The Jahnigen scholars program: a model for faculty career development.

Over the next several decades, there will be unprecedented growth in the number of older adults in the United States. Such growth will require increasing numbers of medical providers with sufficient training in and commitment to geriatrics to meet the healthcare needs of a growing number of seniors, many of whom will be frail and disabled. The April 2008 Institute of Medicine report ‘‘Retooling for an Aging America: Building the Health Care Workforce’’ offers several recommendations to ameliorate what is fast becoming a healthcare provider crisis. The ‘‘retooling’’ will require that all physicians and surgeons who see adult patients become knowledgeable about and experienced in providing ideal care to their older patients. The challenge in meeting this requirement is that there are few geriatrics experts among specialty physicians and surgeons to provide this needed education. Of equal importance to improving the health of America’s seniors is the creation of new knowledge to allow better care. This new knowledge must come through scientific advances. The United States needs programs to nurture the careers of physicians and surgeons who are dedicated to advancing the care provided to seniors. Although several supporting mechanisms, both governmental and nongovernmental, currently exist to fund young physician scientists, opportunities are constrained because of limited financial resources and restrictive granting mechanisms. This is especially true for the surgical specialties. A study comparing discipline-specific success rates for major career development awards from the National Institutes of Health (NIH) is revealing. It has been demonstrated that success rates for award proposals submitted by clinical scientists from departments of surgery are consistently lower than those from other clinical departments such as medicine, psychiatry, pediatrics, and neurology (surgery 41.3% vs nonsurgery 46.7–57.5% P5.009). Furthermore, nonsurgeons were 2.5 times as likely to apply for any type of career development award as surgeons. The largest difference in success rate was noted for the K23 program (mentored patient-oriented research), in which ‘‘non-surgical faculty received 80% more awards on a per proposal basis as compared with surgical faculty.’’ This translates into a 14:1 ratio of nonsurgeon to surgeon physician scientists currently holding a K23 award. Practicing surgeons cite the availability of role models and mentors and support for clinical and basic science research as major concerns in advancing their careers. Not surprisingly, a majority of surgical faculty have cited competing clinical and administrative responsibilities as the reason behind their cessation of research activities. Although non-NIH grants remain available and potentially more accessible (private industry, academic health centers, national medical societies), their limited availability and often low level of support limit their effectiveness. The Dennis W. Jahnigen Career Development Scholars Program (JSP) seeks to address the urgent need to create a structure for developing leaders in geriatrics and academic surgery and related medical disciplines. Launched in 2002 by the American Geriatrics Society (AGS), with support and nurturing from the John A. Hartford Foundation and Atlantic Philanthropies, the JSP fosters the development of greatly needed scientists in the surgical and related medical disciplines. The JSP supports highly qualified young specialty faculty members to initiate and ultimately sustain a career in research and education in the geriatrics aspects of their discipline. It is anticipated that Jahnigen scholars will advance the way each specialty discipline cares for older patients by forging and leading the effort in improving the knowledge base, educational activities, and clinical care within the discipline and by participating in efforts to increase understanding of the geriatric aspects of their specialties at the national and local level. Address correspondence to Paul Katz, Monroe Community Hospital, Medical Administration Monroe Community Hospital, 435 E. Henrietta Road, Rochester, NY 14620. E-mail: [email protected]