Physician-Scientists: Fixing the Leaking Pipeline - A Scoping Review.

Introduction: This scoping review was undertaken to assess the current status of physician-scientists, including the challenges associated with their enrollment and retention, measures of success, and determinants of their satisfaction, all of which contribute to the dwindling numbers of physician-scientists aptly referred to as a "leaking pipeline" of physician-scientists. Methods: A total of 2555 research documents from three databases, viz. Scopus, Web of Science, and PubMed, were selected. A total of 40 documents were considered for final analysis following the 5-stage framework of Arksey and O'Malle. Results: Medical institutions should promote and sustain enrollments by addressing various perceived parameters of success and satisfaction. The challenge of attrition due to individual, regulatory, and sociocultural considerations also needs to be addressed. Conclusions: Medical institutions should focus on establishing well-documented career tracks with provisions for career advancement, promotion of team science, raising mentors, giving preference to students with peer-reviewed publications for post graduate (PG) admissions, and establishing a separate office for career development and guidance for physician-scientist. It is equally important to address the factors which promote retention and prevent attrition, viz. measures of success and determinants of satisfaction. Additional measures include creating a cadre of physician-scientists in government organizations, fostering collaboration of physician-scientists with incubation centers and startups, and adding additional mandatory curriculum components focused on project-based training.