Care For the Caregivers: COVID Has Transformed Academic Medicine. How Can We Support Teaching Physicians?

At its core, the COVID-19 Fund to Retain Clinical Scientists promises to transform how the clinical sciences view caregiving.

The COVID-19 Fund to Retain Clinical Scientists (or FRCS) grant is made up of $12.1 million awarded to 22 medical schools across the United States, designed to support caregivers in the workplace. (Asian Development Bank / Flickr)

Her ailing father’s hospice bed sits squarely in the living room. It’s 7 a.m. and her feverish 3-year-old isn’t able to go to daycare. Meanwhile, patients will soon arrive at the clinic she coordinates. Checking a notification, she discovers an email from one of the younger women of color she mentors, requesting advice about a conflict with a male lab colleague. As if this weren’t already enough, the future of her research—centered on the needs of underserved communities—rests on this clinical scientist’s ability to submit a successful National Institutes of Health grant at the end of the month.

The clinical sciences combine research responsibilities, teaching and mentoring students, and caring for patients. For women in these occupations, work-life balance was difficult enough before March 2020, dependent on personal networks of support and aid. Then COVID-19 disrupted every facet of clinicians’ lives, from their homes to their workplaces. According to the Doris Duke Charitable Foundation, more than 40 percent of young physicians with full time faculty appointments at academic medical schools leave academics within a decade. Though the reasons behind this are complex, the demands of juggling work with caregiving play an outsized role, specifically for women scientists and scientists of color, who often support communities impacted by histories of healthcare inequality.

In 2015, the Doris Duke Charitable Foundation set out to retain diverse early career clinical scientists through a financial support initiative, the Fund to Retain Clinical Scientists. When the pandemic magnified existing problems, the foundation moved quickly to partner with four additional foundations to establish the COVID-19 Fund to Retain Clinical Scientists (or FRCS): $12.1 million of grant money awarded to 22 medical schools across the United States. Designed to support caregivers in the workplace, this funding seeks nothing less than to transform workplace culture by acknowledging the importance of caregiving in clinical scientists’ lives.

When we spoke to Dr. Esa M. Davis—associate professor of medicine, clinical and translational science, director of the UPMC Tobacco Treatment Service and director of the University of Pittsburgh’s Career Education and Enhancement for Health Care Research Diversity (CEED) Program—she reminded us that care and compassion are what draw many to the field of healthcare. Indeed caring for patients, educating and mentoring both students and colleagues remain central to clinical scientists’ work lives. The many hats that Davis and other clinical scientists we spoke to for this article underscore the multifaceted nature of clinical scientists’ work lives.

Unfortunately, their working conditions fail to allow for a healthy work-life balance. This failure owes partly to the fact that these careers were created with very different workers in mind: namely, male scientists dependent on the labor of often unpaid caregivers (often wives), which allowed them to focus on their careers, especially during those critical early years when labs and research agendas are first established.

Davis and many clinical scientists view caregiving as a privilege, a meaningful opportunity to provide support to their patients and the communities they serve. According to Dr. Michael Mugavero, professor of medicine at the University of Alabama at Birmingham, and director for the Center for Outcomes Effectiveness Research and Education (COERE), his mentees remind him “caregiving is a privilege—not a burden or a responsibility.”

But for women and people of color in these settings, caregiving doesn’t stop at home. As Dr. Reshma Jagsi, Newman family professor and deputy chair in the Department of Radiation Oncology and director of the Center for Bioethics and Social Sciences in Medicine at the University of Michigan observes, these groups are “expected more generally to be caregivers in the workplace.”

Frequently, this translates into substantial educational and emotional labor devoted to nurturing the next diverse generation of physicians and nurses. During the pandemic, all forms of caregiving intensified as schools closed and physicians adapted to evolving COVID protocols and treatments. And because of what Jagsi describes as “gendered expectations of caregiving,” the responsibility for “making up those gaps in care” fell to women as well.

Worse still, fear of being labeled weak or less committed to their work often prevents early career scientists from asking for help. These are workplaces that stigmatize vulnerability, viewing the need for support as a personal shortcoming. According to Dr. Katherine Hartmann—vice president of research integration, associate dean of clinical and translational scientist development and professor of obstetrics and gynecology at Vanderbilt University Medical Center—this stigma is often compounded by the perception that asking for support will be construed as a sign of inferiority, particularly for women and people of color.

The FRCS first and foremost provides caregiving individuals with resources necessary to balance their lives and work in more sustainable ways. As Hartmann put it, “To activate someone in a moment of crisis, you must bring the required effort down to the bare minimum so that the moment they decide to ask for support, it’s a baby step and not a hurdle.”

Access to funding might allow an awardee to hire a grant writer or lab assistant, so they can effectively focus on research only they can do. Receiving a prestigious grant can support an awardee on their path to tenure or ensure their research can continue, especially during times of both global and personal crisis.

At its core, the COVID-19 Fund to Retain Clinical Scientists promises to transform how the clinical sciences view caregiving. Several of the scientists interviewed for this article told us that since the grants were announced, many clinical scientists had expressed their gratitude, even those who did not intend to apply for the grants. The very existence of the program, they said, validates their struggles and ongoing need to support those who care. And it elevates caregiving, recognizing its importance in professional and personal settings.

“Normalizing caregiving as part of our humanity is essential,” saaid Mugavero.

Changing workplace culture has the potential to rewrite unfair societal expectations into conscious celebrations of how caregiving contributes to better science. After all, as Jagsi observes, “Do you really want a caregiver who doesn’t care about attachment and family?”

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About and

Anna Pearl Johnson is a fourth-year undergraduate student studying planning, public policy and management at the University of Oregon Clark Honors College. Her interests include the future of cities, placemaking in public spaces, and arts and culture policy.
Carol Stabile is a professor at the University of Oregon who teaches interdisciplinary courses on gender, race and class in media. From 2008 to 2014, she was director of the University’s Center for the Study of Women in Society. She is the author of several books, including The Broadcast 41: Women and the Anti-Communist Blacklist.