Campaign to revitalise academic medicine
http://www.100md.com
《英国医生杂志》
EDITOR—The campaign to revitalise academic medicine may well demand radical thinking.1 Many expect or hope for a continuation of the long term expansion of medical research funding, but consider the fate of physics.
Physics was once the richest, most self confident, and most prestigious science. The first half of the 20th century was a golden age for its science, the time after the second world war a golden age for funding. Achievements did not match the hype, and support for physics has collapsed, fundamental physics research now being pursued in only a few universities in the United Kingdom.
Similarly, the middle of the 20th century was the golden age for clinical breakthroughs and biological science, which was followed by massive expansion in research funding. But the rate of major clinical advances has not lived up to the spin.2 The Human Genome Project was the costliest biological venture in history but the promised major clinical benefits now recede ever further into the future. A continual enhancement in the internal "performance indicators" of medical science, such as grant income and refereed publications, has not been matched by the kind of outputs that are valued by people external to the system. Effective new treatments for serious diseases are progressively drying up,3 perhaps because of fundamental flaws in the "basic to applied" model that is the focus of funding.4
A cull of medical research will therefore probably be a good thing—signs of an imminent modernisation of European science are apparent.5 We predict that, like physics, in a decade or two funding of medical research will be much less, fundamental medical science will be pursued at only a few research centres, and most medical schools and universities will concentrate on training doctors and performing "applied" medical research and development.
Separation of clinical practice and medical research systems will probably be more effective and efficient, but the transition will be painful.
Bruce G Charlton, editor in chief
Medical Hypotheses Bruce.Charlton@newcastle.ac.uk
Peter Andras, lecturer
School of Computing Science Henry Wellcome Building, School of Biology, University of Newcastle upon Tyne, Newcastle upon Tyne NE1 7RU
See also pp 241 and 277-89
Competing interests: None declared.
References
Kmietowicz Z. Campaign to revitalise academic medicine calls for radical thinking. BMJ 2004;328: 1454. (19 June.)
Horrobin DF. Scientific medicine—success or failure? In: Weatherall DJ, Ledingham JGG, Warrell DA, eds. Oxford textbook of medicine. 2nd ed. Oxford: Oxford University Press, 1987: 2.1-2.3.
Fixing the drugs pipeline. Economist 2004 March 11. http://economist.com (accessed 21 Jul 2004).
Rees J. Complex disease and the new clinical science. Science 2002;296: 698-701.
Andras P, Charlton BG. European science must embrace modernization . Nature 2004;429: 699.
Physics was once the richest, most self confident, and most prestigious science. The first half of the 20th century was a golden age for its science, the time after the second world war a golden age for funding. Achievements did not match the hype, and support for physics has collapsed, fundamental physics research now being pursued in only a few universities in the United Kingdom.
Similarly, the middle of the 20th century was the golden age for clinical breakthroughs and biological science, which was followed by massive expansion in research funding. But the rate of major clinical advances has not lived up to the spin.2 The Human Genome Project was the costliest biological venture in history but the promised major clinical benefits now recede ever further into the future. A continual enhancement in the internal "performance indicators" of medical science, such as grant income and refereed publications, has not been matched by the kind of outputs that are valued by people external to the system. Effective new treatments for serious diseases are progressively drying up,3 perhaps because of fundamental flaws in the "basic to applied" model that is the focus of funding.4
A cull of medical research will therefore probably be a good thing—signs of an imminent modernisation of European science are apparent.5 We predict that, like physics, in a decade or two funding of medical research will be much less, fundamental medical science will be pursued at only a few research centres, and most medical schools and universities will concentrate on training doctors and performing "applied" medical research and development.
Separation of clinical practice and medical research systems will probably be more effective and efficient, but the transition will be painful.
Bruce G Charlton, editor in chief
Medical Hypotheses Bruce.Charlton@newcastle.ac.uk
Peter Andras, lecturer
School of Computing Science Henry Wellcome Building, School of Biology, University of Newcastle upon Tyne, Newcastle upon Tyne NE1 7RU
See also pp 241 and 277-89
Competing interests: None declared.
References
Kmietowicz Z. Campaign to revitalise academic medicine calls for radical thinking. BMJ 2004;328: 1454. (19 June.)
Horrobin DF. Scientific medicine—success or failure? In: Weatherall DJ, Ledingham JGG, Warrell DA, eds. Oxford textbook of medicine. 2nd ed. Oxford: Oxford University Press, 1987: 2.1-2.3.
Fixing the drugs pipeline. Economist 2004 March 11. http://economist.com (accessed 21 Jul 2004).
Rees J. Complex disease and the new clinical science. Science 2002;296: 698-701.
Andras P, Charlton BG. European science must embrace modernization . Nature 2004;429: 699.