The Status of Physiologists and Physiology at 
US Medical Schools 

As originally published in The Physiologist
Volume 45, Number 4, August 2002, page 179

Martin Frank and Marsha Matyas

The status of physiology in academic medical schools has been a concern of the American Physiological Society for over 50 years, starting in 1945 with a study chaired by E. F. Adolph (1) and followed in 1958 by a study chaired by R. W. Gerard (11). The APS has undertaken similar studies in the last two decades as part of its efforts to define the future of the Society and the discipline. The most compelling was the study developed by the Long Range Planning Committee chaired by Ernst Knobil and published by the Society in 1990 (10). It explored the status of the science of physiology, departments of physiology, and the American Physiological Society. The recommendations made in the “White Paper” ultimately contributed to the development of the Society’s 1992 Strategic Plan (16) that helped shape the current APS. 

In 1996, the Society published another Long Rang Planning Committee Report that was chaired by Shu Chien (8). As in the 1990 report, the Chien report made a series of recommendations related to physiology as a discipline, physiology education, physiological research, departments of physiology, and the role of the APS. The observations and issues raised in the Chien report served as the basis for the Society’s development of a new Strategic Plan in 2000 (5). In subsequent years, the incoming APS Presidents revisited these reports to comment on the status of the Society and the discipline (9, 12, 13). Through these reports and subsequent discussions, a number of questions have been raised about the status of physiology in academic medicine in four key areas. 

Role of physiology in the medical curriculum. Concerns have been raised that physiology is being de-emphasized in the medical curriculum, with potentially critical consequences for both medical students and the larger physiology teaching and research communities. Is the perceived de-emphasis real? If so, what is its impact on the preparation of medical students in terms of coverage of key concepts and of skills development? What is its impact on the structure of the medical school faculty and on the depth of knowledge available to guide future course development and implementation?

Education and training of PhD physiologists. Life sciences has enjoyed exceptional growth in the awarding of doctoral degrees, particularly in the late 1980s and 1990s, paralleled only by engineering, and far above mathematics, computer science, physical sciences, and geosciences (17). Similarly, the availability of funding for biomedical research has increased in the 1990s. One might expect, therefore, that like other life sciences areas, increases in the numbers of graduate students enrolled in physiology degree programs and PhDs awarded in physiology would be evident. Is this the case? If not, what would lead to a disparity between physiology and many other life sciences fields? Furthermore, numerous discussions and reports have focused on the status of postdoctoral fellows in the US. What are the trends for postdoctoral fellows in physiology? Are they comparable to other fields? What implications does the status of postdoctoral fellows in physiology have for the field as a whole?

Faculty at US medical schools. What is the status of physiology PhDs at US medical schools? During the last decade, the finances of academic medical centers have been challenged by the diminishing recovery of patient care dollars. To balance this decrease in income, there has been an increased emphasis on the acquisition of research grant dollars, taking advantage of the expanding NIH budget. Concerns have been raised that, in order to attract research dollars in more highly funded fields, changes have occurred in the hiring patterns of basic science departments, especially physiology departments. That is, it has been suggested that physiology departments are increasingly hiring faculty trained in research areas outside of physiology with the expectation that they are more likely to generate support from NIH. Is there evidence that this is the case? If so, is the strategy successful, that is, are those faculty members raising a disproportionately high amount of funding for their departments? Have the changes in faculty composition and expertise had impacts on course content, teaching quality, and the preparedness of medical and graduate students? Have these changes impacted the amount and type of research and teaching collaborations among faculty within the department? Finally, are the same trends evident in clinical departments in US medical schools?

Diversity issues. Throughout the 1980s and 1990s, data have been collected by numerous agencies and organizations, including the APS, American Association of Medical Colleges (AAMC), and National Science Foundation (NSF), concerning the status of underrepresented groups in science, particularly women and minorities. What do the current data suggest about the status of these groups in terms of degrees earned and their position in US academic medicine in the field of physiology?

This study attempts to explore these questions that have been raised about the status of physiology in academic medicine and to identify additional studies and possible policy issues that should be further explored. The study draws on an earlier study of 1989 and 1994 data by Matyas and Frank (15), data obtained from the AAMC for the 2001 academic year, and data from the NSF’s Science and Engineering Doctorate Awards: 2000 (19).

Role of Physiology in the Medical Curriculum

As noted in the Knobil White Paper (10), “From the first appearance of the word, physiology has been associated with medical instruction and has been preeminently institutionalized in departments of physiology housed, with but a very few exceptions, in schools of medicine. Physiology in this context has been and continues to be the basic science central to medicine.” 

Medical students confirm the latter statement. They consistently rate physiology as one of the premedical courses that best prepared them for medical school studies (Table 1). Nearly 70% of medical students rated their premedical physiology course as “very important,” higher than any other course. In addition, a high percentage indicated that their medical physiology course provided an excellent (44%) or good (40%) preparation for their clinical clerkships and electives (Table 2), second only to pathology. Therefore, medical students believe that a strong physiology education is key to their success in both medical studies and clinical settings. 

There is evidence, however, that the number of contact hours for the teaching of physiology has significantly decreased since the 1980s. As indicated in Table 3, the average number of hours of instruction of physiology decreased by 38% between the 1983-1984 and 2003 graduating medical students, dropping from 167 to 103 hours (2, 4). Similar reductions occurred in other traditional basic sciences such as pathology (50% decrease) and pharmacology (32% decrease) (Table 3). 

Education and Training of PhD Physiologists

In general, the number of PhDs in animal and human physiology awarded to US citizens and permanent residents has remained relatively constant at about 260 PhD degrees on average granted annually since 1991 (Table 4). In contrast, from 1991 to 2000, the total number of PhD degrees awarded in life/biological sciences increased from 4,650 to 5,855 (19). Most of the increase can be attributed to an increase in PhDs awarded in neuroscience, cell biology, and molecular biology (19). Of the total PhDs awarded in physiology, women received 100 PhDs on average annually, accounting for 41% of the total awarded in 2000. Data on minority PhDs in physiology from the same source were not available, however, overall, minority students continue to be awarded very limited numbers of PhD degrees in biological sciences. In 1997, 2% of biological sciences PhDs were awarded to Black, non-Hispanic students, 3% to Hispanic students, and less than 1% to Native American students, a total of only 262 degrees among the more than 4,200 awarded (20). 

The enrollment of physiology graduate students seeking a doctorate at US medical schools remained relatively consistent overall throughout the 1980s (mean = 1,328) and 1990s (mean = 1,352) (Table 5). There were two notable exceptions. The number of students peaked in 1994 at 1,731; this may reflect the impact of the 1992 Chinese Student Protection Act that allowed the approval of US permanent resident visas for a significant number of Chinese graduate students; the impact of this Act can be seen in all scientific and engineering fields of study. In the late 1990s, following this peak, there has been a significant decline in the number of graduate students in departments of physiology, with the number of students falling under 1,000 for the first time in 20 years (Table 5). This is not comparable to the overall enrollment in graduate studies in biological sciences, which remained relatively constant throughout the 1990s and into the new millennium (6). 

The number of master’s students in departments of physiology increased somewhat between the 1980s (mean = 338) and 1990s (mean = 372) and has ranged from 212 to 492. During the same time period, the number of postdoctoral fellows also increased from an average of 609 annually in the 1980s to 784 in the 1990s, a 29% increase.

Faculty at US Medical Schools

The following section presents information on the status of physiologists and faculty in departments of physiology at US medical schools. The data for this section are drawn from the AAMC Faculty Roster System (FRS). The AAMC FRS is the only comprehensive information system of its kind, containing continuously updated data on the careers of current and past medical school faculty members; the database contains information on more than 80% of US medical schools. The FRS is used for annual reports on medical school faculty, for policy studies, to provide standard and custom reports to member institutions, as a means of identifying and locating current faculty members, and as a recruitment service to assist medical schools and selected institutions seeking to appoint senior faculty.

Faculty Holding Degrees in Physiology. The numbers and rank of faculty holding physiology degrees has remained relatively stable since 1989 (Table 6). In 2001, there were 2,345 faculty members at US medical schools holding degrees in physiology. This was comparable to the number of faculty holding PhD degrees in physiology in 1989 and 1994. Of the 2,345 PhD physiologists at US medical schools, 41% of physiologists held the rank of Professor in 2001 compared with 42% in 1994 and 38% in 1989. Associate Professors accounted for 26% in 2001 and 28% in 1989 and 1994 of the physiologists on faculty. Assistant Professors accounted for 28% of faculty in 2001 and approximately 27% in 1989 and 1994. Instructors comprised approximately 3% of the faculty in the years studied.

In 2001, 47% of faculty holding a degree in physiology had tenure and an additional 14% were in tenure-track positions (Table 7). Both of these figures were less than reported in the 1994 study in which more than half of the faculty had tenure and 17% were in tenure-track positions. 

Gender diversity among faculty with physiology degrees was improved in 2001 compared with the two previous studies. In 2001, 20% (n = 454) of the faculty members were female compared with 14% (n = 330) in 1989 and 16% (n = 361) in 1994. The representation of women in each faculty rank increased relative to the earlier studies. In 2001, women made up 12% of professors, 20% of associate professors, 28% of assistant professors, and 36% of instructors. However, as in the previous studies, women are much less likely than their male cohorts to be in tenure or tenure-track positions. Of the 454 women in faculty positions, 24% are in tenure positions and 12% are in tenure-track positions. Of the 1,867 men in faculty positions, 50% are in tenure positions and 14% are in tenure-track positions. As in 1994, the 2001 data show that at every faculty rank, proportionately fewer women were tenured or on tenure-track.

Racial/ethnic diversity among medical school faculty holding degrees in physiology in 2001 (Table 8) showed limited improvement in comparison to diversity in 1989 and 1994. The overall proportion of underrepresented minority physiologists (African-American, Native American, and Hispanic) increased to 4% from 3% in 1994 and 2% in 1989. Including Asian/Pacific Islanders in the analysis increases the percentage of minority physiologists to 15% compared with 12% in 1994 and 9% in 1989.

Data were also compared on departmental appointments and areas of specialty. In 2001, the percentage of PhD physiologists employed in basic science departments decreased to 49% (Table 9) from 53% in 1994 and 55% in 1989. While the largest percentage was employed in physiology departments (30%) in 2001, this was a smaller percentage than observed in 1989 (38%) and in 1994 (37%). 

PhD physiologists are increasingly employed in clinical science departments. In 2001, 49% were employed in clinical departments compared with 43% in 1989 and 45% in 1994. As in the earlier studies, the largest percentage of PhD physiologists was employed in departments of internal medicine (16%). 
In terms of specific physiology disciplines, in 2001 more than 68% of the respondents stated that their area was “physiology, general.” Neurophysiology (8%), cardiovascular physiology (5%), reproductive physiology (4%), and exercise physiology (2%) accounted for an additional 19% of medical school physiologists.

Faculty in departments of physiology. In 2001, the AAMC FRS included information on 1,851 faculty members with appointments in physiology departments in US medical schools. The number of full-time faculty positions remained stable between the 1980s (mean = 1,833) and 1990s (mean = 1,868) (Table 5). In 2000, however, only 1,768 full-time faculty positions were filled, a decline from most years in the previous two decades. The number of vacant positions decreased, as well, falling from an average of 87 in the 1980s to 64 in the 1990s. Volunteer positions increased by 18% during this period, from a mean of 390 during the 1980s to 459 during the 1990s; these typically are clinical department faculty in teaching roles. 

Among faculty members with a degree in physiology, approximately 41% held the rank of professor (Table 6). Similarly, of the faculty employed in departments of physiology, approximately 44% held the rank of professor (Table 10). The majority of faculty members in departments of physiology in 2001 held the PhD (87%) or MD-PhD (5%) degree (3). Only about 6% held an MD degree only. This distribution is similar to that observed in both 1989 and 1994. More than half (52%) of the faculty members in physiology departments had tenure in 2001, and an additional 15% were in tenure-track positions (Table 10).

As stated earlier, respondents to the FRS survey are asked to indicate their specific field of study or discipline (Table 11). Just over half of faculty members in departments of physiology in 1989 (56%) and 1994 (53%) identified themselves as “physiologists.” In 2001, however, only 42% identified themselves as “physiologists.” Other disciplines commonly cited in 2001 were biochemistry (17%), pharmacology (7%), and biophysics (5%). In contrast, in 1994 biochemistry was identified as the field of study for only 12% of the individuals in departments of physiology.

The proportion of physiology department faculty positions held by women increased between 1989 and 2001. In 2001, women held 22% of faculty positions (Table 12), up from 14% in 1989 and 17% in 1994 (15). In addition, a comparison of the data published in 1995 (15) to the data in Table 12 confirms that the representation of women at all faculty ranks has increased over the decade. However, women in physiology departments— similar to women physiologists in all departments—are much less likely than their male cohorts to be in tenure-track positions (Table 10). In 2001, proportionately fewer women were tenured and more women were not in a tenure-track position at every faculty rank when compared with male faculty members. At the assistant professor level, 45% of women were in non-tenure-track positions compared with 34% of men; therefore, nearly half of women assistant professors in physiology departments are in non-tenure-track positions. 

Racial/ethnic diversity among faculty in physiology departments remained unchanged in comparison to 1994. The overall proportion of underrepresented minority faculty (African-American, Native American/Alaskan Natives, and Hispanic) remained unchanged at 5% of the faculty in departments of physiology (Table 13). Furthermore, Asians, Hispanics, and African-Americans are over-represented in Instructor positions compared with their total representation on the faculty in departments of physiology (Table 13). For example, whereas Hispanics comprise 4% of the total faculty in departments of physiology, they account for 6% of the instructors. These groups are also concentrated more in assistant professor and instructor positions than at higher faculty level positions.

Discussion

Role of physiology in the medical curriculum. It is apparent that physiology training plays a critical role in the education of future medical doctors based on the Medical School Graduation Survey conducted by the AAMC. Medical students felt that their physiology courses were critical in preparing for both their medical studies and clinical clerkships. Despite this feedback, many academic medical centers have restructured the medical school curriculum, effectively reducing the number of instructional contact hours available for providing medical students with training in physiology. While physiology and a number of other basic science courses have seen a reduction in hours, the instructional hours devoted to anatomy and neurosciences has remained stable. Ernst Knobil (10) stated that physiology was “the basic science central to medicine” and data on two decades of medical school classes agree, yet the allocation of instructional hours suggests that medical school curriculum committees do not. Anatomical sciences appear to be weighted more heavily, as evidenced by the retention of hours for anatomy and the addition of anatomically based courses such as cell biology and microanatomy in the medical school curriculum. This restructuring has been encouraged by the Liaison Committee for Medical Education (LCME) and by efforts to also include non-basic science courses in the curriculum. 

The long-term impact of this significant change in the medical curriculum is unknown. It constitutes an educational experiment with tremendous potential impacts, changing the basic core knowledge of the new generation of clinicians. Therefore, it is essential that schools monitor the progress and achievement of students on Board exams, particularly in the areas of the basic sciences, to assure that their training is adequate. Furthermore, it will be incumbent upon schools to assure that, as contact hours are reduced, students effectively learn critical content knowledge and process skills in physiology. Toward this end, the APS and the Association of Chairs of Departments of Physiology have developed Medical Physiology Learning Objectives, a consensus on the physiological principles and concepts that are considered minimal and essential for understanding mechanisms of disease and body defenses (7). 

It will also require, however, that departments have faculty with a clear understanding of not only these basic concepts and principles, but also an ongoing knowledge of progress in the fields of physiology so that important new findings can be incorporated into the curriculum. Evidence from the AAMC survey suggests that physiology departments are, indeed, diversifying their faculty to include fewer “physiologists.” If those involved in teaching medical physiology also reflect that diversity, then the long-term effects of utilizing instructors who are teaching “out-of-field” must be monitored and assessed. Again, it will be incumbent upon each school to address this issue. 

Education and training of PhD physiologists. Unlike many other areas of life sciences, physiology has not enjoyed a growth of graduate students throughout the past two decades. Rather, growth of the number of PhD graduate students has been relatively flat, with a significant decrease in the latter 1990s and into the new millennium. At the same time, there has been a significant increase in the number of postdoctoral fellows in physiology. 

The specific reasons for a lack of growth in the number of graduate students in physiology are unknown. However, there are several possibilities. First, undergraduate students interested in a research career may be increasingly unaware of the broad research opportunities in physiology. There has been considerable focus in the media on biotechnology, biochemistry, and genetics, leading students to the perception that these are the “best” fields in which to work. This makes the current APS programs to increase undergraduate participation in physiology research and to increase public understanding of the benefits of physiology research even more important (13). 

Second, there may simply be decreased recruitment of graduate students in departments of physiology and increased hiring of postdoctoral fellows. Extended postdoctoral positions provide an individual with additional training and opportunities for research during a time of limited opportunities for permanent positions, while providing the employer with a highly trained and motivated collaborator. Third, it may be that fewer graduate students in departments of physiology self-identify themselves as “physiologists.” As physiology departments diversify their faculty, students in physiology departments may be working in the lab of a biochemist, pharmacologist, or biophysicist…and may self-identify themselves as such. Finally, it is possible, albeit less likely, that prospective graduate students may perceive that academic positions are less available in physiology than in other fields. 

The status of postdoctoral fellows is also a concern. The number of postdoctoral fellows at US medical school physiology departments has increased significantly over the past two decades. Factors contributing to this are, certainly, an increase in foreign students and the decreasing number of vacancies in medical school physiology departments (Table 5). However, in contrast, the NSF reports no growth in the number of physiology postdoctoral fellows overall, although the overall number of postdoctoral fellows in biological sciences has increased by 17% (18). Has the diversification of faculty in departments of physiology with the goal of increasing research dollars led to an increase in the number of postdoctoral students at those institutions and a decrease in the number of graduate students in physiology? The data needed to address this issue are not currently available, but the question is an important one for both the future of physiology research and of physiology departments. 

Faculty at US medical schools. The data presented here provide some support for the assertion that physiology departments in medical schools are diversifying their faculty in terms of specific discipline. Approximately half of PhD physiologists working in US medical schools are affiliated with basic science departments (Table 9). However, only 30% of the PhD physiologists employed in medical schools were in physiology departments in 2001, down from approximately 38% in 1989 and 1994. Data suggest that candidates from more highly funded areas such as biochemistry and molecular biology are filling more positions in departments of physiology. As noted in Table 11, 17% of the faculty in departments of physiology in 2001 had degrees in biochemistry, compared with 9% in 1989 and 12% in 1994.

As discussed earlier, one of the implications of this shift is that the faculty responsible for the teaching of physiology to medical students is not as well versed in physiological principles. In addition, it makes it increasingly difficult for the faculty to offer laboratory exercises designed to emphasize physiological principles in the absence of faculty familiar with the experimental procedures. Finally, this shift in the composition of departments of physiology may further contribute to the reduction of instructional hours available to teach physiology to medical students. 

Like the change in curriculum, the shift in faculty composition should be viewed as an organizational experiment in progress. If the shift was made with specific objectives in mind—to increase the level of research funding—then an evaluation of the impact of the experiment should be done. Are those faculty members raising a disproportionately high amount of funding for their departments? Has the change in faculty composition and expertise had impacts on course content, teaching quality, and the preparedness of medical and graduate students? Has it impacted the number of and type of students being trained by the department (e.g., graduate versus postdoctoral)? Has it impacted the amount and type of research and teaching collaborations among faculty within the department? These questions cannot be addressed by national surveys, but they are important ones for each department to consider. 

The other half of PhD physiologists at US medical schools are employed in clinical science departments. This represents an increase compared with the percentage employed in clinical departments in 1989 (43%) and in 1994 (45%). Of those in clinical science departments in 2001, the largest percentage was in internal medicine (16%), somewhat greater than the 14% in 1989 and 1994. Surgery departments accounted for 7% of the PhD physiologists in 2001, a slight increase from 5% in 1989 and 6% in 1994. The shift in employment of physiologists into clinical departments may reflect physiologists’ substantial understanding of clinical problems and their ability to participate in the translational research studies more common in clinical departments. This should also be viewed as an experiment in organizational management with departments monitoring the benefits that PhD physiologists bring to the departments as well as their impacts on the research profile and graduate and medical student training in which the department is involved. 

Diversity Issues. The number and proportion of women awarded physiology PhD degrees has remained fairly constant since 1991, despite the fact that the number of students pursuing graduate degrees in physiology (Table 5) has decreased over the same time period. Additionally, the percentage of women with PhD degrees in physiology employed in US medical schools has increased over this time period. In 2001, 20% of the faculty was female compared with 14% in 1989 and 16% in 1994. Similar increases were found in departments of physiology where the percentage in 2001 was 22% compared with 14% in 1989 and 17% in 1994. Unfortunately, whether the female PhD physiologist was in a physiology department or in another medical school department, they were more likely to be in a non-tenure-track position than their male colleagues. However, proportionally more women on faculty are in professor positions in 2001 than in 1994. 

The increased participation of female physiologists on faculties may be reflective of commitment by administrators and chairs to improve gender diversity in US medical schools and of increased availability of women with physiology degrees. Recently, the National Research Council of the National Academy of Sciences conducted an extensive study, comparing matched samples of men and women in a number of science fields, including biological sciences (14). They found that, even adjusting for differences in the age structure of men and women in the sciences, “…men are still more likely to be tenured than women at any professional age. Although these differences have declined over time, they persist, especially in research universities.…Some of the difference in women’s status in academia can be explained by lower productivity, as measured by publications. It seems clear, however, that difference in the positions held by women are likely the cause of lesser productivity, rather than the other way around” (p. 6). Therefore, if US medical schools are to see the continued increase in women on faculties, it will be necessary, at minimum, to assure that they have access to tenure-track positions, comparable to that of their male colleagues.

Minorities in Physiology. As is apparent from a comparison of the data in Tables 8 and 13 with the results published in 1995 (15), there has been little progress made to increase the number and proportion of minority PhD physiologists in US medical schools. This is most apparent in departments of physiology where the percentage of underrepresented minority faculty (African American, Native American, and Hispanic) remained stagnant at 5%. Those underrepresented minorities trained in physiology and recruited to US medical school were more likely to find employment outside of departments of physiology, resulting in a small increase in the percentage employed to 4% in 2001 from 3% in 1994 and 2% in 1989. When Asians/Pacific Islan-ders are included in the analysis, the percentage representation in both the department of physiology and within the medical school is increased. Within departments of physiology, the percentage of underrepresented minorities including Asians increased to 16% in 2001 from 12% in 1994 and 10% in 1989. Within the medical school, the percentage of underrepresented minority PhD physiologists, including Asians, increased to 15% in 2001. While minorities experienced a slightly increased representation in US medical schools, they were unlikely to be found in higher level academic positions. There was disproportionate representation of minorities in assistant professor and instructor positions.

The results of the 2001 analysis suggest that US medical schools and departments of physiology still have a long way to go before the percentage of minority scientists is increased to levels comparable to their levels in the general population. The fact that levels of minorities have not increased appreciably since the last analysis is disappointing because efforts to encourage minority students to pursue research careers has been a significant interest of NIH and scientific societies like the American Physiological Society. While such federally funded programs as the NIH Minority Access to Research Careers (MARC) and Minorities in Biomedical Research Studies (MBRS) have provided extensive support for the participation of minorities in biomedical research, the effort has not translated to a significant increase in the participation of minorities in physiology research in academia. From the data presented here, it appears that the Federal programs did not significantly increase the number of physiologists employed in US medical schools. It is possible that PhD physiologists trained through these programs have obtained employment in industry, research institutes, or other non-medical school environments. 

The APS is currently conducting a study to provide some insights into this issue. The APS’ efforts for increasing the participation of minorities in physiology have focused on supporting student training at the graduate and postdoctoral levels through the Porter Physiology Development Fellowships and on encouraging the early development of a professional network through the Minority Travel Fellows Program, with support from NIDDK and NIGMS. The APS survey of all past participants in these programs is designed to gain insights into their long-term impacts and to gather information on the career paths of the many minority undergraduate, graduate, and postdoctoral students who have participated in our programs. It is hoped that these data will suggest ways to improve these programs for greater impact. 

Conclusion

This study suggests that physiology and physiologists remain strong within US medical schools, even though their representation has shifted over the decade. While the instructional hours for physiology have declined, medical students remain supportive of the role physiology plays for their medical training. Important changes with specific objectives have been made in both the medical school curriculum and in the composition of departments of physiology, but it is not apparent that important evaluative data are being gathered to assess the impact of these changes. Without assessment, whether or not these changes accomplish their goals will remain unknown. 

Does the current success of the medical physiology teaching programs result from the retention of classically trained physiologists in departments of physiology to teach the physiology course? What is the impact of departmental recruitment of faculty trained in more reductionist approaches in order to maintain the research funding levels of the departments? What will be the long-term impacts of decreases in the number of PhD physiologists employed in physiology departments and increases in the number finding positions in clinical departments where they can contribute their knowledge to translational research programs associated with clinical departments? Again, the data needed to answer these important questions must be gathered and analyzed. 

Women and, to a lesser extent, minority PhD physiologists are better represented in US medical schools in 2001 than in 1994 or 1989. However, their contributions to the field are limited by their overrepresentation in non-tenure-track positions. According to the National Research Council, it is critical that the numbers of women and minorities on faculties and in tenure-track positions increase so that the overall scientific community can benefit from the critical diversity and perspectives they bring (14). It is imperative that the APS and the Federal government continue their efforts to actively recruit and retain undergraduate and graduate students into physiology research programs and to encourage the hiring of women and minorities into tenure-track positions.
 
As stated by Knobil (10), “Physiology … has been and continues to be the basic science central to medicine.” The physiology concepts and principles identified in Medical Physiology Learning Objectives (7) form a solid foundation on which future physicians build their knowledge of not only healthy and disease states, but the understanding of diagnostic measures and diverse treatments and of the elegance and wonder of the living organism. To weaken that solid foundation by offering only a sampling of these key concepts taught by faculty with only a cursory knowledge of the principles and how to teach them would hardly result in a robust and sound medical education. While the questions raised here are not easily answered, they are important. They assure that the future of medical education includes the strong foundation that only physiology can provide for it. 

References

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