A Princeton University professor warns that the American medical community is witnessing “a progressive, dangerous decline” in the number of physician-scientists -- doctors who spend most of their time on research.
In an article in the January 15 issue of Science, Leon E. Rosenberg, a professor of molecular biology, looks at who is applying for research grants from the National Institutes of Health and finds that physician-scientists have become “a progressively smaller minority of those seeking and obtaining N.I.H. project support.”
Fewer young doctors seem to be interested in research careers. The number of medical doctors applying for an N.I.H. research grant for the first time fell 31 per cent from 1994 to 1997, the article says. “If this progression were to continue linearly, there would be no first-time M.D. applicants by 2003,” Mr. Rosenberg writes.
Since 1992, there has also been a 51-per-cent drop -- from 2,613 to 1,261 -- in the number of postdoctoral traineeships awarded to medical doctors from the N.I.H. “If this trend is not changed,” Mr. Rosenberg writes, “there will be no M.D.'s in this pool by 2006.”
Why are physician-scientists so important? “The answer,” he writes, “is that in the absence of physician-scientists, the bridge between bench and bedside will weaken, perhaps even collapse.”
He points to several explanations for the trend, including the emphasis in medicine in recent years on primary care, rather than specialties, and the high debt of medical students that prompts many of them to go into private practice, where the salaries are much higher than in research.
Mr. Rosenberg recommends that Congress create a panel to develop recommendations on the problem. One answer, he suggests, might be for universities to reward students for seeking research experience.
“Physician-scientists have made contributions far beyond their numbers,” he says. Half of the people who have won Nobel Prizes in physiology and medicine since World War II are medical doctors, he notes, although they are only a small fraction of the overall research community.