Effects of 2025-2026 U.S. health and science policy changes on academic pulmonary and critical care medicine: an ASPIRE-PCCM prospective survey study
- 1Johns Hopkins
Abstract
BackgroundThe rapidly evolving United States (U.S.) health and science policy landscape in 2025 may have heterogeneous effects on academic medicine, biomedical research, physician workforce development and patient care.
Research QuestionHow do academic pulmonary and critical care medicine (PCCM) physicians perceive U.S. health and science policy changes and which changes do they consider most influential on research, trainee education and clinical care?
Study Design and MethodsWe conducted a prospective survey from March 27, 2026 through April 29, 2026 among selected faculty at U.S. academic PCCM programs as part of the Alliance of Scholars and Professionals for Innovation, Research, and Education in Pulmonary and Critical Care Medicine (ASPIRE-PCCM).
ResultsNinety-four of 99 ASPIRE-PCCM panel members completed the survey (response rate 95%), representing 18 of 19 ASPIRE-PCCM wave 1 institutions. All respondents reported the rate of changes in U.S. federal health and science policy in the first half of 2025 as 6 or higher on a scale of 1 ("typical pace of change") to 10 ("most change in my lifetime"), with 89 (96%) evaluating the changes as harmful or very harmful. Respondents identified cancellation of research grants, disruptions and changes to NIH scientific review processes, and changes to visa and immigration policies as key factors affecting early career recruitment. Reported negative effects on quality of care included increased vaccine hesitancy, changing reimbursement structures, and diminished research capacity. State-level and non-governmental efforts, including professional society advocacy, institutional bridge funding and personal advocacy efforts were identified as partially mitigating harms. Despite these concerns, 72% of respondents reported that would still pursue careers in PCCM.
InterpretationAcademic pulmonary and critical care physicians reported challenges following recent U.S. health and science policy changes that may be mitigated, but not neutralized, by institutional, professional-society, and individual actions.
Related
- Leadership in Academic Medicine: Lessons We Can Learn from the Military
- Building primary health care from the ground up: family medicine, academic partnership, and health system reform in Ethiopia
- Co-creating point-of-care ultrasound education for family medicine in Ethiopia: reflections on pedagogy, faculty development, and academic partnership.
- Identifying leverage points to sustain community-engaged research infrastructure in academic systems: a participatory systems science approach
- Evaluation of an Internal Medicine Resident Research Program and Barriers to Research at an Academic Medical Center
BibTeX
@misc{iwashyna2026effects,
title = {{Effects of 2025-2026 U.S. health and science policy changes on academic pulmonary and critical care medicine: an ASPIRE-PCCM prospective survey study}},
author = {T. J. Iwashyna and Y. Shu and C. Ettman and E. Viglianti and D. Furfaro and K. Montemayor},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.25.26364007},
url = {https://www.medrxiv.org/content/10.64898/2026.09.25.26364007v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Effects of 2025-2026 U.S. health and science policy changes on academic pulmonary and critical care medicine: an ASPIRE-PCCM prospective survey study
AU - T. J. Iwashyna
AU - Y. Shu
AU - C. Ettman
AU - E. Viglianti
AU - D. Furfaro
AU - K. Montemayor
PY - 2026
DA - 2026/09/25
PB - medRxiv
DO - 10.64898/2026.09.25.26364007
UR - https://www.medrxiv.org/content/10.64898/2026.09.25.26364007v1
AB - BackgroundThe rapidly evolving United States (U.S.) health and science policy landscape in 2025 may have heterogeneous effects on academic medicine, biomedical research, physician workforce development and patient care. Research QuestionHow do academic pulmonary and critical care medicine (PCCM) physicians perceive U.S. health and science policy changes and which changes do they consider most influential on research, trainee education and clinical care? Study Design and MethodsWe conducted a prospective survey from March 27, 2026 through April 29, 2026 among selected faculty at U.S. academic PCCM programs as part of the Alliance of Scholars and Professionals for Innovation, Research, and Education in Pulmonary and Critical Care Medicine (ASPIRE-PCCM). ResultsNinety-four of 99 ASPIRE-PCCM panel members completed the survey (response rate 95%), representing 18 of 19 ASPIRE-PCCM wave 1 institutions. All respondents reported the rate of changes in U.S. federal health and science policy in the first half of 2025 as 6 or higher on a scale of 1 ("typical pace of change") to 10 ("most change in my lifetime"), with 89 (96%) evaluating the changes as harmful or very harmful. Respondents identified cancellation of research grants, disruptions and changes to NIH scientific review processes, and changes to visa and immigration policies as key factors affecting early career recruitment. Reported negative effects on quality of care included increased vaccine hesitancy, changing reimbursement structures, and diminished research capacity. State-level and non-governmental efforts, including professional society advocacy, institutional bridge funding and personal advocacy efforts were identified as partially mitigating harms. Despite these concerns, 72% of respondents reported that would still pursue careers in PCCM. InterpretationAcademic pulmonary and critical care physicians reported challenges following recent U.S. health and science policy changes that may be mitigated, but not neutralized, by institutional, professional-society, and individual actions.
ER -