Fredric M. Hanes Professor and Chairman Department of Medicine Duke University Medical Center Durham, North Carolina the title of this symposium is" The Academic Physician: An Endangered Species." There is a paradox in that title. The paradox is that we have never had more full-time physicians in academic medicine than we have right now. About 33,000 physicians have full-time faculty positions in the United States, and that is close to 10% of the physicians in this country. This large figure reflects the expanding clinical roles of academic medical centers, which include, for example, 25% of all acute and intensive care beds of the country. Annual Association of American Medical Colleges surveys of funded, unfilled faculty vacancies have listed about 1,000 available positions each year over the last 10 or 15 years. Each year faculty ranks grow by 1,000, but another 1,000 new positions become available to be filled the following year. Thus, in the global sense there con-tinuesto be a shortage of academic physicians. But these position vacancies tend to be concentrated in specific fields, such as anesthesiology and pathology, with high service requirements. These are not the endangered species that I am referring to.

Eighteen months ago, as part of a presidential address, I discussedthis topic with respect to the clinical investigator with special emphasis on the physician-scientist. I I usethat term to signify an individual thoroughly trained in clinical medicine and also thoroughly trained in a scientific discipline, and who, in addition, participates in both clinical and ex-perimental endeavors as a career role. Thus I refer to the physician who is simultaneously a serious scientist, and far less to the clinician who may oc-casionally also do some research. I want to discuss the topic in that