The Malthusian Dilemma in Biomedical Research

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00:00:08.01 Hello. My name is Shirley Tilghman,
00:00:10.13 and I'm a Professor of Molecular Biology
00:00:12.16 at Princeton University.
00:00:14.16 For the last two or three years,
00:00:16.09 I have been puzzling over
00:00:19.01 the nature of the stresses and the strains
00:00:21.04 that have clearly engulfed
00:00:24.02 theUS biomedical research enterprise.
00:00:27.04 I have been speaking to my colleagues,
00:00:30.04 here at Princeton and around the country,
00:00:32.11 while I've given talks about this subject.
00:00:34.24 I've written about it with my co-authors,
00:00:38.19 Harold Varmus, Bruce Alberts, and Marc Kirschner.
00:00:41.24 And... really trying to identify
00:00:44.19 the source of the stresses and the strains,
00:00:47.09 which are very real.
00:00:49.16 And then to work on solutions
00:00:52.01 to those kinds of problems.
00:00:54.23 What I'm gonna talk about today
00:00:56.15 is what I think is at the root of the stresses and strains,
00:01:01.15 and I call it the Malthusian Dilemma in Biomedical Research.
00:01:07.14 So, I think all of you know that Thomas Malthus
00:01:10.20 was a demographer in [England] but...
00:01:13.14 a demographer in the 18th century.
00:01:15.03 And his central observation was that
00:01:18.02 when a population is increasing exponentially
00:01:22.06 but the resources to support it
00:01:25.08 are only increasing arithmetically,
00:01:28.03 there comes a point which he called the point of crisis,
00:01:32.00 when, basically, the resources can no longer support the population.
00:01:37.03 And what I'm gonna argue is
00:01:39.13 that's exactly what's been happening
00:01:41.08 in biomedical research.
00:01:43.11 So, let's first of all look at what has happened
00:01:45.21 to the resources that support the enterprise.
00:01:48.17 So, what we're looking at here
00:01:51.19 is a graph of NIH funds.
00:01:55.00 And the bars I want you to focus on
00:01:57.07 are the blue bars,
00:01:59.01 which represent the inflation-adjusted dollars available
00:02:02.13 to support biomedical research from the NIH.
00:02:06.02 And you can see here -- if you look at the blue bars --
00:02:08.24 that after the doubling of the NIH budget,
00:02:10.23 which ended in 2003,
00:02:14.00 there has actually been a steady erosion
00:02:18.22 in the spending power of the NIH budget,
00:02:20.18 to the point then in 2015,
00:02:23.14 the year that we are in,
00:02:25.08 the spendable dollars are almost exactly
00:02:28.13 what they were in 2000,
00:02:31.02 when the NIH doubling was just beginning.
00:02:34.03 So, there is no arithmetic increase in resources;
00:02:37.19 the resources have actually stagnated
00:02:40.19 over the last 15 years.
00:02:42.17 But what has happened to the population?
00:02:45.13 Well, the population has continued to grow.
00:02:48.14 So, this is the production of new PhD scientists
00:02:52.04 over the last 25-30 years.
00:02:55.11 But if we just focus on the period of time in the last slide,
00:02:59.03 there has actually, over that period of time,
00:03:02.00 been a 50% increase
00:03:05.11 in the production of life science PhDs,
00:03:07.15 almost entirely accounted for, as you can see here,
00:03:11.02 by the increase in the number of biomedical scientists.
00:03:17.04 And now we have the classic Malthusian dilemma.
00:03:22.02 So, how has this felt?
00:03:24.02 Well, it's felt, most importantly,
00:03:26.20 by the youngest members of our community,
00:03:29.03 the graduate students and the postdocs,
00:03:31.03 who, 25-30 years ago,
00:03:34.20 probably felt that they were in a very smooth pipeline,
00:03:38.05 where the number entering the field
00:03:41.03 was equivalent to the number who were leaving the field
00:03:43.19 and finding employment that took advantage of their training.
00:03:48.01 What we now see, today,
00:03:50.23 is clearly a bulging pipeline.
00:03:52.16 And probably the best demonstration of the bulge
00:03:57.13 is the fact that training is becoming longer and longer,
00:04:00.23 particularly at the postdoctoral level,
00:04:03.02 so that the average age at which someone achieves
00:04:07.18 an independent position in an academic institution
00:04:12.10 is now approaching 37 and a half years of age.
00:04:16.10 This is a sign of a bulging pipeline.
00:04:20.00 But the problems are not just felt by the young.
00:04:22.08 They're also felt by members of the community
00:04:24.15 who are trying to attract resources for their laboratories
00:04:30.24 with research grants,
00:04:33.02 who are trying to publish papers,
00:04:35.03 which are the coin of the realm in science,
00:04:37.03 who are trying to mentor their young investigat...
00:04:40.01 their young trainees to get them out of the lab
00:04:43.00 and into productive jobs in the future.
00:04:46.13 And so, this image, which I took from Science magazine,
00:04:49.18 I think very accurately reflects
00:04:53.03 the sense of the hyper-competitive environment
00:04:56.15 that currently exists
00:04:59.14 because of the Malthusian dilemma,
00:05:02.03 which has been summarized as
00:05:04.08 "too many people chasing too few resources".
00:05:09.02 So, the question is, what can we do about this?
00:05:12.07 And I would argue that we can't really solve this dilemma
00:05:16.12 until we confront the Malthusian nature
00:05:19.24 of the way in which we have been
00:05:24.16 training biomedical scientists over the last 50 or 60 years.
00:05:27.08 And that is we have been primarily depending on trainees.
00:05:31.24 So, in this cartoon, here,
00:05:34.13 I'm representing graduate students and postdoctoral fellows,
00:05:38.04 who are really the worker bees of the biomedical enterprise.
00:05:44.05 And very few members of a...
00:05:47.06 this is an 11-person lab.
00:05:49.02 Very few members of an average 11-person lab
00:05:51.21 would actually be a permanent member of that laboratory,
00:05:55.02 for example, a staff scientist or the PI himself or herself.
00:06:01.07 This is unsustainable.
00:06:03.09 This is what is creating the stresses and the strains.
00:06:07.05 And so, what we need to do
00:06:10.06 is to go to a sustainable structure
00:06:12.13 for our research laboratories.
00:06:14.07 And I would argue that that inevitably must include
00:06:17.21 fewer trainees,
00:06:19.24 a greater dependence on the use of permanent members of the laboratory --
00:06:24.18 technicians and staff scientists.
00:06:26.22 And I'm going to actually make the case
00:06:29.12 that by a greater use of core facilities,
00:06:31.23 we can reduce the size of laboratories
00:06:34.03 and therefore reduce the dependence
00:06:37.16 that we currently have on trainees
00:06:40.12 as the major source of work.
00:06:43.19 So, what to do?
00:06:46.01 And... and really, I'm going to deliver
00:06:48.01 a fairly positive message here,
00:06:50.02 because I think a lot of progress
00:06:53.04 is beginning to be made in addressing
00:06:55.16 these kinds of problems.
00:06:57.09 And I... I want to begin with a recommendation
00:07:00.03 that has been around for at least 20 years,
00:07:03.18 which is that, first and foremost,
00:07:06.17 we need to have honesty in advertising
00:07:08.24 in biomedical science.
00:07:10.20 And that is, we have to transparently
00:07:14.00 let all prospective students...
00:07:16.01 students who are thinking about entering that bulging pipeline...
00:07:18.10 let them know what is ahead,
00:07:22.00 and probably, most importantly,
00:07:24.14 get them already thinking about what they would do with a PhD.
00:07:28.23 Because, today, there are many things
00:07:31.20 that one can do with a PhD,
00:07:33.13 but the earlier you begin to think about that,
00:07:35.22 the more likely that your path to that job
00:07:38.11 is going to be smooth.
00:07:41.08 So, transparency.
00:07:43.04 And we... recommendations have been offered
00:07:46.14 that each graduate program
00:07:50.01 should be required to provide accurate career outcomes
00:07:52.03 to prospective students.
00:07:53.24 And the wonderful news is that Jon Lorsch,
00:07:56.02 who is the Director of the National Institute of General Medical Sciences,
00:08:00.22 has now sent a directive to all training grant PIs
00:08:05.03 asking them to provide that information on the web
00:08:09.16 so it is available to prospective graduate students.
00:08:13.03 Progress... progress.
00:08:16.04 The second place where we have really seen progress
00:08:18.09 is beginning to focus our faculty
00:08:22.17 on diversifying the kinds of training
00:08:25.13 that are available for graduate students.
00:08:27.03 Once again, this is a recommendation
00:08:30.05 that has been around for a long time.
00:08:32.09 There's a wonderful iBio video by Keith Yamamoto,
00:08:35.02 where he really effectively makes the case for this.
00:08:38.19 But clearly... when I was going through the system,
00:08:41.18 between 60 and 70% of graduate students
00:08:44.16 would ultimately end up in academic jobs.
00:08:47.21 Today, that number is 15%.
00:08:50.08 So, we have to be thinking about the 85%
00:08:54.03 who are not going to be, in the future,
00:08:57.04 in positions that we have classically been training our graduate students
00:09:03.02 to occupy.
00:09:04.22 Again, there's good news,
00:09:07.02 which is the National Institutes of Health,
00:09:09.19 under the directorship of Francis Collins,
00:09:12.05 created the BEST grants.
00:09:14.15 These are grants that are being offered to training programs
00:09:17.23 to experiment with the kinds of diversification
00:09:21.19 that would most effectively prepare this generation of graduate students
00:09:26.09 for the variety of jobs that are going to be available to them.
00:09:31.23 Doing it at the graduate student level
00:09:35.01 makes a great deal of sense because...
00:09:37.02 I think one of the things that must happen is...
00:09:40.02 and again, this was a recommendation
00:09:42.15 that Keith made in his iBio video...
00:09:44.23 is that we have to reserve the postdoc
00:09:48.08 for those who wish to go on to research careers,
00:09:50.02 instead of allowing it to continue to be the default step,
00:09:54.13 which I think is what it is for many postdoctoral fellows today.
00:10:00.03 We want our graduate students,
00:10:03.06 really, from the beginning of graduate school,
00:10:05.05 to be thinking about how they're going to craft their education
00:10:08.01 so that they end up in the positions
00:10:11.08 that they are really interested in pursuing.
00:10:15.03 Here's a recommendation that also has been highlighted
00:10:18.17 in an iBio video by Greg Petsko,
00:10:21.16 who chaired a wonderful committee
00:10:25.13 called the Postdoctoral Experience Revisited.
00:10:28.04 It has many very wise recommendations in it,
00:10:33.12 but one that I think is going to be important if we're going to really get control
00:10:37.00 of the Malthusian Laboratory
00:10:39.05 is we have to pay our postdoctoral fellows
00:10:43.09 in a way that reflects both their education
00:10:46.02 and their experience.
00:10:47.17 Once again, I'm happy to say that
00:10:50.22 there's been small progress on this.
00:10:53.03 Stanford University recently announced
00:10:55.03 that it is going to set a floor for the pay of postdoctoral fellows,
00:11:00.23 including in the biomedical sciences,
00:11:03.07 of $50,000.
00:11:05.01 I think that's a fabulous start.
00:11:07.14 But... and clearly one that may incentive
00:11:11.03 other competitive universities to follow in their suit.
00:11:14.10 Whether that is the right number,
00:11:17.04 I'm not prepared to say.
00:11:19.01 But I do think, by paying postdocs
00:11:22.11 what they deserve to be paid...
00:11:24.00 there will be fewer of them,
00:11:26.01 and that is clearly one of the advantages of this recommendation...
00:11:29.03 but it's also respecting
00:11:32.11 the quality and the extent of their education.
00:11:37.12 Here is probably the most challenging,
00:11:40.13 from the perspective of the community,
00:11:42.20 but I think one of the most important
00:11:45.05 of the recommendations about what to do.
00:11:47.23 And that is, we have to really change the ratio
00:11:53.17 of the members of the laboratory who are trainees,
00:11:55.22 on their way in that bulging pipeline
00:11:58.11 to new positions,
00:12:00.24 relative to the members of the laboratory who will be permanently associated
00:12:04.20 with the laboratory.
00:12:06.05 This is something that has been adopted
00:12:10.12 years ago at the National Institutes of Health,
00:12:12.08 thanks to initiatives led by Harold Varmus.
00:12:15.24 And if you speak to investigators
00:12:18.17 at the National Institutes of Health,
00:12:20.11 they will tell you that,
00:12:22.01 contrary to sort of modern myth,
00:12:25.00 having staff scientists, PhD-trained scientists,
00:12:28.21 as permanent members of your laboratory
00:12:31.03 is an immense advantage
00:12:34.01 and does not decrease productivity.
00:12:35.20 It actually increases productivity.
00:12:38.00 This is not an easy sell.
00:12:41.00 And it is probably one of the hardest recommendations
00:12:43.16 to really get buy-in from the community.
00:12:46.13 But I think unless we head in this direction,
00:12:48.15 it's really gonna be hard to get our handle
00:12:51.23 on this Malthusian dilemma.
00:12:55.05 And then, the last recommendation,
00:12:57.10 which I've alluded to briefly before is...
00:13:02.00 we're very much taken with the idea of
00:13:06.04 increasing the number of core facilities.
00:13:07.13 We think this is a much more eff...
00:13:10.11 efficient and effective way to conduct research.
00:13:14.06 But it also provides employment
00:13:17.03 for PhDs who are not interested in running their own laboratory,
00:13:21.03 or even working in a research laboratory,
00:13:24.04 but really want to be at the cutting edge of a new technology,
00:13:27.05 and to provide that new technology to the entire community.
00:13:33.00 This is, I think, a recommendation that will involve
00:13:38.13 both universities getting behind such an idea
00:13:40.22 and the NIH,
00:13:42.21 and thinking about funding mechanisms to ensure that they are stable.
00:13:46.19 So, where would these recommendations,
00:13:49.02 if they were all implemented...
00:13:51.01 where would they lead?
00:13:53.22 Well, it would lead to a sustainable biomedical laboratory.
00:13:56.16 So, what would be the characteristics of that laboratory?
00:13:59.19 First and foremost, they're going to be slightly smaller.
00:14:03.01 And if they're not going to become slightly smaller,
00:14:06.11 inevitably there have to be fewer laboratories.
00:14:09.24 Second of all, there are going to be fewer postdoctoral fellows,
00:14:13.05 and they will be better paid.
00:14:16.03 Third, there will be more permanent members of the laboratory:
00:14:20.04 technicians and staff scientists.
00:14:23.01 And more of the work
00:14:25.17 that is currently being done by trainees
00:14:27.10 will be undertaken by very effective, competent,
00:14:33.01 and technically expert core facilities.
00:14:36.22 And if we can move in the direction
00:14:39.20 of creating this sustainable biomedical laboratory,
00:14:43.02 I think we will go a long way
00:14:46.03 to reducing the kinds of stresses and the strains
00:14:48.17 that currently plague the enterprise today.
00:14:52.04 So, I want to end by saying thank you
00:14:54.21 for watching this video.
00:14:56.05 Thank you for listening.
00:14:58.02 And I know that I welcome all feedback on this video,
00:15:02.02 as do my co-authors.

This Talk

Speaker: Shirley Tilghman

Audience:

Researcher

Recorded: September 2015

Talk Overview

Shirley Tilghman talks about a Malthusian dilemma in biomedical research. For almost a decade, available research dollars has stayed the same or decreased, while the number of awarded PhDs has risen rapidly. This has resulted in an increase in training times for graduate students and post-docs – a phenomenon she calls a “bulging pipeline.” Tilghman presents several concrete solutions to begin to address the impending unsustainability of the biomedical workforce and improve the Malthusian dilemma.

Speaker Bio

Shirley Tilghman

Shirley Tilghman is the President Emerita and Professor of Molecular Biology at Princeton University. Dr. Tilghman is a strong visionary and leader in academic research and higher-level education. As President of Princeton University for 13 years (2001-2013), she implemented policies and initiatives that supported better training of Princeton students and increased diversity in the faculty… Continue Reading