After recent US policy shifts, a survey of 175 early-career physician-scientists suggests that they struggle with balancing clinical, research, and educational responsibilities; work-family balance; limited funding; and low compensation, with 58% considering leaving academic medicine in the next two years and 44% mulling a move abroad.

The findings, which haven’t been peer-reviewed, were published this week on the preprint server medRxiv.

Researchers from the Yale School of Medicine led the survey, which asked early-career physician-scientists about demographic factors, career-development support, distribution of clinical and research responsibilities, funding, and perceived career barriers. The survey was emailed to department chairs at 110 academic centers.

Physician-scientists translate scientific discoveries into advances in patient care, the study authors noted.

“However, the physician-scientist pipeline has long been laden with challenges, affecting the community at every training stage, particularly those in the early phases of training,” they wrote. “Consequently, this scientific workforce has markedly contracted, declining from approximately 4.5% of the medical community in the 1980s to about 1.5% over the last decade.”

Respondents represent range of specialties

Among respondents, 45.3% were women, and the largest age-group was 35 to 44 years. Assistant professors made up the largest group (46.6%), followed by residents (14.3%) and fellows (12%). Medical domains spanned general medicine and related subspecialties (57.7%), neurology/psychiatry (10.3%), pathology (6.3%), and surgical subspecialties (4.6%). 

The greatest geographic representation was from the Northeast (35.7%), followed by the Southwest (22.8%), Midwest (17%), Southeast (14%), and Northwest (6.4%).

About 74% of participants said they dedicated at least 50% of their time to research, and 4.3% reported full-time research. Among those with a research effort under 50%, 81.8% indicated that they wanted to dedicate more time to research. In total, 25.7% were pursuing mainly basic science, while 30.3% wanted to spend most of their time on translational research, and 25.1% named clinical research. 

Eighty-nine (50.8%) of the 175 respondents had received a career-development award, with only 28.9% citing limited institutional or departmental support. Among the 80 respondents with information on funding-submission attempts, 45% secured funding on their first try and 38.8% on their second, while the remaining participants reported at least three attempts. 

The greatest concern for the future that they cited was for research into health disparities (76%), followed by vaccines (70.3%), and diversity, equity, and inclusion (62.9%).

Funding challenges, low compensation, burnout

The most commonly reported work difficulties were balancing clinical, research, and educational responsibilities (72.5%), balancing work and family responsibilities (48.0%), limited funding (48.0%), and low compensation (34.3%).

These findings underscore an urgent need for sustained investment, targeted retention strategies, and policy reforms to stabilize and strengthen the physician-scientist workforce in the United States.

A total of 16.5% said their outlook on academic medicine was very pessimistic, 35.3% were somewhat pessimistic, 22.9% were somewhat hopeful, and 5.3% were very hopeful. 

In total, 57.7% of respondents said they had thought about leaving academic medicine within the next two years, and 83.2% indicated an over 50% probability of doing so within five years. The most often-cited reasons for this were funding challenges (72%), low compensation (42.3%), feeling unhappy or stressed (40.6%), and burnout (37.7%). 

In addition, 43.9% of those surveyed said they had considered moving outside the United States for better academic working conditions, and 10.4% had already been contacted by institutions in other countries.

Overall, the survey findings suggest that the physician-scientist workforce is at continued risk for contraction.

“Early-career physician-scientists face substantial structural and financial challenges, with limited institutional support, high rates of burnout, and widespread intent to leave academia,” the authors wrote. “These findings underscore an urgent need for sustained investment, targeted retention strategies, and policy reforms to stabilize and strengthen the physician-scientist workforce in the United States.”