Challenges Facing Early-Career Physician-Scientists in the United States Amid Recent Policy Shifts: Findings from a National Survey

BackgroundAmid persistent structural barriers and recent national policy changes, early-career physician-scientists face mounting challenges that threaten the sustainability of the biomedical research pipeline in the United States. MethodsWe surveyed early career physician-scientists collecting demographic data, career development support, distribution of clinical and research responsibilities, funding, and perceived career challenges. The survey was distributed by email to the department chairs at 110 institutions in the United States. ResultsA total of 175 surveys were completed. About half 50.8% (n=89) of respondents received a career development award, with 28.9% of respondents reporting limited institutional/departmental support. The most reported challenges were balancing clinical, research, and educational responsibilities (72.5%, n=127); balancing work and family responsibilities (48%, n= 84); limited funding opportunities (48%, n=84); and under-compensation (34.3%, n=60). About 57.7% (n=101) of respondents had considered leaving academic medicine within the next two years, and 83.2% (n=139) indicated a >50% likelihood of doing so within five years. The most frequently cited reasons for attrition were funding challenges (72%, n=126), under-compensation (42.3%, n=74), feeling unhappy or stressed (40.6%, n=71), and burnout (37.7%, n=66). Furthermore, 43.9% (n=76) of respondents reported considering relocation outside the United States for better academic working conditions, and 10.4% (n=18) had already been contacted by institutions abroad. ConclusionEarly-career physician-scientists face substantial structural and financial challenges, with limited institutional support, high rates of burnout, and widespread intent to leave academia. These findings underscore an urgent need for sustained investment, targeted retention strategies, and policy reforms to stabilize and strengthen the physician-scientist workforce in the United States.