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&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&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 -- CONCLUSIONS -- 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 -- Federal 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 -- CONCLUSIONS -- 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 -- Conflicts of Interest -- 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 -- Background -- Recommendation -- BARRIERS TO THE DVELOPMENT AND SUPPORT OF CLINICAL INVESTIGATORS IN DENTISTRY -- Background -- Recommendations -- 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 -- Recommendations -- Human Resources -- Barriers -- Recommendations -- Clinical Research Training -- Barriers -- Recommendations -- References -- CLINICAL RESEARCH IN PSYCHOLOGY -- Research Opportunities -- Well-Established Areas of Investigation -- Promising Newer Areas of Investigation -- Human Resources -- Training -- Barriers -- 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 -- EXECUTIVE SUMMARY -- 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 -- 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 -- Recommendation -- Institution of Changes in Surgical Residency Training -- ORTHOPAEDIC RESEARCH AND EDUCATION FOUNDATION -- TASK FORCE MEMBERS -- 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.