Factors influencing career progress for early stage clinician-scientists in emerging Asian academic medical centres: a qualitative study in Singapore

OBJECTIVES To explore the factors that influence career progress for early stage clinician-scientists and to identify ways to mitigate these factors in the context of emerging Asian academic medical centres (AMCs). DESIGN Qualitative interviews and thematic data analysis based on grounded theory. SETTING AND PARTICIPANTS Five focus group interviews comprising 29 early career clinician-scientists who have received their first national-level career development award in Singapore. RESULTS Clinical priorities represented an overarching concern with many reporting the difficulty in delineating responsibilities between clinical care and research. Additionally, there was a prevailing perception of the lack of support for research at the institutional level. Participants tended to identify mentors through their own efforts in a relatively haphazard manner, often owing to the dearth of role models and perceived inadequacy of reward systems for mentoring. Support from mentors was thought to be limited in terms of targeted scientific guidance and long-term commitments to the relationship. Most of the participants expressed concerns about how they could secure the next level of funding with diminishing confidence. Notably, the work-life balance was neither conceptualised as a 'barrier' to successful pursuit of research career nor was it translated into the reason for leaving the dual clinical-research career pathway. CONCLUSIONS Results revealed specific limitations presented by the research environment in newly emerging Asian AMCs. To retain a vibrant clinician-scientist workforce, additional measures are needed, aiming to improve institutional culture of research, build mentoring networks, adopt effective tools for tracking career progress and provide a clear and viable career progression path for clinician-scientist. Further research might explore the cross-cultural differences in managing work-life balance in academic medicine.