Promoting Translational and Clinical Science: The Critical Role of Medical Schools and Teaching Hospitals

Abstract

Historic advances in biomedical research provide both unprecedented insights into the pathogenesis of human diseases and the challenge to translate these insights efficiently into improved health. Meeting this challenge requires the creation of a robust translational and clinical research enterprise [1], which, in turn, depends critically on the ability of academic medicine to produce and support enough physician–scientists to enable the enterprise. Yet, academic translational and clinical research in the United States continues to face serious obstacles. These obstacles include the sharply diminishing ability of clinical departments to underwrite research from patient-care revenues; a declining share of industry-sponsored clinical trials; the prospect of flat or declining National Institutes of Health (NIH) budgets over the near term; the perceived disadvantage of clinical research applications in NIH peer review; overly burdensome regulatory requirements; undervaluation by academic medical culture; and the lure of greater financial rewards, and even professional satisfaction, in full-time clinical practice. Responding to this challenge, the Association of American Medical Colleges convened its second Clinical Research Task Force (CRTF II) to advise the academic medical community how best to (1) attract, develop, and nurture increased numbers of independent translational and clinical investigators; (2) create infrastructure needed for these investigators to be successful; and (3) finance translational and clinical science. This Policy Forum summarizes the task force’s recommendations and conclusions, which are animated by the vision of an academic medical culture that values and supports translational and clinical research; transmits the excitement of such research to medical students, residents, and postdoctoral fellows; and establishes viable and Academic translational and clinical research continues to face serious obstacles. appealing career paths for physician investigators who conduct such research. The full report, which is available both in monograph and on the Web [2], focuses specifically on the obstacles facing academic translational and clinical research in the US; a recent report addresses related issues in the United Kingdom [3].