Status of the Clinician Investigator in America: An Essential Healthcare Provider Driving Advances in Cancer Care

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  • 1 University of Hawaii Cancer Center, Honolulu, Hawaii;
  • 2 The Ohio State University, Comprehensive Cancer Center, James Cancer Hospital & Solove Research Institute, Columbus, Ohio;
  • 3 Sidney Kimmel Cancer Center at Jefferson Health, Philadelphia, Pennsylvania;
  • 4 Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah;
  • 5 WVU Cancer Institute, Morgantown, West Virginia;
  • 6 Mays Cancer Center, UT Health San Antonio, San Antonio, Texas;
  • 7 Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa;
  • 8 The Dan L. Duncan Comprehensive Cancer Center at Baylor College of Medicine, Houston, Texas;
  • 9 University of Wisconsin Carbone Cancer Center, Madison, Wisconsin; and
  • 10 University of Mississippi Medical Center Cancer Institute, Jackson, Mississippi.
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Background: Translation of basic discoveries to clinical care for patients with cancer is a difficult process greatly enabled by physician-trained researchers. Three categories of physicians, with responsibilities spanning from laboratory and preclinical research to direct patient care, are involved in the translational research continuum: physician-scientist (PS), clinician investigator (CI), and academic clinician (AC). Methods: To define how protected time for research efforts is supported, the Association of American Cancer Institutes (AACI) conducted a survey of their member institutions, obtaining 56 responses documenting time spent in research and clinical activities across multiple cancer disciplines, and providing information about funding streams for the different categories of cancer physicians. Results: Responses showed that PSs and ACs are minimally involved in clinical research activities; the driver or clinical research in academic cancer centers is the CI. A significant concern was a lack of stable funding streams for nonbillable clinical research activities, putting the sustainability of the CI in jeopardy. Limited funding was derived from hospital sources, with most support derived from cancer center sources. Conclusions: This study highlights the importance of the CI in translational cancer medicine and represents a call to action for institutions and research funding agencies to develop new programs targeted toward CI support to ensure continued progress against cancer.

Submitted October 1, 2020; accepted for publication November 4, 2020.

Disclosures: The authors have disclosed that they have not received any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.

Correspondence: Randall F. Holcombe, MD, MBA, University of Hawaii Cancer Center, 701 Ilalo Street, Suite 600, Honolulu, HI 96813. Email: rholcombe@cc.hawaii.edu
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