Strengthening Research in Academic OB/GYN Departments (1992) / Chapter Skim
Currently Skimming:
1 INTRODUCTION
1 INTRODUCTION
Pages 35-50
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 35... ...
some special charactenstics of the discipline, and of the environment which it operates, Cat are thought to make it particularly difficult to addict talented individuals into research careers or to stimulate and sustain research. There is also a larger fear Cat important health problem, some of which could potentially be solved ~ au intensified ~ch effort, are not receiving the research attention they need and deserve.
|
From page 36... ...
Subsequent heavy health cam, education, "d other expenditures are incurs to care for the * fluent long term morbidity and disability sequelae of low-birthweight babies.
|
From page 37... ...
support OB/GYN receives from NDI might stem from the lack of an ~nsti~te devoted to OB/GYN research, as well as from Be ethical issues raised by some reproductive research. Finally, the plug comnnttee decided that an important research agenda in OBIGYN exists that is not receiving sufficient attention, and ~ academic departments of OB/GYN are the appropriate locus of Us research.
|
From page 38... ...
At He other extreme, He committee could confine its examination to research performed by physicians certified ~ the specials of OBIGYN and coded ~ Anemic documents of OB/GYN. The committee took a Addle position, based on the notion Cat departments of OB/GYN represent He pi locus of research Betided to improve women's reproductive heralds and ameliorate He impact of the many diseases and conditions ~t affect reproductive organs and that are related to different stages of a woman's reproductive life cycle.
|
From page 39... ...
~ making its recommendadons, the comn';tt" has tHed to take an approach that will help Moments of OB/GYN nourish a strong research en~r~ment for He figure, recogr~iang ~$ He development of He necessary infias~ucture and personnel requires a longs m commitment and cannot be rapidly achieved. Lets on the Scope of the Study Many factors impinge on the ability of a discipline such as OB/GYN to develop a research base, including private and federal a~gements for payment for heals care, structural issues ~ the provision ofLealth care, factors relating to the funding of medical schools and their constituent dots, and the content of undergraduate "d glad medical education.
|
From page 40... ...
With NIH policies and structure relating to women's issues in a stare of flux, recommendations for moor s~uc~al change would be ill-timed. And because of a lack of adequate evaluations of past and present programs for the training of investigators, the committee was unable to answer impotent questions on Is topic (such as how best to combine clinical skills and basic science Gaining to ensure the maintenance and currency of bow ads, or how to prepare investigators to take their place in a modern research environment)
|
From page 41... ...
Such concerns form an integral part of the background of the study and are discussed in the section below. General Concerns About Clinical ~0igabon Several commentators have expressed concern about diminishing interest and participation of physics In biomedical resmrch.~'8 Over a decade ago, one such report opened by saying, Clear evidence now at hod demonstrates that there has been and continues to be ~ marked decline in the number of medical students and postdoctoral physician trainees mteIltllpon pursuing caress in investigative Medicine.
|
From page 42... ...
Is For instance, a study found comparable award rates for clinical and basic science applications for msearch project gloats sublimed between 1980 and 1989.16 It is suggested that investigators ~ deform from submitting clinical research applications by Heir belief ~ funding is unlikely. Data illusion a growing discrepancy between He volume of research activity of M.D.
|
From page 43... ...
The success me for research project grants submitted to NIH by M.D.s and M.D.JPh.D.s was slightly higher An the success ~ for Ph.O.s ~ each year Requiting physician invcsiigators with clinical lesea=h and Pn.D. mvesugators with basic research caD be misleading.
|
From page 44... ...
44 S~i~G RESE~RC~l INA~lC OB/G^DEP~ between 1980 and 1989.- Although the success me for both groups declined over the decade, the decline for M.D.s and M.D.IPh.D.s was only 5 percent, compared m~ 6.7 percent for Ph.D.s.22 Other data, however, indigen a decreasing, or at best flat, inmost in research on behalf of physicians: · After nag from 11,929 In 1970 to 18,535 ~ 1983, the numb" of physician reporting research activity fell ~ 16,941 in 1989; this represents a decline in Me proportion of Me U.S. physician poplllmion who report thnt they me engaged in research of from 3.6 percent to 2.8 percent.~24 · Deppite possible flaws ~ data, a 1990 IOM committee concluded abet there has been no growth in me nllrnber of physicians par~cipadog in research in recent years.~s M=y factors are proposed as accouniing for tibe diminished interest of physician in conical inv~gation: · the length of bmining and uncertainties about how best to Win a successful clinical mvestigabor, Me level of debt win which physicians gradual from medical school; a perceived decrease in tibe finding of investigation of clinical problem; · perceived instability in funding, which makes a career ~ research seem an unce~iI~ undertikirlg; the lure of more highly Ad clinical praline; pressures on Polemic departments to prod clinical practice revenue; · the inability of academic depar~ts to Turbo clinical investigators; · multiple demands on Anemic health cuter resources, which make it difficult to obtain the hmds needed ~ protect the We of clinical ~nvestigamrs; Ad Morco~cr, although Pn.D.s acreage slightly better phony scores In M.D.s on co~npeting Id renewal Rots, Tic mc~ score diffcrcoces usually have been only 8 pots or less on scores Mat rage betwccn approximately 200 and 280 (National Dims of Scaly, 'DRG Peer Rcvicw Trends: Worlclosd and Actions of DRG Study Sections, 1979-1989,.
|
From page 45... ...
Threatened Its the loss of highly polished clinical skills and the prospect of isolation from We familiar clinical enact, these physicians are reluctant to enter laboratory research. Subs~cialty fellowship Paining ought to provide an opport3nibr for research, but unfornmamly the labor expe~imce ~ most fellowships Ids to be narrow, is molly focused on a single technique, and does not offer We broad-based lid of training in biomedical research that is necessary to encourage physicians to pursue a research career.
|
From page 46... ...
The academic depot must in effect invest in the young investigator to ensure sufficient protected time. In a surrey of young physician investigators, however, clinical and administrative activities were second only to lack of fielding as factors Cat interfere win the performance of research, and lack of insh~tional s~port was felt to be a grader problem ~n die distraction of Caching duties.3i The importance of this support in allowing the investigator Me to Thee is revealed by NIH grant data: in the 1980s, the success ~ for first-t~ applicants was relatively stable at just under 30 percent, but with Heated applications, 50 percent of applicants won aw~ds.32 A d~rtmeat char can thus expect that protecting He time of hero new investigators to allow them to submit ~ applications will bring in, on average, one award.
|
From page 47... ...
This load is believed deco be especially heavy In OB/GYN for several reasons: · the need to generate sufficient Ace income to cover He high salaries needed to attract to academia individuals whose earning potential ~ practice is large; the high uncom~nsa~ care load borne by obstetrics; and high malpractice premix. When the fig capacity of each faculty member is ~rtant, these factors hinder He ability of a department to develop young investigators and to s~port mature investigators between grants or dig fellow penods, when wn~g grant applications takes pnonty.
|
From page 48... ...
1h short, there ~ a feeling Hat it is particularly difficult to genes intent in a career in OBIGYN research and that individuals who desire such a cur confront ~ia1 problems. Few role models are available to stimulate mtemst in research; only a small number of the nation's academic departments of OB/GYN have the critical mass of researchers needed to engender a lively esmrch egos.
|
From page 49... ...
9. Association of Americ" Medical Colleges.
|
From page 50... ...
27. Association of American Medical Colleges.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.