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.
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.