them intra- and interpersonal skills to persist in a challenging though rewarding career. 36 There is a risk of attrition at each level of professional transition. The PSTP curriculum, which includes mentoring and training in writing, critical review of the literature, and statistical analysis, is designed to build persistence; however, early phases of our curriculum did not explicitly address skills in time management or in dealing with the unpredictability of funding, 2 of the challenges that PSTP students and graduates identified as barriers to persisting in a physician–scientist career.…”

Science in the clinic: a qualitative study of the positioning of MD-PhDs in the everyday clinical setting

“…In a similar vein and with an individual focus, Rosenblum et al [ 43 ] have recently tried to define the nature of clinician-scientist professional identity to understand the underlying motivations and actions that underlie the decision to enter this career track and to remain a clinician-scientist, claiming that understanding the challenges of being a clinician-scientist might contribute to greater career sustainability. With a similar focus on the individual level, it has been suggested that physician scientists need special encouragement and tools in order to balance clinical and research duties as well as balancing (personal) life and career [ 44 ].…”

A nationwide assessment of perceptions of research-intense academic careers among predoctoral MD and MD-PhD trainees

“…In support of this notion, the ability to identify a mentor was significantly associated with academic career intentions and with interest in translational and clinical research by multivariate regression analysis. In addition to cultivating research interest, previous studies have argued that early and persistent mentorship may help address specific concerns from trainees regarding physician-scientist identity formation, as well as the challenges faced by physician-scientists within academia [38]. In this regard, a diverse and dedicated cohort of physician-scientist mentors appears to be a critical determinant of the success of efforts to cultivate a diverse next generation of physician-scientists [39].…”