Lost dollars threaten research in public academic health centers

Decreasing federal and state support threaten long-term sustainability of research in publicly supported academic health centers. In weathering these financial threats, research at the University of California, San Francisco (UCSF) has undergone three substantial changes: (i) institutional salary support goes preferentially to senior faculty, while the young increasingly depend on grants; (ii) private and government support for research grows apace in clinical departments, but slowly declines in basic science departments; and (iii) research is judged more on its quantity (numbers of investigators and federal and private dollars) than on its goals, achievements, or scientific quality. We propose measures to alleviate these problems. Other large public academic health centers probably confront similar issues, but--except for UCSF--such centers have not been subjected to detailed public analysis.