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A new report from a panel of distinguished outside experts cites the joint NIH-Howard Hughes Medical
Institute research training program for medical students as a program worth copying.
In a preliminary draft of the report which will be released in November, the NIH Director's Panel on
Clinical Research, a 14-member committee charged with finding ways to revitalize U.S. clinical research,
singles out the joint venture between the Howard Hughes Medical Institute (HHMI) and NIH as a paradigm for
recruiting talented M.D.s into clinical research.
In the 11 years since its inception, the HHMI-NIH Research Scholars Program has brought 400 medical
students from 89 U.S. medical schools to the Bethesda campus for a year of intensive basic research
experience that adds a year to their regular medical training. According to the panel's report, 40 percent
of participants in the first two years of the program now have full-time academic appointments. Over the
past decade, HHMI research scholars have also published more than 250 research papers based on their work at
Currently, HHMI-NIH scholars are recruited from the ranks of U.S. medical schools and work mainly in
basic research labs at NIH. The draft report recommends that a similar research program be established at
NIH's Clinical Research Center (CRC). Under that recommendation, as many as 30 medical students would
select a preceptor who is a clinical researcher and would also participate in the CRC's formal training
courses, called the core curriculum. "Total cost is estimated to be less than $1 million per year and [the
CRC program] would serve as a model for other centers," the panel states.
Assistant Director for Intramural Affairs, Richard Wyatt, NIH's liaison for the HHMI-NIH Research
Scholars Program, says that he is excited that the panel of outside advisors developed the idea of a
clinically oriented scholars program. Wyatt adds that such a program "should also provide an opportunity for
partnership in clinical research training with other private outside organizations, modeled after the
valuable relationship between NIH and HHMI."
Other aspects of NIH's physician-researcher training program that particularly impressed the outside
reviewers were the CRC's new core curriculum and NIH's loan repayment programs which pay off educational and
medical school loans for clinical researchers from disadvantaged backgrounds and for researchers whose
projects focus on acquired immune deficiency syndrome (AIDS).
Jean Wilson, professor of internal medicine at the University of Texas Southwestern Medical Center in
Dallas and chair of the panel's training subcommittee, says the Clinical Center's core curriculum is a
sterling example for other institutions to follow. "There is widespread sentiment that there needs to be
more rigorous training for clinical investigators," Wilson says. "That should help to ensure the same
quality of research in clinical investigation as in other types of biomedical research."
However, Wilson emphasizes that training is just half of the problem confronting clinical research today.
The other half is recruiting top-quality candidates into the training programs. Unlike Ph.D.s and
M.D.-Ph.D.s, most of whom graduate without a heavy debt burden, M.D.s are typically saddled with significant
debt when they graduate. Financial constraints prevent many from even considering a research career, Wilson
says. The subcommittee chair says he hopes that the loan-repayment programs now available to intramural NIH
re-searchers-which pay up to $20,000 a year of a researchers' educational debt-can be expanded to improve
M.D. recruitment at extramural research institutions.
Other recommendations included in the panel's draft are
Next, the panel will focus on other topics, including the current state of U.S. clinical trials, the role
of the NIH Clinical Research Center in shaping the overall research landscape, and the impact of managed
care on clinical research.