Careers in basic cardiovascular research.

The opportunities in basic science for graduating PhD students and for aspiring physician-scientists have never been so extraordinary. The sequencing of the human genome and the development of the human haplotype map have enabled scientists to begin to unravel the basis of complex multigenic disorders. Rapid developments in stem cell biology are affecting many areas of cardiovascular biology and may enable repair of injured myocardium. High-throughput chemical genetic screening, proteomics, and metabolomics are changing the approaches with which investigators characterize novel signal transduction pathways and develop new therapeutic paradigms. Rapidly evolving molecular imaging technologies are noninvasively illuminating the fundamental processes contributing to cardiovascular diseases. New insights into the mechanisms involved in cardiac myocyte hypertrophy and dysfunction have important therapeutic implications for an expanding population of patients with congestive heart failure. For the young scientist looking to the future, there are major benefits in pursuing a basic science career including the excitement of discovery, the opportunity for life-long learning, and the potential to broadly affect cardiovascular science and medicine. On the other hand, the young investigator considering a basic science career is confronted by many challenges. The budget of the National Institutes of Health (NIH) has remained essentially unchanged for 5 years (when the impact of inflation is considered). The success rate of R01 grant applications has consistently declined since 2000, and the average age when an investigator receives a first R01 grant (or equivalent) increased to 42.6 in 2007 (NIH Extramural Data Book at www.report.nih.gov/index.aspx). At the same time, the increased costs of undergraduate and medical school educations have burdened potential young investigators with ever-increasing financial commitments. Many academic leaders have suggested that an entire generation of young scientists is “at risk” (www.BrokenPipeline. org). Long hours at the laboratory bench are compensated modestly compared with those of other professions. There is no doubt that embarking on a career in basic cardiovascular science has significant risks. A frequently asked question— “How do I know whether I will be successful?”—has no certain answers. This perspective piece focuses on the young investigator or clinician (with a PhD, MD, or both) interested in pursuing postdoctoral training in basic cardiovascular science. It is based in part on the experience of the author, who has been privileged to provide advice to an extraordinary cadre of young scientists pursuing research training, often combined with clinical training, in cardiovascular medicine at the Massachusetts General Hospital. This review will focus on the steps required to secure the ideal postdoctoral fellowship and to initiate research training in a basic science laboratory. Also considered will be the optimal time commitment to research training, as well as the challenges associated with the transition to independence.