Physician-Scientist Training and the Future of Academic Medicine

Physician-scientists bring a critical perspective to scientific discovery and contribute to a significant proportion of medical breakthroughs that improve patient care; however, recent reductions in the proportion of pulmonary and critical care medicine fellows pursuing careers as physician-scientists, mirroring trends in other medical specialties, raise concern about the long-term viability of the current training paradigm. Numerous factors potentially contribute to the drop in trainees pursuing research careers, including reduced availability of research training opportunities during residency and fellowship, increasing clinical and research training complexity, a longer timeline to career independence, and funding uncertainties. Increasing educational debt, an often rigid training structure, and declining resources also contribute. This 2025 American Thoracic Society International Conference symposium provided an overview of these challenges, as well as potential solutions to preserve this vital career path, including the need for critical evaluation of the current training model, reexamination of success metrics, and focused efforts to create more supportive, fair, and collaborative training environments. In response to growing concerns about the sustainability of the physicians-scientist training pathway, education leaders and physician-scientists from around the country presented a special symposium at the 2025 American Thoracic Society International Conference. Content selection was developed through iterative discussion among the presenting authors. The session highlighted important recent trends reflecting decreased engagement with this pathway, challenges faced by trainees, and the potential roles that administrative and education leaders might play in reimagining the physician-scientist training paradigm. This paper summarizes key elements and messages of the session and highlights the opportunity for stakeholders to collaboratively develop a clearer vision of the future for this critical career path. This session highlighted new opportunities, including maximizing competency-based training, enhancing organizational supports, a sharper focus on professional identity formation, and reframing our understanding of what constitutes high-value research contributions by physicians (Table).