Educating Physician-Neuroscientists: The R25 at UCSF

描述（由申请人提供）：医生科学家短缺，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企业的时候，医生神经科学家的机会，使实质性的发现，有助于理解和治疗神经系统疾病（例如-阿尔茨海默病、中风、癫痫、帕金森病）急剧增加。1美国国家卫生研究院（NIH）制定了一个路线图，鼓励在支持性学术环境中进行疾病导向的研究，包括特别强调提高医生科学家培训计划的成功率。2目前医生人数下降的一个原因是，科学家管道是达到研究独立性所需的长期培训。首次获得NIH R 01补助金的人（一种常用的研究独立性衡量标准）的平均年龄已经达到43岁，因为MD申请人在研究独立性的道路上面临着独特的挑战。当医生完成临床住院医师培训并准备申请职业发展资金时，许多人已经30多岁了。这一时期的特点是重要的生活方式决定（例如-有一个家庭，成为经济独立，购买第一个家）和职业发展的决定。再加上在医学院毕业时平均约15万美元的债务，这些财务和生活方式因素联合收割机阻止潜在的医生科学家从事与低收入，低补助金率和几乎没有长期保障相关的研究事业。其他职业途径（例如-私人执业，工业）似乎更有吸引力的许多最聪明的医生在培训。R25研究教育计划通过提供新的资源来帮助有前途的医生研究人员改善培训，指导，支持性研究环境以及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的资源，实现了NINDS的NIH路线图的愿景。加州大学旧金山分校弗朗西斯科的神经病学、神经外科学和放射学系致力于通过鼓励住院医师在临床培训期间发展或扩展调查研究来解决研究职业兴趣下降的问题。UCSF神经病学系非常适合作为临床神经科学研究教育计划的主要赞助商，详见下文，这是本申请的重点。 公共卫生相关性：为常见的神经系统疾病（阿尔茨海默病、帕金森病、癫痫和中风等）开发新的治疗和预防方法，需要维持和更新一支重要的研究队伍，他们了解基础神经科学和临床护理之间的关系，并能够弥合这两个世界。通过支持有前途的医生的早期研究经验，R25教育研究计划是生物医学研究界关注即将到来的关键人力短缺的重要一步。由于其致力于培养医生科学家，在这一领域取得了成功的记录，以及其教师的研究成果，UCSF的临床神经科学界可以为实施该计划提供一个出色的环境。虽然神经科是本申请的主要申办者，但放射科和神经外科对本申请的全力支持和参与（见随附的William Dillon和Nicholas Barbaro博士的支持信）。

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).