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Suggested Citation:"Front Matter." National Research Council. 2004. Bridging the Bed-Bench Gap: Contributions of the Markey Trust. Washington, DC: The National Academies Press. doi: 10.17226/10920.
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Suggested Citation:"Front Matter." National Research Council. 2004. Bridging the Bed-Bench Gap: Contributions of the Markey Trust. Washington, DC: The National Academies Press. doi: 10.17226/10920.
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Suggested Citation:"Front Matter." National Research Council. 2004. Bridging the Bed-Bench Gap: Contributions of the Markey Trust. Washington, DC: The National Academies Press. doi: 10.17226/10920.
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B3RIDGINC THE BED-BENCH GAP Contributions of the Markey Trust Committee on the Evaluation of the Lucille P. Markey Charitable Trust Programs in Biomeclical Sciences Board on Higher Education and Workforce Policy and Global Affairs Division NATIONAL RESEARCH COUNCIL OF THE NATIONAl ACADEMIES THE NATIONAL ACADEMIES PRESS Washington, D.C. www.nap.edu

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Gov- erning Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engi- neering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Contract/Grant No. OSEP-97-M-03-A between the National Academy of Sciences and The Lucille P. Markey Charitable Trust. Any opinions, findings, conclusions, or recommendations expressed in this publica- tion are those of the authoress and do not necessarily reflect the views of the organizations or agencies that provided support for the project. International Standard Book Number 0-309-09112-8 (Book) International Standard Book Number 0-309-52844-5 (PDF) Additional copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, <http://www. nap.edu>. Suggested citation: National Research Council. 2004. Bridging the Bed-Bench Gap: Contributions of the Markey Trust. Committee on the Evaluation of the Lucille P. Markey Charitable Trust Programs in Biomedical Sciences. Board on Higher Edu- cation and Workforce, Policy and Global Affairs Division. Washington, D.C.: The National Academies Press. Copyright 2004 by the National Academy of Sciences. All rights reserved. Printed in the United States of America

THE NATIONAL ACADEMIES . Advisers to the Nation on Stiente, Engineering, and Medirine The National Academy of Sciences is a private, nonprofit, self-perpetuating soci- ety of distinguished scholars engaged in scientific and engineering research, dedi- cated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its mem- bers, sharing with the National Academy of Sciences the responsibility for advis- ing the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sci- ences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal gov- ernment. Functioning in accordance with general policies determined by the Acad- emy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering commu- nities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. Wm. A. Wulf are chair and vice chair, respectively, of the National Research Council. www.national-acaclemies.org

COMMITTEE ON THE EVALUATION OF THE LUCILLE P. MARKEY CHARITABLE TRUST PROGRAMS IN BIOMEDICAL SCIENCES Enriqueta Bond (IOM), Burroughs Wellcome Fund, Chair William T. Butler (IOM), Baylor College of Medicine Elaine K. Gallin, Doris Duke Charitable Foundation Mary-Lou Pardue (NAS), Massachusetts Institute of Technology Georgine Pion, Vanderbilt University Lee Sechrest, University of Arizona Lloyd Hollingsworth Smith (IOM), University of California, San Francisco (Ret.) Virginia V. Weldon (IOM), Monsanto Company (Ret.) James B. Wyngaarden (IOM), Duke University (Ret.) Staff George R. Reinhart, Senior Project Officer Elaine Lawson, Project Officer Stacey Kozlouski, Research Associate Elizabeth Briggs Huthnance, Administrative Assistant

BOARD ON HIGHER EDUCATION AND WORKFORCE Richard A. Tapia, Rice University, Chair Burt Barnow, Johns Hopkins University Ronald G. Ehrenberg, Cornell University Carlos G. Gutierrez, California State University, Los Angeles Nancy B. Jackson, Sandia National Laboratories Donald L. Johnson, Graining Processing Corporation (Ret.) Claudia I. Mitchell-Kernan, University of California, Los Angeles Michael T. Nettles, University of Michigan Debra W. Stewart, The Council of Graduate Schools Tadataka Yamada, GlaxoSmithKline John D. Wiley, University of Wisconsin-Madison Staff Peter Henderson, Director, Board on Higher Education and Workforce Elizabeth Briggs Huthnance, Administrative Assistant

Preface In 1997, as the 15-year term of the Lucille P. Markey Charitable Trust neared its end, the Trust asked the National Research Council (NRC) of the National Academies to evaluate the Trust's approach to supporting programs in biomedical science. The National Academies agreed to un- dertake a project to study the Markey Trust as a model of philanthropy. To commence this project the National Academies established a Com- mittee on the Evaluation of the Lucille P. Markey Charitable Trust. The Committee was charged with addressing two questions: "Were the Trust's funds well spent?" and "What can others learn from the programs of the Markey Trust both as an approach to funding biomedical research and as a model of philanthropy?" The five reports of the Committee will 1. examine the General Organizational Grants program that was in- tended to catalyze new ways to train students in translational research; 2. evaluate the program for Markey scholars and visiting fellows, which supported young biomedical investigators in their early careers; 3. report on a conference of Markey scholars and visiting fellows that was organized by The National Academies in 2002; 4. review the Research Programs Grants, which provided funding to institutions to support the work of senior investigators; and 5. report on methods used to evaluate funding of biomedical science by philanthropic donors. Since it was established in 1998, the Committee has collected data, conducted site visits, convened workshops, and interviewed grantees to vz'

vI!! PREFACE determine the answers to the questions that the Trust posed about its impact on biomedical research. The study will be completed in 2005. This first report of the Committee presents findings concerning the Markey General Organizational Grants. This report has been reviewed in draft form by individuals chosen for their diverse perspectives and tech- nical expertise, in accordance with procedures approved by the NRC's Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and respon- siveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report: Jules Hirsch, Rockefeller University; Richard McGee, Mayo Medi- cal School; Joel Oppenheim, New York University; Gary Pasternack, Johns Hopkins University; Deborah Powell, University of Minnesota; and Gayle R. Slaughter, Baylor College of Medicine. Although the reviewers listed above have provided many construc- tive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Paula Stephan, Georgia State University. Appointed by the National Research Council, she was responsible for making certain that an independent ex- amination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Re- sponsibility for the final content of this report rests entirely with the authoring committee and the institution. The production of this report was the result of work over a sustained period of time by the study Committee. George Reinhart, study director, Elaine Lawson) program officer, and Elizabeth Briggs Hu~nance, admin- istrative assistant, ably assisted the Committee in this study. Virgirua Weldon, M.D., who earlier served as chair of the Committee, was instru- mental in the early development of both the study and this report. Enriqueta Bond Chair Committee on the Evaluation of the Lucille P. Markey Charitable Trust Programs in Biomedical Sciences

Contents EXECUTIVE SUMMARY INTRODUCTION HISTORY OF THE MARKEY TRUST GRANT" PROGRAMS Markey Scholars and Visiting Fellows Awards, 14 Miscellaneous Awards, 15 General Organizational Grants, 16 ASSESSING DIE MARKEY GENERAL ORGANIZATIONAL GRANTS PROGRAM Limitations to This Assessment, 20 THE BIOMEDICAL RESEARCH ENVIRONMENT IN THE 1980s CLOSING THE BED-BENCH GAP Training Programs for Physicians, 25 Training Programs for Ph.D. Scientists, 27 Training Programs for Both Ph.D Scientists and Physicians, 30 6 8 13 19 22 24 TEIE CURRENT BIOMEDICAL RESEARCH ENVIRONMENT 32 CONCLUSIONS AND OBSERVATIONS FOR PHILANTHROPIC FUNDERS REFERENCES lo 35 40

x APPENDIXES A Bridge Building Between Medicine and BasicScience, IRWIN ARIAS, M.D. B The Endangered Physician-Scientist: Opportunities for Revitalization Emerge, LEON ROSENBERG, M.D., AND TIMOTHY J. LEY, M.D. Workshop on Training Programs in Patient-Oriented Pathobiology for Basic Scientists: Agenda D Workshop on Training Programs in Patient-Oriented Pathobiology for Basic Scientists: Participants Descriptions of Programs Participating in the Workshop on Training Programs in Patient-Oriented Pathobiology for Basic Scientists CONTENTS 45 60 69 71 74 Summary of Site Visits to Markey-Funded Programs that Provided Training in Basic Research to Physicians 109 Biographies of Members of the Lucille P. Markey Charitable Trust Programs in Biomedical Sciences Commitee 121

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Since the 1970s there has been a serious gap between fundamental biological research and its clinical application. In response to this gap the Lucille P. Markey Charitable Trust instituted the General Organizational Grants program, which funded two types of awards to provide training that would bridge the bed-bench gap. These training awards fell into two categories: (1) those that provided significant opportunities for M.D.s to engage in basic research during and immediately following medical school and residency, and (2) those that provided significant clinical exposure for Ph.D.s while they were predoctoral or postdoctoral students. These grants were intended to close the widening gap between rapid advances in our understanding of the biological process and the translation of that knowledge into techniques for preventing diseases. This report examines the General Organizational Grant programs, identifies best practices, and provides observations for future philanthropic funders.

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