R.E. McKinney Jr is chief scientific officer, Association of American Medical Colleges, Washington, DC, and professor emeritus, Duke University School of Medicine, Durham, North Carolina.
Acad Med. 2017 Oct;92(10):1368-1370. doi: 10.1097/ACM.0000000000001869.
For many years, physician-investigators have had a particularly difficult time with their academic careers, so that they have been labeled an endangered species. In this Invited Commentary, the author defines three career paths for physician-investigators-clinical researcher, clinician-scientist, and physician-scientist. Each of these pathways has common and distinct challenges that should be studied and potential improvements that should be evaluated through pilot research projects.The first challenge that all physician-investigators face is securing funding. Physicians are funded by their clinical activities, which often lures physician-investigators to increase their clinical work, particularly when research funding from the National Institutes of Health is difficult to secure and seemingly arbitrarily granted. The second challenge is an appointments, promotion, and tenure system that is not responsive to the needs of faculty working across clinical care and research, particularly when it comes to evaluating team science. Physician-investigators not working full-time in either discipline then may have trouble being promoted. The third challenge is the increasing burdens of clinical activities, particularly with the advent of electronic medical records.In this issue, two articles address overcoming the challenges faced by physician-investigators, one from the National Institutes of Health to grow the workforce and the other to offer organizational and individual solutions to support these investigators in faculty roles. These solutions are encouraging, but data about the extent of the challenges and the potential effects of the solutions are needed to make the physician-investigator career path less daunting.
多年来，医师研究者在学术生涯中一直面临着特别大的困难，以至于他们被贴上了“濒危物种”的标签。在这篇特邀评论中，作者定义了医师研究者的三种职业道路——临床研究员、临床科学家和医师科学家。这些途径都有共同的和独特的挑战，应该通过试点研究项目进行研究和评估潜在的改进。
所有医师研究者面临的第一个挑战是获得资金。医生的资金来源于他们的临床活动，这往往诱使医师研究者增加他们的临床工作，特别是当从美国国立卫生研究院获得研究资金变得困难且似乎是任意授予时。第二个挑战是任命、晋升和终身教职制度，该制度不能满足跨临床护理和研究工作的教师的需求，特别是在评估团队科学时。因此，非全职从事这两个领域工作的医师研究者可能会在晋升方面遇到困难。第三个挑战是临床活动负担的增加，特别是随着电子病历的出现。
本期杂志中有两篇文章探讨了克服医师研究者所面临的挑战，一篇来自美国国立卫生研究院，旨在扩大研究队伍，另一篇则提供了组织和个人解决方案，以支持这些研究人员在教职中的角色。这些解决方案令人鼓舞，但需要有关挑战的程度和解决方案的潜在影响的数据，以使医师研究者的职业道路不那么令人生畏。
