Pediatricians value caring above
research
An MUSC study published in the Journal of Pediatrics November
issue surveyed nearly 3,500 medical school graduates and found that
while future pediatricians (particularly females) ranked caring for
others as a top professional value, they ranked research, academic and
teaching pursuits at the bottom of the values list. The study, “What do future (female) pediatricians value?” polled recent medical school graduates registered with the Careers in Medicine Web site, an online career planning program operated by the Association of American Medical Colleges (AAMC). Only participants in residency two years or less were included.
Dr. Ken Holden
(Silent Generation), far left, Dr. Michelle Hudspeth (Generation X),
MD/PhD student Amena Smith (Generation Y), and Dr. Bernie Maria (Baby
Boomer), discuss the different technologies and professional values
employed across generations. A follow-up paper from Maria, Holden and
Smith will discuss generational differences in terms of professional
values and what mentors can do to connect new physicians values and the
needs
of academic medicine. First author and MUSC’s Medical Scientist Training Program (MSTP) student Amena Smith (MD/PhD) said the first concern was the shortage of academic pediatric neurologists and other pediatric sub-specialists. “We wanted to know why there was a deficit. And we hoped to determine how to address it,” she said.
Using a 35-value inventory called Physician Values in Practice Scale (PVIPS), the survey measured six values that help identify what’s most important and satisfying about being a physician: prestige—being recognized by others as a top physician; service—caring for others regardless of financial gains or other rewards; autonomy—the importance of freedom, independence and control over clinical decision making; lifestyle—having a predictable and stable work schedule, management—supervising and having responsibility for others; and scholarly pursuits—engaging in clinical or basic research, academic medicine and teaching.
It found that pediatric students scored much higher than others on service, placing it above autonomy, management and prestige.
“Regrettably, across all specialties, scholarship ha s a lower value, and in people choosing pediatrics, scholarship was the lowest,” said Bernie Maria, M.D., Darby Children’s Research Institute (DCRI) executive director and principal investigator of the ongoing study.
Smith said that pediatricians entering the field are very interested in caring for people, but are not as interested in research. “That is problematic for institutes like the DCRI, and ultimately for the advancement of children’s medical care,” she noted.
“We’re making important discoveries in science, yet if we don’t create proper incentives, we may not have the medical professionals to carry this work forward,” Maria added. “We won’t be able to make optimal use of this information without new generations of academicians.”
The survey also looked at differences between the sexes, finding significant differences between men and women on all professional values except management issues in practice.
Among the findings: women in both the pediatrics group and the “all other” group valued service to a greater extent than their male counterparts, and both placed significantly lower emphasis on the value of scholarly pursuits. Overall, men in both groups valued autonomy, prestige and scholarly pursuits, while women placed higher value on lifestyle and service.
Second-year student and co-investigator Robbie Hendry agreed with the findings. “My classmates seem more focused on recognition and prestige,” he said.
Hendry believes part of the problem is new physicians are not familiar with academic medicine. “They don’t understand the benefits of it, that it offers opportunities to be effective participants in a patient’s quality of life. The rewards are more related to direct patient contact and to being part of a rewarding care team,” he said.
“Since scholarly pursuits are less appealing overall and particularly among women, who make up the majority of the pediatric field, pediatrics really stands to lose in the research world,” Smith said.
The survey was a first step, and next steps involve determining the differences among generations, how to acknowledge them and how to foster career development for future generations.
“The strategy is for current mentors in the field to link the scholarly aspect more closely to the highly valued autonomy, lifestyle, and service, to make it more attractive,” Smith said. “That’s where the appeal of translational research comes in.”
In their next paper, the authors will report values differences by generation and findings from focus groups of Generation Y students (born 1980 and beyond) that probe the dichotomy between prestige and scholarly pursuits.
This is the first time there’s been data that addresses these issues, Maria said. “It’s a snapshot that shows us that people in their 40s to 60s are mentoring young physicians in their 20s and 30s who have very different priorities. To attract more of the new generation to medicine, to pediatrics, to academics—to move the field forward—we need to pay attention more than ever to generational and individual differences.”
Maria said he hopes Generation Y pediatricians will see that one of the best ways to serve many children is to move the field forward with novel treatments through translational research.
MSTP students discover the human side of research
A unique program makes it possible for students to take what’s captivated them during hands-on clinical work, and then apply that knowledge to discoveries in the lab.
“These are our future scientists, the people we’re counting on to be the future faculty of medical schools,” Perry Halushka, M.D., Ph.D., MSTP director. “These are young people who want to make a difference. They’ll be the ones who will make discoveries and then translate them into therapies and medical improvements.”
By combining clinical and research opportunities, the program offers MD/PhD students the chance to become physicians as well as scientists. The NIH-funded program at MUSC is one of about 40 in the country, and is highly competitive. Halushka said the number of applicants rose 10 percent this year, to 96 candidates for about seven positions.
The curriculum includes basic science courses and clinical rotations, plus graduate education and sufficient time to conduct a significant research project leading to a Ph.D. Students are encouraged to enroll the summer before the first year of medical school; most complete the program in seven to eight years.
“We’re encouraged to go to clinic, identify a problem and then address it with our research,” Smith said. “Because we’ve met patients with the disease and have seen the consequences of the disease, we’re able to come into the lab and research something we have a passion for. It’s motivating.”
Currently the 55 MSTP students at MUSC are investigating issues ranging from aging and cancer to cardiovascular disease and the neurobiology of addiction.
Eleven are collaborating within the DCRI to tackle child-related diseases. First year student Anthony Leonard is analyzing the expression patterns of the breast cancer resistance protein in human glioblastoma.
“This is the most malignant and deadly brain tumor we’ve classified,” Leonard said. He hopes his research will help clarify the protein’s role in enhancing tumor cell resistance, particularly tumor regrowth in children.
DeAnna Baker is also working in the DCRI, researching the removal of sphingosine kinase, one of the sphingolipids, which she believes could lead to a decrease in inflammation related to rheumatoid arthritis.
Relating her medical background to her current research gives her a more concrete perspective on her goal, she said.
“The MSTP provides a great infrastructure for research, even before I start work on my PhD,” Leonard said. “Working in the DCRI puts me within easy access to collaborators, and it’s full of investigators who emphasize the importance of translational research.”
Third-year student Joe Palatinus is collaborating with researchers in the DCRI to develop an ACTI peptide to increase the rate of diabetic wound healing.
“The program has allowed me to work on the human, animal model and cellular levels,” Smith added. She said her experiences as a medical student, such as drawing blood and talking to patients, give her an advantage. “The nice thing about being both a clinician and a researcher is that you get to see problems up-close, and then you get to take that information and do something about it in the lab.”
“I always remind these students that they’re doing research and collaborating on studies that could have an impact on potentially thousands of people,” Halushka said.
Friday, Nov. 16, 2007
Catalyst Online is published weekly,
updated
as needed and improved from time to time by the MUSC Office of Public
Relations
for the faculty, employees and students of the Medical University of
South
Carolina. Catalyst Online editor, Kim Draughn, can be reached at
792-4107
or by email, catalyst@musc.edu. Editorial copy can be submitted to
Catalyst
Online and to The Catalyst in print by fax, 792-6723, or by email to
catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island
Publications at 849-1778, ext. 201.