Support of academic non-clinical efforts for cancer investigator faculty at Association of American Cancer Institutes.

Abstract

9005 Background: Academic non-clinical time (NCT) for physician scientists (PS) and clinical investigators (CI) is critical in advancing novel scientific findings from the laboratory to the community through clinical trials implemented to improve patient outcomes. CI are uniquely positioned to bridge these bench findings to bedside applications given their dual clinical and research training. However, CI face increasing competing pressures that threaten this career path. The Association of American Cancer Institutes (AACI) Physician Clinical Leadership Initiative (PCLI) conducted a national survey in 2018 to identify trends in academic NCT for the physician-trained researchers across US academic cancer centers involved in basic, translational, or clinical research. We recently reevaluated allocation of academic NCT to support faculty. Methods: In 2024, AACI PCLI electronically sent a 20-question descriptive survey to 95 academic cancer centers. Survey items assessed the time commitments of medical oncologists caring for patients with hematologic (including cellular therapy and stem cell transplantation) and solid tumor malignancies, as well as institutional academic NCT policies and incentive structures. Responses were summarized using descriptive statistics for quantitative items and qualitative review for open-ended responses. Results: Sixty centers (63%) participated. Clinical effort expectations and the amount of academic NCT varied widely by center and faculty role. The median expected effort was 30% (IQR 18%) clinical research and 50% (IQR 14%) direct patient care for CI, and 70% (IQR 20%) basic/clinical research and 20% (IQR 10%) direct patient care for PS. The most common duration of CI startup academic NCT support was 3 years, but this varied greatly across centers. Most centers required external funding to continue academic NCT (48% for CI and 72% for PS). PS were more likely than CI to receive more sustained support when some degree of extramural funding was obtained. Nearly 80% of CI academic NCT was supported by cancer center funds. Clinical trial accrual was the top priority for academic NCT for faculty engaged in clinical research, while mentoring and teaching ranked among the lowest. Incentive plans for clinically active faculty were common (85% of centers) and were largely work relative value unit (wRVU)-based, with limited incorporation of research or mentoring contributions. Conclusions: This survey highlights systemic failures in institutional support for CI, including inconsistent allocation of academic NCT, limited support duration, misaligned incentives, and lack of succession planning. These findings underscore the need for sustainable, multisource funding models, recalibrated incentive structures, and robust mentoring pathways to retain and advance CI for accelerating cancer research through advancing discoveries into the clinic.