The attrition of young physician-scientists: problems and potential solutions.

Physician-scientists have played a prominent role as thought leaders in American medicine over the past century. This group has produced many basic scientific advances and pioneered the translation of these advances into clinical practice. Now that we are in the post-genomic era, there is a greater need than ever for the continued participation of this group because of their unique ability to bridge the "bench to bedside." However, the number of physicians pursuing this career is static and their average age is rising. Recent data indicate that the many benefits of this career path are seen as being outweighed by so many negative factors, as to prompt the question, "Is this a career that a reasonable person should undertake in 2007 and beyond?" The following analysis suggests that the current answer is "no." We have identified the lack of professional security as a major factor that prompts young physicians to abandon the physician-scientist track. Because this problem has not been sufficiently emphasized, we believe current efforts are unlikely to reverse this disturbing trend. We propose strategies that seek to address this problem and help sustain young physician-scientists at career transition points at which they are most vulnerable to give up.