Despite the critical role that physician-scientists play in the biomedical work force, often from bedside to bench and back, concern for the health of this enterprise was apparent to James Wyngaarden¹ 40 years ago when he described this “endangered species.” Former National Institutes of Health (NIH) director, Elias Zerhouni, in 2008, said of the young scientist conundrum, “I think anybody who thinks this is not the number one issue in American science probably doesn’t understand the long-term issues.” The myriad challenges this presents have been addressed recently by many (see Schafer²). In 2 striking articles, Alberts et al^3,4 have focused attention on what they term “rescuing US biomedical research from its systemic flaws.” Among the key areas identified is the next generation of biomedical scientists (including both fundamental and clinician scientists), wherein 18% of NIH R01-funded investigators were aged 36 years or younger in 1980, yet only 3% were in that age group in 2010. Furthermore, the percent of R01 principal investigators older than 65 years increased more than 10-fold during this same period: the aging of the workforce. Daniels⁵ dissected many of the causes for this current young generation at risk and noted that the average age for an MD investigator to receive her or his first R01 was 38 years in 1980 and rose to more than 45 years in 2010. To address this, he suggested 4 areas for potential action: strategic reinvestment in scientific research, reform of external peer review, rebalancing the compact between universities and the government, and developing sustainable career paths for young scientists. Indeed, the 2014 NIH Physician-Scientist Workforce (PSW) Report (https://acd.od.nih.gov/), noted that there are approximately 9000 physician scientists in the NIH-funded workforce and discussed the challenges confronting them: the cost of medical education with resultant debt, prolonged training required in both clinical medicine and research, funding challenges, shifting finances of schools of medicine and academic health centers, funding mentors for guidance, work-life balance, and increasing as well as demanding compliance, among others.

尽管医师和科学家在生物医学工作人员中发挥着关键作用，通常从床边到长凳再到背部，但40 年前詹姆斯·温加登 (James Wyngaarden) ^{1在描述这个“濒临灭绝的物种”时，对这个企业的健康的关注是显而易见的。}前美国国立卫生研究院 (NIH) 主任 Elias Zerhouni 在 2008 年谈到年轻科学家的难题时说：“我认为任何认为这不是美国科学中的头号问题的人都可能不了解长期问题。 ” 许多人最近已经解决了这带来的无数挑战（参见 Schafer ²）。在 2 篇引人注目的文章中，Alberts 等人^{3 ,4}将注意力集中在他们所谓的“从系统性缺陷中拯救美国生物医学研究”上。确定的关键领域包括下一代生物医学科学家（包括基础科学家和临床科学家），其中 18% 的 NIH R01 资助的研究人员在 1980 年年龄在 36 岁或以下，但在 2010 年只有 3% 处于该年龄组. 此外，65 岁以上的 R01 首席研究员的百分比在同一时期增加了 10 倍以上：劳动力老龄化。丹尼尔斯⁵剖析了当前年轻一代面临风险的许多原因，并指出 MD 调查员接受她或他的第一个 R01 的平均年龄在 1980 年为 38 岁，到 2010 年上升到 45 岁以上。为了解决这个问题，他建议4 个潜在行动领域：科学研究的战略再投资、外部同行评审改革、重新平衡大学与政府之间的契约以及为年轻科学家开发可持续的职业道路。事实上，2014 年 NIH 医师-科学家劳动力 (PSW) 报告 (https://acd.od.nih.gov/) 指出，在 NIH 资助的劳动力中约有 9000 名医师科学家并讨论了他们面临的挑战：导致债务的医学教育成本，临床医学和研究所需的长期培训，资金挑战，