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ulty member to an established investigator with his or her own trainees can be more difficult for physician-scientists, who must balance the demands of seeing patients with those of conducting research. By providing up to five years of support to these junior investigators to protect their time and support their research, it was expected that they would be more likely to compete successfully for subsequent grants and to remain in clinical research.

THE CSDA PROGRAM

Between 1998 and 2001, five CSDA grant competitions were held that awarded grants to junior physician-scientists with an M.D. or M.D.-Ph.D. who either completed one or more years of a full-time clinical research fellowship or were faculty members at the assistant professor level or below for three years or less. Eligibility requirements included the need to be (1) a physician (M.D. or M.D.-Ph.D.) conducting translational clinical research; (2) working at and nominated by a U.S. institution; (3) devoting at least 75 percent of one’s time to clinical research; (4) mentored by a senior clinical investigator; and (5) at the point in their career path where they have not yet received a National Institutes of Health (NIH)–type R01 grant.

The nominee’s research proposals needed to have direct application to the prevention, diagnosis, or treatment of cardiovascular diseases, cancer, AIDS, or sickle cell anemia and other blood disorders. The proposed research could include (1) studies on the etiology and pathogenesis of these diseases in humans; (2) therapeutic interventions; (3) clinical trials; (4) disease control research that investigates how scientifically obtained information on prevention, early detection, and early diagnosis can be efficiently applied; (5) epidemiological studies; and (6) health outcomes research that attempts either to determine systematically the risks/benefits and costs of various medical practices or to utilize these results in defining more effective medical practice guidelines.

CSDA grantees were selected using a two-stage process. Institutions were invited to nominate several candidates in each disease area, and then nominees submitted research proposals and letters of recommendation, which were reviewed by an expert review panel.

Table 1 summarizes the number of applicants and grants awarded from 1998 to 2002. Junior-faculty-level grants were awarded during each of the five CSDA competitions. These grants provided $100,000 annually plus $8,000 per year in indirect costs. Faculty-level grantees were reviewed during the third year of their grants to determine if they would receive funding for years 4 and 5. CSDA grants also were made to support fellows in 2000, 2001, and 2002. Fellows received grants of $65,000 per year



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