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Solutions and Strategies from Medical and Nursing School Leadership for the Challenges Facing the Clinical Research Enterprise

Murillo, Horacio MD, PhD; Reece, E Albert MD, PhD, MBA

Academic Medicine:
doi: 10.1097/ACM.0b013e318065b4f9
Research Issues

Purpose: For decades, the U.S. clinical research enterprise and its workforce have faced diminishing numbers and significant challenges. This study, conducted by the Institute of Medicine’s Clinical Research Roundtable (CRR), sought to learn about the perceptions by medical and nursing school deans of these challenges or the efforts and strategies needed to address them.

Method: The authors mailed structured questionnaires about clinical research and workforce issues to medical and nursing school deans in the continental United States in the fall of 2003, and on October 16 and 17, 2003, the CRR held a two-day workshop with deans and their representatives to discuss the survey findings and to propose solutions.

Results: Survey participation was 55 (45%) for medical school deans and 37 (46%) for nursing school deans. Various efforts exist at individual schools for recruitment, training, and retention of clinical researchers. Most of the responding medical (53; 96.7%) and nursing (28; 75.4%) school deans reported that demand for clinical researchers exceeded or sharply exceeded supply, and about half of these institutions had a formal mentor program for their students. The percentage of graduates with methodological training in clinical research varied widely, with a mode of 10% and 100% for medical and nursing schools, respectively. Most medical school deans (47; 85.5%) rated their basic research enterprises good to excellent, whereas only a third (19; 34.6%) rated their clinical research programs similarly. Likewise, nursing school deans rated their basic research programs more favorably (23; 62.2%) than they rated their clinical research enterprises (17; 46.0%). However, prioritization of changes needed to address the challenges facing clinical research and its workforce were similar for medical and nursing school deans.

Conclusions: Clinical research is underdeveloped and underrepresented within the clinical research enterprise. There is a need to develop and execute uniform strategies to grow and expand the clinical research workforce. Workshop participants, including 14 deans or their representatives as panelists and CRR members, proposed solutions and strategies.

Author Information

Dr. Murillo is resident physician, Department of Radiology, University of Texas Health Science Center San Antonio, San Antonio, Texas.

Dr. Reece is vice president for medical affairs, University of Maryland, and dean, University of Maryland School of Medicine, Baltimore, Maryland.

Correspondence should be addressed to Dr. Reece, Vice President for Medical Affairs, University of Maryland School of Medicine, 655 W. Baltimore Street, Room 14-029, Baltimore, MD 21201; telephone: (410) 706-7410; fax: (410) 706-0235; e-mail: (

© 2007 Association of American Medical Colleges