Training the next generation of Canadian Clinician-Scientists: charting a path to success

Abstract

Clinician-scientists are physicians with training in both clinical medicine and research that enables them to occupy a unique niche as specialists in basic and translational biomedical research. While there is widespread acknowledgement of the importance of clinician-scientists in today's landscape of evidence-based medical practice, training of clinician-scientists in Canada has been on the decline, with fewer opportunities to obtain funding. With the increasing length of training and lower financial compensation, fewer medical graduates are choosing to pursue such a career. MD-PhD programs, in which trainees receive both medical and research training, have the potential to be an important tool in training the next generation of clinician-scientists; however, MD-PhD trainees in Canada face barriers that include an increase in medical school tuition and a decrease in the amount of financial support. We examined the available data on MD-PhD training in Canada and identified a lack of oversight, a lack of funding and poor mentorship as barriers experienced by MD-PhD trainees. Specific recommendations are provided to begin the process of addressing these challenges, starting with the establishment of an overseeing national body that would track long-term outcome data for MD-PhD trainees. This national body could then function to implement best practices from individual programs across the country and to provide further mentorship and support for early-career physician-scientists. MD-PhD programs have the potential to address Canada's growing shortage of clinician-scientists, and strengthening MD-PhD programs will help to effect positive change. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45

Is It Possible for Registered Nurses and Physicians to Combine Research and Clinical Work to Facilitate Evidence‐Based Practice?

“…However, there are few research‐educated RN clinician‐scientists with a PhD degree in many countries, although outstanding examples exist on the opposite end of the spectrum for high‐ranked institutions (Rugs et al, 2020). There has also been a decline in the number of physicians in the role of clinician‐scientist (Blish, 2018; Weggemans et al, 2019; Yin et al, 2017). From Canada, Yin et al (2017) reported a decrease in the number of physicians who are clinician‐scientists, attributing it to longer training and less financial compensation, resulting in fewer medical graduates choosing to become clinician‐scientists.…”

“…There has also been a decline in the number of physicians in the role of clinician‐scientist (Blish, 2018; Weggemans et al, 2019; Yin et al, 2017). From Canada, Yin et al (2017) reported a decrease in the number of physicians who are clinician‐scientists, attributing it to longer training and less financial compensation, resulting in fewer medical graduates choosing to become clinician‐scientists. Within nursing, the number of doctoral programs has increased, although little time is spent on preparing doctoral students for the role of clinician‐scientist (Lewallen & Kohlenberg, 2011).…”

Newsletter Spring 2018: Clinician Investigator Trainee Association of Canada (CITAC)

“…2. Recommendation Papers: CITAC contributed to recommendation papers on clinician-investigator training (2,3). Published recommendations included establishing a n a t i o n a l c o u n c i l w i t h a m a n d…”

International training considerations of Canadian Clinician-Scientist Trainees - A national survey

“…Among respondents appointed at academic institutions, 77% dedicated at least 20% of their time to research and 44% dedicated at least 50% to research. While effective, these programs have been continually reviewed to determine best practices and optimize the training pathway of clinician-scientist trainees [5][6][7][8].…”