WASHINGTON, DC—Although the field of rheumatology as a whole is thriving, the inability of academic medical centers to recruit and retain rheumatologists may jeopardize the future of this specialty, Mary K. Crow, MD, said at the opening ceremony of the 70th Annual Meeting of the American College of Rheumatology in Washington, DC.¹

"If faculty can't be retained, mentoring the future generation will be difficult. We need to develop strategies to help academic institutions improve recruitment and retention. We may have a problem developing people willing to put in the work needed to advance medicine if we can't retain teachers, leaders, and researchers in our institutions. We must work hard to develop and retain talented faculty," said Dr. Crow, ACR President and Benjamin M. Rosen Professor, director of rheumatology research, and associate chief of rheumatology at the Hospital for Special Surgery in New York City.

Gold vs glory? Or buildings vs people?

About 10% of nonacademic rheumatologists leave academia within 5 years; also, industry recruits heavily at academic medical centers. Dr. Crow said, "We need to encourage industry to work with talent collaboratively rather than recruiting them away. [At present] industry's gain is rheumatology's loss."

Rheumatologists leave academia for an array of reasons, Dr. Crow told CIAOMed. Money certainly plays a role but is not the only factor, since people who start out in academia are willing to tolerate salaries that average 30% lower than those of rheumatologists in clinical practice.

Dr. Crow points to the need for more respect and recognition for academic rheumatologists.

"It is very difficult for strong people to hang in," she said. "We have to look at academic centers' priorities, and academic medical centers need to recognize the value of people. As it is, they put significant money into building new facilities."

Only 28% of academic rheumatologists are tenured while another 16% are eligible for tenure, Dr. Crow said.

The crunch is coming in rheumatology

The demand for rheumatologists is expected to exceed the supply in the next 20 years because of the increasing prevalence of musculoskeletal diseases, which is due to the growth and aging of the population.

Dr. Crow said that the ACR is working to increase the supply of highly qualified rheumatology fellows. In fact, the number of pediatric rheumatology trainees has doubled since 2000–2001, and the number of adult rheumatology trainees increased from 270 in 2000–2001 to 366 in 2005–2006.

The ACR is also working on new initiatives; these include developing treatment guidelines, as well as disease, diagnosis, and response criteria.

Despite advances in treating rheumatoid arthritis (RA), Dr. Crow highlighted two areas where much more research funding is needed. "There have been no new therapies for lupus in 40 years, and in scleroderma, the situation is even grimmer," she said.

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Reference

1. Crow, MK. Opening lecture. Presented at: American College of Rheumatology Meeting; November 11, 2006; Washington, DC.