Research conducted in academic departments of obstetrics and gynecology could result in substantial improvements in the health of women and the outcomes of pregnancy.
Strengthening Research in Academic OB/GYN Departments determines whether such departments are capable of fulfilling this promise. The committee finds that these departments have a poor track record in their ability to compete for research funds and in the extent to which their faculty contribute to research. Adding to the problem are factors that deter OB/GYNs from a research career and a dearth of dynamic research leaders in the profession.
The volume explores reasons for this situation and makes recommendations to counteract them. Also included is an agenda of needed research.
- STRENGTHENING RESEARCH IN ACADEMIC OB/GYN DEPARTMENTS
- Copyright
- PREFACE
- Contents
- EXECUTIVE SUMMARY
- THE CURRENT SITUATION
- COMMITTEE FINDINGS
- Findings Related to Career Choices
- Findings Related to NIH and Other External Support
- Findings Relating to Departments of OB/GYN
- Findings Related to Professional Organizations
- COMMITTEE RECOMMENDATIONS
- Recommendations for NIH and NICHD
- Recommendations for Other External Support
- Recommendations for Which Multiple Groups Have Responsibility
- Recommendations for Departments of OB/GYN
- Recommendations for Professional Organizations
- Recommendations for Leadership
- A RESEARCH AGENDA FOR OB/GYN
- OOCYTE AND FOLLICULAR DEVELOPMENT IN THE OVARY
- Follicular Formation
- Follicular Atresia
- Follicular Recruitment, Selection, and Dominance
- Corpus Luteum Function
- Leukocytes, Cytokines, and Ovarian Function
- FERTILIZATION
- FETAL GROWTH AND DEVELOPMENT
- Embryology and Congenital Malformations
- Fetal Growth and Placental Transport
- Congenital Infection and Substance Abuse
- Perinatal Research
- Epidemiological Research
- PRETERM LABOR
- Preterm, Premature Rupture of the Fetal Membranes
- Complications of Pregnancy That Compromise Fetal or Maternal Well-Being Independent of the Onset of...
- Preterm Onset of Labor
- Preterm Labor and Infection
- CONTRACEPTION
- Contraceptive Implants
- Contraceptive Rings (CRs)
- Transdermal Delivery
- Intrauterine Devices (IUDs)
- Oral Contraception
- Barrier Methods
- Male Contraception
- Antifertility Vaccines
- Sperm Antigens
- LHRH-Vaccine Used With or Without a Vaccine to the Luteinizing Hormone or FSH (Follicle Stimulating...
- Medical Abortifacients
- INFERTILITY
- Epidemiology
- Cervical Physiology and Function
- Fallopian Tube Function
- Endometriosis
- Male Infertility
- In Vitro Fertilization and New Reproductive Technologies
- PREMENSTRUAL SYNDROME
- THE BRAIN AND REPRODUCTION
- MENOPAUSE
- ONCOLOGY
- Ovarian Cancer
- Uterine Neoplasms
- Cervical Cancers
- Vulvar Malignancies
- Breast Cancer
- Trophoblastic Disease
- SEXUALLY TRANSMITTED DISEASES
- Prevent Sexually Transmitted Diseases by Developing Clinically Effective and Safe Vaccines
- Develop Cost-Effective Tests for Early Diagnosis of STDs
- Develop New Therapies Where Needed and New Cost-Effective Antibiotics That are Easily Administered a...
- Clarify the Natural History of Genital Infections
- Define Behaviors Associated with the Acquisition and Spread of STDs
- Characterize the Role of STDs in Adverse Pregnancy Outcomes
- 1 INTRODUCTION
- ORIGINS OF THE STUDY
- THE CHARGE TO THE COMMITTEE
- THE COMMITTEE'S INTERPRETATION OF ITS CHARGE
- LIMITS ON THE SCOPE OF THE STUDY
- CONDUCT OF THE STUDY
- GENERAL CONCERNS ABOUT CLINICAL INVESTIGATION
- BELIEFS ABOUT RESEARCH AND ACADEMIC DEPARTMENTS OF OB/GYN
- REFERENCES
- 2 IS THERE A PROBLEM?
- SUPPORT OF RESEARCH AND TRAINING IN DEPARTMENTS OF OB/GYN
- The Role of Foundations
- Other Private-Sector Training Support
- Voluntary Health Agencies
- Federal Support
- Competition for NIH Funds
- STRUCTURAL CHARACTERISTICS OF DEPARTMENTS OF OB/GYN
- Overview of Faculty in Clinical Departments of Medical Schools
- Research Intensiveness
- A RESEARCH AGENDA FOR DEPARTMENTS OF OB/GYN
- CONCLUSION
- REFERENCES
- 3 CAREER CHOICES
- CAREER PATHWAYS
- DEBT
- FOREGONE EARNINGS
- DURATION OF TRAINING
- Specialty and Subspecialty Training in OB/GYN
- Fast-Track Training for Researchers in Other Specialties
- WOMEN AND RESEARCH
- SUMMARY OF CAREER CHOICE FACTORS
- REFERENCES
- 4 NIH POLICIES AND STRUCTURE
- ABSENCE OF OB/GYN IN THE NIH INTRAMURAL PROGRAM
- ABSENCE OF A FOCAL POINT FOR OB/GYN RESEARCH AT NIH
- Pros and Cons of Creating New Institutes
- Structure and Priorities of NICHD
- STUDY SECTIONS
- RESTRICTIONS ON NIH RESEARCH SUPPORT
- REFERENCES
- 5 DEPARTMENTAL AND LEADERSHIP ISSUES
- DEPARTMENTAL ISSUES IN EXPANDING RESEARCH CAPABILITIES
- SOME PROBLEMS
- Is the Past a Guide for the Future?
- Some Solutions
- LEADERSHIP
- OB/GYN Leadership and Research
- Leadership and Its Impact Within the Discipline
- Leadership and Its Impact Outside the Discipline
- REFERENCES
- 6 A RESEARCH AGENDA FOR DEPARTMENTS OF OBSTETRICS AND GYNECOLOGY
- OOCYTE AND FOLLICULAR DEVELOPMENT IN THE OVARY
- Follicular Formation
- Follicular Atresia
- Follicular Recruitment, Selection, and Dominance
- Corpus Luteum Function
- Leukocytes, Cytokines, and Ovarian Function
- Follicular Fluid
- Conclusion
- FERTILIZATION
- FETAL GROWTH AND DEVELOPMENT
- Embryology and Congenital Malformations
- Fetal Growth and Placental Transport
- Congenital Infection and Substance. Abuse
- Perinatal Research
- Epidemiological Research
- PRETERM LABOR
- Preterm, Premature Rupture of the Fetal Membrane
- Complications of Pregnancy That Compromise Fetal or Maternal Well-Being Independent of the Onset of...
- Preterm Onset of Labor
- Preterm Labor and Infection
- Role of the Obstetrician in Research to Define Physiological and Pathophysiological Mechanisms of Sp...
- CONTRACEPTION
- Proposed Research
- Contraceptive Implants
- Contraceptive Rings
- Transdermal Delivery
- Intrauterine Devices (IUDs)
- Oral Contraception
- Barrier Methods
- Male Contraception
- Antifertility Vaccines
- Proposed Research
- Proposed Research
- Medical Abortifacients
- INFERTILITY
- Proposed Research
- Epidemiology
- Cervical Physiology and Function
- Fallopian Tube Function
- Endometriosis
- Male Infertility
- In Vitro Fertilization and New Reproductive Technologies
- PREMENSTRUAL SYNDROME
- THE BRAIN AND REPRODUCTION
- MENOPAUSE
- ONCOLOGY
- Ovarian Cancer
- Proposed Research
- Proposed Research
- Uterine Neoplasms
- Cervical Cancers
- Vulvar Malignancies
- Breast Cancer
- Trophoblastic Disease
- SEXUALLY TRANSMITTED DISEASES
- Proposed Research
- Prevent Sexually Transmitted Diseases by Developing Clinically Effective and Safe Vaccines
- Develop Cost-Effective Tests for Early Diagnosis of STDs
- Develop New Therapies Where Needed and New Cost-Effective Antibiotics That Are Easily Administered a...
- Clarify the Natural History of Genital Infections
- Define Behaviors Associated with the Acquisition and Spread of STDs
- Characterize the Role of STDs in Adverse Pregnancy Outcomes
- REFERENCES
- APPENDIX A PREPARING FOR THE TWENTY-FIRST CENTURY IN THE REPRODUCTIVE SCIENCES:
- THE HISTORY AND PRESENT STATUS OF RESEARCH TRAINING IN OBSTETRICS AND GYNECOLOGY
- TRAINING PATHS
- PRIVATE FOUNDATION FUNDING FOR RESEARCH TRAINING: 1950 TO 1985
- The Markle Scholar Program: A Case Study
- Josiah Macy, Jr. Foundation
- Ford Foundation
- Rockefeller Foundation
- Andrew W. Mellon Foundation
- FEDERAL SUPPORT FOR RESEARCH TRAINING
- The National Institutes of Health and the National Institute of Child Health and Human Development
- NIH Research Training Programs
- OBSTETRICS AND GYNECOLOGY RESEARCH TRAINING: 1985 TO THE PRESENT
- American Gynecological Society
- American Association of Obstetricians and Gynecologists Foundation Scholarship Program
- OTHER FOUNDATIONS AND PHARMACEUTICAL COMPANIES
- American College of Obstetricians and Gynecologists
- Society for Gynecologic Investigation
- Berlex Foundation
- Reproductive Scientist Development Program
- PROBLEMS OF RESEARCH TRAINING
- General Problems
- Problems in Establishing a Research Program
- MANPOWER IN ACADEMIC OBSTETRICS AND GYNECOLOGY CURRENT STATUS AND FUTURE NEEDS
- LESSONS LEARNED
- Importance of Research Training in the Reproductive Sciences
- Centers of Excellence
- Discovery of Potential Physician-Scientists
- Residency-Fellowship Training
- Research Training
- Post-Research Training
- Clinical Investigators
- The Role of Private Foundations
- Follow-Up
- CONCLUSION
- ADDENDUM:
- GENERAL BACKGROUND
- SCHOLARLY PRODUCTIVITY
- RESEARCH TRAINING IN OBSTETRICS AND GYNECOLOGY
- REFERENCES
- APPENDIX B NATIONAL INSTITUTES OF HEALTH SUPPORT OF RESEARCH IN DEPARTMENTS OF OBSTETRICS AND GYNECO...
- NIH SUPPORT FOR OB/GYN RESEARCH
- Overview
- Support by Institute
- Support by Review Group
- OB/GYN Departments Compared with Other Clinical Departments
- Degree of Principal Investigator
- Investigator Initiated Research (RO1s)
- NIH SUPPORT FOR OB/GYN RESEARCH TRAINING
- Fellowships and Institutional Training Awards
- Number of Individuals in Departments of OB/GYN with NIH Training Support
- Beginning Research Awards
- Institutional Grants
- SUMMARY OF NIH SUPPORT OF DEPARTMENTS OF OB/GYN
- NIH ADMINISTRATION AND STRUCTURE
- Actions and Further Analysis Needed to Improve NIH Support of OB/GYN Research
- REFERENCES
- APPENDIX C BACKGROUND PAPERS FOR THE RESEARCH AGENDA
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