Optimism About the Future of the Biomedical Workforce

Nancy J. Brown, MD, Jean and David W. Wallace Dean of Yale School of Medicine, recently participated on a panel at the Milken Institute’s Future of Health Summit 2025 where she and others discussed the challenges facing the biomedical workforce in the United States, what’s at stake, and potential solutions for sustaining this workforce that’s so critical for research.

“The two things that I’m particularly worried about are the great uncertainty about funding and how funding is changing very rapidly, and a feeling of insecurity about immigration,” Brown said when asked about challenges regarding the biomedical workforce. “A very large proportion of our biomedical research workforce are immigrants. And attracting those people to the U.S. is a concern.”

The conversation touched on the particular impacts on physician-scientists, how to effectively reach out to young people, and ways to support early-career scientists.

The Milken Institute is a nonprofit think tank focused on financial, physical, mental, and environmental health. Women’s Health Research at Yale was recently named a founding member of the institute’s Women’s Health Network. Basmah Safdar, MD, director of Women's Health Research at Yale, attended the Washington, D.C. summit as a Women's Health Network member.

Brown was joined by Ranu Jung, PhD, associate vice chancellor of the Institute for Integrative and Innovative Research at the University of Arkansas; Melissa Laitner, PhD, director of strategic initiatives at the National Academy of Medicine; Harlan Levine, MD, president of health innovation and policy at City of Hope; and Louis Muglia, MD, PhD, president and chief executive officer of the Burroughs Wellcome Fund. The panel was moderated by The Atlantic staff writer Nicholas Florko.

The group turned their attention early in the conversation to physician-scientists—those who do research and treat patients—and how experts have been highlighting for over four decades the challenges preventing people from pursuing this career path. Brown noted that while there are “tremendous stresses” on physician-scientists in the current moment, there is also great opportunity to rethink how physician-scientists are funded.

“We’ve had this view of only one way to do that—NIH R01 funding. We as institutions have the ability to decide how we spend our money and we need to spend it on science,” she said.

Brown described making the choice to support early-career researchers outside of traditional National Institutes of Health (NIH) funding, signaling that as an institution, YSM believes in the researchers and the work they are doing, and will invest in them and their research.

“If you hire somebody and say, ‘We’ll give you this job if you get that grant,’ that’s a very different message from saying, ‘We are very excited about your career. We’re going to invest in you,’” she said. “And there are ways to do that, to have internal selection processes, to provide career development in terms of how do you write the best grant, to make sure everybody has mentorship, and that everybody has the time to think and to do the work.”

Messaging is key too, she said. “We need to convey optimism to our young faculty because if all they hear is that the sky is falling, we shouldn’t expect them to stay in the career,” said Brown. “And in fact, the advances that we’ve had in terms of genomics and the ability of gene therapy and AI, it’s a very exciting time, and we need to emphasize that and make programs of support.”

The panel agreed, with Levine noting that reducing uncertainty in the career path and highlighting optimism will be essential going forward.

The panel also explored solutions to the challenges they discussed. Regarding funding, Brown noted that upcoming changes to how the NIH reviews grants—maintaining its requirement for rigor and feasibility but putting less emphasis on prior achievement—could reduce the delay to independent research that early-career investigators can experience. Further, she said, more flexibility in adjusting a funded grant’s aims as the research moves along, would allow researchers to be nimbler and to follow the best ideas.

Returning to the topic of immigrants in the workforce, Laitner shared what her colleagues have been hearing at the National Academy of Medicine, that students outside of the U.S, no longer want to come here to study. “We used to be the place to go for science and innovation and academic freedom to… follow pursuit of whatever your interest was,” said Laitner, noting that the change in that perception was “very concerning.”

To respond to this shift, Brown said it is key to do “all that we can to facilitate people coming to this country” and to engage in outreach, noting the efforts YSM has made to form collaborations with institutions in other countries. “In the process, we’re feeding the workforce in a bigger way, in a global sense,” she said.

Florko began to wrap up the discussion by polling the panelists on who was optimistic about the future of the biomedical workforce—everyone raised their hand. When asked why, the panelists said they think this moment is an opportunity for innovation.

“Out of chaos come really truly transformative changes,” said Brown, who was the first to raise her hand. “And I think we’re at the point where we can make those.”