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INTRODUCTION
Physician–scientists are licensed medical professionals with advanced degrees who possess medical knowledge and clinical skills, enabling them to conduct independent research in the field of biomedical sciences.12 However, there has been a noticeable decline in the number of medical doctors specializing in basic medical sciences since the 2000s. To address this issue, graduate school programs in medicine and MD–PhD dual-degree programs were introduced, modeled after U.S. medical school training programs. Although these programs were expected to enhance the training of basic medical scientists, the MD–PhD program was discontinued when medical graduate schools reverted to the traditional medical school system. Furthermore, although physician–scientist training grants are available to cover tuition and research expenses, the short duration of these programs has limited their effectiveness in fostering basic medical scientists.
Subsequently, the Integrated Physician–Scientist Training Program was established to support master’s and doctoral programs, resulting in the training of 39 MD–PhDs.3 Recently, the Global Physician–Scientist Training Program (2024) has been implemented to provide comprehensive support throughout all stages of training, including postdoctoral programs, global fellowships, leader physician–scientists, and international collaborative research.
In recent years, several domestic studies have investigated physician–scientist training. Song et al.4 introduced three types of physician–scientist training programs and highlighted the significant efforts made to cultivate physician–scientists through various initiatives. Bae explored medical students’ interest in pursuing doctoral programs, noting that many students were hesitant to pursue research careers due to concerns about career stability.5 Long-term follow-up studies have been recommended to gain a better understanding of the career trajectories of trained scientists. Similarly, a survey on the perception of reality among prospective physician–scientists identified their primary challenges as anxiety about their future careers and differences in professional experiences compared with their physician colleagues.6 Given their unstable career trajectories, these individuals expressed greater concerns about long-term professional security than clinical doctors. The finding suggest that offering stable employment opportunities could help mitigate these concerns.
From a policy perspective, Cho suggested providing financial support and establishing national research institutions similar to the National Institutes of Health (NIH) in the United States to ensure stable employment opportunities for physician–scientists and enable them to focus on research.1 Ra advocated for expanding research participation incentives and supporting the growth of independent researchers within a hospital-centered innovation ecosystem. He argued that reducing clinical hours and improving research environments would promote research participation, while supporting startups and fostering collaboration among academia, industry, research institutes, and hospitals would help build a robust research ecosystem.7 Additionally, a policy planning study on physician–scientist development proposed ten key policy tasks related to defining, training, research activities, and career development for physician–scientists.6
Building on previous studies and initiatives, this article aimed to review the definition of physician–scientists, examine training systems and grants, identify key challenges, and propose strategies for their effective development.
DEFINITION OF THE PHYSICIAN–SCIENTIST
Physician–scientists are individuals who have completed both MD and PhD programs, although there is no consensus on their exact definition. The key definitions are summarized in Table 1.12689101112131415
Table 1
Definition of physician–scientists
| References | Definition | Remarks | |
|---|---|---|---|
| PSW report (2014)2 | Physician–scientists are defined as scientists with professional degrees, who have undergone clinical care training and engage in independent biomedical research. This group includes individuals with an MD, DO, DDS/DMD, DVM/VMD, or nurses with research doctoral degrees who devote the majority of their time to biomedical research. | - Possession of professional degrees such as MD | |
| - Clinical care training | |||
| - Independent biomedical research | |||
| - PhD qualification | |||
| - Research-dominant focus | |||
| Davila (2016)8 | Emphasized the role of physician–scientists as a unique link between basic science research and clinical practice, facilitating new discoveries in the understanding and treatment of human disease. | - Translational medicine | |
| Glickman (2018)9 | Described a physician–scientist as an MD or MD–PhD who continues to see patients throughout their career while managing a laboratory research program, with a 90:10 time split between research and clinical duties. | - Clinician | |
| - Research-dominant focus | |||
| Strong et al. (2018)10 (Canadian National Consensus Conference, 2016) | Defined physician–scientists as those actively involved in patient care, having undergone additional research training, devoting the majority of their time to research, and playing a key role in bridging the gap between research and clinical practice. | - Active across a range of research area, from basic sciences to clinical, health policy, population health, and education research | |
| Bensken et al. (2019)11 | Highlighted the need for substantial protected time for research, suggesting that physician–scientists should include all physicians contributing to science. | - Protected research time | |
| - Broad definition includes all physicians contributing to science | |||
| Gotian and Andersen (2020)12 | Defined physician–scientists as individuals with an MD and research training required to become successful scientists. | - Research training | |
| AAMC (2024)13 | Described physician–scientists as MDs or DOs who contribute to scientific investigation as a central part of their careers, emphasizing their vital role in the biomedical ecosystem. | - Central role of careers | |
| - Key players in the biomedical ecosystem | |||
| Domestic literature | |||
| Choi et al. (2018)14 | A licensed physician who has graduated from medical school, provides patient care or conducts research on diseases in their field, and engages in translational research with an interest in relevant science and technology. | - Research on diseases | |
| - Engagement in translational research | |||
| Kim et al. (2021)15 | A researcher with an MD license conducting medical-related research. | - Medical-related research | |
| KAMC (2022)6 | A physician with medical education and training who primarily focuses on medical science research. | - Medical science research | |
| Cho (2024)1 | A licensed physician with medical knowledge and clinical skills, as well as expertise in natural sciences, capable of leading research in biomedical sciences. | - Expertise in natural sciences | |
| - Leadership in biomedical research | |||
In the United States, the NIH Physician–Scientist Workforce defines physician–scientists as professionals with MD degrees who have undergone clinical training and are capable of conducting independent biomedical research.2 This definition highlights key characteristics, including possessing a professional degree, clinical training, a PhD, conducting independent biomedical research, and having a research-dominant focus. Davila has emphasized different perspectives on the role of physician–scientists in translational medicine,8 while Glickman has highlighted their significance as clinicians.9 Strong et al.10 have described physician–scientists as professionals active across diverse research fields, and Bensken et al.11 have proposed redefining the term to include all physicians contributing to research, with an emphasis on the need for protected research time.
In South Korea, physician–scientists are physicians who research diseases and biomedical science.61415 The traditional definition includes holding an MD, clinical care training, a PhD, independent biomedical research, a research-dominant focus, translational medicine, and clinical roles. However, this strict definition excludes many physicians actively engaged in research, posing a significant limitation. To better reflect the realities of biomedical research in Korea, it is proposed to broaden the definition to include a wider range of physicians contributing to research.
The Association of American Medical Colleges has recognized that the number of physicians involved in research exceeds those traditionally classified as physician–scientists. They proposed expanding the definition to encompass all physicians involved in research, regardless of time commitment or research type.1316 This inclusive approach acknowledges the diverse contributions of physician–scientists across clinical and biomedical research fields. Building on this perspective, the authors propose defining a physician–scientist as a physician who has completed medical education and training, obtained a master’s degree or higher, and actively engages in biomedical research. This broadened definition aligns with the evolving roles of physician–scientists and better captures their impact on advancing medical science.
INTERNATIONAL TRAINING MODELS
Although South Korea has not yet established a systematic training framework for physician–scientists, some countries have recognized the importance of this field and have made significant investments in nationwide efforts. While it is not feasible to present examples from every country, the cases of the United States, Canada, the United Kingdom, and Japan can serve as valuable references for South Korea to consider.
United States of America
In the United States, there is a well-established framework for training physician–scientists, which includes structured MD–PhD dual-degree programs and Physician–Scientist Training Programs. These initiatives are often supported by the NIH through grants such as T32 and the Medical Scientist Training Program.17 These programs provide tuition waivers and stipends to support living and research expenses for dual-degree candidates, allowing them to integrate clinical practice with scientific research.1317 Over 98 medical schools in the United States provide a Medical Scientist Training Program based on a “2-4-2” model, integrating medical education with four years of PhD research.18 Physician–Scientist Training Programs also incorporate research into clinical residencies and fellowships, offering a pathway to early research independence. However, challenges such as extended training durations, financial burdens, and limited research opportunities in certain clinical specialties persist.19 In response, institutions such as Vanderbilt and Duke have implemented accelerated curricula and competency-based assessments to shorten the time to degree completion and facilitate early-career advancement.
Canada
Canada’s physician–scientist training model has historically been similar to that of the United States, with MD–PhD programs funded by organizations like the Canadian Institutes of Health Research. However, in 2015, the Canadian Institutes of Health Research discontinued its national funding for these programs, prompting individual institutions to develop and maintain their training pathways.20 Canadian programs typically last six to eight years, integrating medical education with graduate-level research.10 Although the Canadian model prioritizes a shorter research phase and lower medical school debt, the lack of consistent national funding has resulted in uneven support across institutions.19 It is essential to reinstate national funding and establish structured frameworks to ensure the long-term sustainability of these programs.20
United Kingdom
In the United Kingdom, only a limited number of medical schools offer combined MD–PhD programs, with many students opting for an intercalated BSc year that includes hands-on research experience. Although these paths are popular, they often come with additional fees, which may deter talented individuals.21 PhD training typically begins after medical graduation, supported by the National Health Service and the National Institute for Health and Care Research, offering structured pre- and post-PhD research opportunities integrated with clinical practice. Funding for these programs is often secured through “Research Training Fellowships” from organizations like the Medical Research Council or major charities such as the Wellcome Trust.21 Despite this support, only a small percentage of PhD graduates pursue long-term careers as physician–scientist due to challenges such as the demanding nature of National Health Serve practice and regulations prioritizing clinical exposure over research competency. Additionally, early-career opportunities heavily rely on research track records, which can be difficult to establish during clinical training.21 To address these issues, leading United Kingdom research institutes, such as the Francis Crick Institute, now offer fixed-term positions (e.g., six-year renewable terms) to enable researchers to return to university hospitals and strengthen the physician–scientist workforce.21
Germany
In Germany, several universities offer MD–PhD programs through physician–scientist training initiatives, enabling medical graduates to pursue a doctoral degree alongside their clinical education. One of the initial challenges in establishing these programs was the exclusivity of academic titles granted to medical doctors and biologists. However, numerous universities, including the University of Würzburg, the University of Göttingen, Hannover Medical School, and Berlin Humboldt University Medical School Charité, have implemented such programs.22
MD–PhD programs in Germany follow different structural models. Some allow students to integrate medical education with doctoral research, whereas others require candidates to obtain a medical degree before commencing their research studies.23 Generally, participants complete a year of seminars and practical training before engaging in research projects, which typically last an average of 3 years. Most of these programs offer financial support, including living stipends; although, the provided funding is generally lower than the salaries of postdoctoral researchers. Various organizations, including the German Academic Exchange Service, the German Research Foundation, and the German Federal Ministry of Education and Research, contribute to funding these initiatives.22
Despite these efforts, Germany faces a shortage of physician–scientists, and increasing their numbers remains a key objective of the country’s national science policy. In 2015, the German Research Foundation issued specific recommendations advocating for the “establishment of integrated research and continuing education programs for clinician scientists in parallel with residency training.” The foundation also estimated that approximately 5–8% of physicians who have completed residency training would be suitable candidates for such programs.24 To address this need, most university hospitals have implemented support programs that are often funded by external sources.
Japan
Japanese training models for physician–scientists aim to integrate clinical skills with research capabilities. MD–PhD programs, funded by the Ministry of Education, Culture, Sports, Science, and Technology since 2012, offer a combined medical and research degree pathway.25 Despite the establishment of 39 programs by 2017, low participation rates persist due to the lengthy training duration and uncertain career prospects.25 Postgraduate physician–scientist training courses enable clinicians to transition into research-focused roles, offering specialized training with reduced clinical responsibilities. These initiatives are complemented by the Ministry of Education, Culture, Sports, Science, and Technology’s “Program for Nurturing Physicians in Basic Research,” which promotes collaborations and career development opportunities. However, limited funding, amounting to USD 1 million in 2017, constrains the expansion of these programs.25 Undergraduate research opportunities, including internships and practice sessions, introduce students to medical research early on, but financial obstacles often hinder sustained involvement.25 Career support services and institutional partnerships offer guidance, networking opportunities, and joint academic-industry appointments to support physician–scientists. Overcoming challenges like low compensation, rigid structures, and limited support is crucial to sustaining Japan’s physician–scientist workforce.25
TRAINING SYSTEM IN SOUTH KOREA
Policies before 2018
The training systems for basic medical scientists in Korea are divided into three main categories: the basic medical specialty system, combined degree programs, and the physician–scientist programs. These programs are supported by research funding initiatives such as the Medical Scientist Support Program and Leading Research Centers by the National Research Foundation of Korea. Recently, the Korea Health Industry Development Institute introduced the Integrated Physician–Scientist Training Program to provide further support (Table 2).
Table 2
Training system in South Korea
Basic medical specialty system
For a long time, Korea lacked a formal MD–PhD training program, leading physicians to pursue graduate studies in basic medical science departments to become scientists. The process of obtaining a PhD typically took 5–8 years, with men facing extended training periods (from 9 to 11 years) due to mandatory military service. These MD–PhDs mainly served as faculty in basic medical science departments, where they taught undergraduate medical students and conducted research without having clinical duties. Despite the need for faculty in basic medical science departments, the number of professors in this field only increased by 32 over a decade (2004–2013).26
Combined MD–PhD programs
To address the demand for physicians from diverse backgrounds, South Korea introduced a graduate school system for medicine in 2005. This system replaced the traditional six-year medical curriculum with a two-year premedical program followed by four years of medical school. Medical graduate school graduates were awarded both a medical license and a mandatory master’s degree, which, although distinct from a conventional master’s degree under the Higher Education Act, was widely recognized as equivalent to a Master of Science. This qualification allowed direct entry into PhD programs. The MD–PhD program was established to train physician–scientists with expertise in both clinical practice and research, offering separate quotas and financial support, including full scholarships and living expenses. Graduates were given priority for faculty positions in basic medical science departments. The program was funded by the Medical Scientist Support Program of the National Research Foundation of Korea. Customized curricula are designed to meet institutional requirements, with formats like 1-3-3 or 2-3-2 years, allocating three years to basic research. Students had the option to extend their research period by up to two years, totaling five years. Despite its ambitious goals, only a small proportion of program graduates ultimately joined basic medical science departments or pursued sustained research, raising doubts about its efficacy. Consequently, most medical schools reverted to the traditional six-year curriculum, leading to the discontinuation of the MD–PhD program.
Leading Research Centers: Medical Research Centers (MRCs)
Launched in 2002, the MRC initiative aimed to promote research groups in the fields of medicine, dentistry, and pharmacy. The primary objective was to advance the understanding of human biology and disease mechanisms while providing training for medical scientists. MRC projects focused on training basic medical scientists and included their research output as an evaluation criterion. The government designated MRC centers as alternative workplaces for military service, enabling medical doctors starting their graduate studies to serve as research personnel and ensuring uninterrupted research careers. In 2006, an amendment to the Military Service Act expanded eligibility for research personnel to include individuals pursuing doctoral degrees in basic sciences after completing clinical training. This legislative change played a significant role in the development of current physician–scientist programs. MRC centers continue to play a vital role in supporting basic medical scientists.
Physician–scientist programs
Traditionally, male medical graduates embarking on clinical training were required to complete military service as public health doctors or military physicians. However, in 2006, amendments to the Military Service Act permitted graduate students pursuing PhDs to serve as research personnel instead, leading to the establishment of integrated MD–PhD-research personnel programs. The Korea Advanced Institute of Science and Technology (KAIST) was the first institution to implement such a program systematically. Starting in the 2008 academic year, KAIST secured quotas for research personnel directly from the Military Manpower Administration, streamlining the process for students to become research personnel. While the typical military service duration is 38 months, KAIST’s program offered unique benefits such as uninterrupted research experience, exemption from frontline deployment, and the opportunity to complete a PhD in four years. Despite commencing their basic science training relatively late, many participants achieved outstanding research outcomes during their doctoral studies. Upon obtaining their PhDs, graduates often returned to their original institutions as fellows or clinical faculty to continue their research. Inspired by KAIST’s success, many medical schools adopted similar physician–scientist programs, which are highly effective in training physician–scientists and remain active.
Nevertheless, despite the consistent production of trained personnel through the program, the proportion of participants maintaining active research careers remains relatively low. Furthermore, the program has not significantly increased the number of basic medical science faculty members. Some critics argue that the program is misused as a means to evade mandatory military service rather than as a genuine commitment to basic research. This criticism highlights the importance of conducting detailed analyses of external factors impeding the career progression of physician–scientists and developing tailored strategies to address the reasons for interruptions in their research careers.
Policies after 2019
Despite concerted efforts, the proportion of MDs in basic medical science departments has been steadily declining due to the lower number of new faculty appointments compared to retirements. Notably, the proportion of MD faculty in disciplines such as anatomy, physiology, biochemistry, pharmacology, microbiology, and parasitology has significantly decreased from 65.2% in 2000 to 41.7% in 2021.2728 Given the expected retirement of additional MD faculty within the next five years, this downward trend is expected to accelerate further.28 However, a significant shift occurred in 2019 in the training system, moving from nurturing basic medical scientists to supporting physician–scientists throughout their careers (Table 2). Landmark policies were introduced to facilitate this transition (Fig. 1). A pilot project targeting medical residents was initiated in 2019, followed by the full-scale implementation of research funding for full-time PhD students in 2020. By 2022, the eligibility criteria were expanded to include undergraduate students, establishing a comprehensive training system aimed at fostering physician–scientists throughout their careers. Additionally, funding programs for early-career researchers were introduced to support their successful integration into research careers. Representative programs are outlined below.
Integrated Physician–Scientist Training Program: Residency Support Project
This program supports research activities for medical residents to help them develop as leading researchers in biomedical science and the biopharmaceutical industry alongside their clinical practice. It provides training in research methods and opportunities for graduate student residents to engage in research, facilitating their transition into physician–scientist careers. Further, it offers the necessary education for residents to advance into foundational or interdisciplinary scientific fields as full-time PhD students. Multiple universities collaborate in consortia, receive institutional designation, and independently manage recruitment and operations using allocated research funding. These institutions award selected individuals scholarships and research funds as part of the program.
Integrated Physician–Scientist Training Program: Full-Time PhD Coursework Support Project
This program targets physicians pursuing PhDs in basic medical science departments, regardless of whether they have completed their residency training. It is tailored for medical graduates who begin graduate programs immediately after their undergraduate studies or those who are not suitable for physician–scientist programs linked to military service alternatives. Applicants must be enrolled within specific timeframes (e.g., six semesters for PhD programs or eight semesters for integrated master’s and PhD programs) from the beginning of their doctoral studies, and individuals who have completed their coursework within these limits are not eligible. To promote interdisciplinary research, applications from candidates in PhD programs aligned with their residency specialties are excluded.
Integrated Physician–Scientist Training Program: Undergraduate Support Project
This program aims to foster interest in physician–scientist careers among undergraduates, identify talented individuals, and train physician–scientists capable of conducting multidisciplinary research throughout their careers. It supports the development of educational programs and research environments that integrate medicine with other disciplines, including basic science, natural science, and engineering. Through these initiatives, the program has established a comprehensive training network that spans medical school, residency, and beyond. While currently implemented in a limited number of medical schools, this initiative is expected to expand to more institutions in the future.
Postdoctoral Research Capacity Building Program
As previously mentioned, many physician–scientists trained through various routes fail to secure stable research positions in clinical or basic science departments and often leave their research careers prematurely. While the challenge of securing research time is typically institution-specific and hard to address through policy, the lack of stable research funding has been a consistent concern. To address this issue, funding programs have been developed to support research activities. The Ministry of Health and Welfare, in collaboration with the Korea Health Industry Development Institute, has provided funding through initiatives such as Medistar; however, these programs have been sporadic and lacked long-term sustainability.
The postdoctoral funding programs include the Global Physician–Scientist Training Program and the Postdoctoral Physician–Scientist Growth Support Program. These initiatives aim to establish a stable research foundation for young physician–scientists engaged in basic and interdisciplinary research to address unmet medical needs and intractable diseases. Eligibility is limited to individuals with doctoral degrees in basic medical sciences, engineering, or natural sciences, with research funding levels adjusted based on the number of years since obtaining the degree (e.g., within 5, 10, or 15 years). Furthermore, the long-standing global training support for physician–scientists has been significantly expanded in both duration and funding to facilitate sustained participation in international training opportunities for up to 30 months.
Global Collaborative Research Support
This initiative aims to promote multidisciplinary collaborative research led by domestic and international physician–scientists, focusing on elucidating disease mechanisms and developing treatments or therapeutic technologies. The ultimate goal is to foster the recognition of physician–scientists on a global scale. Eligibility for the program is limited to individuals with doctoral degrees in basic medical sciences, engineering, or natural sciences, similar to postdoctoral research programs. Research teams must include at least one MD–PhD physician–scientist who obtained their PhD within the past five years. Launched in 2024, this program aims to serve as a cornerstone for nurturing globally leading physician–scientists through sustained support.
CHALLENGES AND POLICY RECOMMENDATIONS
We conducted a review of the training process and support system for physician–scientists in South Korea, aiming at proposing strategies to address identified weaknesses at each stage of the training process (Table 3).
Table 3
Suggestions for physician–scientist training
Enhancing student exposure to research
One of the key components of physician–scientist training is providing medical students with research experience. While students generally express interest in research and degree programs and have a positive outlook on career paths,528 they often have limited chances to participate in actual research activities. Furthermore, research-related topics are inadequately covered in the curriculum, limiting students’ ability to explore their research potential and influencing their career decisions. The Accreditation Standards of the Korean Institute of Medical Education and Evaluation 2019 have encouraged medical schools to establish policies and curricula focused on student research to increase research opportunities.29 It is crucial to cultivate a culture of student research within medical schools to spark students’ interest in research and foster a positive attitude toward physician–scientist careers.6 This can be achieved by exposing students to various physician–scientist role models and implementing initiatives such as curricular and extracurricular student research programs, mentorship from research-oriented faculty, opportunities to attend domestic and international academic conferences, and short-term research visits to overseas laboratories.
Developing a medical research immersion curriculum
With the recent transition to a six-year integrated curriculum in medical schools, many institutions are developing curricula that incorporate educational programs and support for training physician–scientists.3031 Research programs are often offered as extracurricular activities, such as academic festivals, but some universities have integrated them into the formal curriculum to ensure all students have research opportunities. Medical schools aiming to cultivate physician–scientists should develop and operate medical research education programs or physician–scientist training programs.1 A recent study on curriculum development for the integrated six-year program proposed a five-year medical science research pillar program.32 This approach enables students to gain essential knowledge through courses covering research topic discovery, research presentation, and active involvement in research projects. Additionally, support for research mentoring, laboratory orientation sessions, Institutional Review Board review, research conduct, and presentation should be provided. Advanced courses in subsequent stages should also be developed and implemented.
Establishing MD–PhD degree pathways
The MD–PhD program, which was introduced alongside the medical school system, has been inactive since the abolition of the medical school system in 2015, leaving no dedicated pathway for training physician–scientists.33 Therefore, the only available option is to pursue a master’s or doctoral degree after obtaining a medical degree. Given that the majority of medical school graduates specialize in clinical fields, those who opt for graduate studies typically focus on clinical practice to advance their careers as clinicians. A small number of students engage in interdisciplinary graduate studies, such as basic medical sciences and engineering, which are crucial for the advancement of the Integrated Physician–Scientist Training Program. There is a clear need for well-defined training programs tailored for physician–scientists, encompassing combined medical-master’s programs or integrated medical, master’s, and doctoral pathways. These programs should offer flexibility in terms of timing and duration, similar to Australia’s concurrent MD-Master program, which enables students to complete both degrees simultaneously.34 These training pathways should be integrated with support programs for physician–scientists to ensure smooth progression and effective career development.
Supporting master’s and doctoral students
Programs supporting master’s degrees for residents and full-time doctoral degrees are essential components of the integrated physician–scientist training initiative. Each year, approximately 20 participants join the full-time doctoral degree program, with an additional 50 residents receiving research support, resulting in a total of 39 integrated physician–scientists being trained.3 Residents and fellows engage in research through these degree programs and often pursue careers as physician–scientists. However, their clinical training can limit their research time and pose challenges in conducting research, generating results, and accessing opportunities. Therefore, it is essential to provide scholarship support for the degree programs and make adjustments to clinical responsibilities to safeguard research time, offer research guidance, and provide support for research staff. Despite the assistance offered by the integrated physician–scientist training program, there is still a need for fundamental support from hospitals and medical schools to facilitate research, adjust workloads, and protect research time.
Protecting research time
Early-career physician–scientists typically balance research responsibilities with clinical duties at hospitals, leading to a scarcity of research opportunities and time. This situation can also impact research funding and outcomes. Therefore, reducing clinical workload and implementing measures to safeguard research time could be beneficial. For instance, United States NIH K awards require recipients to dedicate 50–75% of their time to research, while mid-career physician–scientists are guaranteed over 50%, and senior physician–scientists are guaranteed 20–30%.6 Additionally, research time protection systems are implemented even during training programs in other countries. In the United States, the internal medicine residency system requires trainees to dedicate at least 80% of their time to research for a minimum of three years, while clinical research trainees in Japan are mandated to have 50% research protection time.6 Hence, early-career physician–scientists require systems that protect their dedicated research time, enabling them to focus on research for a specific time.
Creation of a research-friendly ecosystem for physician–scientists
To address the challenges faced by individuals considering the physician–scientist career path, it is crucial to establish a research ecosystem that is conducive to their needs.35 Many are deterred by concern about future career prospects and perceived differences from other physicians.16 Although there are physician–scientists working in research institutes and companies, job opportunities are limited, particularly outside of medical school faculty positions. In the past, some medical doctors who specialized in basic medicine could not secure faculty positions and had to return to clinical training.
To enhance the physician–scientist career path, it is essential to establish national research institutes led by physician–scientists, similar to the NIH in the United States, and create diverse job opportunities. Establishing and operating independent organizations, such as an Association of Physician–Scientists or a Consortium of Physician–Scientists, to facilitate collaboration among physician–scientists would be beneficial. Medical schools could also consider implementing research-focused tracks for physician–scientists. To address the issue of reduced salary due to fewer clinical duties, incorporating research funding into the salary from research projects would be helpful. Additionally, enhancing military service systems, supporting patents and technology transfer, and providing assistance with entrepreneurship would further support and enhance the physician–scientist career path.
Building a stage-specific support system
The support system for physician–scientists should be specialized and interconnected, tailored to their specific career stages. Currently, there are only 1–2 grants available for each stage of a physician–scientist’s career, including undergraduate, graduate, early-career, advanced, and leadership stages. The existing programs are inadequate to fully support physician–scientists, necessitating the development of additional specific programs at each career stage. Notably, there is a lack of programs that link different career stages, highlighting the need for long-term programs that connect undergraduate to graduate, graduate to early-career, and early-career to advanced stages.
To enhance long-term competitiveness, efforts should focus on expanding collaboration and joint research with international institutions, increasing opportunities for overseas training, and strengthening support systems such as the Training Center for Innovative Medical Scientists. The current physician–scientist training programs only support three undergraduate institutions, and student research support programs, such as the National Health Insurance Service’s project, are relatively limited, hindering the cultivation of a robust student research culture. Thus, there is a pressing need to support more medical schools and medical students.
Furthermore, large-scale projects closely linked to the development of physician–scientists, such as the MRC, Research-driven hospitals, the Innovative Future Medical Research Center Development Project, and various laboratory projects, should be closely integrated with physician–scientist training programs for optimal outcomes. Support should be provided in a collaborative manner for physicians working at hospitals while pursuing their degrees and conducting research.
Support strategies for training physician–scientists in basic medical sciences
Basic medical sciences, such as anatomy and physiology, serve as the foundation of medicine and medical education. However, in recent years, the number of specialists in these fields has declined.272836 Despite the implementation of various support programs, the number of physicians specializing in basic medical sciences remains critically low. Among the existing initiatives, the Full-Time PhD Coursework Support Project of the Integrated Physician–Scientist Training Program and the Global Physician–Scientist Training Program are most suitable for medical graduates seeking careers in basic medical sciences. These programs allow graduates to enroll in a integrated master’s and PhD programs within a basic medical science department immediately after completing medical school, providing financial support for up to 6 years. Additionally, researchers can receive continued funding for up to 15 years even after obtaining a PhD. Those interested in international research opportunities can also benefit from the Global Training Support initiative. Compared with previous programs, as of 2025, these support systems have been improved considerably.
Despite these advancements, career instability remains a major barrier for physicians in basic medical sciences due to the limited number of available positions and significantly lower salaries compared with clinical physicians. Consequently, the number of physician–scientists in this field remains persistently low. Given their critical role and the shortage of specialists, financial support from the Ministry of Health and Welfare, similar to the funding provided for essential specialties like thoracic surgery, should also be extended to basic medical science.
Additionally, a growing trend has emerged in some medical schools, where physicians initially specialize in clinical medicine before transitioning to research in basic medical sciences and securing faculty positions. This career pathway presents a potential solution to the chronic shortage of faculty in basic medical science departments. However, to effectively address this issue, further strategies must be developed to strengthen faculty recruitment and retention in these fields.
In addition, proposals have been made to further enhance the training and support system for physician–scientists. Key recommendations include developing a national R&D policy to support physician–scientists, enacting legislation to formalize the role of physician–scientists and establishing legal frameworks to institutionalize the support system.3738 Additionally, establishing a research residency training system, developing a specialized certification system for basic medical sciences, and fostering collaborations with leading international research institutions are essential steps in enhancing physician–scientist training and support.6 Implementing a competency-based model for research education39 will further strengthen these initiatives.
PERSPECTIVES
The development of physician–scientists is essential for advancing biomedical research and addressing unmet medical needs. South Korea has made significant progress in nurturing physician–scientists through initiatives like the Integrated Physician–Scientist Training Program and the Global Physician–Scientist Training Program. However, challenges persist in ensuring the sustainability and effectiveness of these efforts.
To overcome these challenges, it is essential to establish a Korean-style NIH to provide stable research opportunities and career paths for physician–scientists. Incorporating research immersion tracks into medical school curricula and integrating bachelor’s and master’s degree programs are crucial steps in strengthening physician–scientist training. Additionally it is essential to ensure that early- and mid-career physician–scientists have protected research time while effectively balancing their clinical and research responsibilities. These measures would not only support the development of physician–scientists but also enhance South Korea’s global competitiveness in biomedical research.
Additionally, fostering collaborations with international institutions, expanding global training opportunities, and creating a robust ecosystem for interdisciplinary research can amplify the impact of physician–scientists. By addressing systemic barriers and implementing targeted policies, South Korea can create a dynamic and sustainable pipeline for physician–scientists, bridging the gap between clinical practice and cutting-edge research.
These perspectives underscore the importance of a coordinated and comprehensive approach to nurturing physician–scientists, enabling them to make meaningful contributions to medical science on both national and global scales. Therefore, to enhance the development and sustainability of physician–scientists, efforts should be made to foster a supportive environment within the healthcare industry, including the pharmaceutical and government.
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