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• W2022992942 abstract "Dr. Brown's article “National Institutes of Health Support for Individual Mentored Career Development Grants in Emergency Medicine” in the November 2014 issue of Academic Emergency Medicine provides an objective lens with which to observe the future of academic emergency medicine (EM), and his conclusions should give all Society for Academic Emergency Medicine (SAEM) members a reason for pause.1 In general, clinician-scientists are an endangered species. Declining levels of interest in research by medical students, increasing postresidency financial debt, and an increasingly unstable environment for established investigators have all been cited for the decline in the physician scientist work force.2 Dr. Brown's excellent article establishes that the national trend in the decline of physician-scientists in training is also true for EM and that if this trend continues, the future of our specialty and the care of our patients is threatened. Dr. Brown in his article notes that from 2008 to 2013, emergency physicians submitted only 45 National Institutes of Health (NIH) K awards with a funding rate of approximately 60%. This translates into seven submissions and 4.5 awards annually. Considering that some of these awards likely represent failed submissions resubmitted in subsequent years, the number of physicians attempting to apply for NIH K awards is probably lower than the actual number of submitted grants. These data demonstrate that the number of clinician-scientists in training is incredibly low for a rapidly growing specialty with 164 ACGME-accredited residency programs and nearly 1,600 newly board-certified physicians annually. What is the answer to this dilemma? One argument that Dr. Brown makes is that the lack of K awards to emergency physicians is simply due to a lack of applications. Could simply encouraging more of our recent trainees to apply for this award mechanism be the answer? Unfortunately, it is clear from the national data that the total number of K awards has been declining annually and that the total percentage of K awards now funded is in the 40% range.2 Dr. Brown cites an average 60% success rate for 2008 to 2013, but it is unclear if that success rate has been declining in recent years or if it represents a constant average. Another issue is whether EM has enough clinician-scientists to serve as mentors. Dr. Brown argues that EM is a mature specialty with over 40 EM faculty holding NIH-funded R awards and that this is not the sole explanation for the lack of K awardee applicants. However, it is unclear how many of these faculty are EM board-certified and whether they are truly independent principle investigators with the resources to mentor prospective trainees. It is likely that relatively few of the current 164 accredited programs have truly NIH-funded independent principal investigators capable of serving as role models or mentors. Lack of the right mentors at the right institutions for the right EM candidates is certainly an issue for our specialty. Dr. Brown's data and conclusions may have a few debatable elements, but the evidence is clear. EM is not training enough physician scientists to support the needs of the 21st century. Even more worrisome is the issue of how many recent K awardees actually go on to be successful NIH R-funded investigators, data often missing in this discussion. Ensuring that current trainees are successful and that a stable funding environment is created must be part of the solution. Our specialty, with the aid of societies like SAEM, has made progress in becoming a rigorous academically oriented specialty emphasizing research, education, and patient care. However, the rapid growth of our specialty, along with the decline of NIH funding, is creating a gap in the physician-scientist workforce. The need to encourage potential future clinician-investigators, the development of future mentors, and the creation of a stable funding environment are essential for the further development of our specialty. This is our challenge going forward as SAEM members." @default.
• W2022992942 created "2016-06-24" @default.
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• W2022992942 date "2015-03-13" @default.
• W2022992942 modified "2023-10-16" @default.
• W2022992942 title "The Crisis in the Emergency Medicine Physician Scientist Workforce" @default.
• W2022992942 cites W1981084248 @default.
• W2022992942 cites W2006121766 @default.
• W2022992942 doi "https://doi.org/10.1111/acem.12635" @default.
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