A global view of the aspiring physician-scientist

Abstract

Physician-scientists have epitomized the blending of deep, rigorous impactful curiosity with broad attention to human health for centuries. While we aspire to prepare all physicians with an appreciation for these skills, those who apply them to push the understanding of the boundaries of human physiology and disease, to advance treatments, and to increase our knowledge base in the arena of human health can fulfill an essential space for our society, economies, and overall well-being. Working arm in arm with basic and translational scientists as well as expert clinicians, as peers in both groups, this career additionally serves as a bridge to facilitate the pace and direction of research that ultimately impacts health. Globally, there are remarkable similarities in challenges in this career path, and in the approaches employed to overcome them. Herein, we review how different countries train physician-scientists and suggest strategies to further bolster this career path.

Keywords: Scholarly Review Article in Medicine; medicine; physician-scientist; training.

Figure 1.. Translational Science Continuum.

The T0 pillar anchors basic science bench research, whereas T1 work extends basic science discovery to the first in human trials looking for safety and efficacy endpoints, proof-of-concept, and phase 1 clinic trials. T2 science includes the phase 2 and 3 clinical trials of diagnostics, therapeutics, devices, and other interventions for human health. The physician-scientist must have a different educational focus for this pillar than the T0/T1 physician-scientist. Education must cover clinical trials science, observational studies, meaningful endpoint detection, statistical methods focused on human populations, and human behavior. T3 science extends to phase 4 clinical trials and other observational studies such as health services and clinical outcomes research. Physician-scientists in this arena need education in community-based participatory research and cost-effectiveness and comparative effectiveness research methods. T4 science looks at population-level outcomes and how social determinants of health significantly influence health. Physician-scientists must gain specialization in public policy and health disparities research to include population health guideline development and rigorous meta-analytic strategies.