Preventive health care for an endangered species--the physician scientist

The environment of the successful clinician-scientist

The number of clinician-scientists has declined over the past several decades and evidence suggests this trend also applies to orthopaedic surgery. A previous study identified only 64 principle investigator orthopaedic surgeons with over 100,000 dollars of NIH funding from 1992 to 2001, during which funding declined for orthopaedic surgeons. We surveyed 58 of these 64 surgeons (six were retired) to ascertain aspects of their environment that might lead to success and what obstacles they encountered. The common definition of a clinician-scientist was an individual who obtained external funding for research. With a response rate of 79%, 26 of 40 (65%) began their research careers before residency. Nearly half had additional specialized training in research and most thought at least 6 months training was important. Thirty four of 46 respondents (74%) percent spent less than 20% of their time in research but 43 of 45 (95%) thought at least 30% ideal. Twenty five of 43 (58%) had unshared laboratory space and those without typically share with three or more scientists. Twenty eight of 43 (65%) believed their level of external funding adequate. Twenty of 46 (43%) believed their colleagues resented the time they spent in research. Demands on clinical time continue to be a major impediment to orthopaedic clinician-scientists. The orthopaedic community must develop supportive environments for clinician-scientists.