H. Burrell Ward was chief resident for research, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, at the time of writing. The author is associate director, Research Track, Psychiatry Residency Training Program, Department of Psychiatry, and Sidney R. Baer, Jr. Foundation fellow, Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; ORCID: https://orcid.org/0000-0003-2901-8004 .
F.R. Levin is Kennedy-Leavy professor of psychiatry and chief, Division on Substance Use Disorders, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York; ORCID: https://orcid.org/0000-0003-4209-1329 .
Acad Med. 2022 Apr 1;97(4):487-491. doi: 10.1097/ACM.0000000000004224.
The size of the physician-scientist workforce has declined for the past 3 decades, which raises significant concerns for the future of biomedical research. There is also a considerable gender disparity among physician-scientists. This disparity is exacerbated by race, resulting in a compounding effect for women of color. Proposed reasons for this disparity include the time and expense physicians must devote to obtaining specialized research training after residency while at the same time burdened with mounting medical school debt and domestic and caretaking responsibilities, which are disproportionately shouldered by women. These circumstances may contribute to the overall gender disparity in research funded by the National Institutes of Health (NIH). Women apply for NIH grants less often than men and are therefore less likely to receive an NIH grant. However, when women do apply for NIH grants, their funding success is comparable with that of men. Increasing representation of women and groups underrepresented in medicine (UIM) requires not only improving the pipeline (e.g., through training) but also assisting early- and midcareer women-and especially women who are UIM-to advance. In this article, the authors propose the following solutions to address the challenges women and other UIM individuals face at each of these career stages: developing specific NIH research training programs targeted to women and UIM individuals in medical school and residency; creating institutional and individual grant initiatives; increasing student loan forgiveness; setting up robust institutional mentorship programs for individuals seeking to obtain independent funding; providing childcare stipends as part of NIH grants; and instituting an NIH requirement that funded investigators participate in efforts to increase diversity in the physician-scientist workforce. Enabling more women and UIM individuals to enter and thrive in the physician-scientist workforce will increase the size and diversity of this critical component of biomedical research.
过去 30 年来,医师科学家队伍的规模一直在缩小,这对未来的生物医学研究提出了重大担忧。医师科学家队伍中也存在相当大的性别差距。这种差距因种族而加剧,对有色人种女性的影响更为严重。造成这种差异的原因包括,医生在住院医师培训后必须投入时间和费用接受专门的研究培训,同时还要背负日益增加的医学院债务和家庭及照顾责任,而这些责任主要由女性承担。这些情况可能导致美国国立卫生研究院 (NIH) 资助的研究存在整体性别差异。女性申请 NIH 资助的频率低于男性,因此获得 NIH 资助的可能性较小。然而,当女性确实申请 NIH 资助时,她们的资助成功率与男性相当。增加女性和医学领域代表性不足的群体(UIM)的代表性不仅需要改善人才库(例如通过培训),还需要帮助处于职业生涯早期和中期的女性,尤其是 UIM 女性,以获得晋升。在本文中,作者提出了以下解决方案,以解决女性和其他 UIM 个人在这些职业阶段面临的挑战:为医学院和住院医师阶段的女性和 UIM 个人制定特定的 NIH 研究培训计划;创建机构和个人资助倡议;增加学生贷款减免;为寻求获得独立资金的个人建立强大的机构指导计划;将儿童保育津贴作为 NIH 资助的一部分;并制定 NIH 要求,即资助的研究人员必须参与增加医师科学家队伍多样性的努力。使更多的女性和 UIM 个人能够进入并在医师科学家队伍中茁壮成长,将增加这一生物医学研究关键组成部分的规模和多样性。