是时候研究澳大利亚的医生-研究人员了。

Time to research Australian physician-researchers.

作者信息

Traill C L, Januszewski A S, Larkins R, Keech A C, Jenkins A J

机构信息

Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.

NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.

出版信息

Intern Med J. 2016 May;46(5):550-8. doi: 10.1111/imj.13043.

DOI:10.1111/imj.13043

PMID:26909676

Abstract

BACKGROUND

Concerns have been expressed 'that the physician-researcher is a dying breed'. As yet there are few Australian data.

AIMS

To compare over time: (i) research progress of Sydney Medical School (SMS) medical practitioner - PhD awardees; (ii) National Health and Medical Research Council (NHMRC) project grant success rates for physician-researchers; and (iii) compare current NHMRC, NSW University and NSW Public Hospital pay scales for physician-researchers.

METHODS

We evaluated 303 medical practitioners awarded a University of Sydney/SMS PhD in 1989-2012 and their publications. We assessed 1990-2014 NHMRC grants to physicians and non-physicians (nationally) and compared physician salaries from NHMRC, the University of Sydney and NSW public hospitals.

RESULTS

SMS PhD completions by clinicians increased ≈2.4-fold since 1989, with a recent decline, whilst non-medical PhD awardees rose 10-fold. The median time of PhD award after medical degree completion was stable at 13 years. A lower percentage of the more recent physician-researchers had completed specialty training at PhD award (34% in 2011-2012 vs 71% in 1989-1990, P = 0.017). Publication rates were stable, but low. Although NHMRC funding increased >10-fold since 1990, national project grant success rates declined (35% in 1990, 17% in 2013 and 15% in 2014, P < 0.0001), with physician-led funded grants declining from 29% in 1989 to 21% in 2013, P = 0.002. Current NHMRC and University salaries are less than comparable-stage public hospital salaries.

CONCLUSION

Since 1989, more medical graduates are completing SMS PhDs, although more often prior to completing clinical Fellowships, and many have ongoing, albeit low, research activity. Nationally NHMRC project grant success rates have declined significantly, as has the proportion of funded physician-led projects. Medical practitioner salaries from NHMRC and from Universities are less than in public hospitals. The Australian physician-researcher is at-risk. Knowledge and actions are needed to protect our medical research capacity.

摘要

背景

有人担心“临床医生 - 研究者这一群体正在消亡”。然而，澳大利亚目前这方面的数据很少。

目的

对不同时期进行比较：（i）悉尼医学院（SMS）医学博士获得者的研究进展；（ii）国家卫生与医学研究委员会（NHMRC）对临床医生 - 研究者的项目资助成功率；（iii）比较NHMRC、新南威尔士大学和新南威尔士公立医院目前针对临床医生 - 研究者的薪资标准。

方法

我们评估了1989年至2012年间获得悉尼大学/SMS博士学位的303名医学从业者及其发表的论文。我们评估了1990年至2014年NHMRC对临床医生和非临床医生（全国范围）的资助情况，并比较了NHMRC、悉尼大学和新南威尔士公立医院支付给临床医生的薪资。

结果

自1989年以来，临床医生完成SMS博士学位的人数增加了约2.4倍，近期有所下降，而非医学博士获得者人数增长了10倍。医学学位完成后获得博士学位的中位时间稳定在13年。在获得博士学位时，完成专科培训的较近期临床医生 - 研究者比例较低（2011 - 2012年为34%，1989 - 1990年为71%，P = 0.017）。发表率稳定，但较低。尽管自1990年以来NHMRC的资金增加了10倍以上，但全国性项目资助成功率却下降了（1990年为35%，2013年为17%，2014年为15%，P < 0.0001），由临床医生主导的获得资助的项目从1989年的29%降至2013年的21%，P = 0.002。目前NHMRC和大学的薪资低于处于同等阶段的公立医院薪资。

结论

自1989年以来，更多医学毕业生完成了SMS博士学位，尽管更多是在完成临床研究员培训之前，而且许多人有持续的研究活动，尽管研究活动较少。在全国范围内，NHMRC项目资助成功率显著下降，由临床医生主导的获得资助的项目比例也下降了。NHMRC和大学支付给临床医生的薪资低于公立医院。澳大利亚的临床医生 - 研究者面临风险。需要知识和行动来保护我们的医学研究能力。