For several years, leaders of academic medical centers at the levels of dean, department chair, and division director have focused on the need to restructure their institutions in light of changes in the health care delivery system. Still, research, along with patient care, remains an important part of a quality medical education.
The lack of growth in the National Institutes of Health (NIH) spending for extramural research in the early- and mid-1990s has discouraged many faculty from submitting applications and pursuing research careers. Yet, according to the U.S. Department of Health and Human Services (1994), total funding for biomedical research has continued to climb, with funding from industry surpassing total federal government support in 1994. Significant new growth in funding for the NIH and other federal government research programs is expected as the decade closes.
There is no end to research opportunities, some of which are central to the success of integrated health care delivery systems - whether built around academic medical centers or not. The revolution that began with molecular biology still has a long running time, even as research and academic leaders work to reestablish clinical research as a key link between the wet bench and the patient.
The academic research enterprise derives part of its stimulation and innovation from new researchers joining and initiating investigative groups and collaborative teams. Recruiting is a continuous process, although the pace and volume of recruiting are heavily influenced by the actual and perceived availability of external funding. Since much of the funding for faculty recruitment and startup costs has come from the academic clinical enterprise over the past 3 decades, anticipated reductions in these funds raise several concerns about future recruitment packages:
1. Where will recruitment and startup funds come from?
2. How much funding will be needed?
3. What factors will affect the amount of monetary support and other resources?
4. Can useful alternatives to traditional funding patterns be identified?
This paper examines the financial aspects of recruiting in relation to the purpose of the recruitment, the stature of the investigator, and the nature of his or her research.
INITIATING THE RECRUITMENT PROCESS
For the recruiting unit, a fundamental set of issues must be considered. Before the recruiting begins with what is often a hastily put-together job description and advertisement, careful thought should be given to the following questions:
1. What is the purpose of the research program?
2. What kinds of research faculty should be recruited?
3. What kinds of facilities and equipment will the selected faculty require to be successful?
4. What are the candidate's financial concerns?
5. What research support structures can be used to magnify the effects of startup assistance and improve the potential for each candidate's success?
These questions have received little attention during the exponential growth of the academic medical research enterprise over the past 30 years. Now that resources are tighter and external funding more difficult to obtain, these questions must be addressed if newly recruited researchers are to become early programmatic and financial contributors to the institution.
WHAT IS THE PURPOSE OF THE RESEARCH PROGRAM?
This first question seems so obvious that I can almost hear readers say, "Everybody knows the purpose of the research program is to create new knowledge." No argument. However, the successful recruiter should pursue this point by asking some additional questions:
1. How does the current research program contribute to the medical education and patient-care delivery missions of the institution?
2. Is the purpose of the recruitment to develop a new research direction or to fill a gap in an existing stream of research? …