Clinician-Investigator Training and the Need to Pilot New Approaches to Recruiting and Retaining This Workforce.

Clinician-investigators, also called physician-scientists, offer critical knowledge and perspectives that benefit research on basic science mechanisms, improved diagnostic and therapeutic approaches, population and outcomes medicine, health policy, and health services, yet few clinically trained health professionals pursue a research career. Sustaining this workforce requires attention to the unique challenges faced by investigators who must achieve clinical and research competence during training and their careers. These challenges include the duration of required clinical training, limited or discontinuous research opportunities, high levels of educational debt, balancing the dual obligations and rewards of clinical care and research, competition for research funding, and the need for leadership development after training. Women and individuals from underrepresented racial and ethnic groups comprise a small percentage of this workforce.The authors summarize the recent literature on training for clinician-investigators, emphasizing approaches with encouraging outcomes that warrant broader implementation. Using this overview as background, they convened three workshops at the National Institutes of Health in 2016 to identify and refine key priorities for potential new pilot programs to recruit and retain the clinician-investigator workforce. From these workshops emerged three priorities for future pilot programs: (1) support for research in residency, (2) new research on-ramps for health professionals at multiple career stages, and (3) national networks to diversify and sustain clinician-investigator faculty. Implementation of any pilot program will require coordinated commitment from academic health centers, medical licensing/certification boards, professional societies, and clinician-investigators themselves, in addition to support from the National Institutes of Health.

Measuring Diversity of the National Institutes of Health-Funded Workforce.

PURPOSE: To measure diversity within the National Institutes of Health (NIH)-funded workforce. The authors use a relevant labor market perspective to more directly understand what the NIH can influence in terms of enhancing diversity through NIH policies. METHOD: Using the relevant labor market (defined as persons with advanced degrees working as biomedical scientists in the United States) as the conceptual framework, and informed by accepted economic principles, the authors used the American Community Survey and NIH administrative data to calculate representation ratios of the NIH-funded biomedical workforce from 2008 to 2012 by race, ethnicity, sex, and citizenship status, and compared this against the pool of characteristic individuals in the potential labor market. RESULTS: In general, the U.S. population during this time period was an inaccurate comparison group for measuring diversity of the NIH-funded scientific workforce. Measuring accurately, we found the representation of women and traditionally underrepresented groups in NIH-supported postdoc fellowships and traineeships and mentored career development programs was greater than their representation in the relevant labor market. The same analysis found these demographic groups are less represented in the NIH-funded independent investigator pool. CONCLUSIONS: Although these findings provided a picture of the current NIH-funded workforce and a foundation for understanding the federal role in developing, maintaining, and renewing diverse scientific human resources, further study is needed to identify whether junior- and early-stage investigators who are part of more diverse cohorts will naturally transition into independent NIH-funded investigators, or whether they will leave the workforce before achieving independent researcher status.

Smoking cessation interventions in U.S. racial/ethnic minority populations: an assessment of the literature.

BACKGROUND: Smoking prevalence rates in some ethnic minority groups are elevated relative to the majority population. Thus, identifying cessation interventions that are effective for these groups is important. This article reviews published studies that examine effects of smoking cessation interventions relevant to racial ethnic minority populations. METHODS: A literature search of tobacco interventions, reporting smoking cessation outcomes (including quit rates) in U.S. minority populations, was conducted for the period 1985 to 2001. RESULTS: Thirty-six studies met preset criteria for inclusion. Twenty-three reported quit rates for African Americans, 4 for Asian/Pacific Islanders, 3 for Native Americans, and 10 for Hispanics. CONCLUSIONS: The disproportionate number of studies that focused on African American smokers compared with the other major racial/ethnic groups suggests the need for continued efforts to develop and evaluate the effectiveness of smoking cessation interventions for all ethnic minority populations. Abstinence rates varied considerably depending on study design and intervention strategy. Moreover, a relatively small percentage of studies that were randomized trials reported statistically significant findings, and most used intervention strategies that do not reflect the current state-of-the-art. These results strongly suggest that more research is needed to identify successful smoking cessation interventions in these populations.