Career in clinical research : obstacles and opportunities / Committee on Addressing Career Paths for Clinical Research, Division of Health Sciences Policy, Institute of Medicine ; William N. Kelley and Mark A. Randolph, editors.

Format:

Book

Contributor:

Kelley, William N., 1939-

Randolph, Mark A.

Institute of Medicine (U.S.). Committee on Addressing Career Paths for Clinical Research.

Language:

English

Subjects (All):

Medicine--Research--Government policy--United States.

Medicine.

Medicine--Research--Study and teaching--Government policy--United States.

Physical Description:

xii, 332 p.

Edition:

1st ed.

Place of Publication:

Washington, D.C. : National Academy Press, 1994.

Language Note:

English

Summary:

Transforming biological discoveries into medical treatment calls for a cadre of health professionals skilled in patient-oriented research. Yet many factors discourage talented persons from choosing clinical research as a profession. This new volume lays out the problem in detail, with specific recommendations to the federal government, the biotechnology and pharmaceutical industries, professional organizations, the health care industry, organized medicine, and the nation's universities and academic health centers. The volume explores How clinical research is conducted, what human resources are available, and what research opportunities lie ahead. Why health professionals become discouraged about clinical research. How the educational system has failed in this area and what programs stand out as models. How funding affects the supply of researchers. This practical book will be of immediate interest to public and private agencies funding research, research administrators, medical educators, health professionals, and those pursuing a career in clinical investigation.

Contents:

CAREERS in CLINICAL RESEARCH

Copyright

Preface

Contents

Executive Summary

FOCUS OF THIS REPORT

FINDINGS

RECOMMENDATIONS

NIH and Other Federal Agencies Supporting Research

Data Analysis

Study Section Oversight

Newly Independent Investigators

Centers and Program Projects

General Clinical Research Centers

Multiyear Stabilization

Support of Training Programs

UNIVERSITIES AND ACADEMIC MEDICAL CENTERS

Academic Recognition and Rewards

Faculty Protection

Infrastructure

Medical School Curriculum

Postgraduate Training

ACCREDITATION AND CERTIFICATION ORGANIZATIONS

Liaison Committee on Medical Education

Accreditation Committee for Graduate Medical Education

American Board of Medical Specialties

EXECUTIVE BRANCH, CONGRESS, INDUSTRY, FOUNDATIONS, AND PROFESSIONAL SOCIETIES

Conflicts of Interest

Preserving Academic Health Centers

1 Introduction

SCOPE OF CLINICAL RESEARCH

ORIGINS OF THE STUDY

CHARGE TO THE COMMITTEE

DEFINING CLINICAL RESEARCH

LIMITS ON THE SCOPE OF THE STUDY

CONDUCT OF THE STUDY

Subcommittees

Task Forces

Workshop

Commissioned Papers

Grants Analysis

STRUCTURE OF THE REPORT

2 Nurturing Clinical Researchers

ENVIRONMENT FOR CLINICAL RESEARCH

CLINICAL RESEARCH WORKFORCE

RESEARCH INVOLVEMENT OF FACULTY

ACADEMIC RECOGNITION

FACULTY TRACKS

COMPETING TIME DEMANDS

CLINICAL RESEARCH TRAINING

MENTORING

LIFESTYLE ISSUES

CONCLUSIONS

3 Clinical Research Funding and Infrastructure

THE BIG PICTURE

FEDERAL SUPPORT FOR HEALTH SCIENCES R&amp

D

National Institutes of Health

Intramural Research

Extramural Programs at NIH

Setting Program Priorities Through Peer Review

Funding Clinical Research

IMPAC Data

OMAR Data

Ahrens' Analysis

CRISP Data

Committee's Analysis

R&amp.

D Centers

Centers for Disease Control and Prevention

Agency for Health Care Policy and Research

U.S. Department of Veterans Affairs

U.S. Department of Education

U.S. Department of Defense

NONPROFIT ORGANIZATIONS

Foundations

Voluntary Health Agencies

Medical Research Organizations

INDUSTRY

CLINICAL RESEARCH AND THIRD-PARTY PAYERS

Third-Party Payers' Perspective

Involvement in Study Design and Data Analyses

Data Sharing and Analysis

Possible Solutions

MODELS OF COOPERATION

4 Training Pathways

DEMOGRAPHICS

KINDERGARTEN TO COLLEGE

Classroom Experience

Science Fairs and Competitions

Specific Initiatives

Effecting Change

Federal Programs

Nonfederal Programs

Summary

RESEARCH EXPERIENCES FOR UNDERGRADUATE STUDENTS

Institutional Programs

Program Shortcomings

Assessing Program Effectiveness

Designing Effective Programs

Establishing Specific Goals

Selecting Appropriate Strategies

Designing an Evaluation Plan

Characteristics of Successful Programs

Conclusions

HEALTH PROFESSIONAL SCHOOLS

Physician-Scientists

What's Wrong with Medical Education?

UNDERGRADUATE MEDICAL EDUCATION

Medical School Science Curriculum and Culture

Research Interests of Medical Students

Research Participation by Medical Students

Training Programs for Medical Students

Dual-Degree Programs

MST Program Outcomes

Training in Research Ethics

Financing and Debt

GRADUATE MEDICAL EDUCATION

How Long Should Training Be and What Should the Training Involve?

External Factors Affecting Research Training During GME

Residency Review Committees and Certification Boards

Role of RRCs

Role of Certification Boards

Liaison Committee for Medical Education

BARRIERS TO CLINICAL RESEARCH TRAINING.

Inadequate Training in Research Methods

Inadequate Mentoring

Timing of Training

Competing Commitments

AVENUES FOR POSTDOCTORAL RESEARCH TRAINING

Federal Support from NIH

ASSESSING THE OUTCOMES OF TRAINING PROGRAMS

Postdoctoral Ph.D. Training

Postdoctoral M.D. Training

Research Career Development Awards

Clinical Associate Physician Program

Non-NIH Federal Support

Private Support

Payback of Debt

MODEL PROGRAMS FOR RESEARCH TRAINING

Overview of Selected Programs

Robert Wood Johnson Clinical Scholars Program

University of Michigan School of Public Health

Harvard Clinical Effectiveness Program

Other Programs

Common Characteristics

Remaining Obstacles

5 Academic-Industry Relationships

OBJECTIVES OF ACADEMIC-INDUSTRY RELATIONSHIPS

TWO CULTURES

TYPES OF ACADEMIC-INDUSTRY LINKAGES

PROGRAMS TO HELP COMMERCIALIZE FACULTY RESEARCH

PREVALENCE OF ACADEMIC-INDUSTRY RELATIONSHIPS

BENEFITS FOR INDUSTRY

Access to Fundamental Scientific Advances

Access to Academic Personnel

Human Resources Needs

BENEFITS FOR ACADEMIC INSTITUTIONS, FACULTY, AND STUDENTS

RISKS, CONCERNS, AND CONFLICTS

Scientific Communication and Proprietary Rights

Ownership of Proprietary Rights for New Discoveries

Exclusivity of Information

Conflict of Commitment

MANAGING ACADEMIC-INDUSTRY RELATIONSHIPS

SUMMARY AND CONCLUSIONS

References

Appendix A Report of the Task Force on Clinical Research in Dentistry

EXECUTIVE SUMMARY

CLINICAL RESEARCH IN DENTISTRY

Background

Recommendations

HUMAN RESOURCES

Recommendation

BARRIERS TO THE DVELOPMENT AND SUPPORT OF CLINICAL INVESTIGATORS IN DENTISTRY

Measurement of Outcomes

Projecting the Potential Need for Clinical Researchers.

TASK FORCE MEMBERS

Appendix B Report of the Task Force on Clinical Research in Nursing and Clinical Psychology

CLINICAL RESEARCH IN NURSING

Research Opportunities

Barriers

Human Resources

Clinical Research Training

CLINICAL RESEARCH IN PSYCHOLOGY

Well-Established Areas of Investigation

Promising Newer Areas of Investigation

Training

Failure to Retain Clinical Psychologists as Researchers

Chilly Academic Climate for Women

Chilly Academic Climate for Minorities

Erosion of the Science Training Base by Professional Schools of Psychology

Increasingly Inflexible Licensing Requirements That Impede Clinical Researchers' Eligibility for Licensure

REFRENCES

TASK FORCE MEMBERS

Appendix C Report of the Task Force on Clinical Research in Surgery

DEFINING CLINICAL RESEARCH IN SURGERY

Examples of Human Studies

Examples of Animal Studies

Studies at the Tissue, Cellular, and Molecular Level

IMPROVING CLINICAL RESEARCH IN SURGERY

RESOURCE BASE FOR CLINICAL RESEARCH IN SURGERY

Orthopedic Surgery

NIH

Department of Defense

BARRIERS TO CLINICAL RESEARCH CAREERS IN SURGERY

Barriers at Entry Level

Barriers During Residency

Barriers After Residency

General Barriers to Surgical Research

Special Problems of Women in Surgery

Minorities in Surgical Research Faculty Careers

HUMAN RESOURCES PROFILE AND TRAINING BACKGROUNDS OF THE PRESENT COHORT OF CLINICAL RESEARCHERS

EDUCATION AND TRAINING REQUIREMENTS FOR CLINICAL RESEARCH IN SURGERY

IMPLEMENTING CHANGES IN CLINICAL RESEARCH TRAINING

CHANGES IN SURGICAL RESIDENCY TRAINING

RECOMMENDATIONS.

Collaboration Between Basic Sciences and Department of Surgery

Proposal to American College of Surgeons Board of Regents to Undertake Direct Support of Research by Surgeons

NIH-Peer Review

Collaboration Between Military and Civilian Sectors

Recruitment and Retention of Academic Faculty in Surgery

Women in Surgical Research Faculty Careers

Under-represented Minorities in Academic Surgery

Development of NIH Surgical Scientist Training Program

Institution of Changes in Surgical Residency Training

ORTHOPAEDIC RESEARCH AND EDUCATION FOUNDATION

Appendix D Agenda for the Workshop on Clinical Research and Training: Spotlight on Funding

Appendix E Contributors

Appendix F Biographies of Committee Members

Glossary

Index.

Notes:

Bibliographic Level Mode of Issuance: Monograph

Includes bibliographical references and index.

ISBN:

1-280-19657-2

9786610196579

0-309-58547-3

0-585-02546-0

OCLC:

923260132