The Physician-Scientist Model: Does It Work in Our Specialty?

Paul Spring, MS, MD, is Associate Professor and Director of Research in the Department of Otolaryngology–Head and Neck Surgery at the University of Arkansas for Medical Sciences in Little Rock.

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Academic medical centers within the United States bear the primary responsibility for promulgating and performing life sciences research. James Shannon, MD, PhD, is considered the father of the modern National Institutes of Health (NIH)—established in the late 1940s and early 1950s—and creator of our nation’s biomedical research enterprise. Among his most passionate charges was the development of research programs that focused on disease processes as described and treated by physicians. Thus, during the “golden years” of the NIH, the concept was born regarding the unique perspective and role of a physician–scientist.

Fifty years have passed since Dr. Shannon’s idea was originated. It is at once an interesting irony and a troublesome reality that contemporary medicine and state-of-the-art technology have arrived at a time when the cultural, societal, and fiscal challenges facing those engaged in the conduct of medical research are greater than at any previous time in our country’s history. Physician–scientists and the infantry of clinicians who devote their professional efforts toward the attainment of new medical knowledge using established scientific principles are a tenuous, yet necessary, link in medical advancement. Many scientists and educators have been instructive about the major problems facing the clinical research community and the fact that these problems are affecting the training of physicians who wish to enter this career path.

At the annual meeting of the Society of Head and Neck Surgeons in 1995, Dr. Helmut Goepfert delivered the Hayes Martin Lecture on “Training the Head and Neck Surgeon–Scientist.”1 His paean to physician–scientists in general and the surgeon–scientist in particular was one of the society’s first public calls to the significance and need for individuals to pursue this career track within our specialty. Dr. Goepfert stressed the notion that “clinical training alone is not enough to forge the future.” He also challenged modern head and neck surgeons by reminding them that “faithful acceptance of dogma” was a misguided practice and that it represented the greatest obstacle to constructive change in our specialty. Dr. Goepfert, a preeminent leader of a surgical discipline, was warning a skeptical generation about the consequences of repeating the past. He averred that the confluence of clinical excellence and scientifically applied theory was the most valid approach to improving the lives of our patients. His concept of a true surgeon–scientist was his answer to the dilemma.