Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX; Department of Cancer Biology, Metastasis Research Center, The University of Texas MD Anderson Cancer Center, Houston, TX.
Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.
Am J Obstet Gynecol. 2022 Jan;226(1):1-11. doi: 10.1016/j.ajog.2021.09.045.
Obstetricians know the statistics-1 out of every 10 babies is born premature; preeclampsia affects 1 in 25 pregnant people; the United States has the highest rate of maternal mortality in the developed world. Yet, physicians and scientists still do not fully understand the biology of normal pregnancy, let alone what causes these complications. Obstetrics and gynecology-trained physician-scientists are uniquely positioned to fill critical knowledge gaps by addressing clinically-relevant problems through fundamental research and interpreting insights from basic and translational studies in the clinical context. Within our specialty, however, physician-scientists are relatively uncommon. Inadequate guidance, lack of support and community, and structural barriers deter fellows and early stage faculty from pursuing the physician-scientist track. One approach to help cultivate the next generation of physician-scientists in obstetrics and gynecology is to demystify the process and address the common barriers that contribute to the attrition of early stage investigators. Here, we review major challenges and propose potential pathways forward in the areas of mentorship, obtaining protected research time and resources, and ensuring diversity, equity, and inclusion, from our perspective as early stage investigators in maternal-fetal medicine. We discuss the roles of early stage investigators and leaders at the institutional and national level in the collective effort to retain and grow our physician-scientist workforce. We aim to provide a framework for early stage investigators initiating their research careers and a starting point for discussion with academic stakeholders. We cannot afford to lose the valuable contributions of talented individuals due to modifiable factors or forfeit our voices as advocates for the issues that impact pregnant populations.
每 10 个婴儿中就有 1 个是早产儿；子痫前期影响了 1/25 的孕妇；美国是发达国家中孕产妇死亡率最高的国家。然而，医生和科学家仍然不完全了解正常妊娠的生物学特性，更不用说是什么导致了这些并发症。接受过妇产科培训的医师科学家通过基础研究来解决临床相关问题，并在临床背景下解释基础和转化研究的见解，从而处于独特的位置来填补关键的知识空白。然而，在我们的专业领域，医师科学家相对较少。缺乏指导、支持和社区，以及结构性障碍，阻碍了研究员和早期教职员工走上医师科学家的道路。培养妇产科领域下一代医师科学家的一种方法是揭开这一过程的神秘面纱，解决导致早期研究人员流失的常见障碍。在这里，我们从母胎医学早期研究人员的角度，回顾了主要挑战，并提出了在指导、获得受保护的研究时间和资源以及确保多样性、公平性和包容性方面的潜在途径。我们讨论了机构和国家层面的早期研究人员和领导者在留住和发展我们的医师科学家队伍方面的作用。我们旨在为处于职业生涯早期的研究人员提供一个框架，并为与学术利益相关者进行讨论提供一个起点。我们不能因为可改变的因素而失去有才华的人的宝贵贡献，也不能放弃我们作为倡导者的声音，因为这些倡导者的声音会影响到孕妇群体。
