To the Editor: I applaud Zerhouni's call (Oct. 13 issue)1 fora new vision of translational research with the Clinical andTranslational Science Awards. However, a key impediment to translationalresearch remains unaddressed — namely, the limited incentivesfor basic scientists to collaborate with clinical investigators.Translational clinical research requires collaborations betweenclinician investigators with the requisite skills to designlongitudinal studies and deal with regulatory and human-protectioncomplexities and a range of scientists, such as molecular geneticists,electrophysiologists, and biomedical engineers. Unfortunately,the academic promotion process rewards individual accomplishments,particularly first or senior authorship and the principal investigatorposition. Generally, the academic career of a biomedical researchscientist who spends considerable time collaborating with ateam is short-lived. The approach in academia tacitly discouragesthe collaboration and team building needed for translationalclinical research. Ideally, the Clinical and Translational ScienceAwards program will encourage academic institutions to rethinktheir tenure process and modify their incentives to encouragemultidisciplinary translational research. Basic scientists area crucial part of the translational research process, and encouragingtheir collaboration must be a part of the new vision for thefuture.
Robert J. Fox, M.D. Cleveland Clinic Foundation Cleveland, OH 44195
References
Zerhouni EA. Translational and clinical science -- time for a new vision. N Engl J Med 2005;353:1621-1623. [Free Full Text]
Dr. Zerhouni replies: Dr. Fox is correct in describing the currentacademic promotion process as one that rewards principal investigators,thereby providing no incentives for basic scientists to collaboratewith clinical investigators. The National Institutes of Health(NIH) has recognized this issue and is providing a number ofincentives to address it. For example, the NIH is developinga new grant policy that formally recognizes more than one investigatoras principal on an extramural award. We believe that this willencourage the academic promotion process to reward meaningfulcollaborations. Our new initiative, the institutional Clinicaland Translational Science Awards, specifically calls for greaterinteractions among basic, clinical, and translational scientists.In addition, as part of the Roadmap effort to develop researchteams of the future, the NIH is funding 21 investigator-initiatedExploratory Centers for Interdisciplinary Research. These three-yearplanning grants will begin interdisciplinary research programsthat address complex health problems ranging from antimicrobialresistance to new directions in stroke rehabilitation. Theywill prepare investigators for submitting a subsequent applicationto become part of an Interdisciplinary Research Consortium.
Through these and other mechanisms, the NIH is fostering thecritical exchanges between basic and applied disciplines thatare increasingly important to progress in the life sciences.
Elias A. Zerhouni, M.D. National Institutes of Health Bethesda,MD 20892
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