Many observers believe that the United States is churning out too many new Ph.D. biomedical researchers, creating a hypercompetitive, unhealthy environment. But a new report from an advisory panel to the director of the National Institutes of Health (NIH) paints a different picture for physician-scientists: There may not be enough of them to replace those preparing to retire.
A 2012 study on the U.S. biomedical workforce, requested by NIH and led by Princeton University molecular biologist Shirley Tilghman, found that the output of biomedical Ph.D.s exceeded the supply of academic jobs. However, her committee ran out of time to look at physician-scientists, who make up about 32% of all NIH principal investigators, a total of roughly 9000 individuals. The task was assigned to a new working group of the NIH Advisory Committee to the Director (ACD), which delivered its report on 6 June.
After digging into data on M.D.-Ph.D.s, M.D.s, nurses, and other researchers with clinical training, the working group found new evidence for long-standing concerns about the supply of physician-scientists. The number of physicians conducting research has declined 5.5% since 2003 to about 13,700 in 2012, according to a survey by the American Medical Association (AMA). And AMA and NIH data show that the demographics of physician-scientists have shifted dramatically over the past decade, with the proportion of NIH-funded principal investigators in their 60s and 70s soaring and the share under 60 declining (see graph above and slide 14 here). “We’re being sustained by this aging group,” said working group co-chair David Ginsburg of the University of Michigan, Ann Arbor, at the ACD meeting at NIH headquarters in Bethesda, Maryland.
Although NIH has been worrying for years about the aging of the biomedical workforce, the need for younger physician-scientists is even more pressing, the working group found. As those at the elderly end of the spectrum retire or die, “we’re worried that they’re [physician-scientists are] going to dry up and this is going to be a serious problem,” Ginsburg said in a call with reporters.
The working group recommends bolstering training programs and giving greater weight to proposals from young researchers, two ideas that the Tilghman panel also endorsed. It also recommends creating a category for physician-scientists within the so-called kangaroo, or K99/R00, awards—two-stage awards that include a training grant and research support.
However, working group members acknowledge that the dearth of young physician-scientists is also influenced by forces beyond NIH. For example, the costs of the Affordable Care Act are putting pressure on academic medical centers to ask clinical faculty to devote more time to patient care and less to research, they noted. “All the NIH can do is call attention to these problems and how important this group of individuals is to the future of biomedical research,” Ginsburg said.