“An endangered species”: what is driving physician-scientists out of science?

Survey of 230 US professionals finds that 49% are considering leaving research, for reasons beyond lack of funding

Image of a middle-aged woman with short, light-brown hair, wearing black-rimmed glasses and green medical scrubs, with a stethoscope around her neck. She is sitting at a desk, resting her face on her left hand, looking at an open laptop with a tired or worried expression. On the desk are marker pens, a surgical mask, and other objects. The background is white.

Physician-scientists—professionals who divide their time between scientific research and clinical practice—play a key role in translating scientific discoveries into new treatments.

A study published in the journal BMC Medical Education, however, revealed that almost half (49%) of these professionals in the United States are considering quitting their research careers within the next two years to work exclusively in patient care.

The survey, conducted online using SurveyMonkey, involved 230 physician-scientists from 110 US institutions. Most respondents were medical residents, research fellows, or graduates of training programs within the last ten years.

Men accounted for 56% of participants, and 67% of all respondents were aged between 35 and 44.

The most commonly cited reasons for considering leaving research were unhappiness and stress (35%), burnout (35%), and difficulties obtaining funding (30%). Only 10% stated they had no intention of discontinuing the activity.

Barriers to starting a career

When asked about the biggest challenges, 63% of participants mentioned the difficulty of balancing clinical and academic responsibilities. Maintaining a healthy work-life balance was cited by 53%, while insufficient research funding was reported by 41%.

The study revealed that the majority spent more time on research than on patient care. The most common ratio was 80/20 (37% of cases), followed by 75/25 (18%). A smaller group divided their time equally between both activities.

The authors also identified disparities in representation: women, ethnic minorities, people from poorer socioeconomic backgrounds, and those with disabilities were underrepresented, although no statistically significant differences were found between the responses of men and women.

“Physician-scientists possess a unique combination of skills that provides insight into the limitations of current practice and motivates the development of innovative solutions,” said Gary Désir, of Yale University, a coauthor of the study, in a statement on the institution’s website.

Work and family

More than half of the participants said they found it difficult to balance work and family life. The main reasons given were the prolonged periods of training, pressure to produce high volumes of scientific work, and low pay.

As a consequence, physician-scientists may postpone or even abandon plans to start a family—a decision that can be particularly difficult for women due to the risks associated with later maternity.

The authors argue that institutional policies such as childcare and flexible hours are essential to enabling people to opt for parenthood.

The decline in the number of these professionals is not a recent phenomenon.

According to a December 2023 article in the journal Nature Medicine cited by the researchers, their prevalence in the field of medicine decreased from 4.5% to 1.6% between 1985 and 2011, representing a 35% drop during the same period in which the National Institutes of Health (NIH) budget doubled.

Another concern is the aging of the workforce. A paper published in the Journal of Infectious Diseases in August 2018 showed a significant reduction in the number of physician-scientists aged 31 to 50.

“Physician-scientists are considered an endangered species,” says Jennifer Kwan.

Commitment to science

Although many participants were considering leaving research, most stated that they were highly likely to remain in the field. The authors believe this reflects their strong commitment to science and the perceived impact of their research.

Other factors that may encourage them to continue include securing funding—which, although highly competitive, can provide temporary stability—along with the belief that the research environment will improve and a feeling that they are not prepared to work exclusively in patient care or the pharmaceutical industry.

To mitigate the decline in the medium and long term, the authors recommend expanding fellowship programs for early-career physicians, offering financial incentives, and creating structured mentoring and career development programs.

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