Ross Levine: IMHO, the biggest risks/barriers for physician scientists are…

Ross Levine, Leukemia Specialist and Physician-Scientist at Memorial Sloan Kettering Cancer Center, recently shared on X/Twitter:

“Lots of insightful discussions about the dearth of physician scientists. IMHO, the biggest risks/barriers for physician scientists are:

1. The K08 paylines, in the best of times, are woefully low, and when there are budgetary crunches (NOW!) they get even worse. This means they are awarded late in training after papers/lots of data and not on potential.

2. Clinical training (fellowships, Holman for rad one) do not include sufficient time for most physician scientists to get the training they need, mentorship time, and productivity. This creates a false “cliff” at the end of formal training->
When most trainees are not ready for independence. Yet most institutions have no formal plan for how to assess/financially support people in the physician scientist “valley of death” between formal fellowship and PI/independence. And with K awards incredibly hard to get….

3. Most institutions do not have a homogeneous plan for how much clinical time to ask for from physician scientists, nor a transparent formula for how this contributes to salary/time and effort.

4. The path for a 80/20 lab based physician scientists is hard, but at least is well trodden historically. For investigators with a different mix (50/50), in non-lab based investigative disciplines (Data sciences), there are fewer examples/mentors or guardrails.

There are potential solutions to each of these. Some thoughts.

1. Until the K payline improves, foundations and institutions should take people who have strong, but not funded K awards and provide K-equivalent/bridge funding. And not require an actual K award for a job

2. Institutions/departments should provide clear, transparent expectations for time and effort for physician scientists which fellows and junior faculty can easily see without waiting for an offer letter.

3. The time between fellowship/residency and PI/independence should be considered a next step in training , and not a true transition requiring a job search, understanding that is it often a faculty appointment (not always TT). Alignment between trainee, mentor and chair is key

4. Clinical departments need to bring Pis in data sciences field, who often are not clinicians, into the fold re: how to train/support physician scientists and how we can ensure there is an increasing number of physician scientists with computational skills.

5. Physician scientists need TIME. They have done both clinical training and research training, are in their mid-30s (in many cases with families, geographic roots), and need both sufficient % protected time and sufficient duration of protected time to reach their goals.”

Source: Ross Levine/Twitter