The Changing Spectrum of Biomedical and Clinical Research

Robert Clarke, Elliott Crooke, Howard J. Federoff

Research output: Chapter in Book/Report/Conference proceedingChapter


The landscape of extramural funding for biomedical and clinical research has been undergoing substantial change over the last five years. Among the drivers of change is diminished NIH funding, fewer training opportunities, reduced interest among physicians to pursue research careers and an aging faculty of US academic health centers (AHCs). Further, changes in the economics of health care delivery will likely narrow margin generation among the academic clinical enterprise thereby reducing the potential to subsidize the biomedical and clinical research missions. Newer models to enhance research competitiveness are needed, that in part, require efforts to reengineer the practices of AHCs to successfully achieve a vibrant faculty, a more efficient operating research model, and a governance with sufficient flexibility to adapt in a highly dynamic competitive context.

Original languageEnglish (US)
Title of host publicationThe Transformation of Academic Health Centers
Subtitle of host publicationMeeting the Challenges of Healthcare's Changing Landscape
PublisherElsevier Inc.
Number of pages12
ISBN (Electronic)9780128010044
ISBN (Print)9780128007624
StatePublished - Apr 7 2015
Externally publishedYes

Bibliographical note

Funding Information:
Physician-scientists typically pose clinically relevant questions in research settings and often utilize scientific inquiry in patient care. Accordingly, they are key contributors to the biomedical research workforce. In the past 10 years, NIH grants to investigators with an MD degree—compared to those scientists with a PhD degree—were more likely to involve research with human subjects [24] . A recent analysis [10] of physician-scientists indicates that the numbers of physicians have nearly doubled since 1980, accompanied by a greater than 50% reduction (from 3.6% to 1.6%) reporting research as their primary activity (from 1982 to 2011). The data reveal declining number of medical students who express strong interest in research. This is paralleled by declining numbers of medical doctors supported by NIH T32 and F32 awards during their training. In addition, the trend for clinical doctorate holders for K08 and K23 awards has also declined, particularly after the period of NIH doubling (1998–2003).

Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.


  • Clinical research
  • Scientist training
  • Translational research


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