As part of the mini-symposium entitled  The Challenge of Maintaining our Physician-Scientist Workforce,  Dr. Moore Simas discusses the epidemiology of physician scientists in the modern era with a focus on specialty-based and demographic issues

Moore Simas, Tiffany A.

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University of Massachusetts Medical School eScholarship@UMMS UMass Center for Clinical and Translational Science Research Retreat 2016 UMass Center for Clinical and Translational Science Research Retreat May 20th, 11:15 AM The Challenge of Maintaining our Physician-Scientist Workforce (Rare Breed/Endangered Species): Epidemiology & Anecdotes Tiffany A. Moore Simas University of Massachusetts Medical School Let us know how access to this document benefits you. Follow this and additional works at: https://escholarship.umassmed.edu/cts_retreat  Part of the Translational Medical Research Commons Moore Simas TA. (2016). The Challenge of Maintaining our Physician-Scientist Workforce (Rare Breed/Endangered Species): Epidemiology & Anecdotes. UMass Center for Clinical and Translational Science Research Retreat. Retrieved from https://escholarship.umassmed.edu/cts_retreat/2016/program/19 Creative Commons License This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 License. This material is brought to you by eScholarship@UMMS. It has been accepted for inclusion in UMass Center for Clinical and Translational Science Research Retreat by an authorized administrator of eScholarship@UMMS. For more information, please contact Lisa.Palmer@umassmed.edu. The Challenge of Maintaining our Physician-Scientist Workforce (Rare Breed/Endangered Species)  Epidemiology & Anecdotes Tiffany A. Moore Simas, MD, MPH, MEd Joy McCann Professor of Women in Medicine  Associate Professor of Ob/Gyn and Pediatrics Director, Ob/Gyn Research Division Outline • Who makes up the P-S workforce? • What are their demographics? – Age – Gender – Race/Ethnicity – Specialty • What Challenges do P-S face? History 1979:  James Wyngaarden, NIH Director - rang warning bells that PS with medical degree was ‘an endangered species’ (NEJM) 1996: ‘Nathan Committee’ to address perceived shortfall of PS.  Recommended career development grants and LRPs to offset PS education debt and encourage research careers.                 Physician-Scientist – Who are they? • Scientists • With professional degrees • With training in clinical care • Engaged in independent research (basic or clinical) • MD, DO, DDS, DVM ± PhD • (Not necessarily simultaneous efforts) • “Bridge” – Bench↔ Bedside  Size and Composition • Numbers hard to capture • NIH-funded workforce • ‘Invisible’ – Industry  – Non-NIH funded – Unfunded • 2 categories: – Clinical research with patients in practice – Laboratory-based research  NIH PSW-WG, 2014  AMA data from NIH PSW-WG, 2014 1.5% P-S Pool is Decreasing Pipeline J Clin Invest 2015 Oct 1;125(10):3742-7 NIH PSW-WG, 2014 Pipeline:  NIH P-S Pathway P-S Pool is Aging • Age profile has increased over past decade. – Decline 31-60 years – Increase ≥60 years NIH PSW-WG, 2014  NIH Funded P-S Pool is Aging • Average Age of P-S with NIH RPGs (Research Project Grants) has increased – Decline 31-50 years – Increase ≥50 years NIH PSW-WG, 2014  Average Age of First Time RPG Awards Increasing • Longer training times • Higher grant success rates for established investigators • Postponement of retirement P-S Pool is Aging Unequal Participation by Women • 42% F MD/PhD Grads • Gender gap with entrance into and promotion in AMC AAMC, 2013-2014 Medical Education 2004; 38: 848–851 Unequal Participation by Women • Large difference in number of M and F applicants.  • No difference in NIH RPG award rates by gender.   22.9% 23.8% NIH PSW-WG, 2014  Unequal Participation by Women • Work – Life Balance • Women still share disproportionate burden for family care responsibilities – Child-bearing – Start of Lab • Boundaries  Unequal Participation by Minorities Race/ Ethnicity US Population*  NIH Applicants† NIH Awardees† White 64% 70% 74% Hispanic 16% 5% 4% African Am 12% 2% 2% Asian 5% 23% 20% * Wikipedia (Demography of the United States) † NIH PSW-WG, 2014 (rounded to nearest whole numbers) • Sig growth of Asian and Hispanic awardees #s • Less growth of African-American and Native Am #s Unequal Participation by Minorities NIH PSW-WG, 2014 • 5 career groups: 1. Medical Specialties (Allergy, Cards, Derm, GI, Neuro) 2. Surgical specialties (Surg, Urol, Ophtho, Otolaryn) 3. Other (Phys Med & Rehab, Psych, Other) 4. Primary care (FP, IM, OBG, Peds) 5. Hospital-based (Anesth, ED, Path, Rad)  Disparities by Specialties Medical Education 2004; 38: 848–851 Penn State • Financial – Individual: • Increasing education cost & training length - ↑ Debt – MD vs MD/PhD • ↓ Income Potential – Institutional: • Certainty of Clinical Revenue – Salary support • Uncertainty of Research Funding – Expensive hobby – Funding Environment Challenges • Time – Increased training length – All things to all people? – mission tensions – Pressures related to finances – Work-life balance – ‘Tyranny of the Urgent’ • Timing – Start clinical care, lab, & family and lab – Age out of young investigator perks   Challenges  • Confidence  • Contribution • Competitiveness  – RVUs – Grants – Reviewer perceptions • Competence • Coaching (mentors; protectors)  Challenges  • The Bridge • Personal satisfaction – Greater good, more than the individual – Intellectual stimulation – Thrill of discovery • Perseverance, tenacity, grit • Future leadership relevance   Rewards • PS are a rare breed/endangered species. • PS workforce is aging. • Women and minorities are under-represented. • The challenges are numerous. • The rewards are great. • We need to redefine the PS and address supports.  Summary DEAN - Summary • Value of Physician-scientists remains central to mission of academic medicine • Challenges have stabilized but require ongoing affirmative efforts • Specific purposeful mechanisms must be developed to ensure ongoing viability of physician-scientist role 

The Challenge of Maintaining our Physician-Scientist Workforce (Rare Breed/Endangered Species): Epidemiology & Anecdotes

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The Challenge of Maintaining our Physician-Scientist Workforce (Rare Breed/Endangered Species): Epidemiology & Anecdotes

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