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PubMed2002

Science at a crossroads.

Science is entering an alliance with the economy that will speed the effect of innovation through society. Despite the slowdown of the 'new economy', a cascade paradigm of innovation appears key to increasing the rate of economic growth. Yet for science to continue to thrive and make this contribution to innovation, it must traverse at least three key crossroads. First, while life sciences have built a strong advocacy model to secure growing federal research funding, the physical sciences (including mathematics and engineering) have not and must now do so to thrive. Second, the drop in the numbers of physical scientists and engineers must be reversed if we are to have the talent to maintain a strong trend of scientific advance. Third, although science advances are increasingly interdisciplinary and occurring in the space between the historic science stovepipes, the organization of federal science support is largely unchanged since the beginning of the cold war. While a decentralized model has value, we must also consider new approaches that encourage deeper cooperation across science sectors and agencies.

Biological Science Disciplines↗
PubMed2007

NASA--has its biological groundwork for a trip to Mars improved?

In a 1991 editorial in The FASEB Journal, Robert W. Krauss commented on a recent report of the Presidential Advisory Committee on the Future of the U.S. Space Program (Augustine report). He concluded that, although a manned mission to Mars with life sciences as the priority was endorsed by the Committee, it failed to deal realistically with one huge gap; biological sciences have never been given high priority. According to Krauss, this left a void that will cripple, perhaps fatally, any early effort to ensure long-term survival on any mission of extended duration. The gap included insufficient flight time for fundamental biological space research and insufficient funds. Krauss expressed his opinions 15 years ago. Have we better knowledge of space biology now? This question becomes more acute now that President George W. Bush recently proposed a manned return to the moon by 2015 or 2020, with the moon to become our staging post for manned missions to Mars. Will we be ready so soon? A review of the progress in the last 15 years suggests that we will not. Because of the Columbia disaster, flight opportunities for biological sciences in shuttle spacelabs and in Space Station laboratories compete with time for engineering problems and construction. Thus, research on gravity, radiation, and isolation loses out to problems deemed to be of higher priority. Radiation in deep space and graded gravity in space with on board centrifuges are areas that must be studied before we undertake prolonged space voyages. Very recent budgetary changes within National Aeronautics and Space Administration threaten to greatly reduce the fundamental space biology funds. Are we ready for a trip to Mars? Like Krauss 15 years ago, I think not for some time.

Biological Science Disciplines↗
PubMed1992

Technology assessment in medicine.

The author defines the concepts medical technology and technology assessment and presents a paradigm for the evaluation of medical technologies. He proposes a hierarchical assessment scheme in which level I, biologic plausibility, compares the technology's proposed mode of action with current biologic information and theory. Level II, technical feasibility, determines whether the technology can be delivered to the target population. Level III, intermediate outcomes, assesses whether the technology has a short-term impact on the biologic or physiologic process that is diseased. Level IV, patient outcomes, investigates the overall medical, psychologic, and financial impacts of the technology upon the patient, including unintended side effects and long-term morbidity and mortality. Level V, societal outcomes, measures the cost of the technology to society in terms of resource use, ethical issues, and social and political hazards. As an example, the author employs this scheme to analyze the use of screening tests for hypercholesterolemia.

Biological Science Disciplines↗
PubMed1992

The role of natural science in the premedical curriculum.

The authors examined the role of natural sciences in entering students' academic preparation for admission to the University of California, Los Angeles (UCLA), School of Medicine by analyzing the college transcripts of 290 students in the classes of 1990 and 1995 to determine the breadth of the students' college course work. In addition, during 1990 the authors surveyed 126 full-time basic science and clinical faculty about their views regarding the optimal requirements for admission. The vast majority of the students' college courses had been in the natural sciences, with no significant change in this finding over the five-year period. Of the faculty surveyed, 97 (77%) responded, stating that the majority of prerequisites should be in the natural sciences; their prerequisites were similar to UCLA's 1991-92 admission requirements. The authors suggest that the persistently narrow focus on the natural sciences as a preparation for medical school may explain the nationwide need to instruct medical students in the humanities, and that perhaps it is time to require non-science courses to broaden the educational backgrounds of entering students.

Adolescent↗
PubMed1993

Creating a course on ethics in the biological sciences.

The authors examine the social and scientific context within which a course on the ethical dimensions of the biological sciences was created in the mid-1980s to instruct students at The University of Texas-Houston Health Science Center's Graduate School of Biomedical Sciences. They discuss how the basic purposes of such a course--to help students resolve ethical issues encountered in the scientific work, examine the values underlying science, and explore its relation and obligations to society--may be accomplished, and describe the salience to scientific work of two ethical values significant for science, truthfulness and benefit to others, to demonstrate the application of ethics to science. The present version of the course is described. Particular issues arising in the construction of a course on ethics and science are described, such as gaining faculty support, selecting instructors, constructing a syllabus of topics, using cases in instruction, creating examinations dealing with students from other cultures who may have difficulty with applying and using American values, and evaluating the educational effort.

Biological Science Disciplines↗
PubMed1996

Preventing academic medical center from becoming an oxymoron.

Many academic medical institutions are facing serious threats to their survival today as changes in the organization and financing of health care delivery and reductions in federal support create damaging pressures. In order for Americans to continue to have the best health care in the world, academic medicine and its crucial contributions of medical education, training, and research must receive adequate support. The author maintains that it is up to the Association of American Medical Colleges and associated organizations to ensure that this message is heard and recognized and to seek an all-payer approach that would support the costs associated with medical education and training and would allow teaching hospitals to compete on a level playing field with non-teaching hospitals. Academic medical institutions must face painful transformations while maintaining their academic missions; the author discusses the nature of these transformations and missions, particularly research, and outlines useful strategies to maintain these missions, such as establishing a centralized approach to curriculum and having clinical and basic science faculty form alliances to address common research problems and secure more research funding. He concludes that many of the structural and other changes that academic medicine's institutions must make may result in true improvements and help maintain the validity of the term academic medical center in the future.

Academic Medical Centers↗
PubMed1996

On the crisis in biomedical education: is there an overproduction of biomedical PhDs?

The United States is the world leader in biomedical science (BMS) education and research. This preeminence is reflected in superior medical education, the attraction of U.S. educational institutions to foreign visitors seeking advanced training, and a high rate of transfer of knowledge between basic biomedical research and the delivery of health care at the bedside. The foundation for this excellence and leadership has been the research carried out by MD and PhD biomedical scientists. It has been suggested that there is now an oversupply of BMS PhDs, and thus that BMS PhD programs should be downsized. Full examination of the issues involved, including a case study of doctoral graduates and postdoctoral fellows at Tulane Medical Center, leads the authors to conclude that a biomedical PhD "glut" does not exist at the present time, that downsizing training programs would have a serious, long-term negative impact on biomedical research, and that medical school administrators and faculty should resist attempts to reduce biomedical research and training at the local and national level. However, times have changed and training programs must evolve to adapt to the technologic changes occurring in the workplace. Alternatives, such as new alliances with industry, must be sought to compensate for decreased resources at federal and institutional levels; new and innovative curricula must be developed to prepare biomedical scientists for nonacademic, as well as academic, job opportunities in the twenty-first century; and medical center administrators and faculties must work together to increase the visibility of BMS and stress its critical relationship to the research base of the nation.

Academic Medical Centers↗
PubMed1996

Ethics issues in academic-industry relationships in the life sciences: the continuing debate.

The author reviews in detail the status of academic-industry relationships (AIRs) in the life sciences from both ethical and empirical perspectives, and identifies ethical issues that have been resolved and those that must still be debated. He summarizes by stating that ethical reasoning militates against the involvement of scientists and universities in those AIRs in which a financial conflict of interest on the part of life science investigators may affect the welfare of human subjects and trainees. Even in other types of AIRs, conflicts of interest have effects on professional decision making that could damage the integrity and productivity of life sciences research, especially scientists' withholding of data and their redirecting of research in more commercial directions. These effects could also help undermine public trust in and support of university researchers. Balanced against these worrisome effects are the benefits of AIRs in increasing some investigators' creativity and productivity, in encouraging technology transfer, and thus in promoting economic growth and public health. He concludes that more research is needed on the harms and benefits of AIRs, especially the development of better data on the effects of withholding data, and also on the economic and health benefits of AIRs and public attitudes toward issues of scientific research that involve possible conflicts of interest. More information on these questions would allow policymakers to make more realistic estimates of the gains and losses associated with AIRs. In the meantime, current information suggests that in general the conflicts of interest created by AIRs are real, consequential, but tolerable if managed carefully. Until more is known about the effects of AIRs, it is prudent for universities and faculty to participate at modest levels in such relationships and to monitor them carefully. This article is one of three in this issue of Academic Medicine that deal with issues of conflict of interest in university-industry research relationships. These articles are discussed in an overview that precedes them.

Biological Science Disciplines↗