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August 15, 2001

Clinical Investigators— The Endangered Species Revisited

Author Affiliations

Author Affiliation: Dean and CEO, Johns Hopkins Medicine, Baltimore, Md.

JAMA. 2001;286(7):845-846. doi:10.1001/jama.286.7.845

The premise that clinical research needs to be strengthened was placed squarely on the medical agenda more than 2 decades ago. In his landmark paper "The Clinical Investigator as an Endangered Species," Wyngaarden1 described a number of problems that he believed jeopardized the future of clinical research. These included declining interest in biomedical research and decreases in the number of postdoctoral training awards granted to young clinicians. The solution he proposed, implementing a series of steps to encourage young physicians to pursue biomedical research careers, has in many respects been adopted. For example, the National Institutes of Health (NIH) has developed a number of new grant mechanisms, such as the K23 and K24 awards, designed to encourage clinical investigators to compete for peer-reviewed funding. This measure and numerous others, implemented by funding agencies and by individual academic health centers, have succeeded in the sense that today clinical investigators are not extinct. To the contrary, by a number of objective measures, they are thriving. For example, at the Johns Hopkins University School of Medicine, the amount of support for sponsored projects that involve human subjects comprises more than half the total amount awarded. This is not surprising, given the greater number of clinical faculty compared with basic science faculty. However, the clinical research would not pass peer review if it was of lower quality than nonclinical research.

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