Context Physician-scientists play a unique and critical role in medical research.
Nonetheless, a number of trends followed during the 1980s and 1990s revealed
that this career pathway was in serious jeopardy. Physician-scientists were
declining in number and were getting older. A variety of factors were thought
to contribute to this problem, including increasing indebtedness of medical
school graduates caused by rapidly rising medical school tuition costs.
Objective To evaluate the impact of recently initiated programs from the National
Institutes of Health (NIH) and several not-for-profit institutions designed
to revitalize the physician-scientist career pipeline.
Design We assessed recent trends in the physician-scientist career pipeline
using data obtained from the NIH, the American Medical Association, the Association
of American Medical Colleges, and other sources.
Main Outcome Measures Total numbers of physicians performing research, grant application numbers
and success rates for MDs, MD-PhDs, and PhDs at various stages in their careers,
interest in research among medical students, medical school tuitions and postgraduate
salaries, numbers and composition of applicants for NIH loan repayment programs,
and gender distribution of young physician-scientists.
Results The number of physician-scientists in the United States has been in
a steady state for the past decade, but funded physician-scientists are significantly
older than they were 2 decades ago. However, the study of early career markers
over the past 7 to 10 years has demonstrated increasing interest in research
careers by medical students, steady growth of the MD-PhD pool, and a new burst
of activity in the “late bloomer” pool of MDs (individuals who
choose research careers in medical school or in residency training), fueled
by loan repayment programs that were created by the NIH in 2002. Several recent
trends for more established physician-scientists have also suggested improvement.
Conclusions Although it is too early to assess the impact of these indicators on
the long-term career pathway, the recent growth in activity in the physician-scientist
career pipeline is an encouraging development. Continued funding of these
new programs, coupled with sustained support for physician-scientists committed
to the pathway, will be required to maintain these positive trends.