The Institutional Challenge to Train and Maintain Physician Scientists:
The very best physician scientists are required to generate and transmit new knowledge to fellow scientists, clinicians and trainees. Physician scientists need to have an environment that rewards their motivation, their ability to unravel the mysteries of pathobiology, and that fosters innovative and transformative research. High-quality programs are required to provide the unique training that Pathology and Laboratory Medicine offers to study, understand, diagnose, treat and prevent human disease. A stimulating intellectual environment with state-of-the-art resources and time dedicated to research are needed to launch physician scientist careers and support their productive growth, especially in the early stages of their careers. Universities, teaching hospitals, affiliated research institutes, granting agencies (both private and government), and industrial partners need to actively support these academic initiatives and create capacity to train physician scientists and to support their mentors. All will benefit from having a strong core of physician scientists in the biomedical research and clinical community. It is indeed this group of investigators who form an essential component to achieve the current NIH goal of transforming medicine from curative to preventative.
Departments of Pathology and Laboratory Medicine across the globe require the very best faculty to successfully meet the challenges of the medicine that is practiced today and that will be practiced tomorrow. Universities, teaching hospitals, and research institutes need to develop training programs to train individuals along three interdependent pathways which support the three pillars of academic medicine - research, teaching, and clinical care:
Research: Excellent productive investigators need to be trained to acquire a knowledge base and the technical expertise to explore mechanisms of disease and translate basic knowledge to clinically useful information to diagnose, treat, predict prognosis, and prevent disease.
Teaching: Innovative teachers require the training to be able to link teaching to research and to state-of-the-art knowledge and technology, and to be able to carry out research in education.
Clinical care: Subspecialty clinicians need to be trained to produce consultants who are exceptional diagnosticians and who continuously push the limits of diagnosis through innovative use of modern biological concepts and state-of-the-art technology.
These three pathways are all important and since pathology sits at the cross roads of basic science and clinical medicine, Departments of Pathology are excellent training environments for physician scientists. As the practice of modern academic medicine becomes more complex, it is not practical to demand in-depth expertise in all the three pillars of academic laboratory medicine - research, teaching, and clinical care. A logical approach in today's biomedical world is to develop excellence in one or two of the three pathways and to be competent in the others.
Thus training programs need to be adjusted to provide the very best opportunities to train future faculty along the excellent/competent paradigm. Departments would do well to adjust their academic resources to provide their academic faculty with career development and advancement that focus on these pathways, always demanding that innovation, new knowledge, and international recognition be the hallmark of excellence for all the three pillars of academic laboratory medicine.