Plan for U.S. biomedical policy reforms not yet ready for prime time

Graduate training is seen as a crown jewel of U.S. higher education.

Graduate training is seen as a crown jewel of U.S. higher education.

University of Southern Mississippi/Van Arnold

They probably should have known better, admits Harold Varmus, one of the authors of a controversial proposal this spring to correct the “systemic flaws” affecting U.S. biomedical research. But he and two of the other co-authors acknowledged Friday that one aspect of their call to arms was flawed, namely, that the community was close to agreeing on how to deal with the complex problems that affect training and funding.

 “We were naive,” said Varmus, director of the National Cancer Institute, after a presentation to the President’s Council of Advisors on Science and Technology (PCAST). “We were hoping to pick off some low-hanging fruit.”

But that fruit isn’t ripe yet, he and Princeton University’s President Emerita Shirley Tilghman and Harvard Medical School’s Marc Kirschner told PCAST. The council had invited the four authors (Bruce Alberts, the former editor of Science, was unable to attend) because of the furor their article had raised within the biomedical community, explained PCAST Co-Chair Eric Lander.

Shortly after the article appeared in the Proceedings of the National Academy of Sciences in April, a members-only session held on the last morning of the academy’s annual meeting generated a “very heated” discussion, Varmus said. A follow-up meeting of community leaders sponsored by the Howard Hughes Medical Institute convinced the authors that they were far from achieving the consensus they wanted before holding a national gathering to come up with a list of solutions.

“So we’ve decided to take more time,” Varmus explained. He and others said the next step would be to assemble a larger and more representative group—in particular with early-career scientists—to continue discussing the issues, which cover everything from graduate training and university oversight of research to federal grants management and partnerships with industry.

The system has worked well for a long time, Tilghman explained, and nobody wants to do something that might have unintended negative consequences. “We are very sensitive to the principle of ‘First, do no harm.’ ”

Put succinctly, Tilghman described the problem as “too many people chasing too little money.” And after the trio presented their views on what factors are putting stress on the system and what might be done to alleviate it, Lander, a biologist at the Massachusetts Institute of Technology in Cambridge, got to the heart of the matter.

“You’ve suggested a lot of reasons for the current situation,” he said. But in the absence of hard evidence to back up their assertions, he noted, it’s very difficult to know which remedies might solve the problem and which might make it worse.

“That’s exactly the question that I would have asked us,” Tilghman confessed. “There’s a consensus that the current system is at risk for not producing the best science. But there’s little consensus on what to do to make it better.”

One reason, Lander hinted, may be the large number of unproven—and possibly untestable—hypotheses about the crisis that have become accepted wisdom. The article asserted, for example, that the current “hypercompetitive system” is driving away the best students and “making it difficult for seasoned investigators to produce their best work.” The article also stated that low success rates have spawned “conservative, short-term thinking” throughout the community, a problem compounded, the authors say, by the fact that “time for reflection is a disappearing luxury.”

Another hugely controversial issue is whether some type of “birth control” is needed to ease the intense competition for research funding and academic positions. The phrase usually applies to limiting the number of graduate students. But biologist Jo Handelsman, associate director for science at the White House Office of Science and Technology Policy and a participant at the Hughes meeting, said that emphasis may be inappropriate.

“I think that graduate education is the pinnacle of what we do in education in the United States,” said Handelsman, on leave from Yale University. “And I don’t think there’s anything wrong with unleashing a large group of trained Ph.D.s. The question is what they do after graduation.”

Her suggestion: Make sure that universities “train students just as rigorously” for careers outside academia as is now done to prepare them for academic careers. “The answer is not limiting the number of graduate students, but perhaps limiting the number of PIs,” Handelsman remarked after the meeting.

Although nothing was resolved during the 75-minute discussion, one of Tilghman’s comments midway through it captured the tenor. “We don’t know what to do, and we’re open to your suggestions,” she said. “But I do know one thing: If we go home and do nothing, the problem will just get worse.”