The crisis in medical research. And how to fix it.

Recent US government budgets have harmed the National Institutes of Health. But the problems in the medical research system are deeper than just the current budget. If you care about medical research, read this article in the Proceedings of the National Academy of Sciences by Bruce Alberts, Marc Kirschner, Shirley Tilghman, and Harold Varmus.

Alberts and his colleagues describe a hypercompetitive culture in science that undermines the process of discovery.

Competition… has always been a part of the scientific enterprise, and it can have positive effects. However, hypercompetition for the resources and positions that are required to conduct science suppresses the creativity, cooperation, risk-taking, and original thinking required to make fundamental discoveries… biomedical scientists are spending far too much of their time writing and revising grant applications and far too little thinking about science and conducting experiments.

You probably expect that the next sentence will be, “So give us more money.” But that’s not where they go.

We believe that the root cause of the wide-spread malaise is a longstanding assumption that the biomedical research system in the United States will expand indefinitely at a substantial rate. We are now faced with the stark realization that this is not the case.

Assuming that science will expand forever, senior scientists have trained far more junior scientists than the system can support, leading to hypercompetition.

The mismatch between supply and demand can be partly laid at the feet of the discipline’s Malthusian traditions. The great majority of biomedical research is conducted by aspiring trainees: by graduate students and postdoctoral fellows. As a result, most successful biomedical scientists train far more scientists than [there are] relevant positions in academia, government, and the private sector.

The overproduction of new scientists is driven by “perverse incentives”:

Salaries paid by grants are subject to indirect cost reimbursement, creating a strong incentive for universities to enlarge their faculties by seeking as much faculty salary support as possible on government grants. This has led to an enormous growth in “soft money” positions, with stagnation in the ranks of faculty who have institutional support. The government is also indirectly paying for the new buildings to house these scientists by allowing debt service on new construction to be included in its calculations of indirect cost recovery.

Alberts et al. have detailed suggestions for reform. They write

(i) to advocate for predictable budgets for US funding agencies and for an altered composition of the research workforce, both with the aim of making the research environment sustainable; (ii) to rebalance the research portfolio by recognizing the inertia that favors large projects and by improving the peer review system so that more imaginative, long-term proposals are being funded and scientific careers can have a more stable course; and (iii) to encourage changes in governmental policies that now have the unintended consequence of promoting excessive, unsustainable growth of the US biomedical research enterprise.

I cannot overstate how distinguished these authors are, both as researchers and institutional leaders in science. Alberts made discoveries in how chromosomes replicate during cell division, is the former editor of Science, and former President of the National Academy of Sciences. Kirschner made discoveries in developmental biology and is a University Professor at Harvard, where he served as chair of the departments of systems biology and developmental biology. Tilghman made discoveries in gene regulation and is the former President of Princeton. Varmus won the Nobel Prize for discovering retroviral oncogenes. He is the former director of the NIH, former President of the Memorial Sloan-Kettering Cancer Center, and the current director of the National Cancer Institute.

Get it? It’s as if the Pope and three leading cardinals held a press conference predicting the collapse of the Catholic church. These people know what they are talking about and we need to listen.


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