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Abstract
The U.S. physician-scientist (PS) workforce is invaluable to the nation's biomedical
research effort. It is through biomedical research that certain diseases have been
eliminated, cures for others have been discovered, and medical procedures and therapies
that save lives have been developed. Yet, the U.S. PS workforce has both declined
and aged over the last several years. The resulting decreased inflow and outflow to
the PS pipeline renders the system vulnerable to collapsing suddenly as the senior
workforce retires. In November 2015, the Alliance for Academic Internal Medicine hosted
a consensus conference on the PS workforce to address issues impacting academic medical
schools, with input from early-career PSs based on their individual experiences and
concerns. One of the goals of the conference was to identify current impediments in
attracting and supporting PSs and to develop a new set of recommendations for sustaining
the PS workforce in 2016 and beyond. This Perspective reports on the opportunities
and factors identified at the conference and presents five recommendations designed
to increase entry into the PS pipeline and nine recommendations designed to decrease
attrition from the PS workflow.
The long-held but erroneous assumption of never-ending rapid growth in biomedical science has created an unsustainable hypercompetitive system that is discouraging even the most outstanding prospective students from entering our profession--and making it difficult for seasoned investigators to produce their best work. This is a recipe for long-term decline, and the problems cannot be solved with simplistic approaches. Instead, it is time to confront the dangers at hand and rethink some fundamental features of the US biomedical research ecosystem.
Medical research is a prerequisite of clinical advances, while health service research supports improved delivery, access, and cost. Few previous analyses have compared the United States with other developed countries.