Our expert answers 3 Questions
As a physician and social scientist, one question that I have found particularly compelling is how to ensure a robust pipeline of physician-researchers to continue to advance the public health. I am particularly concerned about gender differences in career development and success in academic medicine. Although women have constituted nearly half of the medical student body for over a decade, the proportion of women in senior leadership positions remains extremely low. I have conducted several studies to evaluate the challenges encountered by the highly select cadre of physician-scientists who receive K08 and K23 career development awards from the National Institutes of Health. This is a particularly informative group because the men and women who receive these competitive awards have demonstrated aptitude and commitment to research careers, and society has invested considerable resources in promoting their development into independent investigators. Nevertheless, we have found significant gender differences in career outcomes in this population, suggesting that similarly bright and committed men and women are not succeeding at the same rates in academic medicine. Understanding the challenges they have encountered and the factors that have shaped their careers can help identify potential targeted interventions to promote both greater gender equity and greater success for all who pursue careers in academic medicine.
As a physician-researcher myself, I try to advance science in a specific area of interest (promoting the quality of care for breast cancer patients, particularly in the context of radiation therapy). Much of that research involves the application of social scientific methods that turn out to be equally useful in the investigation of the physician-scientist pipeline problem. To the extent that rigorous investigation can help advance our understanding of why promising young clinician-researchers sometimes fail to reach their full potential, I hope that this work will have a broad impact on the field of medicine as a whole, even beyond my own discipline of oncology.
The quality of health care depends critically on a robust and diverse physician-scientist pipeline. Medical science is most likely to advance when individuals with vastly different backgrounds and life experiences interact to develop innovative approaches to the prevention and management of illness. Ensuring gender equity in academic medicine is likely to promote innovation and quality in the scholarly enterprise. Especially given that half of our patients and half of our students are women, women must be retained within the pipeline so that they reach senior positions through which they may serve as thought leaders and role models. There is growing recognition that we need to evaluate career development in academic medicine with the same academic rigor that we bring to other endeavors. After all, if we can develop targeted interventions that effectively promote retention and success among clinician-researchers, medical science is bound to benefit.