Representative schematic of the pipeline that yields the physician-scientist workforce and points of attrition, with best known estimates of losses. Also shown are multiple on-ramps for recruitment to this career path. Labeled block arrows represent training opportunities. Arrows indicate options for transitions between training programs, with solid black arrows denoting the standard research-based physician-scientist training pathway, solid gray arrows indicating on-ramps, and dashed gray arrows showing points of pipeline leakiness, where trainees opt not to pursue research-based careers. PSTP: physician-scientist training program; RiR: research in residency. The pipeline was adapted with permission from ref. 1, and the figure was conceptualized in its entirety by AJA and PJH.