Doctoral programs to train future leaders in clinical and translational science.

In 2005, the National Institutes of Health (NIH) called for proposals to develop clinical and translational science (CTS) centers at institutions nationwide.1 As first articulated in the NIH Roadmap,2 the rationale for funding this initiative was that, by making the boundaries between basic and clinical research more permeable, research findings could be more rapidly translated into broad improvements in public health.3 Every year, the NIH gives $500 million in Clinical and Translational Science Awards (CTSAs) to create and support these centers, representing the largest publicly funded outlay aimed at stimulating translational research.4 In 2006, the NIH awarded its first 12 CTSAs through the National Center for Research Resources. As of 2011, the NIH reached its goal of funding 60 institutions through the CTSA program, which is now under the auspices of the National Center for Advancing Translational Sciences.5 A primary mission of CTSA-funded institutions is establishing CTS as a discipline; the key metric for judging their success will be the number and quality of translational investigators they train.6 The overall initiative was based on the recognition that, to promote CTS objectives, a qualitatively different type of investigator was required, one for whom the necessary expertise could no longer be acquired on the job.1,7 To fulfill the education and training goals of this new discipline, the majority of CTSA-funded institutions have established certificate programs and master’s degree programs in CTS.8 Because a doctoral program is the most academically rigorous form of training in the core principles of CTS, the NIH encourages institutions that do not have PhD programs in CTS to develop them. It also encourages institutions that already have CTS-related PhDprograms to consolidate these programs under CTSA program oversight.1 Anecdotal evidence indicates that institutions have faced challenges to creating these programs, including financial barriers, lack of institutional support, and competition for students from similar programs. They have also faced challenges to developing and strengthening the programs, including difficulties in defining CTS and delineating it from other disciplines, lack of agreement about core competencies and related curricula, and problems in demarcating and defining the core faculty.9–11 Yet, despite the fact that some CTSAs were awarded as long as six years ago, no systematic investigation has been done of the development and characteristics of PhD programs in CTS. We believed that the maturation of the CTSA programs made this an ideal time to address several key questions about the evolution of PhD programs in CTS. We therefore developed a cross-sectional survey to gather data from leaders of CTS programs at the 60 institutions that have received CTSAs. Our specific goals were to determine how many of these institutions currently had or were developing PhD programs in CTS; to examine potential differences between programs developed before and after the CTSA funding initiative (previously existing versus newly developed programs); and to describe in detail the characteristics of the new programs. We believed that the findings from our survey would serve as a marker of the impact of CTSA funding on the development and deployment of trained investigators in CTS.