Issues such as, over commitment, insufficient time, and lack of funding, threaten physicians' entry and sustainability in a research career pathway. Social cognitive career theory is presented as a conceptual framework to critically examine the limitations of the National Institutes of Health's (NIH) efforts to promote the career development of physician-scientists. Special attention is given to the unique challenges of promoting this career pathway for women and underrepresented minorities. The authors propose enhanced recommendations for the career development of physician-scientists and research questions for future studies and program development aimed at advancing the nation's efforts to promote clinical research.

Between 1980 and 1993, only 19% of medical school graduates chose faculty appointments with research responsibilities. Women and minorities represent only a small fraction of these, despite their growing numbers. The authors' goal is to study the effects of human agency, particularly self-efficacy, on the career development of physician researchers, especially women and people of color; therefore, we developed a reliable and valid inventory for assessing clinical research self-efficacy in a population of physicians training for clinical research careers. Scale items were pooled from expert knowledge, relevant literature, and existing inventories to create a 92-item Clinical Research Appraisal Inventory that was factor analyzed and refined to include 88 items. Although instruments have been developed to successfully assess research self-efficacy, this is the first instrument designed to assess self-efficacy in the clinical research domain using a population of academic physicians.

Women physicians consistently rated their abilities to perform or apply knowledge and skills related to clinical research lower than men rated themselves, and a traditional training venue exacerbated these gender differences. This previously unexplored gender difference in self-perceived competency may indicate an additional barrier women face in academic career development and suggests that educational programs incorporate learning activities that address gender differences when training physicians for careers in clinical research.