J.M. Kwan is a cardiologist, Yale School of Medicine, New Haven, Connecticut, and director, Board of Directors, American Physician Scientists Association, Westford, Massachusetts; ORCID: https://orcid.org/0000-0002-4715-1848 .
E. Noch is a neurologist, Weill Cornell School of Medicine, New York, New York, and director, Board of Directors, American Physician Scientists Association, Westford, Massachusetts; ORCID: https://orcid.org/0000-0002-4561-1169 .
Acad Med. 2022 Oct 1;97(10):1536-1545. doi: 10.1097/ACM.0000000000004802. Epub 2022 Sep 23.
Physician-scientists have long been considered an endangered species, and their extended training pathway is vulnerable to disruptions. This study investigated the effects of COVID-19-related challenges on the personal lives, career activities, stress levels, and research productivity of physician-scientist trainees and faculty.
The authors surveyed medical students (MS), graduate students (GS), residents/fellows (R/F), and faculty (F) using a tool distributed to 120 U.S. institutions with MD-PhD programs in April-June 2020. Chi-square and Fisher's exact tests were used to compare differences between groups. Machine learning was employed to select variables for multivariate logistic regression analyses aimed at identifying factors associated with stress and impaired productivity.
The analyses included 1,929 respondents (MS: n = 679, 35%; GS: n = 676, 35%; R/F: n = 274, 14%; F: n = 300, 16%). All cohorts reported high levels of social isolation, stress from effects of the pandemic, and negative impacts on productivity. R/F and F respondents were more likely than MS and GS respondents to report financial difficulties due to COVID-19. R/F and F respondents with a dual degree expressed more impaired productivity compared with those without a dual degree. Multivariate regression analyses identified impacted research/scholarly activities, financial difficulties, and social isolation as predictors of stress and impaired productivity for both MS and GS cohorts. For both R/F and F cohorts, impacted personal life and research productivity were associated with stress, while dual-degree status, impacted research/scholarly activities, and impacted personal life were predictors of impaired productivity. More female than male respondents reported increased demands at home.
This national survey of physician-scientist trainees and faculty found a high incidence of stress and impaired productivity related to the COVID-19 pandemic. Understanding the challenges faced and their consequences may improve efforts to support the physician-scientist workforce in the postpandemic period.
长期以来，医师科学家一直被认为是濒临灭绝的物种，他们的延长培训途径容易受到干扰。本研究调查了 COVID-19 相关挑战对医师科学家受训者和教师的个人生活、职业活动、压力水平和研究生产力的影响。
作者使用一种工具对美国 120 家拥有 MD-PhD 项目的机构的医学生（MS）、研究生（GS）、住院医师/研究员（R/F）和教师（F）进行了调查。2020 年 4 月至 6 月期间分发了该工具。使用卡方检验和 Fisher 精确检验比较了组间的差异。采用机器学习选择变量进行多变量逻辑回归分析，旨在确定与压力和生产力受损相关的因素。
分析包括 1929 名受访者（MS：n = 679，35%；GS：n = 676，35%；R/F：n = 274，14%；F：n = 300，16%）。所有队列都报告了高水平的社交隔离、大流行带来的压力以及对生产力的负面影响。与 MS 和 GS 受访者相比，R/F 和 F 受访者更有可能因 COVID-19 而面临经济困难。与没有双学位的人相比，拥有双学位的 R/F 和 F 受访者表示生产力受损更为严重。多变量回归分析确定了受影响的研究/学术活动、经济困难和社交隔离是 MS 和 GS 队列压力和生产力受损的预测因素。对于 R/F 和 F 队列，个人生活和研究生产力受影响与压力相关，而双学位身份、受影响的研究/学术活动和个人生活受影响是生产力受损的预测因素。与男性相比，更多的女性受访者报告称家庭需求增加。
这项针对医师科学家受训者和教师的全国性调查发现，与 COVID-19 大流行相关的压力和生产力受损发生率很高。了解所面临的挑战及其后果可能会改善在后大流行时期支持医师科学家劳动力的努力。
