Perspective: tectonic shifts in academic pediatrics: changes and adaptation.

Pediatric academia is evolving in the face of many changes: a challenging funding environment, trainees who favor clinical care and part-time careers over biomedical research, and a shrinking pipeline of physician-scientists and clinician-scholars. The trend toward fewer pediatric-based academicians with classical academic interests is the consequence of numerous factors and parallels the decline in MDs entering research careers in other fields. With increasing interest in clinical positions. After fellowship, fewer trainees focus on the rigorous prospective clinical or basic projects which used to dominate fellowship research training. Trainees increasingly choose clinician or clinician-educator career paths. Contributing to this shift are substantial economic pressures that favor the recruitment and development of clinician faculty over research scholars. As these trends continue, there will be a less pluralistic pediatric research base, and high-value pediatric research will become consolidated at institutions with the financial capacity to support pediatric research. The challenge in pediatrics is to anticipate and manage these academic shifts and determine where pediatric academia should move. The author offers several ideas for managing and adapting to the challenges facing academic pediatrics.