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。在医生-神经科学家为了解和治疗神经系统疾病(如阿尔茨海默病、中风、癫痫、帕金森病)做出实质性发现的机会急剧增加之际，这种短缺威胁着生物医学研究事业。1美国国家卫生研究所(NIH)制定了一份路线图，鼓励在支持性学术环境中进行以疾病为导向的研究，包括特别强调提高医生-科学家培训计划的成功率。对于在研究独立的道路上面临独特挑战的MD申请者来说，首次获得NIH R 01拨款(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资金时，许多人已经快30岁了。这一时期的标志是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平均约15万美元的债务，这些经济和生活方式因素共同阻碍了潜在的医生-科学家从事与低收入、低拨款比率和几乎没有长期保障相关的研究职业。其他职业途径(例如，私人执业、行业)对许多正在接受培训的最聪明的医生来说似乎更具吸引力。R25研究教育计划通过提供新的资源来帮助有前途的内科研究人员改善培训、指导、支持性研究环境，以及最大限度地提高从培训环境向独立研究职业成功过渡的可能性，从而实现NINDS NIH路线图的愿景。加州大学旧金山分校(UCSF)神经病学、神经外科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延长研究追求，来解决人们对研究职业兴趣下降的问题。加州大学旧金山分校的神经病学系是临床神经科学研究教育项目的主要赞助商，具体内容如下，这也是本申请的重点。 公共卫生相关性：为常见神经系统疾病(阿尔茨海默病、帕金森病、癫痫和中风，以及许多其他疾病)开发新的治疗和预防方法，需要维护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，并能够架起这两个世界的桥梁。通过支持有前途的医生的早期研究经验，R25教育研究计划是使生物医学研究社区关注迫在眉睫的严重人力短缺的重要一步。加州大学旧金山分校的临床神经科学界致力于培养内科科学家，在这一领域取得了成功的记录，并取得了教师的研究成就，因此可以为这一计划的实施提供一个出色的环境。虽然神经科是这项申请的主要赞助商，但放射科和神经外科对这项申请的全力支持和参与(见所附威廉·狄龙博士和尼古拉斯·芭芭罗博士的支持信)。

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).