Training basic scientists to bridge the gap between basic science and its application to human disease

Article Abstract:

As medical science becomes ever more specialized and esoteric, the number of physicians who are able to do competent medical research decreases. Although the value of those in the basic sciences has increased, many of them lack knowledge of pathobiology or clinical medicine. The situation demands that the basic scientist become sufficiently knowledgeable about clinically related disciplines to continue the process of medical research. Other factors conspire to limit the number of research physicians, including the increasing level of debt developed during their training period, the lengthened period of residency training, increasing competition for grants, and reduced esteem for the physician-scientist as a role model. The gradual erosion of the status of the physician-scientist is evidenced by the reduction in the number of individuals with an M.D. degree who were awarded government grants, down from 37 percent in 1970 to 26 percent in 1987. There have been several attempts to improve this situation, such as the M.D.-Ph.D. programs developed in the 1950s and 1960s. The premise of these programs was to develop individuals who were capable of teaching, conducting research and providing patient care. Though noble, this goal is not currently in vogue as the requirements of teaching, research and clinical practice are each so demanding as to consume an individual's full attention. Most medical school departments train graduate students who may be interested in clinical research at the beginning of their training but often seek appointments in academic institutions or in industry after receiving their degrees. Many Ph.D.s harbor negative attitudes toward doing research within clinical departments. These include the apprehension that the physicians will control rather than collaborate with the scientists.

Evaluation, Practice, Medical personnel, Medical research, Allied health personnel, Medical education, Medical scientists, Medical research personnel, Medical researchers, editorial, Paramedical education

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Correcting the oversupply of specialists by limiting residencies for graduates of foreign medical schools

Article Abstract:

Both government regulation and market forces should be used to reduce the excess supply of medical specialists in the US. The supply of these specialists is determined by the number of medical school graduates entering residency programs and their choices of specialties. Market forces which provide less demand for specialists have and will continue to influence graduates of US medical schools to enter primary care residencies. However, the available specialty residencies will not be shrunk, but filled by the large numbers of foreign medical school graduates. Thus, the US government should restrict the number of foreign medical school graduates who may enter US residencies. Furthermore, selection should not favor the large portion of foreign schools graduates who are US citizens. Selection should favor foreign graduates who must return to their native countries after training. US medical graduates should be informed of market trends, and they will freely choose not to enter specialties.

Column, Appointments, resignations and dismissals, Residents (Medicine)

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