The Impact of COVID-19 on Physician-Scientist Trainees and Faculty in the United States: A National Survey

Evaluating factors impacting early career physician-scientists' decisions to continue research careers in the United States of America

BACKGROUND

Bridging the gap between laboratory discoveries and patient care relies heavily on the physician-scientist workforce, which has historically served as a cornerstone in advancing biomedical sciences. However, the past decade has witnessed a remarkable decline in the number of emerging physician-scientists, raising concerns about the future of this vital community. This study aimed to evaluate the current state of early career physician-scientists on a national scale and explore challenges that hinder its growth, thereby limiting potential scientific innovation and progress.

METHODS

A survey was conducted in the United States and distributed to 110 nationally representative institutions using an online platform (SurveyMonkey), targeting physician-scientists at their late stage of clinical training (residents/fellows) and graduates of training programs within the past 10 years. 265 submitted results but after filtering for incomplete responses, a total of 230 survey results were used in the analysis. The survey evaluated scientific career trajectories, challenges encountered, and top priorities. Statistical analyses, including Chi-square and Fisher's exact tests, were used to compare differences between groups.

RESULTS

A total of 230 physician-scientists completed the survey. The respondents were predominantly assistant professors (46%), while 27% were still enrolled in career training programs. Nearly half of the participants reported considering leaving their research career within the next two years. The primary reasons cited for this included burnout and unhappiness (35%), stress (35%), and lack of funding (30%). The most frequently reported career challenges were achieving a balance between clinical and educational responsibilities (63%) and maintaining work-life balance (53%), followed by insufficient research funding (41%). Additionally, participants underscored key factors they prioritize when seeking employment, including hybrid research-clinical opportunities (67%), work-life balance (52%), and financial security (26%).

CONCLUSION

This national survey provides an overview of the current state of early-career physician-scientists. It examines the factors contributing to the inclination to leave the scientific track and identifies the primary career challenges faced by this vulnerable community. Furthermore, it highlights key priorities of physician-scientists and gaps that require attention, offering valuable insights into strategies for retaining and supporting this critical workforce.

"I realized I was not alone": A mixed-methods investigation of the implementation of Ubuntu groups to reduce burnout and social isolation in an allopathic medical School in the Southeastern United States

PURPOSE/BACKGROUND

Healthcare providers experience higher rates of workplace burnout, a reality highlighted by the COVID-19 pandemic. In response, small groups, inspired by South African philosophy, Ubuntu, were introduced to decrease burnout and social isolation and build community and belonging. This study examines how participation in these groups can impact these measures.

METHODS

In this mixed-methods study, trained facilitators led small groups that utilized story-sharing to foster connections within the group and broader community. Quantitative and qualitative data were analyzed separately and merged to identify convergence.

RESULTS

Three main qualitative themes emerged: 1) seeking and building connections and community, 2) curiosity, learning, and growing, and 3) open-hearted and thriving. These themes were linked to quantitative outcomes, showing a statistically significant decrease in social isolation among staff/faculty and students. Furthermore, faculty/staff exhibited reduced burnout compared to students, while students reported increased feelings of belonging.

CONCLUSION

Participation in Ubuntu groups positively influenced students' sense of belonging, reduced faculty/staff burnout, and alleviated social isolation for all participants. Future research should explore the potential of this intervention to further promote wellness on medical campuses. Programs emphasizing the well-being of individuals, including faculty, staff, and students, are crucial for supporting the overall health of medical communities and the wider society.

Physician-scientists' perspectives on key factors, emotions and feelings about selecting and attending continuous professional development events: a mixed-method study

BACKGROUND

Almost 40% of the Nobel-Prize-winning discoveries in medicine are made by physician-scientists, who are a driving force in the evolving medical, academic and research landscape. However, their training has few defined milestones. To be effective clinicians, educators and researchers, they need to maintain and hone skills, often via continuous professional development (CPD) activities covering different domains. They have recurrently been described as an endangered species. Yet, warnings and recommendations across several decades did not stop the declining number of physician-scientists, which is now a chronic issue. This is further exacerbated by a lack of resources and support, especially after the COVID-19 pandemic.

METHODS

We administered a questionnaire called Positive and Negative Affect Schedule (PANAS-GEN) to get an initial emotional snapshot before performing individual semi-structured interviews with five physician-scientists in neurology working in the United Kingdom. We explored the key factors they balance before selecting CPD activities, along with their views on compulsory CPD events and assessments. We investigated their general feelings towards compulsory and non-compulsory CPD, how they felt the night before and the morning of the events, and the perceived consequences attending these have on their learning.

RESULTS

In our study, physician-scientists tend to choose training in their area of expertise but would enjoy exploring more if they had more time. The CPD choice was chiefly driven by speakers and topics, followed by learning needs. They disputed the utility of the current assessments, which are often seen as box-ticking exercises. While frustration, hostility and negative feelings were voiced for the compulsory ones, other CPD activities were welcomed with excitement, curiosity and a sense of adventure. Enthusiasm and excitement were felt the night before and the morning of the non-compulsory ones. CPD events were perceived to positively affect further learning, with the most immediate consequences being reading an article, networking or interacting with the speakers.

DISCUSSION

This is the first study exploring the key factors driving a group of physician-scientists while selecting CPD activities and investigating their feelings and emotions related to CPD attendance. More engaging and less box-ticking CPD should be on the cards, along with an adequate evaluation of these activities. It is essential to increase enthusiasm, which can facilitate engagement, and decrease frustration surrounding compulsory CPD activities. We still know too little about the role of emotions in learning, especially about CPD. Future studies should investigate the emotional side of learning across different career stages to restore the leaky pipeline and create a tailored environment with benefits for each of the three sides of the physician-scientist's identity: the clinical, the research, and the academic.

Time to Publication in Medical Education Journals: An Analysis of Publication Timelines During COVID-19 (2019-2022)

Introduction

COVID-19 changed scholarly publishing. Yet, its impact on medical education publishing is unstudied. Because journal articles and their corresponding publication timelines can influence academic success, the field needs updated publication timelines to set evidence-based expectations for academic productivity. This study attempts to answer the following research questions: did publication timelines significantly change around the time of COVID-19 and, if so, how?

Methods

We conducted a bibliometric study; our sample included articles published between January 2018, and December 2022, that appeared in the Medical Education Journals List-24 (MEJ-24). We clustered articles into three time-based groups (pre-COVID, COVID-overlap, and COVID-endemic), and two subject-based groups (about COVID-19 and not about COVID-19). We downloaded each article's metadata from the National Library of Medicine and analyzed data using descriptive statistics, analysis of variance, and post-hoc tests to compare mean time differences across groups.

Results

Overall, time to publish averaged 300.8 days (SD = 200.8). One-way between-groups ANOVA showed significant differences between the three time-based groups F (2, 7473) = 2150.7, p < .001. The post-hoc comparisons indicated that COVID-overlap articles took significantly longer (n = 1470, M= 539; SD = 210.6) as compared to pre-COVID (n = 1281; M = 302; SD = 172.5) and COVID-endemic articles (n = 4725; M = 226; SD = 136.5). Notably, COVID-endemic articles were published in significantly less time than pre-pandemic articles, p < .001.

Discussion

Longer publication time was most pronounced for COVID-overlap articles. Publication timelines for COVID-endemic articles have shortened. Future research should explore how the shift in publication timelines has shaped medical education scholarship.

Lost in the pandemic: COVID-19's impact on health professions educators

BACKGROUND

Minimal research has explored the pandemic's impact on health professions educators (HPEs). Given that health professions educator academies provide centralised support and professional development to HPEs through communities of practice and promoting education at their institutions, it is important to examine how academies met HPEs' needs during the pandemic. This study investigates the COVID-19 pandemic's effects on HPEs and examines how academies supported HPEs' educational roles during the pandemic.

METHODS

Using a mixed-methods approach, the authors surveyed United States educator academy members on changes in HPEs' activities, emphasising clinical and educational tasks and work-life integration. Participants shared their academies' innovations and support responses. Data were analysed using chi-square and content analyses.

FINDINGS

Twenty percent of 2784 recipients (n = 559) completed the survey. Most respondents indicated the pandemic caused them to spend more time on clinical and education leadership/administration than before the pandemic. HPEs integrated innovative instructional strategies, yet many shifted away from teaching, mentoring and scholarship. Over half were dissatisfied with work-life integration during the pandemic. Females, especially, reported that professional work was compromised by personal caregiving. Academies increased their range of member services; however, they did not fully meet their members' needs, including providing expanded professional development and advocating on HPE's behalf for increased protected time dedicated to educator responsibilities.

DISCUSSION

HPEs faced unprecedented challenges in their personal and professional lives during the COVID-19 pandemic. Neglecting the needs of HPEs amidst global crises poses a substantial threat to the quality of education for upcoming generations of health care professionals.

Group peer mentoring to improve faculty connections and enhance mentoring networks

BACKGROUND

Difficulty finding mentors and forging connections in academic departments can be challenging and became even more so when the COVID-19 pandemic reduced opportunities for informal networking. Even as restrictions on in-person meetings eased, many faculty preferred meetings to remain virtual. Because some of the most powerful predictors of faculty vitality are positive professional relationships and feelings of inclusion and belonging to an institution, attending to faculty needs in this area is important to mitigate undesired lingering consequences.

APPROACH

We created structured peer mentoring groups for our department's physicians and psychologists that meet virtually. Groups span career stages, academic appointments and clinical interests. The purpose was to establish a deeper culture of mentoring, increase feelings of connection to a supportive community within the department, facilitate career planning and enhance the development of skills necessary in academic medicine such as teaching skills, scholarly productivity and personal wellness.

EVALUATION

A survey conducted after the first year of the programme was completed by 70% of eligible faculty (31/45). Ninety-six percent felt the programme had created an inclusive and appreciative culture, 86% met faculty members they had never met before and 79% sought mentoring advice from a colleague they would not usually have interacted with in that manner. All participants appreciated hearing their colleagues' perspectives on topics they do not typically discuss.

IMPLICATIONS

Departmentally based group peer mentoring that spans career stages and interests can facilitate faculty connections and enhance a supportive culture of mentorship.

Impact of COVID-19 pandemic on physician-scientist trainees to faculty one year into the pandemic

PURPOSE

Physician-scientists play a crucial role in advancing biomedical sciences. Proportionally fewer physicians are actively engaged in scientific pursuits, attributed to attrition in the training and retention pipeline. This national study evaluated the ongoing and longer-term impact of the COVID-19 pandemic on stress levels, research productivity, and optimism for physician-scientists at all levels of training.

METHODS

A multi-institutional cross-sectional survey of medical students, graduate students, and residents/fellows/junior faculty (RFJF) was conducted from April to August 2021 to assess the impact of COVID-19 on individual stress, productivity, and optimism. Multivariate regression analyses were performed to identify associated variables and unsupervised variable clustering techniques were employed to identify highly correlated responses.

RESULTS

A total 677 respondents completed the survey, representing different stages of physician-scientist training. Respondents report high levels of stress (medical students: 85%, graduate students: 63%, RFJF: 85%) attributed to impaired productivity concerns, concern about health of family and friends, impact on personal health and impairment in training or career development. Many cited impaired productivity (medical students: 65% graduate students: 79%, RFJF: 78%) associated with pandemic impacts on training, labs closures and loss of facility/resource access, and social isolation. Optimism levels were low (medical students: 37%, graduate students: 38% and RFJF: 39%) with females less likely to be optimistic and more likely to report concerns of long-term effects of COVID-19. Optimism about the future was correlated with not worrying about the long-term effects of COVID-19. Since the COVID-19 pandemic, all respondents reported increased prioritization of time with family/friends (67%) and personal health (62%) over career (25%) and research (24%).

CONCLUSIONS

This national survey highlights the significant and protracted impact of the COVID-19 pandemic on stress levels, productivity, and optimism among physician-scientists and trainees. These findings underscore the urgent need for tailored support, including mental health, academic, and career development assistance for this biomedical workforce.

Impact of the COVID-19 pandemic on pediatric faculty: a report from nine academic institutions

BACKGROUND

The COVID-19 pandemic affected home and work routines, which may exacerbate existing academic professional disparities. Objectives were to describe the impact of the pandemic on pediatric faculty's work productivity, identify groups at risk for widening inequities, and explore mitigation strategies.

METHODS

A cross-sectional study of faculty members was conducted at nine U.S. pediatric departments. Responses were analyzed by demographics, academic rank, and change in home caregiving responsibility.

RESULTS

Of 5791 pediatric faculty members eligible, 1504 (26%) completed the survey. The majority were female (64%), over 40 years old (60%), and assistant professors (47%). Only 7% faculty identified as underrepresented in medicine. Overall 41% reported an increase in caregiving during the pandemic. When comparing clinical, administrative, research, and teaching activities, faculty reported worse 1-year outlook for research activities. Faculty with increased caregiving responsibilities were more likely to report concerns over delayed promotion and less likely to have a favorable outlook regarding clinical and research efforts. Participants identified preferred strategies to mitigate challenges.

CONCLUSIONS

The COVID-19 pandemic negatively impacted pediatric faculty productivity with the greatest effects on those with increased caregiving responsibilities. COVID-19 was particularly disruptive to research outlook. Mitigation strategies are needed to minimize the long-term impacts on academic pediatric careers.

IMPACT

The COVID-19 pandemic most negatively impacted work productivity of academic pediatric faculty with caregiving responsibilities. COVID-19 was particularly disruptive to short-term (1-year) research outlook among pediatric faculty. Faculty identified mitigation strategies to minimize the long-term impacts of the pandemic on academic pediatric career pathways.

Impact of COVID-19 Pandemic on Physician-Scientist Trainees to Faculty One Year into the Pandemic

Purpose

Physician-scientists play a crucial role in advancing biomedical sciences. Proportionally fewer physicians are actively engaged in scientific pursuits, attributed to attrition in the training and retention pipeline. This national study evaluated the ongoing and longer-term impact of the COVID-19 pandemic on research productivity for physician-scientists at all levels of training.

Methods

A survey of medical students, graduate students, and residents/fellows/junior faculty (RFJF) was conducted from April to August 2021 to assess the impact of COVID-19 on individual stress, productivity, and optimism. Multivariate regression analyses were performed to identify associated variables and unsupervised variable clustering techniques were employed to identify highly correlated responses.

Results

A total 677 respondents completed the survey, representing different stages of physician-scientist training. Respondents report high levels of stress (medical students: 85%, graduate students: 63%, RFJF: 85%) attributed to impaired productivity concerns, concern about health of family and friends, impact on personal health and impairment in training or career development. Many cited impaired productivity (medical students: 65% graduate students: 79%, RFJF: 78%) associated with pandemic impacts on training, labs closures and loss of facility/resource access, and social isolation. Optimism levels were low (medical students: 37%, graduate students: 38% and RFJF: 39%) with females less likely to be optimistic and more likely to report concerns of long-term effects of COVID-19. Optimism about the future was correlated with not worrying about the long-term effects of COVID-19. Since the COVID-19 pandemic, all respondents reported increased prioritization of time with family/friends (67%) and personal health (62%) over career (25%) and research (24%).

Conclusions

This national survey highlights the significant and protracted impact of the COVID-19 pandemic on stress levels, productivity, and optimism among physician-scientists and trainees. These findings underscore the urgent need for tailored support, including mental health, academic, and career development assistance for this biomedical workforce.

Making the match and breaking it: values, perceptions, and obstacles of trainees applying into physician-scientist training programs

BACKGROUND

Replenishing the physician-scientist workforce constitutes a central mission of medical education, but the loss of qualified trainees to non-academic positions remains an ongoing threat. Among the barriers facing physician-scientists today is the game-like model of U.S. medical residency matching through the National Research Matching Program (NRPM), which applies several assumptions regarding the comparability of applicant qualifications, cohort size, and the institutional breadth of applicants' training needs.

METHODS

The current report therefore summarizes the survey-based views and experiences of physician-scientist trainees obtained following the 2021-2022 application cycle for research-oriented residency programs, or physician-scientist training programs (PSTPs). From among this small cohort of applicants, we obtained survey-based feedback of 27 PSTP applicants across 17 U.S. medical universities, among whom 85% (23/27) matched into a PSTP.

RESULTS

Among these PSTP applicants, 25/27 (93%) recognized "scientific community" as the most important feature of a postgraduate training program, with applicants identifying as female placing a higher value on the program's infrastructure of personal and/or family support. Most (18/27) respondents found "waiting for interviews" as the most stressful phase of their application cycle, and roughly half of all respondents encountered at least one NRMP policy violation through post-interview communication. Specifically, 93% (25/27) respondents were contacted by at least one PSTP following interviews, and 1/3 of them admitted to feeling pressured into sharing their ranking preferences.

CONCLUSION

We highlight many previously unrecognized priorities among applicants to PSTPs, which include fostering community among its trainees and reinforcing structured mentoring. We uncover an inconsistency among PSTPs regarding the post-interview process, which represents an opportunity to better support applicants seeking to gauge programs according to their clinical, scientific, and academic interests as physician-scientists, while still adhering to NRMP policies.