Editorial: The Vulnerable Physician-Scientist

A new era of academic medicine is upon us. The current funding climate for research has many medical schools throughout the United States initiating new strategies to conserve costs while still trying to maintain excellence in their tripartite mission of research, education, and clinical care. New measures have been instituted at many schools in which faculty salaries must be balanced by sources of income, including effort on extramural grants, clinical relative value units, educational relative value units, and administrative effort, among others. With its clinical and research skills, one group of individuals, the physician-scientist, is particularly well equipped to face these new challenges. In his book, The Vanishing Physician-Scientist? (1), Andrew Schafer broadly defines a physician-scientist as a physician (with an MD degree or an MD combined with other advanced degrees) who spends most of his/her professional effort engaging in research that seeks knowledge about human health and disease. Because the nature of biomedical research has changed over the decades, so too has the nature and breadth of research conducted by physician-scientists (ranging from basic laboratory studies to translational studies involving human tissues, humans, or human populations). Physician-scientists can engage in all aspects of the medical school tripartite mission, and are seemingly highly marketable. Physician-scientists are also natural candidates for leadership positions (eg, department chairs, center directors, and deans), because they are among the few individuals who can bridge crucial clinical and research issues at the administrative level. But their marketability may very well be their vulnerability in the current academic climate. Recent statistics reported by the National Institutes of Health (NIH) and others identify worrisome trends in pre- and postdoctoral training that cast some doubt on the future of physician-scientists in academics.