Careers in translational clinical research-historical perspectives, future challenges.

ARECENT SURVEY REVEALS THAT ONLY ABOUT 11% OF medical school graduates plan careers that are exclusively or significantly devoted to research. This small but vital group of nearly 1600 graduates each year holds the future of medicine in its hands. Some are badly needed to replenish the ranks of patient-oriented translational clinical researchers, who apply findings derived in basic science to the development of new understanding of disease mechanisms, diagnostics, and therapeutics. Herein I propose several improved approaches to the recruitment and retention of patient-oriented translational clinical researchers. The task is not simple because ample evidence indicates that the professional career pathways of all classes of clinical researchers have been uncertain and seriously troubled. In fact, clinical researchers are considered such an “endangered species” that many leaders of training programs across the United States have expressed serious doubts about whether such careers will be viable in the future. Before proposing a new approach to career development for patient-oriented translational clinical investigators, it is important to review the short history of the field and recent efforts to improve the morale of its researchers. Important policy improvements have been made in recent years, and the total impact of these changes is not yet fully apparent. But I believe that more fundamental changes must be made now to encourage this important group of medical scientists to continue their efforts to learn biology from patients and to apply basic medical science for their benefit.