Early-Career Academic Cardiology: The Challenges Continue

The global status of early-career academic cardiology remains uncertain. This is among the conclusions of the Early Career Section Academic Working Group of the ACC, in a report of their study assessing the current status and challenges for this group, published Oct. 23 in the Journal of the American College of Cardiology.

Carl W. Tong, MD, PhD, FACC, et al., also recommend a set of potential solutions to promote the survival and success of early career academic cardiologists (ECACs) and academic cardiology. They note the reliance on academic cardiology to drive research in all settings to address the rising burden of cardiovascular disease and to train the next generation of cardiologists.

Among the challenges faced by ECACs – defined as those within 10 years of completion of a cardiology fellowship – are limited funding, insufficient protected time, increased regulatory compliance burden, increased competition from pure-PhD scientists, and personal financial disincentives, according to a report in 2014 from the Early Career Section Academic Working Group.

To evaluate the progress made over the past three years, the Working Group collaborated with the National Heart, Lung, and Blood Institute (NHLBI) and with the American Heart Association to understand the grant funding picture. They also conducted a survey of ACC members who are ECACs – including international cardiologists – and obtained other international data.

On the negative side, the study found that a global reduction in gaining funding for research has likely occurred; only a minority of respondents reported satisfaction in teaching development; the ability of mentoring to positively affect grant outcome has diminished; financial disincentives for pursuing academics are increasing, and 14 percent of ECACs reported a high likelihood of leaving academics. The researchers note these findings are consistent with a declining physician-scientist workforce that has been documented by the National Institutes of Health.

On the positive side, the NHLBI has increasing funding through multiple mechanisms; the ACC has provided new grants; and although currently small in number ECACs who are ACC members continue to obtain NHLBI K grants.

Factors found to correlate with obtaining external grand funding included personal motivation, home institution and connection to collaborators, but mentoring did not. "Mentoring needs attention," the study authors write. "A local mentor who can provide support, feedback, and when necessary hard-hitting critique, is pivotal importance in launching a physician-scientist’s career."

The Working Group details nine recommendations for the ACC and other cardiovascular professional organizations and five recommendations for academic centers and clinical institutions. Importantly, for the individual ECAC, they outline factors look for in a fellowship program and what to look for in cardiologist position that can support academic pursuits.

"We believe that successful development of ECACs is critical for continued viability of cardiology as a profession as well as advancing improved cardiovascular care globally," the authors write. "We hope this report will serve as a catalyst for discussion and policy changes that will promote the survival and success of ECACs and the profession as a whole."


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