Surgeon-Scientists Going Extinct

OBJECTIVE: To define the concept of surgeon-scientists and identify the root causes of their decline in number and impact. The secondary aim was to provide actionable remedies. BACKGROUND: Surgeons who conduct research in addition to patient care are referred to as "surgeon-scientists." While their value to society remains undisputed, their numbers and associated impact have been plunging. While reasons have been well identified along with proposals for countermeasures, their application has largely failed. METHODS: We conducted a systematic review covering all aspects of surgeon-scientists together with a global online survey among 141 young academic surgeons. Using gap analysis, we determined implementation gaps for proposed measures. Then, we developed a comprehensive rescue package. RESULTS: A surgeon-scientist must actively and continuously engage in both patient care and research. Competence in either field must be established through protected training and criteria of excellence, particularly reflecting contribution to innovation. The decline of surgeon-scientists has reached an unprecedented magnitude. Leadership turning hospitals into "profit factories" is one reason, a flawed selection process not exclusively based on excellence is another. Most importantly, the appreciation for the academic mission has vanished. Along with fundamentally addressing these root causes, surgeon-scientists' path to excellence must be streamlined, and their continuous devotion to innovation cherished. CONCLUSIONS: The journey of the surgeon-scientist is at a crossroads. As a society, we either adapt and shift our priorities again towards innovation or capitulate to greed for profit, permanently losing these invaluable professionals. Successful rescue packages must not only involve hospitals and universities but also the political sphere.