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Physician-Scientists Are “Endangered Species”

June 21, 2023

Jennifer M. Kwan, MD/PhD, is passionate about sharing the importance of physician-scientists in medicine, and doing her part to highlight their challenges, especially in recent years.

“Physician-scientists play a unique role in helping to bridge the basic science discoveries to the bedside. They have unique training in science as well as medicine, and so they speak the language of both worlds and they're able to help connect those two worlds together to move forward disease understanding as well as improve disease prevention, treatment, and patient outcomes,” explained Kwan, assistant professor of medicine (cardiovascular medicine).

For people who are interested in both science and medicine, Kwan believes that being a physician-scientist would be a “great line of work.”

“People with a curiosity and passion for science and medicine, but also persistence, because in the world of both medicine and science, there are challenges within research and at times, experiments don't work. You have to go back to the drawing board to try to figure out how to troubleshoot roadblocks,” said Kwan.

For Kwan, this work is immensely personal. She always wanted to be a physician, but when exposed to research, she decided to do both, and decided that being a physician-scientist was for her. Kwan is a cardiologist and a cardio-oncologist leveraging genomics and imaging to predict cardiovascular outcomes in cancer and heart failure patients.

Understanding the importance of physician-scientists and their role in moving the field of medicine forward, Kwan has also studied the leaky pipeline and endangered species phenomenon of physician-scientists and has co-authored papers published in BMC Medical Education and the Journal of Clinical and Translational Science, evaluating factors that physician-scientist trainees deem important as well as challenges in their careers, highlighting women and those underrepresented in medicine. When the COVID-19 pandemic hit, she conducted a national study to evaluate the effects of the pandemic on physician-scientists and found that there was increased stress and decreased productivity, published in Academic Medicine.

To boost advocacy and raise visibility for this issue, she published an op-ed in The Hill calling on national leaders to increase support of physician-scientists to decrease the risk of losing them. More recently, she helped spearhead a national study along with Evan Noch, MD, PhD, assistant professor of neurology, Weill Cornell Medicine, to evaluate the recruitment and retention process of physician-scientists in academic institutions, surveying deans and department chairs.

In late April 2023, Kwan organized and co-moderated a session of the AAP/ASCI/APSA Joint Meeting, an annual gathering of the Association of American Physicians, the American Society for Clinical Investigation, and the American Physician-Scientists Association, to discuss the hiring and retention of physician-scientists.

Along with Kwan and Noch, the panelists included Mary E. Klotman, MD, dean of the Duke University School of Medicine, chief academic officer for the Duke University Health System, and vice chancellor for health affairs at Duke University; Yale School of Medicine’s (YSM) Department of Internal Medicine Department Chair Gary V. Désir, MD, Paul B. Beeson Professor of Medicine and vice provost for Faculty Development and Diversity; M. Elizabeth Ross, MD, PhD, Nathan Cummings Professor of Neurology and Neuroscience, Weill Cornell Medicine; Edward Schaeffer, MD, PhD, chair, Department of Urology, and Harold Binstein Professor of Urology, Northwestern University; and Griffin Rodgers, MD, MACP, director, National Institute of Diabetes and Digestive and Kidney Diseases.

Moderators included Kwan; Noch; Alok Jha, PhD, YSM researcher; and Pearl Sutter, 5th year MD-PhD student at the University of Connecticut School of Medicine.

Kwan presented preliminary results from their national survey of deans and department chairs to evaluate hiring and retention practices and found that although support for physician-scientists remains strong, financial effects of the pandemic decreased funding sources to support physician-scientists.

During the session, Désir presented Yale University’s physician-scientists’ development, recruitment, and retention plan. Yale’s Office of Faculty Development & Diversity offers numerous tools to support best practices while conducting a faculty search, such as the principles of a faculty search, steps to initiate a search, the process itself, and evaluating candidates.

“By virtue of their rigorous training in both medicine and scientific investigation, physician-scientists possess a unique combination of skills that provides insight into the limitations of current practice and motivates the development of innovative solutions,” said Désir.

An important element of Yale’s plan is the dedication to “improving diversity, equity, and justice,” said Désir.

“Yale offers many resources for their physician-scientists, such as the grant repository where people can look at successful grants when they're trying to prepare their own. Yale also has a good mentorship structure; they have mentorship committees and a faculty career development committee that allows the leadership to continue to monitor one’s progress as a physician-scientist,” Kwan continued.

“One thing that was discussed in the session that would help was that we need to help educate the community, improve science communication so that we can communicate why biomedical research is important, why we need to support it. Because some of the current House of Representative members do not understand the importance of biomedical research. There is talk from them to want to cut the NIH budget by 20%. So educating the public and our publicly elected officials so that we help ensure that there continues to be good bipartisan support for research funding is crucial.”

Financial challenges due to the COVID-19 pandemic have become more pressing, impacting biomedical research support said Kwan.

“There definitely is something to be said when you have a face-to-face meeting with your publicly elected official and tell them your story about why this research funding is so important, one, in your own career, but also what your research is going to potentially do in terms of helping patients with cancer, Parkinson's, Alzheimer's, heart disease. It makes a big difference to be able to tell those personal stories and why that research is important,” said Kwan.

“As physician-scientists, our mission is to promote health and alleviate human suffering by both caring for those in need and by helping close the gap between scientific discoveries and patient care,” said Désir.

For Kwan’s upcoming project, she partnered with Olympic Figure Skating Gold Medalist, Yale University undergraduate student (majoring in statistics and data science) and friend, Nathan Chen to create a series of videos exploring a day in the life of physician-scientists, Chen, currently working in Kwan’s lab as an undergraduate student researcher, ventures across Yale University and interviews scientists in the Yale School of Engineering and Applied Science’s Department of Biomedical Engineering, and YSM’s Departments of Biomedical Informatics & Data Science, Genetics, Internal Medicine, Pathology, and Pediatrics. Watch the video on the Section of Cardiovascular Medicine’s YouTube channel.

Chen is interested in a physician-scientist training pathway and just won an American Heart Association undergraduate research award to continue his research in genomics and cardiovascular outcomes. In addition, he is contributing to several cardio-oncology related research projects due to his growing interest in oncology.

“Having done skating my entire life, I was not aware of the physician-scientist training pathway and the work that physician-scientists do. It’s incredible to see how their advancements in biomedical research impacts patient outcomes,” said Chen.

“From our advocacy efforts, we know that physician-scientists are considered an endangered species. I see firsthand what we have to deal with, so it's a personal passion of mine to try to help physician scientists address these issues for the greater good, to allow more physician-scientists to stay in the pipeline, to allow more physician scientists to contribute their insights to improving human health,” said Kwan.

The Department of Internal Medicine at Yale is among the nation's premier departments, bringing together an elite cadre of clinicians, investigators, educators, and staff in one of the world's top medical schools. To learn more, visit Internal Medicine.