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The Urgent Need to Increase Support for the NIH's MD–PhD Student Fellowships

Samarasinghe, Ranmal Aloka

doi: 10.1097/ACM.0b013e3182084542
Letters to the Editor

MD/PhD student, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;

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To the Editor:

A crucial aspect of the NIH's Medical Scientist Training Program (MSTP) is support of PhD research through competitive awards termed F30 fellowships. F30s, unlike other funding mechanisms, support MD/PhD candidates during both their graduate and medical training. Unfortunately, as of this writing, only 8 of the 20 NIH institutes support F30s, and the National Institutes of Neurological Disorders and Stroke (NINDS), a major source of F30 funding, recently decided to scrap F30 support. The adverse consequences of having fewer institutions supporting F30s is compounded by the decrease in real, inflation-adjusted, NIH dollars available to support this program.1

The sparse number of institutes that support F30s is disturbing for MSTP students in particular and the broader physician–scientist community in general. The purpose of training MD/PhD physician–scientists is to produce a cadre of scientists who are well equipped to bridge the gap between clinical care and basic science research. Limitations in F30 funding will deny some MD/PhD trainees the valuable learning experience of applying for a competitive scientific award. For example, a candidate with a clinical interest in neurology and a research interest in the molecular mechanisms underlying neuronal cell death, such as occurs during a stroke, will be unable to apply for an F30 now that the NINDS does not support this fellowship. In other instances, trainees will be forced to apply for monies awarded solely on the basis of basic science merits without consideration of their budding clinical skills or interests. Consequently, this funding atmosphere creates a separation between the clinical and scientific interests of the candidate and is therefore directly at odds with the goal of training true physician–scientists. In the longer term this may create the unfortunate situation where MD/PhDs are forced to choose between either making a total commitment to scientific research at the cost of clinical obligations to be competitive in grant seeking, or giving up entirely in their research pursuits and focusing on clinical work.

MD/PhD physician–scientists have made important, unique contributions to U.S. biomedical research.2,3 Due to its positive impact on MD/PhD trainees, a vibrant F30 system would be almost certain to help sustain the United States as the world leader in biomedical research and would reinforce the NIH's commitment to combined clinical and basic science training. The case for maintaining and enlarging the F30 program is therefore both strong and urgent.

Ranmal Aloka, Samarasinghe

MD/PhD student, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;

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1 NIH Office of Extramural Research. Trends in Research Training and Fellowships. Accessed October 25, 2010.
2 Brass LF, Akabas MH, Burnley LD, Engman DM, Wiley CA, Anderson OS. Are MD–PhD programs meeting their goals? An analysis of career choices made by graduates of 24 MD–PhD programs. Acad Med. 2010;85:692–701. Accessed October 25, 2010.
3 National Institute of General Medical Sciences. MSTP Study: The Careers and Professional Activities of Graduates of the NIGMS Medical Scientist Training Program. Accessed October 25, 2010.
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