Improving the US Biomedical Research Environment

While neither the only nor the first to offer similar advice, the recent paper by Alberts, et al., in Proceedings of the National Academy of Sciences, Rescuing US biomedical research from its systemic flaws, is the most recent and one of the most significant calls for reform.

The authors identify a crisis in the US biomedical research ecosystem that ultimately is the result of an unrealistic assumption of continuous growth. While the authors are quick to point out the importance of continued, stable and predictable funding for the NIH, they recognize that the assumption of constant expansion is neither being borne out by recent events nor realistic. Further, they tag that as the central factor driving imbalances that exist today in the discipline and its workforce that threaten the future of biomedical research in the US.

The current hyper-competition for grant support results, according to the authors, from a combination of the increasing number of people being trained as biomedical researchers and the flattening or reducing  federal support for research.

The authors’ recommendations will not be an easy pill to swallow, as they ultimately encourage rightsizing of the biomedical workforce and rethinking the way in which federally funded research activity is supported in the US. Through limiting support for graduate students to training grants and fellowships and disallowing their funding on research grants, the authors suggest that agencies will have better control over the number of trainees and the quality of their training – ultimately reducing the number of trainees in the pipeline. They expect (and hope) this will also increase reliance on staff scientists, in concert with additional practical limits on post doctoral training experiences. These adjustments will, over time, reduce the number of faculty researchers and provide support for them to reduce the administrative burden associated with research. The authors also encourage moving toward an funding model that is more focused on supporting great scientists than on incremental advances and publication volume.

The authors further identify the current approach to indirect cost reimbursement in the US as having encouraged universities and medical centers to expand their facilities and staff in ways that are unsustainable. They propose changes including reducing reimbursement for facility depreciation costs, reducing or eliminating indirect costs on faculty salaries, and limiting the reimbursable effort for faculty on research grants to less than 100%.

The authors’ point ultimately is that the biomedical research enterprise in the US cannot expand forever. There are limits – whatever those are. They suggest that the time is now to begin to rethink some of the fundamental principles that have supported the growth and development US biomedical research to ensure its future vitality.

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