Educating Physician-Neuroscientists: The R25 at UCSF

描述（由申请人提供）：内科科学家短缺，选择进入研究职业的医生数量正在下降。这种短缺威胁着生物医学研究事业，而此时，内科神经科学家在理解和治疗神经系统疾病（如阿尔茨海默病、中风、癫痫、帕金森氏病）方面做出重大发现的机会正在急剧增加美国国立卫生研究院（NIH）制定了一个路线图，鼓励在支持性的学术环境中进行以疾病为导向的研究，其中特别强调提高医师-科学家培训项目的成功率目前，医师-科学家人才队伍减少的一个原因是，达到研究独立性所需的培训时间很长。对于在研究独立道路上面临独特挑战的医学博士申请者来说，首次获得NIH R 01资助（一种常用的研究独立性衡量标准）的平均年龄已达到43岁。当医生完成临床住院医师培训并准备申请职业发展基金时，许多人已经快40岁了。这一时期的特点是做出重要的生活方式决定（例如组建家庭、经济独立、购买第一套住房）和职业发展决定。再加上医学院毕业时的平均债务约为15万美元，这些经济和生活方式因素结合在一起，使潜在的医生科学家不愿从事收入低、资助率低、缺乏长期保障的研究事业。其他职业道路（如私人执业、工业）似乎对许多最聪明的医生更具吸引力。R25研究教育计划通过提供新的资源，帮助有前途的医师研究者改进培训、指导、支持性研究环境和资源，最大限度地提高从培训环境成功过渡到独立研究职业的可能性，在NINDS实现了NIH路线图的愿景。加州大学旧金山分校（UCSF）的神经内科、神经外科和放射科致力于通过鼓励住院医生在临床培训期间发展或扩展研究追求来解决对研究事业兴趣下降的问题。加州大学旧金山分校的神经学系有能力成为临床神经科学研究教育项目的主要赞助者，详情如下，这是本申请的重点。

DESCRIPTION (provided by applicant): There is a shortage of physician scientists and the number of physicians choosing to enter research careers is declining. This shortage threatens the biomedical research enterprise at a time when the opportunities for physician-neuroscientists to make substantial discoveries contributing to understanding and treatment of nervous system diseases (e.g.-Alzheimer disease, stroke, epilepsy, Parkinson disease) have increased dramatically.1 The National Institute of Health (NIH) has developed a roadmap to encourage disease-oriented research in supportive academic environments, including a special emphasis on improving the success rate of training programs for physician-scientists.2 One reason for the current decline in the physician-scientist pipeline is the long training period required to reach research independence. The average age of a first-time NIH R 01 grant recipient (one commonly used measure of research independence) has reached 43 years for MD applicants who face unique challenges on the path to research independence. By the time physicians have completed clinical residency training and are ready to apply for career development funding, many have reached their late 30s. This period is marked by important lifestyle decisions (e.g.-having a family, becoming financially independent, purchasing a first home) and career development decisions. Coupled with an average debt of approximately $150,000 at the end of medical school, these financial and lifestyle factors combine to discourage potential physician-scientists from embarking on research careers associated with low income, low rates of grant funding, and little long term security. Other career avenues (e.g.-private practice, industry) may seem more attractive for many of the brightest physicians in training. The R25 research education program implements the vision of the NIH roadmap at NINDS by providing new resources to assist promising physician investigators with improved training, mentorship, a supportive research environment, and resources that maximize the probability of a successful transition from the training environment to independent research careers. The Departments of Neurology, Neurosurgery, and Radiology at the University of California, San Francisco (UCSF) are committed to addressing the problem of declining interest in research careers by encouraging residents to develop or extend investigative pursuits during the clinical training years. The Department of Neurology at UCSF is well positioned to serve as the primary sponsor of the clinical neuroscience research education program, detailed below, that is the focus of this application. PUBLIC HEALTH RELEVANCE: The development of new treatments and preventions for common nervous system disorders (Alzheimer disease, Parkinson disease, epilepsy, and stroke, among many other maladies) requires the maintenance and renewal of a vital research workforce that understands the relationship between basic neuroscience and clinical care, and is capable of bridging these two worlds. By supporting early research experiences for promising physicians, the R25 education research program is one important step that focuses the biomedical research community on the impending critical manpower shortage. Because of its commitment to training physician-scientists, demonstrated track record of success in this area, and the research accomplishments of its faculty, the clinical neuroscience community at UCSF can provide an outstanding environment for implementation of this program. Although the Department of Neurology is the primary sponsor of this application, the full support and participation of the Departments of Radiology and Neurosurgery for this application (see attached letters of support from Drs. William Dillon and Nicholas Barbaro).