NEW YORK (Reuters Health) – A fund that facilitates the success – and retention – of junior physician-scientists with substantial caregiving responsibilities has been enthusiastically received, according to a new report.
The success of these young academics “benefits society as a whole,” Dr. Reshma Jagsi of the University of Michigan, in Ann Arbor, told Reuters Health by email. But many of them “face difficulties integrating their demanding careers with domestic responsibilities.”
In a paper online March 20 in Annals of Internal Medicine, Dr. Jagsi and colleagues report on the initial experience of the Fund to Retain Clinical Scientists, a national program from the New-York based Doris Duke Charitable Foundation.
In 2015, the Foundation solicited proposals from medical schools for funding. It received 72 letters of interest and 61 full applications. Ten sites received five-year grants. Awards of $540,000 support approximately six junior physician-researchers at each site.
The Foundation recommended support of approximately $30,000 to $50,000 per year for one to two years. Funds were designated for research support, not childcare or eldercare costs.
Each funded site solicited proposals from candidates at an early-career faculty rank (i.e., not yet associate professors). Eligibility requirements for applicants were work on human research with the potential to affect health, evidence of strong research training and productivity, active financial research support, and compelling needs related to caregiving demands.
Medical schools had substantial latitude in how they defined caregiving demands and compelling need, and how they implemented their individual programs.
The authors conducted in-depth, semi-structured interviews with leaders from each site approximately one year after program initiation. They also assessed the characteristics of applicants and awardees, and they gathered feedback from site representatives who attended a full-day symposium on the program.
Each site received a median of 10 applications (range 2-28) and awarded a median of 3.5 grants (range, 2-5) in the first year.
Overall, 123 physician-researchers applied for funding; 82.9% were female. Most (80.5%) had authored at least six publications and 30.1% had received $500,000 or more in extramural grants.
The caregiving needs of applicants included elder care (21.1%), partner care (1.6%), and childcare (91.1%). Many faced simultaneous demands for elder care and childcare, challenges exacerbated by job-related relocations that precluded calling on extended family for help. Caregiving demands were also complicated by divorce or illness of the physician-researcher or family members.
Many sites leveraged institutional funds and programs to support additional scholar positions and provide supplemental resources. These included administrative and psychosocial support, research services, and domestic help.
Several sites also provided awardees and some applicants with executive coaching, leadership development, and mentorship programs, including peer mentorship networks.
During launch, institutions struggled with such operational issues as how to evaluate the intensity of applicant need and understand how funding enables ongoing productivity
Nonetheless, site leaders were enthusiastic about the intent of the program. They anticipated that it would drive change in institutional culture by normalizing caregiving challenges and supporting research during difficult times, Dr. Jagsi and colleagues report.
Dr. Deborah Blazey-Martin, chief of the division of internal medicine and adult primary care at Tufts Medical Center in Boston, said such initiatives are important.
“The Doris Duke Charitable Foundation . . . acknowledges that work-life struggles can derail promising careers,” Dr. Blazey-Martin, who was not involved in the study, told Reuters Health by email.
She added that it’s critical not only to create these programs, but to demonstrate that they are effective in enabling clinical scientists to produce cutting-edge research despite family demands.
Dr. Carol R. Bates, associate dean for faculty affairs at Harvard Medical School in Boston, agreed. “Clearly, the prevalence of personal challenges is quite high,” she told Reuters Health by email.
There is substantial evidence of work-life obstacles for early-career faculty at Harvard Medical School, said Dr. Bates, who was not involved in the study.
“The Doris Duke Foundation has taken the lead with this much-needed pilot program,” she said. “Hopefully, other foundations and grant agencies will follow suit.”
The study was supported by a grant to Dr. Jagsi from the Doris Duke Charitable Foundation.
SOURCE: https://bit.ly/2I4MkOD
Ann Intern Med 2018.
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