The physician-scientist: career issues and challenges at the year 2000.

In the midst of a promising era of expansion in biomedical research, there is growing concern about a serious decline in a crucial category of research personnel: physician-scientists. If this trend continues, many believe that key types of medical research will suffer (1). While apprehension about the survival of physician-scientists had been expressed previously (2–4), there are a number of indications that this problem is becoming more severe. Anecdotal evidence of the difficulties in recruiting and retaining medical school faculty has been growing. Increasingly, prominent leaders in the research community are calling attention to this issue (5, 6). External forces, leading to changes in the finances of academic health centers, are raising new obstacles to research and training (7). Nominations of physicianscientists age 45 or younger to honorary societies such as the American Society for Clinical Investigation have declined by almost 30% over the past decade, suggesting that the pool of talented young investigators is shrinking. The implications of this situation for the progress of medical research made the question relevant to the mission of the Federation of American Societies for Experimental Biology (FASEB): To enhance the ability of biomedical and life scientists to improve, through their research, the health, well-being, and productivity of all people. At its December 1998 meeting, the FASEB Board voted to initiate an investigation of physicianscientists and career opportunities for biomedical research. Responsibility for this study was given to the Career Opportunities Subcommittee of the Science Policy Committee, under the leadership of Nicola Partridge. The subcommittee collected and analyzed data on training and research activities from the Association of American Medical Colleges (AAMC), the American Medical Association (AMA), and the National Institutes of Health (NIH). In addition, the subcommittee organized a conference to address the following questions: • Are physician-scientists critical to the success of the biomedical research enterprise? • What evidence exists that there is a decline in physician-scientists? • If there is a decline, how might it be reversed or alleviated? Delegates from the FASEB societies held a closed session at the conclusion of the conference in order to review the data and the panelists’ testimony and to formulate recommendations. Through ongoing communication with the delegates, the Career Opportunities Subcommittee has endeavored to present, along with the data and conclusions from the conference, the consensus-based recommendations of the FASEB society delegates.