Current Education of Physicians: Lost in Translation?

TY - JOUR

T1 - Current Education of Physicians

T2 - Lost in Translation?

AU - Schafer, Andrew I.

AU - Mann, Douglas L.

N1 - Funding Information: Thorough and intensive clinical training cannot be replaced, even for future physicians who aspire to predominantly research careers. So what can be done to keep the pilot light of interest in a research career burning during this period of intensive clinical training? First, dedicated research time during undergraduate and graduate medical education requires extramural financial support, which is conspicuously absent today. Given the massive commitment to biomedical research in the United States that is supported by industry, philanthropy, and public tax dollars (5) , it is ironic that we are failing to invest in the durable cultivation of the very workforce that will be required to sustain this country’s biomedical research enterprise. A notable exception has been the long-standing and highly successful support by the NIH for MD-PhD combined degree programs. Another possibility for fostering the development of translational physician-scientists during clinical training would be to incorporate elements of the NIH Intramural Translational Science Training Program into medical school and post-graduate medical training programs. The Translational Science Training Program is currently a 2-day boot camp–style course that intertwines multidisciplinary scientific content, understanding of the drug development process, clinical trial terminology, and career exploration ( https://www.training.nih.gov/tstp ). A similar type of approach could be adopted to research electives in medical school, residency, and fellowship to provide ongoing exposure to scientific thinking. For medical students, a meaningful period of protected time for original research under the guidance of a good faculty mentor can be introduced into the curriculum late in the third year or during the fourth year. An example of this is the required 6-month block of “protected” research time toward the end of medical school, named the Areas of Concentration program, that has been successfully implemented at Weill Cornell Medical College. Another example is the Duke medical school curriculum, wherein students learn the core basic sciences in the first year and complete core clinical clerkships in the second year. The students then devote 10 to 12 months to scholarly investigation and fulfill elective rotations in the third and fourth years. Thus, by condensing the traditionally structured training from 4 years into 3 years, the Duke medical school curriculum provides students with ample opportunity to pursue their own independent research interests. Finally, active physician-scientists must be brought back onto inpatient services for attending and teaching rounds in partnership with hospitalists, who should maintain responsibility for supervision and oversight. Not only would this kind of arrangement permit continued exposure of clerkship students and residents to the scientific underpinnings of medical practice, but it would also provide the hospitalists with the same and the physician-scientists with much needed exposure to the current realities of clinical practice. As always, we welcome your thoughts about how to train the next generation of translational scientists, either through social media ( #JACC:BTS ) or by e-mail ( jaccbts@acc.org ).

PY - 2019/9

Y1 - 2019/9

UR - http://www.scopus.com/inward/record.url?scp=85072165695&partnerID=8YFLogxK

U2 - 10.1016/j.jacbts.2019.08.002

DO - 10.1016/j.jacbts.2019.08.002

M3 - Editorial

C2 - 31768480

AN - SCOPUS:85072165695

SN - 2452-302X

VL - 4

SP - 655

EP - 657

JO - JACC: Basic to Translational Science

JF - JACC: Basic to Translational Science

IS - 5

ER -