The Clinician Scientist, a Distinct and Disappearing Entity.

linician scientists are commonly defined as those individuals holding an MD or MD/PhD degree who perform biomedical research of any type as their primary professional activity.1 Here we discuss issues that affect the choice to pursue a clinician scientist career in the various areas of medical research, including pediatrics, and how these issues are changing in light of recent developments in the biomedical research environment and the practice of medicine. The clinician scientist has become a rare and distinct entity, or an “endangered species” as James Wyngaarden, former director of the National Institutes of Health stated decades ago. Recent data show a consistent worldwide decrease in the rate of medical doctors pursuing this path3 For instance, reports from the US have emphasized that although an absolute increase in medical students has been observed during the past few years, the number of MD/PhD applicants has plateaued. According to the National Institutes of Health Physician Scientist Workforce report, in 2012 physician scientists comprised only 1.5% of the total physician workforce in the US. Also of concern is the aging of the clinician scientist workforce. The average age of the workforce has increased, as has the age of independence for researchers (grant holders), suggesting a decrease in the pool of young researchers and an inability to compete with PhDs for grants. Notably, an overall gender inequality was also reported, with females representing only 22% of MD/PhD physician scientists.