Opportunity

The American Board of Pathology (ABP) has recently approved a physician-scientist research pathway (PSRP) for pathologists in training. This new pathway was specifically created to increase the recruitment of new physician-scientists to our specialty. Other specialties, such as internal medicine, pediatrics, radiology/radiation oncology, and dermatology, have formally Board approved research training pathways, and there was concern that without a Board sanctioned research training pathway, there would be a decline in such individuals training in pathology. Indeed, published data on specialty choices of MD-PhD graduates have suggested that such a decline may have already begun. Pathology is a unique discipline that is recognized as both a basic biomedical science and a clinical specialty, and it has therefore traditionally attracted energetic, intelligent physician-scientists, interested in studying disease mechanisms at the cellular, molecular, and genetic level. A survey done in 2014 by the Association of Pathology Chairs (APC) showed that 70 of 86 responding chairs favored the creation of a research training pathway. With this overwhelming mandate from the pathology chairs, the APC Research Committee diligently debated and ultimately designed a research training pathway and formed a coalition to work with the ABP to achieve this goal. Pathology has been a major participant in the promotion of the physician-scientist. Based on the Blue Ridge Institute for Medical Research analysis of National Institutes of Health (NIH) grant data for fiscal year 2014, the top 5 departments nationally in total NIH dollars awarded are internal medicine, psychiatry, pediatrics, microbiology/immunology, and pathology. Table 1 shows an analysis of the 4 clinical disciplines in this group with respect to some parameters of physicianscientist training. While pathology commands the least percentage of the NIH budget among the 4 clinical disciplines, the percentage of MD-PhD faculty among all MD faculty is highest in pathology by a factor of 2 to 3 compared to the other disciplines. Table 1 shows that pathology does successfully compete for NIH training grants including institutional T grants, individual fellowship F grants, and the mentored clinical scientist K08 grants. The T and F awards are given to physician-scientists in training, while the K08 awards are provided to junior faculty. Table 2 shows that pathology has the highest percentage of training grants but the lowest percentage of K08 grants, indicating that we are training physicianscientists but failing to recruit them into our discipline. The 2014 APC survey showed while more than half of pathology departments train MD-PhD students, 69% of chairs stated that they had trouble recruiting physician-scientists, reinforcing that our discipline trains but has difficulty in recruiting. It was clear that a number of academic programs within pathology have had strong track records of training successful physician-scientists and it was therefore important that any new pathway not create obstacles to their continued success. The