Australian clinician-researchers: an endangered but not dying breed


Australian clinician-researchers are at risk but not yet on the brink of extinction, an analysis of successful PhD candidates at the University of Sydney has concluded.

PhD degrees awarded to clinicians at the university’s medical school increased 2.4-fold between 1989 and 2008, with a recent dip, but in the same period the number awarded to non-medical graduates increased 10-fold.

Similarly, total NHMRC funding rose about 10-fold during the same period, but the number of grants led by physicians declined from 29% to 21%.

Dr Caroline Traill and colleagues, in a project led by Professor Alicia Jenkins, evaluated 303 registered medical practitioners awarded a PhD and will report their findings in the Internal Medicine Journal.

“Knowledge and actions are needed to protect our medical research capacity,” they concluded.

The physician-scientist was first described as a ‘dying breed’ in the United States in 1979, following a decline in the proportion of post-doctoral trainee positions and research fellowships awarded to physicians by the National Institutes of Health.

The Sydney authors identified many potential deterrents to a joint clinical and research career, including career uncertainty and lower pay. For example, the NHMRC salary for a senior research professional was about 22% of the salary for a senior staff specialist in the NSW health service.

Other barriers probably included the years of training needed to become a successful researcher, the stressful nature of grant applications, low rates of success in obtaining funding, an often unsupportive academic culture and job insecurity.

“Potential solutions include more research funding for clinicians, perhaps via the Medical Future Fund, protected research time in clinical posts, academic clinical centres, greater job security, reduced salary gaps and a more supportive workplace culture,” they said.

Doctors received their PhDs at a similar stage in their careers over the time covered by the study – about 13 years after their primary medical degree. In recent years, though, they were less likely to have also completed their specialist training.

“We speculate that this may reflect the rising age of medical school graduates, competition with other life priorities (eg mortgages and child-rearing), and medical graduates undertaking PhDs to increase likelihood of entry into competitive training programs,” they said.

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