Dr. Christopher Cogle writes every day, usually at night in his office after he’s finished with patients and students. He pens newspaper columns sometimes and toils on his research manuscripts, sentence by sentence. But mostly, Cogle writes grants.
The UF assistant professor of hematology and oncology churns out at least one grant every month. It’s the only way a young researcher can survive in academic medicine, he says.
“I’m shooting for about one in 10 right now,” says Cogle, a 1997 UF College of Medicine alumnus. “For every 10 grants I write, I get one. It’s scary … there’s a lot of responsibility on something as prospective as grant applications. It takes either courage or foolishness, depending on the outcome.”
Academic medicine is an uncertain business. Winning support from the National Institutes of Health proves trickier by the day as funding levels stagnate and the pool of applicants grows. Young researchers who don’t have years of findings already tucked under their belts are especially challenged. The hours are long – Cogle works nearly twice as long as the average American worker each week – and the pay at a university isn’t usually as much as a young doctor could earn in private practice.
But for most, the benefits of being a physician-scientist who sees patients, teaches students and solves clinical questions that could help cure the diseases they treat far outweigh the uncertainties of academic medicine or the pros of private practice. And young researchers in the College of Medicine say UF is one of the best places to get started.
“In private practice you may be able to take great care of patients, but you’re not in a position to push the envelope at all to try and come up with new therapies,” said Amy Smith, MD, a UF assistant professor of pediatric oncology who came here in 2003 to revitalize the department’s neurooncology program.
More than 41 percent of students left medical school with plans of pursuing private practice in 2006, according to a graduation questionnaire the American Association of Medical Colleges conducts each year. But over the past three years, the number of students who say they hope to join the faculty of a university someday has inched upward to 33 percent. About 20 percent of students were undecided.
The ever-so-slight rise in the number of students interested in academic medicine could be because medical schools are doing more to challenge students and residents to develop cures. The opportunities for training and experience in translational research have been there, but aren’t always taken, usually because students and residents haven’t heard of them, Cogle says.
“We also recruit trainees that are more clinically minded,” Cogle says. “They don’t have eyes open to translational research. That’s been a trend in the past, but that’s shifting at UF. We are taking more trainees that are coming in saying, ‘I want to be a physician-scientist.’”
Smith chose academic medicine for a pretty simple reason — she wants to help kids with brain tumors. Survival rates for childhood brain tumors are lower than those for other better-known pediatric cancers, such as leukemia, she says. While researchers have focused on finding better treatments for those cancers, pediatric brain tumors have been left wedged in the gap between oncology and neurology.
“The way to have an impact on that is to participate in academic medicine, where you have all the experts and researchers working as a team,” Smith says. “In the relapse setting we need better therapy, and we need less toxic therapy.”
Smith hasn’t been able to focus on much research since she joined the UF faculty in 2003. She’s been too busy seeing patients — the number of brain tumor patients seen at UF has doubled since she came — and the program doesn’t have the resources or staff for Smith to focus on her scientific aspirations yet. And nationally, research on pediatric cancers aren’t funded at the same levels as studies on adult cancers, in part because cancer is more rare in children.
“That’s one of the major frustrations for me,” Smith says.
This is an incredible place to be a junior faculty member.They really care about fostering careers here. You don’t find that everywhere.
-Glen Finney, MD, associate professor of neurology
Busy clinical responsibilities and the pressure to earn a certain amount for the department through patient care can cut into a young researcher’s time in the lab. That wasn’t a problem Dr. B.J. Wilder, a professor emeritus of neuroscience, faced when he was a fellow at Stanford University.
“I immediately embarked on research projects,” Wilder remembers. “I was very free to pursue projects that I wanted to do. In order for people to do research, they have to have blocks of uninterrupted time. (Now) the people who have potential have no time.”
In order to give faculty a chance to have those blocks of time to devote to research, Wilder and his wife donated $2 million to establish the B.J. and Eve Wilder Center for Excellence in Epilepsy Research in 2004. The Wilders’ donation funds postdoctoral fellowships and a professorship for a faculty member who studies epilepsy.
“This is an incredible place to be a junior faculty member,” says Glen Finney, an associate professor of neurology who studies memory and cognitive disorders. “They really care about fostering careers here. You don’t find that everywhere. It’s just not that common.”
Finney credits his mentors, Drs. Kenneth Heilman and Kimford Meador, with helping him “navigate the water” of clinical research. But even with moral support, he worries about funding. He applied for a grant from the NIH earlier this year, but because only 9 percent of grants are funded these days there are no guarantees, he says.
“You have to work harder and harder for less and less,” Finney says.
With funding from both the NIH and the James & Esther King Biomedical Research Program, Cogle has been able to strike a balance between research and his time with patients too. The grants allow him not only to parcel out time for research but also to spend more time with each patient rather than worry about making clinical quotas.
“To get (grants) requires a lot of planning,” Cogle says. “You can’t, on a Tuesday morning, decide I’m going to do research next week. You need to prepare two and a half years ahead of time. Two and a half years is the time it takes to gather preliminary data, publish, apply, get rejected, apply again and then usually get grant funding after that. We have a track record of success here at UF.”
You can’t, on a Tuesday morning, decide I’m going to do research next week. You need to prepare two and a half years ahead of time. (That’s) the time it takes to gather preliminary data, publish, apply, get rejected, apply again and then usually get grant funding after that.
-Chris Cogle, MD97, assistant professor of hematology and oncology
Younger researchers do have one advantage when trying to get their first NIH grant, though: The agency cuts new investigators a tiny bit of slack when scoring grants to level the playing field between senior and junior authors, says Elaine Young, PhD, assistant program director of research development in the college.
Young, who worked at the NIH for several years, offers a training course on grantwriting to help new, and more established, investigators at UF.
“I have the knowledge from both sides,” says Young, who also helps UF researchers one-on-one.
As challenging as the funding environment is and as complicated as balancing research and patient care has become, Cogle knows this: In some ways, researchers actually have it pretty easy.
He discovered this while sorting through the drawer of an old desk he uses in his office. He found a stack of yellowed postcards. Typed on each was a generic request for a journal article. Looking at the card, Cogle realized how long it would have taken researchers to gather data for grants or research articles prior to the Internet. What it takes him two minutes to do would have taken two weeks for the researcher who once used that desk.
“I don’t know how they did research 30 years ago,” he says. “To me it seems completely impossible.”