Academia losing luster

July 1, 2006

National report - According to a recent survey, high levels of depression, anxiety and workplace dissatisfaction among academic physicians threaten patient care and bode ill for the long-term health of academic programs themselves.

Researchers distributed a 136-item anonymous questionnaire to more than 3,500 academic faculty (1,951 replied) at four U.S. medical schools and found that 20 percent of respondents reported symptoms consistent with clinical depression; more than 25 percent reported mild to severe anxiety; and younger faculty experienced more depressive and anxious symptoms than their older counterparts (Schindler BA et al. Acad Med. 2006 Jan;81(1):27-34). Lead researcher was Barbara A. Schindler, M.D., who is vice dean for educational and academic affairs and professor of psychiatry, Drexel University College of Medicine, Philadelphia.

"In academia, there are greater pressures than ever for productivity, and the amount of contemplative time is ever shrinking. Finding individuals who are willing to accept lower salaries, more oversight and greater demands will increasingly become more difficult," says Alan B. Fleischer, Jr., M.D., professor and chair of dermatology, Wake Forest University School of Medicine.

Glitter of gold

"A related problem of great concern to the academic community is the attraction of highly lucrative private practice for graduating residents," elaborates Barbara A. Gilchrest, M.D., chairman, department of dermatology, Boston University School of Medicine, Boston.

Graduating residents' high indebtedness partly explains this allure, she says.

And because dermatologists enjoy greater opportunities for extremely lucrative private practices than do physicians in many other disciplines, she adds, "The risk to dermatology of losing the next generation of teachers and researchers to private practice is much greater."

Minimizing threat

One dermatology department that's working to minimize this threat is Harvard Medical School, says Joseph Kvedar, M.D., the department's vice chairman.

"As recently as three to five years back, we expected people to work in an academic setting for less," he says.

However, Dr. Kvedar says that while this disparity may still exist in some parts of the country, "In our case, if one compares apples to apples - meaning for a standard, varied general dermatology practice - we're paying market-competitive salaries."