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Translational and Clinical Science
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     To the Editor: I applaud Zerhouni's call (Oct. 13 issue)1 for a new vision of translational research with the Clinical and Translational Science Awards. However, a key impediment to translational research remains unaddressed — namely, the limited incentives for basic scientists to collaborate with clinical investigators. Translational clinical research requires collaborations between clinician investigators with the requisite skills to design longitudinal studies and deal with regulatory and human-protection complexities 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 investigator position. Generally, the academic career of a biomedical research scientist who spends considerable time collaborating with a team is short-lived. The approach in academia tacitly discourages the collaboration and team building needed for translational clinical research. Ideally, the Clinical and Translational Science Awards program will encourage academic institutions to rethink their tenure process and modify their incentives to encourage multidisciplinary translational research. Basic scientists are a crucial part of the translational research process, and encouraging their collaboration must be a part of the new vision for the future.

    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.

    Dr. Zerhouni replies: Dr. Fox is correct in describing the current academic promotion process as one that rewards principal investigators, thereby providing no incentives for basic scientists to collaborate with clinical investigators. The National Institutes of Health (NIH) has recognized this issue and is providing a number of incentives to address it. For example, the NIH is developing a new grant policy that formally recognizes more than one investigator as principal on an extramural award. We believe that this will encourage the academic promotion process to reward meaningful collaborations. Our new initiative, the institutional Clinical and Translational Science Awards, specifically calls for greater interactions among basic, clinical, and translational scientists. In addition, as part of the Roadmap effort to develop research teams of the future, the NIH is funding 21 investigator-initiated Exploratory Centers for Interdisciplinary Research. These three-year planning grants will begin interdisciplinary research programs that address complex health problems ranging from antimicrobial resistance to new directions in stroke rehabilitation. They will prepare investigators for submitting a subsequent application to become part of an Interdisciplinary Research Consortium.

    Through these and other mechanisms, the NIH is fostering the critical exchanges between basic and applied disciplines that are increasingly important to progress in the life sciences.

    Elias A. Zerhouni, M.D.

    National Institutes of Health

    Bethesda, MD 20892