Howard H. Garrison

The physician-scientist: career issues and challenges at the year 2000.

In the midst of a promising era of expansion in biomedical research, there is growing concern about a serious decline in a crucial category of research personnel: physician-scientists. If this trend continues, many believe that key types of medical research will suffer (1). While apprehension about the survival of physician-scientists had been expressed previously (2–4), there are a number of indications that this problem is becoming more severe. Anecdotal evidence of the difficulties in recruiting and retaining medical school faculty has been growing. Increasingly, prominent leaders in the research community are calling attention to this issue (5, 6). External forces, leading to changes in the finances of academic health centers, are raising new obstacles to research and training (7). Nominations of physicianscientists age 45 or younger to honorary societies such as the American Society for Clinical Investigation have declined by almost 30% over the past decade, suggesting that the pool of talented young investigators is shrinking. The implications of this situation for the progress of medical research made the question relevant to the mission of the Federation of American Societies for Experimental Biology (FASEB): To enhance the ability of biomedical and life scientists to improve, through their research, the health, well-being, and productivity of all people. At its December 1998 meeting, the FASEB Board voted to initiate an investigation of physicianscientists and career opportunities for biomedical research. Responsibility for this study was given to the Career Opportunities Subcommittee of the Science Policy Committee, under the leadership of Nicola Partridge. The subcommittee collected and analyzed data on training and research activities from the Association of American Medical Colleges (AAMC), the American Medical Association (AMA), and the National Institutes of Health (NIH). In addition, the subcommittee organized a conference to address the following questions: • Are physician-scientists critical to the success of the biomedical research enterprise? • What evidence exists that there is a decline in physician-scientists? • If there is a decline, how might it be reversed or alleviated? Delegates from the FASEB societies held a closed session at the conclusion of the conference in order to review the data and the panelists’ testimony and to formulate recommendations. Through ongoing communication with the delegates, the Career Opportunities Subcommittee has endeavored to present, along with the data and conclusions from the conference, the consensus-based recommendations of the FASEB society delegates.

NIH research funding and early career physician scientists: continuing challenges in the 21st century

Physician scientists (researchers with either M.D. or M.D.‐Ph.D. degrees) have the unique potential to combine clinical perspectives with scientific insight, and their participation in biomedical research has long been an important topic for policymakers and educators. Given the recent changes in the research environment, an update and extension of earlier studies of this population was needed. Our findings show that physician scientists are less likely to take a major role in biomedical research than they were in the past. The number of physician scientists receiving postdoctoral research training and career development awards is at an all‐time low. Physician scientists today, on average, receive their first major research award (R01 equivalent) at a later age than in the 1980s. The number of first‐time R01‐equivalent awards to physicians is at the same level as it was 30 yr ago, but physicians now represent a smaller percentage of the grant recipients. The long‐term decline in the number of physicians entering research careers was temporarily halted during the period of substantial U.S. National Institutes of Health (NIH) budget growth (1998–2003). These gains are lost, however, in the subsequent years when NIH budgets failed to keep pace with rising costs.—Garrison, H. H., Deschamps, A. M. NIH research funding and early career physician scientists: continuing challenges in the 21st century. FASEB J. 28, 1049–1058 (2014). www.fasebj.org

In an era of scientific opportunity, are there opportunities for biomedical scientists?

Has the dramatic growth in the NIH budget affected the training and production of biomed‐ ical Ph.D.s? Examination of new survey data reveals surprising findings. Despite the need for an increased workforce to carry out the expansion in biomedical research, there has not been an increase in new U.S. doctorates awarded, and time‐to‐degree in the biomed‐ ical sciences is no longer increasing. Furthermore, both the frequency and length of postdoctoral appointments are decreasing for U.S. biomedical science recipients. There has been, however, continued growth in the number of foreign postdoctorals. Industrial employ‐ ment of biomedical scientists continues to increase, but there has been only modest growth in tenured or tenure‐track academic jobs.

Underrepresentation by Race–Ethnicity across Stages of U.S. Science and Engineering Education

Differential graduation rates have the greatest impact on underrepresentation in science and engineering. Undergraduate and graduate school matriculation rates also contribute to the race-ethnicity gap. Race-ethnic differences among college freshmens plans for a science or engineering major are small and have less impact on later outcomes.

Education and Employment Patterns of U.S. Ph.D.'s in the Biomedical Sciences

During most of the 1970s and 1980s, the number of biomedical Ph.D.s conferred in the United States was fairly constant. From 1987 to 1995, however, there was an increase of almost 50% in the number of biomedical Ph.D.s awarded by U.S. institutions; nearly 70% of this increase can be accounted for by the increase in the number of noncitizens receiving a Ph.D. in the U.S. Although unemployment among U.S. citizens with biomedical Ph.D.s is now extremely low—less than 2.0%—there have been some important changes in the job market for biomedical Ph.D.s. The total number of biomedical scientists has grown, whereas the number of faculty positions has remained stable, causing a deline in faculty positions as a percentage of total employment for biomedical scientists. Jobs in industry have increased, and in the future might surpass academic jobs as the most prevalent form of employment for U.S. biomedical scientists.—Garrison, H. H., Gerbi, S. A. Education and employment patterns of U.S. Ph.D.s in the biomedical sciences. FASEB J. 12, 139–148 (1998)

Biomedical science postdocs: an end to the era of expansion

After >3 decades of steady growth, the number of biological and medical science postdoctorates at doctoral degree‐granting institutions recently began to decline. From 2010 through 2013, the most recent survey years, the postdoctoral population decreased from 40,970 to 38,719, a loss of 5.5%. This decline represents a notable departure from the previous long‐standing increases in the number of postdoctorates in the biomedical workforce. The rate of contraction appears to be accelerating in the most recent survey years, and this has important implications for the biomedical workforce.—Garrison, H. H., Justement, L. B., Gerbi, S. A. Biomedical science postdocs: an end to the era of expansion. FASEB J. 30, 41‐44 (2016). www.fasebj.org

Increased Funding for NIH: A Biomedical Science Perspective

IN THE LAST FEW MONTHS, science policy has become a major focus of attention in our nation’s capital. Numerous major reports and studies examining current science policies have been published, and several other high profile studies are currently under way. Thoughtful reviews of the nation’s research policies were completed by economist Kenneth Brown and political scientist Donald Stokes (1). The National Academy of Sciences released its analysis of the federal science and technology budget (2) and congressional reviews of our science policies are being chaired by Representatives Vern Ehlers (R-MI) and George Nethercutt (R-WA). The spotlight on science in general, and medical research in particular, reflects the priorities of the American public, who believe that science is vital for our nation’s future. Polls conducted by Research!America consistently demonstrate that Americans support additional expenditures for medical research. Almost three-fourths were willing to pay more in taxes to support it, and 90% believe the United States should remain preeminent in this research (3). Health research has been at the center of this heightened interest in science, interest that has included proposals for substantial increases in funding. President Clinton’s FY 1999 Budget released last February contained the largest increase for NIH ever proposed by a president (8.4%). Budget resolutions prepared by the House and Senate Budget Committees also recognized the national priority for investing in science, singling out the importance of increased funding for NIH. The Senate Budget Resolution included an 11% increase for NIH while the House counterpart was reported to have assumed an increase of about 8% for NIH. The FY1999 appro-

Careers in immunology: the new reality

Are appropriate numbers of scientists being trained for research in immunology? Available data suggest that supply is not yet outstripping opportunities. The form of those opportunities, though, should change.