Table 2.

Overarching Theme: Shift Toward Culture of Validation at Some Fund to Retain Clinical Scientists Participating Institutions

Subtheme	Category	Exemplar quotes
Valuing work-life integration solutions		“… just knowing that the Doris Duke Foundation has been willing to think about this issue and acknowledge the needs of working early-stage clinician investigators who are trying to balance a lot. That in and of itself is very helpful.” (female, 30s)
		“When you see leadership being willing to engage in programs like these and valuing them…it affects everybody to some extent, because it's just part of who we become… [The FRCS] just sort of highlighted and was emblematic of the culture that already existed …. the administration could put their money where their mouth is and say ‘no, we really do value work life balance; we really do value you taking care of your family, and here are some mechanisms that we're going to put in place to help you with that.’” (male, 30s)
Reframing caregiving from stigma to validation	Recognition of the value of participants' research	“I think in a way I [applied for the FRCS award] not just for the financial assistance but, really, kind of to show to myself more than anyone else that I can still do it, that my work is worth continuing and that it's worth supporting. I think it was really just for myself that if you get this, somehow, it's like a sign that you should keep going.” (female, 30s)
		“I think it's also just nice to be recognized as somebody who's really trying to continue to strive under circumstances that are difficult. I think in that way it's kind of psychologically beneficial to have it recognized that ‘we think your work is important, and we know you're going through a difficult time right now, and we want to make sure that you're able to continue to do this work.’” (female, 40s)
	Constructive recognition of caregiver responsibilities	“I think [the FRCS has] been huge. Again, I feel like as a junior faculty under so many stresses career-wise, as a caregiver, a parent, a son, to be under all these pressures and I think number one, just to have the recognition of that…” (male 30s)
		“It actually was my department chair who said, “I know what you've been through, I've seen this before and you seem like you would be a good fit for this, I suggest you try for it.” It wasn't just me feeling that way…That was sort of validating…” (female, 40s)
Cultivating community through shared experiences		“… absolutely I think it's important to create a community and to kind of build on this energy that Doris Duke has started in making those people like myself who are balancing a lot feel supported and like this is an issue that the institution recognizes.” (female, 30s)
		“…. all the FRCS events that have been held on campus so far are not only for people who get the award but also prospective applicants and whoever are interested and curious about it. [The FRCS] reaches out to an audience that is already aware of the issue…for them, it must be extremely gratifying to know that, “yes, people on our campus are actively supporting each other with these kinds of scenarios” … I'm sure many of them are thinking about applying because they have these similar challenges at home.” (female, 30s)
Social support and information		The other part of the [FRCS] program that I really appreciated is the social networking…we've had the opportunity to meet…for a meal outside of work with the other [Doris Duke award recipients] … knowing that there are other junior faculty…who also juggle significant caregiving responsibilities and hearing their very specific stories about how they managed it, how they managed the sort of the multiple roles, has been very helpful to me. (female, 40s)
		…. serving as a forum for people to have discussions about caregiving issues and challenges [is] something that this [FRCS] award already is doing. I remember attending a few lunches not just for FRCS recipients but people who applied for the FRCS just to talk about what we need as faculty, as caregivers, at this phase in our lives, and talk about the resources available. (male 30s)
Improved morale		“Many, many, many of my colleagues have kids and sick in-laws and sick parents, and I suppose they've all had their different methods and tactics and help to get through it, but it felt like a safe place to finally talk about the truth of how many sacrifices I had to make on a daily basis to keep everything rolling and to keep achieving at the level that I'd been achieving…” (female, 40s)
		“… I think having programs like this where you can relax and sort of talk to other people about the struggles you face and other people that understand what you're going through, is really beneficial.” (female, 40s)
		… having the acknowledgment that this is an issue, and that a foundation like Doris Duke recognizes that this is an issue, and that I'm not the only one going through it. That, emotionally, is a huge benefit. (female, 30s)
		[The FRCS is] actually a really nice moral support just to know that there's someone out there who thinks this is important, that recognizes that juggling these things is a challenge and that it's reasonable to offer some additional help to people like me. (female, 30s)
Satisfactory work-life integration and promotion of women in science		I think that what [the FRCS program has] been really trying to do is normalize the fact that there are other considerations that can impact the productivity of physician scientists and that there are things that we can do to practically make it better…also since I think most of the people who've applied have been younger…junior female investigators, I think that it has also been intentionally or not linked to the need to help promote women in science. (female, 30s)
		…I think [the FRCS has] begun to create more of a culture of open discussion and recognition that extraprofessional caregiving responsibilities impact—I should say can significantly impact the early career trajectory for clinician investigators. And I think that that openness and recognition is really important… until there is that recognition…it will be more difficult for people like me who wear these numerous hats, especially female faculty because of the biological reality of carrying pregnancies and going out on maternity leave, to actually compete and, therefore, stay involved in the clinician investigator track. (female, 40s)
		… a lot of my mentees are females…they always asked me, “When am I going to get married? How does it work? And, how do I do research when I'm having kids?” and to say, “There are funds… people recognize this and are supporting it.….It's a matter of putting it on the table and then creating a plan and working the plan and being professional but still honest with your mentors about what you need to succeed and being, solution oriented”… I think that has benefited trainees…It has sort of inspired a little bit of hope. And it's also changed culture. (female, 40s)