Physician-Scientists: Fixing the Leaking Pipeline - A Scoping Review

Introduction

This scoping review was undertaken to assess the current status of physician-scientists, including the challenges associated with their enrollment and retention, measures of success, and determinants of their satisfaction, all of which contribute to the dwindling numbers of physician-scientists aptly referred to as a "leaking pipeline" of physician-scientists.

Methods

A total of 2555 research documents from three databases, viz. Scopus, Web of Science, and PubMed, were selected. A total of 40 documents were considered for final analysis following the 5-stage framework of Arksey and O'Malle.

Results

Medical institutions should promote and sustain enrollments by addressing various perceived parameters of success and satisfaction. The challenge of attrition due to individual, regulatory, and sociocultural considerations also needs to be addressed.

Conclusions

Medical institutions should focus on establishing well-documented career tracks with provisions for career advancement, promotion of team science, raising mentors, giving preference to students with peer-reviewed publications for post graduate (PG) admissions, and establishing a separate office for career development and guidance for physician-scientist. It is equally important to address the factors which promote retention and prevent attrition, viz. measures of success and determinants of satisfaction. Additional measures include creating a cadre of physician-scientists in government organizations, fostering collaboration of physician-scientists with incubation centers and startups, and adding additional mandatory curriculum components focused on project-based training.

A Cross-Sectional Survey of Practice Patterns and Selected Demographics of Respiratory Therapists in India

BACKGROUND

Respiratory therapy was introduced to India in 1995. Respiratory therapists (RTs) work alongside doctors in hospitals. Of the 993 universities in India, a few have bachelor's or master's programs in respiratory therapy, but no studies have examined the demographics, geographical spread, or skills used by these RTs. This study assessed the demographics and services offered by RTs in India.

METHODS

This was a cross-sectional study based on a survey administered on paper, by telephone, or online. RTs were selected by convenience sampling from institutional databases and from WhatsApp groups of RTs in India, as well through snowball sampling of co-workers. A link to the online survey was shared on the author's personal social media channels. Of the invited RTs, 465 consented and participated; of those, 237 answered all questions.

RESULTS

Of the 237 respondents completing the survey, 73% had bachelor's degree, 16.5% had a master's degree, 4.6% had a diploma, 2.5% had mixed qualifications, 1.7% had post graduate diploma, 0.8% had a certificate, 0.4% had a master of business administration degree, and 0.4% had a PhD degree. Almost all (96.6%) worked as an RT or in a job that required respiratory therapy knowledge. Although individuals may have had multiple job roles, 77.6% worked as a hospital staff RT. The least frequently performed competencies were recommending diagnostic procedures, using evidence-based principles, initiating and conducting patient and family education, and administering home care and pulmonary rehabilitation; the most frequently performed competencies were support oxygenation and ventilation, ensuring infection control, and maintaining a patent airway.

CONCLUSIONS

Most subjects were employed in south India and had a bachelor's degree. They worked as staff RTs with a focus on the acute care environment. Pneumonia, asthma, COPD, and ARDS were the most commonly managed diseases. Competencies such as recommending procedures, planning and providing pulmonary rehabilitation, and administering home-based care were the least frequently performed.