April 13, 2001

Kirschstein delivers Chapman lecture

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Dr. Ruth Kirschstein, NIH acting director, sits beside Dr. John E. Chapman last week before delivering the lecture in honor of the former dean of the Medical School. (photo by Anne Rayner)

Kirschstein delivers Chapman lecture

It is imperative that the world’s major medical centers not only encourage, but also provide medical students and residents with the opportunity to pursue clinical research.

“Clinical research, while hardly dying on the vine, is hardly thriving like basic research,” said Dr. Ruth Kirschstein, acting director of the National Institutes of Health. Kirschstein presented last week’s John E. Chapman Lectureship on the Ecology of Medicine and Medical Education.

The lectureship, which honors the former Vanderbilt University School of Medicine dean, was established in 1975 to address the changing role of medicine in our culture. It was held last week to coincide with two days of events held to honor Chapman, who assumed the role of associate vice-chancellor for Medical Alumni Affairs March 1, after completing more than 25 years as Dean and conferring degrees on two-thirds of the living medical alumni of VUSM.

Kirschstein, who Chapman introduced last week as the “den mother to science,” served as NIH deputy director between 1993 and 1999. She was named acting NIH director on Jan. 1, 2000. She administers the Medical Scientist Training Programs of the NIH and has made major contributions to the nation’s graduate programs in the biomedical sciences.

During her lecture, Kirschstein told the capacity crowd that for every grant application for clinical research, there are two for basic research. The disparity is even greater with re-submissions.

But Kirschstein, quoting Louis Pasteur, said, “clinical and basic research are no more separable than the tree from its fruit.”

Clinical research is necessary to carry forth new scientific advances. It is a necessity with the advancements in the human genome project, she said. And it’s not enough to encourage those who are already doing active clinical research.

“We need the fresh and enthusiastic perspective from medical students,” she said. “It’s our responsibility to help produce a number of first rate clinical investigators and the academic medical centers are best suited to do this work.

Kirschstein said that the NIH is doing all it can to make clinical research more appealing to young physicians. NIH clinical research curriculum awards are being offered to teach medical students, housestaff, fellows and faculty members how to put together clinical protocols. About 80 percent of these awards have been given to individuals at institutions like VUMC with general clinical research centers, she said.

Going one step further, the United States Congress has approved the Clinical Research Enhancement Act that is expected to revitalize patient-oriented investigations. The act calls for a tuition loan repayment plan to provide relief from the educational debt that prevents many health professionals from pursuing careers in clinical research. Under the plan, qualified clinical researchers can agree to conduct clinical research in exchange for loan repayment. For each year of research service, NIH can repay up to $35,000 of the principal and interest of the educational loans.

Plans are for the program to be in place by 2002.