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Group on Graduate Research, Education, and Training
Annual Conference -- September 25-28, 1997
Group Consensus Discussions
An important element of the 1997 GREAT Group Conference was the
opportunity to discuss in small breakout groups the themes that
emerged from the plenary sessions. Through these focused and interactive
discussions, members were able to develop points of consensus
and recommendations for consideration by the entire GREAT membership.
The major conclusions of these sessions are presented below:
Plenary Session I - The Future Environment for Biomedical Research,
Education, and Training
Topic 1: What three new skills and/or aptitudes will be most important
for tomorrow's students to function effectively in the academic
biomedical research sector 20 years from now?
(Moderators: Zach Hall, Ph.D. and David Meyer, Ph.D.)
Acknowledging the complexity of this question, participants suggested
that attitudes as well as aptitudes are relevant. Given that finding,
the group distinguished between necessary training and useful
skills. Three important areas of training were determined to be:
- Goal-directed research: to recognize commercially-viable projects
and results for potential partnerships;
- Integrative and systems biology: to see the broader relevance
and applicability of findings; and
- Relevant ethical issues.
Participants then identified four skills to cultivate and encourage:
- Flexibility: to remain uncommitted and open-minded, yet able
to become the world's expert in a given area;
- Independence of thought: the ability to filter and to focus
as necessary and the ability to devise appropriate strategies
and to be "technologically fearless:"
- Collaboration: to pursue opportunities and resources; and
- Communication: oral (essential for teaching) and written (important
for the acquisition of resources).
Topic 2: What three new skills and/or aptitudes will be most important
for tomorrow's students to function effectively in the industrial
biomedical research sector 20 years from now?
(Moderators: Charles McOsker, Ph.D. and Robert O. Kelly, Ph.D.)
This group identified three salient skills of similar priority:
- Leadership: to be a visionary champion for project direction,
management, and implementation.
- Problem solving: to have flexible abilities to acquire and
to adapt new technologies to new, significant biomedical problems.
- Communication: independent thinking with an ability to communicate
in writing and orally to achieve team success in problem solving.
Topic 3: What three major changes will be necessary in university
and medical school structure to accommodate the biomedical research
environment that our pre- and postdoctoral students will face in
20 years?
(Moderators: Michael Crow, Ph.D., and William R. Brinkley, Ph.D.)
Participants identified the following:
- Developing local institutional mechanisms to increase public
knowledge and awareness of the contributions of science to
society: In addition to measuring and publicizing scientific
outcomes, this would include educating students and postdocs
to involve themselves effectively in primary and secondary
educational issues and in guiding local and national science
policy.
- Restructuring/rethinking strategic investment and the funding
of academic biomedical research, including financing for the
training of students and postdocs: The system must provide
long-term stability rather than an immediate, bottom-line
approach and be capable of funding individuals and groups
in a flexible and adaptable way.
- Developing ways to supplement and enhance doctoral and postdoctoral
training at an institutional level: Critical thinking and
learning skills are essential but programs should promote
and assist career choices and continue to develop faculty
mentoring.
- Developing a biological information network to provide access
to new, expensive technology, technology transfer, and core
facilities.
Plenary Session II - Educating for Translational Biomedical Research
Topic 4: Where in the educational sequence should the training
for clinical investigation be accomplished?
(Moderators: John Gallin, M.D. and James E. K. Kildreth, M.D.)
This discussion group believed the answer to the questions to
be related to (1) the supply of clinical investigators and (2)
notions of competency. Another point of discussion related to
the distinction between education and training. The group reached
consensus on the following points:
- All medical students should be exposed to education in clinical
research.
- Courses in biostatistics, epidemiology, and ethics should
be combined to meet this need in a problems-based approach.
- Training should be a continuum during medical school and
occur in more than just summer programs, elective courses,
and advanced degrees.
The group closed by recommending that the AAMC maintain a database
of training opportunities in clinical investigation (including
electives and summer programs) that would be available to students
and fellows.
Topic 5: What should be the role of industry, government, managed
care organizations, and academic institutions in supporting the
education of clinical investigators?
(Moderators: N. Franklin Adkinson, Jr., M.D. and Terry A. Krulwich,
Ph.D.)
As a preamble, this group discussed the need for training clinical
investigators at multiple levels. One model is the type of clinical
investigator developed in the Johns Hopkins program, who identifies
a research idea, develops an investigative approach and assembles
a research team to solve a novel problem in an interpretative,
creative way. In some settings, such programs could include Ph.D.s
and advanced medical/Ph.D. students. Also needed are individuals
trained in clinical investigation at levels sufficient to collect
data for clinical trials, to coordinate trials, and to manage
data.
Managed care organizations were considered very unlikely to support
training of clinical investigators except, perhaps, if a stream
of funds were to arise through the public's willingness to pay
a fee on their managed care premiums for participation and access
to clinical trials. Industry might offer (1) some possible tuition
capture and support via the participation of industry scientists
in the programs, and (2) possible programmatic experiences (e.g.,
short internship) in industrial settings; some have been tried
but are underutilized. Academia may support clinical investigators
after some prioritization of funds, but there is nonetheless pessimism
in some sectors about the ability of academic institutions to
the primary souce of support. Government represents the best hope
for support of clinical research training. Some vehicles include
the GCRC mechanism and institutional training awards.
Topic 6: What are minimum criteria for research competency? What
are the best routes to promote these? Should there be standards
and consistency in dual degree programs?
(Moderators: Thomas O. Fox, Ph.D. and Brenda Russell, Ph.D.)
The group concluded that the minimum criteria for research competency
ought to be:
- Being able to define and solve a problem;
- Engaging in a rigorous scholarly experience;
- Having the ability to be flexible; and
- Being time and cost effective.
As for the best routes to promote these attributes in clinical
investigations, the group concluded that many routes work and
all should be kept. The M.D./Ph.D. is one of these routes and
does produce leaders in academic medicine. However, this is not
necessarily the same goal as the ability to do clinical research.
Clinical research can also be achieved by:
- Ph.D. alone;
- M.D. alone;
- M.D./M.S.; and
- Being time and cost effective.
The consensus was that all these other paths reduce time and
cost below that of the M.D./Ph.D. dual degree. The group noted
that women comprise less than 25 percent of the M.D./Ph.D. cohort
and that the alternate, shorter routes above may be more attractive
to them. The group also encouraged M.D.s to have research experience
as post doctoral fellows and encouraged Ph.D.s to obtain clinical
experience. Finally, physician scientists may tend to give up
the research aspects of the careers, the group observed, because
of financial debt. Loan forgiveness for M.D.-postdocs should be
considered to be comparable to the tuition forgiveness of M.D./Ph.D.
programs. A last question was whether there should be standards
and consistency in dual degree programs. Programs will vary from
one school to another, participants agreed, but the Ph.D. component
should not be debased. M.D./M.S. degrees, or M.D./postdocs should
be available to those who do not complete the whole Ph.D.
Plenary Session III - Support and Oversight of Postdoctoral Students:
Who, How Many, and Whose Responsibility?
Topic 7: Why is postdoc training lengthening? What should be done
about it?
(Moderators: James A. Voytuk, Ph.D. and Terrance G. Cooper, Ph.D.)
The group identified many reasons for the lengthening of postdoc
training:
- Market saturation;
- Increased time to acquire scientific and non-scientific
skills;
- Market not being "fair" in an econometric sense;
- Decreasing quality;
- Need for researchers in the principal investigator's lab;
- The label "postdoc" is being used to describe
other jobs;
- Mobility issues; and
- An increasingly competitive job market.
To deal with this phenomena, participants suggested:
- Adding teaching assistants to teaching positions;
- Developing Masters degree programs;
- Increasing information on job market for undergraduates;
and
- Providing postdocs with better job information.
Topic 8: What are the three most important aspects that serve
to integrate postdocs into university family?
(Moderators: Barbara Foster, Ph.D. and George A. Hedge, Ph.D.)
Participants identified:
- Administrative representation (establishing postdoc associations,
developing a postdoc "Bill of Rights and Responsibilities,"
and defining better the training objective);
- Providing benefits; and
- Relevant ethical issues.
Topic 9: What universal definition might be applied to distinguish
a postdoctoral fellow as a student from a postdoctoral fellow as
an employee?
(Moderators: Levi Watkins, Jr., M.D., John P. Perkins, Ph.D.,
and Alan M. Kaplan, Ph.D.)
A postdoctoral fellow is a time-limited position (3-5 years):
- that has "substantial" benefits,
- is found in a structured, organized, and educational program
including career development and perhaps a certificate at
completion, and
- leads to a permanent career postion.
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