1. Publicize fiscal models that support retention of staff, comparing the cost of attrition with that of training new staff. Specific programs include debt forgiveness, staff reentry programs, and flexible arrangements.

  2. Present these issues as cutting across disciplines to funding agencies and Congress.

HERBERT PARDES, M.D. (NEW YORK-PRESBYTERIAN HOSPITAL) LEADER, BREAKOUT SESSION 4

This group identified five areas that require emphasis.

  1. Ways in which women can more successfully balance their personal lives (including elder care and child care) and professional development.

  2. The criteria for promotion and tenure in universities. Organize a consensus conference on such criteria?

  3. Mentoring, from defining it to finding incentives for its adoption. Mentors must feel valued, and so links should be established with the criteria for promotion and tenure. The following concerns were raised about mentoring:

  • Within research institutions, it is better that mentoring relationships be established between the mentee and more than one senior person (mentor)—for example, a mentee might have both a personal and a scientific mentor.

  • Mentoring raised concerns because established clinical researchers seem to live more fragile lives than some of the basic scientists; placing young people in mentoring relationships with those whose own lives are precarious may present problems. In a related area, basic scientists may find it easier to extricate themselves from the mentor’s lab and establish their own independence than clinical researchers, who are so highly entangled in clinical investigations and collaboration.

  1. What is special and different about the clinical research environment.

  • Young men and women from a medical training environment have far less in the way of basic training in research methodology, statistics, and many other areas that allow a researcher to succeed. As a result, more programs based on the curriculum programs run by the NIH are needed, and stipends should be attached.

  • As for the role of the NIH, its debt forgiveness programs and financial support for mentors are laudable. It is also paying greater attention to the review of clinical research to ensure that clinical research gets a fair shot in its reviews rather than being overseen by a review panel made up of 11 basic scientists and a token clinical researcher. But the NIH should be in continuing contact with its consumers, its grantees, to see how it can better foster careers, and it should



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