tive studies for which they may not receive much authorship recognition. Michael Caliguiri, CEO of the James Cancer Hospital and Solove Research Institute, director of the Comprehensive Cancer Center, and professor of internal medical at the College of Medicine at Ohio State University, agreed. He noted that “the ability to convince department chairs and deans at academic institutions to be more tolerant of the extramural situation and clinical research and to recognize accomplishments that aren’t traditionally measured has been a challenge. We need to come together and set some new rules in these changing times about what we regard as worthy of promotion, because that’s ultimately what keeps many of our young investigators in the game.” Doroshow pointed out that since 2009, the NCI has been providing Clinical Investigator Team Leadership Awards to promote collaborative science and to recognize outstanding clinical investigators.

Adamson added that young investigators could also be encouraged by a more efficient system that results in faster decisions, saying that

the most disheartening thing for young investigators is to invest 1 or 2 years of their career developing a clinical protocol that doesn’t get approved. We need a system where we can fail early [rather than later]. If we don’t solve that, it’s going to be hard to sit across the table from any young investigator and tell them why they should be involved. It’s one thing to invest 4, 5, or 6 months of an academic career and have an idea die. It’s very different to do it for 2-plus years, and then have to go back to the drawing board. I don’t think NCTN has addressed this.

Tapping Community Practices

Worta McCaskill-Stevens, Chief of the Community Clinical Oncology Program and program director for the Minority-Based Community Clinical Oncology Program at the NCI’s Division of Cancer Prevention, expanded on what has been done recently to increase patient diversity and the involvement of community practices in NCTN clinical trials. She began by describing recent changes affecting research conducted by community practices. She noted that due to financial pressures, such practices are increasingly merging and being acquired by hospitals. Consequently, investigators are “having to negotiate and see affirmation of the role of clinical trials within those systems,” she said. Stephen Grubbs, principal investigator of the Delaware Community Clinical Oncology Program and managing partner at Medical Oncology Hematology Consultants, PA, said these mergers are a major problem in the current era of tight budgets because hospital administrators often are not willing to devote resources to cancer research.

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