They Often Hold the Key to Medical Breakthroughs. Who's Backing Physician-Scientists?

Physician-scientists can offer an important link between basic science and patient care. Their ability to straddle both worlds has contributed to advances in surgical techniques, understanding drug interactions, new therapies, and much more.

It takes extensive training, dedication and the right personality to both treat patients and conduct scientific research, and there’s been growing concern about the dwindling supply of physicians who do both.

This problem has been on the radars of a handful of philanthropies, one of which is the North Carolina-based Burroughs Wellcome Fund. BWF has had a program offering awards to individual physician-scientists since 2007, and recently announced its first $12.5 million round of grants to institutions to develop programs that could counter the shortage.

Concerns over a lack of up-and-coming physician scientists have been stewing for a while now, perhaps first flagged in a 1979 article calling the clinical investigator an “endangered species,” again in a 2009 book titled The Vanishing Physician-Scientist?, and in a number of editorials and studies. A 2014 report by the NIH Physician-Scientist Workforce Working Group found physician-scientists made up only 1.5 percent of all U.S. physicians. That same report points out "persistent patterns of unequal participation by women and racial/ethnic minorities."

Explanations include limited educational and training opportunities, high costs of pursuing the required advanced degrees, and a “leaky pipeline” stemming from challenges in balancing both a clinical practice and a research career. This may be exacerbated by the increasing complexity of biomedical research.

There are some private funders that have taken an interest in this problem, including HHMI, Doris Duke Charitable Foundation, the Lasker Foundation, and Burroughs Wellcome.

BWF was initially launched by the American branch of the U.K.-based pharmaceutical firm, which has since been absorbed by GlaxoSmithKline. The foundation then split off to become independent of corporate backing, now funding biomedical science research and education, including support for diversity in the field and infectious disease research.

Its Career Awards for Medical Scientists (CAMS) program launched about a decade ago, giving $700,000 grants to physician-scientists. The latest round announced this month sent $9.1 million to work including the use of computation for early identification of psychosis, and immunotherapy treatment for cancer.

The new program moves the foundation’s support higher up the ladder, attempting to establish new training programs at research institutions. Over the past year, BWF has been reviewing proposals for such initiatives, starting with 30 planning grants in the U.S. and Canada, and then narrowing it down to five universities that will execute their plans with $2.5 million each.

The winners are Stanford, University of Pittsburgh, Vanderbilt, University of Texas Southwestern Medical Center, and Duke, for their plans to train researchers and help them launch their research careers.

This type of program is a logical fit for a private funder because it targets a small but potentially powerful niche in science research. In other words, the NIH may be able to crank out billions in biomedical research grants every year, while foundations are better off hammering down on specific problems that might have a big influence—advancing research tools or backing interdisciplinary research, for example.

In this case, physician-scientists make up a very small number of overall medical doctors, but the unique perspective gained from caring for patients can make their insights pivotal. If small funders like BWF can bump up their numbers by even a modest amount, or ease future attrition, it can maintain important connective tissue in the research world.

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