Background/Purpose: Development of young rheumatology investigators is critical to the future of rheumatology. Beyond funding, the specific barriers to maintaining a career in rheumatology research remain unclear. The objective of this study was to determine the perceived barriers and facilitators to a career in rheumatology research.
Methods: A web-based survey was conducted among the domestic ACR membership from Jan-Mar 2014. Inclusion criteria were current or previous fellowship in rheumatology, ACR membership, and an available email address. Non-rheumatologist members were excluded. The instrument was developed by the Early Career Investigator subcommittee using a Delphi method to identify and distill facilitators and barriers to a career in research for inclusion in the survey. The survey also assessed demographics, research participation, and free text response for ways in which the ACR could support young investigators. After excluding incomplete surveys and duplicates, demographics were summarized. The chi-squared test was used to assess differences in rating of barriers and facilitators by category of respondents (e.g., young investigators, mentors, fellows, and R01 recipients). Free text comments were analyzed by content analysis using NVivo software.
Results: Among 5,448 ACR domestic members, 502 responses were obtained (9.2% response rate). After exclusions (38 incomplete, 2 duplicates, 32 non-rheumatologists), 430 responses were analyzed. Demographics and types of research represented are shown in the Table. The most highly ranked barrier and facilitator of a career in research was funding. Other common barriers were clinical workload, insufficient protected time, lower salary, and lack of institutional research infrastructure. Current fellows were more likely to report difficulty establishing a niche as an important barrier (34% vs 22%, p=0.04) and mentors were significantly less likely to report personal finances as an important barrier (21% vs 39%, p=0.004). Facilitators included protected research time, outstanding mentors, institutional support, as well as personal skills or traits such as hard work, resilience, initiative, persistence and passion for the job. Personal skills were significantly more often cited by recipients of an R01 than other groups (71% vs 49%, p=0.001). Evaluation of free text comments revealed few additional themes including gender issues and lack of flexibility to allow part-time work to care for children.
Conclusion: To our knowledge, this is the first study to examine barriers and facilitators to a career in rheumatology research from the perspectives of young investigators, established investigators, mentors, and fellows. Knowledge of such barriers and facilitators may assist in designing interventions to support young investigators during vulnerable points in their career.
Table. Demographics of Survey Participants (N=430)
|
Current Position |
Adult Rheumatologist |
309 (72%) |
|
|
Pediatric Rheumatologist |
62 (14%) |
|
|
Adult Fellow |
42 (10%) |
|
|
Pediatric Fellow |
17 (4%) |
|
Place of Employment |
Academic Medical Center |
306 (71%) |
|
|
Clinical Practice |
97 (23%) |
|
|
Industry |
20 (5%) |
|
|
Government |
3 (1%) |
|
|
Retired |
4 (1%) |
|
Academic Appointment |
Instructor (or equivalent Junior Faculty) |
34 (8%) |
|
|
Assistant Professor |
102 (24%) |
|
|
Associate Professor |
58 (13%) |
|
|
Professor |
89 (21%) |
|
|
Other (or no academic appointment) |
147 (34%) |
|
Year Completed Fellowship |
Median (IQR) |
2005 (1987-2012) |
|
|
1960-1969 |
6 (1%) |
|
|
1970-1979 |
27 (6%) |
|
|
1980-1989 |
73 (17%) |
|
|
1990-1999 |
51 (12%) |
|
|
2000-2009 |
98 (23%) |
|
|
2010-2016 |
131 (30%) |
|
|
Missing |
6 (1%) |
|
Female Sex |
N (%) |
241 (56%) |
|
Medical School in the US |
N (%) |
318 (74%) |
|
Underrepresented Minority* |
N (%) |
28 (7%) |
|
Effort** median (IQR) |
Clinical |
50% (20-75%) |
|
|
Research |
15% (2-70%) |
|
|
Teaching |
5% (4-10%) |
|
|
Administrative |
5% (0-11%) |
|
Successful Funding |
Foundation fellowship/post-doc award |
92 (21%) |
|
|
Foundation career development award |
99 (23%) |
|
|
NIH Loan Repayment Program |
24 (6%) |
|
|
NIH K-series or VA career development award |
76 (18%) |
|
|
NIH R01 |
59 (14%) |
|
|
Other NIH awards |
71 (17%) |
|
|
Other grants |
141 (33%) |
|
Current Researcher |
Total |
171 (40%) |
|
|
Young Investigator |
88 (20%) |
|
|
Mentor† |
76 (18%) |
|
|
Research effort ≥50% |
134 (31%) |
|
|
Research effort ≥70% |
100 (23%) |
|
Type of Research‡ |
Clinical |
88 (51%) |
|
|
Epidemiology/Health Services |
18 (11%) |
|
|
Translational |
99 (58%) |
|
|
Basic Science |
53 (31%) |
|
All percentages are of the total N=430. *An “under-represented minority within rheumatology” was defined as Black, Hispanic, or Native American (that is, American Indians, Alaska Natives, and Native Hawaiians **Effort estimates exclude fellows. †Mentor refers specifically to a mentor of a young investigator ‡Among those currently engaged in research (N=171), participants were allowed to select more than one answer so the total adds to greater than 100%. Abbreviations: NIH = National Institutes of Health |
||
Disclosure:
A. Ogdie,
None;
S. Angeles-Han,
None;
U. Makris,
None;
Nelson,
None;
A. Shah,
None;
Y. Jiang,
None;
J. M. Kahlenberg,
None;
E. Muscal,
None;
F. V. Castelino,
None;
A. Golding,
None;
A. Kim,
Pfizer Inc,
5,
Amgen,
5,
Janssen Pharmaceutica Product, L.P.,
5,
Kypha, Inc.,
2.
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