Abstract
Clinician scientists have gained institutional support in the era of translational research, as the key solution to closing the ‘translational gap’ between biomedical research and medical practice. However, clinician scientists remain an ‘endangered species’ in search of a secure niche, while new grants and training programs attempt to counteract their measurable decline in numbers over the past decades. Our study asks how an occupational space for clinician scientists is currently situated between the politics of translation, professional dynamics, and the specialization of academic disciplines. We interviewed clinician scientists, their adjacent professions—clinicians and biomedical researchers—, and contrast their views with expectations from the discourse on clinician scientists in the biomedical and policy literature. We identify professionalizable work and tasks that relate to, first, being able to speak the two languages of both clinic and research, second, translating patients’ needs and clinical experience for further research, and third, counteracting the trends towards specialization by providing an inclusive point of view. We find that clinician scientists are overburdened with fulfilling a hybrid role of simultaneously being clinicians and scientists. Based on these findings, we suggest a path for the future professional development of clinician scientists towards the role of a translator.
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References
Abbott, Andrew. 1988. The System of Professions: An Essay on the Division of Expert Labor. Chicago: University of Chicago Press.
Abbott, Andrew. 2005. Linked Ecologies: States and Universities as Environments for Professions. Sociological Theory 23(3): 245–274.
Abbott, Andrew. 2016. Processual Sociology. Chicago: University of Chicago Press.
Blümel, Clemens, Stephan Gauch, Barbara Hendriks, Anne K. Krüger, and Martin Reinhart. 2015. In Search of Translational Research: Report on the Development and Current Understanding of a New Terminology in Medical Research and Practice. IFQ-BIH-Report. Berlin: Institute for Research Information and Quality Assurance; Humboldt-University Berlin.
Bogusz, Tanja, and Martin Reinhart. 2018. Öffentliche Soziologie als Experimentalistische Kollaboration. In Öffentliche Gesellschaftswissenschaften, eds. Stefan Selke, and Annette Treibel, 345–359. Wiesbaden: Springer.
Brosnan, Caragh. 2017. Alternative Futures: Fields, Boundaries, and Divergent Professionalisation Strategies Within the Chiropractic Profession. Social Science & Medicine 190: 83–91.
Butler, Declan. 2008. Translational Research: Crossing the Valley of Death. Nature 453: 840–842.
Calvert, Jane. 2010. Systems Biology, Interdisciplinarity and Disciplinary Identity. In Collaboration in the New Life Sciences, eds. John N. Parker, Niki Vermeulen, and Bart Penders, 201–218. London: Routledge.
Daye, Dania, Chirag B. Patel, Jaimo Ahn, and Freddy T. Nguyen. 2015. Challenges and Opportunities for Reinvigorating the Physician-Scientist Pipeline. The Journal of Clinical Investigation 125: 883–887.
DFG. 2015. Etablierung eines integrierten Forschungs- und Weiterbildungs- Programms für „Clinician Scientists“ parallel zur Facharztweiterbildung. Empfehlungen der Ständigen Senatskommission für Grundsatzfragen in der Klinischen Forschung der Deutschen Forschungsgemeinschaft. Bonn: Deutsche Forschungsgemeinschaft.
Fournier, Valérie. 2000. Boundary Work and the (Un)Making of the Professions. In Professionalism, Boundaries and the Workplace, ed. Nigel Malin, 67–86. London: Routledge.
Freidson, Eliot. 1988. Profession of Medicine: A Study of the Sociology of Applied Knowledge. Chicago: University of Chicago Press.
Freidson, Eliot. 2004. Professionalism Reborn: Theory, Prophecy and Policy. Reprinted. Cambridge: Polity Press.
Fudge, N., E. Sadler, H.R. Fisher, J. Maher, C.D.A. Wolfe, and C. McKevitt. 2016. Optimising Translational Research Opportunities: A Systematic Review and Narrative Synthesis of Basic and Clinician Scientists’ Perspectives of Factors Which Enable or Hinder Translational Research. PLoS One 11(8): e0160475.
Gee, James Paul. 2014. An Introduction to Discourse Analysis: Theory and Method. London: Routledge.
Ioannidis, John P.A. 2004. Materializing Research Promises: Opportunities, Priorities and Conflicts in Translational Medicine. Journal of Translational Medicine 2: 5.
Ioannidis, John P.A., Daniele Fanelli, Debbie Drake Dunne, and Steven N. Goodman. 2015. Meta-Research: Evaluation and Improvement of Research Methods and Practices. PLoS Biology 13(10): e1002264.
Kellogg, Katherine C. 2014. Brokerage Professions and Implementing Reform in an Age of Experts. American Sociological Review 79(5): 912–941.
Kluijtmans, M., E. de Haan, S. Akkerman, and J. van Tartwijk. 2017. Professional Identity in Clinician-Scientists: Brokers Between Care and Science. Medical Education 51(6): 645–655.
Koehn, Daryl. 1994. The Ground of Professional Ethics. Professional Ethics. London: Routledge.
Kultgen, John H. 1988. Ethics and Professionalism. Philadelphia: University of Pennsylvania Press.
Lander, Bryn, Gillian E. Hanley, and Janet Atkinson-Grosjean. 2010. Clinician-Scientists in Canada: Barriers to Career Entry and Progress. PLoS One 5(10): e13168.
Lemoine, Nick R. 2008. The Clinician-Scientist: A Rare Breed Under Threat in a Hostile Environment. Disease Models & Mechanisms 1(1): 12–14.
Ley, Timothy J., and Leon E. Rosenberg. 2002. Removing Career Obstacles for Young Physician-Scientists—Loan-Repayment Programs. New England Journal of Medicine 346(5): 368–372.
Lockyer, Jocelyn M., Paul L. Beck, Morley D. Hollenberg, Brenda R. Hemmelgarn, Jennifer Taber, Kenneth A. Harris, Lisa Gorman, and Michael Strong. 2014. 11. The Clinician Scientist in Canada: Supporting Innovations in Patient Care through Clinical Research. Ottawa: Royal College.
Macleod, M.R., et al. 2014. Biomedical Research: Increasing Value, Reducing Waste. The Lancet 383(9912): 101–104.
Marincola, Francesco. 2003. Translational Medicine: A Two-Way Road. Journal of Translational Medicine 1(1): 1.
Meltzer, S.J. 1909. The Science of Clinical Medicine: What It Ought to Be and the Men to Uphold It. Journal of the American Medical Association LIII 7: 508–512.
Milewicz, Dianna M., Robin G. Lorenz, Terence S. Dermody, Lawrence F. Brass, and National Association of MD-PhD Programs Executive Committee. 2015. Rescuing the Physician-Scientist Workforce: The Time for Action is Now. Journal of Clinical Investigation 125(10): 3742–3747.
Nancarrow, Susan A., and Alan M. Borthwick. 2005. Dynamic Professional Boundaries in the Healthcare Workforce. Sociology of Health & Illness 27(7): 897–919.
Roberts, Scott F., Martin A. Fischhoff, Stacey A. Sakowski, and Eva L. Feldman. 2012. Perspective: Transforming Science into Medicine: How Clinician-Scientists Can Build Bridges Across Research’s ‘Valley of Death’. Academic Medicine: Journal of the Association of American Medical Colleges 87(3): 266–270.
Rosen, Michael R. 2011. The Role of the Physician-Scientist in Our Evolving Society. Rambam Maimonides Medical Journal 2(4): e00063.
Rosenberg, Leon E. 1999. Physician-Scientists—Endangered and Essential. Science 283(5400): 331–332.
Rosenblum, Norman D., Manon Kluijtmans, and Olle ten Cate. 2016. Professional Identity Formation and the Clinician-Scientist: A Paradigm for a Clinical Career Combining Two Distinct Disciplines. Academic Medicine 91(12): 1612–1617.
Schafer, Andrew I. 2009. The Vanishing Physician-Scientist? Cornell: Cornell University Press.
Stephenson, William. 1993. Introduction to Q-Methodology. Operant Subjectivity 17(1/2): 1–13.
Taylor, Kathryn M. 1992. Integrating Conflicting Professional Roles: Physician Participation in Randomized Clinical Trials. Social Science & Medicine 35(2): 217–224.
Timmermans, Stefan. 2008. Professions and Their Work: Do Market Shelters Protect Professional Interests? Work and Occupations 35(2): 164–188.
Vignola-Gagné, Etienne. 2014. Argumentative Practices in Science, Technology and Innovation Policy: The Case of Clinician-Scientists and Translational Research. Science and Public Policy 41(4): 94–106.
Watts, S., and P. Stenner. 2012. Doing Q Methodological Research: Theory, Method and Interpretation, 1st ed. Los Angeles: Sage.
Westfall, John M., James Mold, and Lyle Fagnan. 2007. Practice-Based Research: ‘Blue Highways’ on the NIH Roadmap. Journal of American Medical Association 297(4): 403–406.
Wilson-Kovacs, Dana M., and Christine Hauskeller. 2012. The Clinician-Scientist: Professional Dynamics in Clinical Stem Cell Research. Sociology of Health & Illness 34(4): 497–512.
Wissenschaftsrat. 2016. Perspektiven der Universitätsmedizin, vol. 566, 3–16. Weimar: Wissenschaftsrat.
Xyrichis, Andreas, Karen Lowton, and Anne Marie Rafferty. 2017. Accomplishing Professional Jurisdiction in Intensive Care: An Ethnographic Study of Three Units. Social Science & Medicine 1982(181): 102–111.
Acknowledgments
We would like to thank Faten Ahmed for her contributions to the study design and Ruth Sonnet for her assistance with the coding process and manual data input. We thank Anne K. Krüger, Stephan Gauch and Clemens Blümel as well as the Berlin Institute of Health (BIH) and the research group at QUEST Center for their constructive discussions. We also want to thank the participants and convenors of the sub-theme “Justifying the Organization: Dealing with Conflicting Economies of Worth and Legitimacy Struggles” at the European Group for Organizational Studies (EGOS) in Copenhagen for their helpful advice. Last but not least, we want to thank the anonymous reviewers for their constructive feedback.
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Hendriks, B., Simons, A. & Reinhart, M. What are Clinician Scientists Expected to do? The Undefined Space for Professionalizable Work in Translational Biomedicine. Minerva 57, 219–237 (2019). https://doi.org/10.1007/s11024-019-09367-4
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DOI: https://doi.org/10.1007/s11024-019-09367-4