The Physician–Scientist in the Pediatric Intensive Care Unit

Recent occurrences have laid the groundwork for immense research opportunities in pediatric critical care medicine. Just after the start of the new millennium, the journals Science and Nature respectively announced the completion of the Human Genome Project by Celera and the National Institutes of Health (NIH) [1,2]. The realization of this vision, once considered by many as the ultimate pinnacle of science, came to fruition largely as a result of the great advances in molecular biology over the past decades. The completion of this crucial task has identifi ed an estimated 30,000 genes in the human genome. However, with alternative splicing variants, single nucleotide polymorphisms, and post-transcriptional modifi cations, it is estimated that these genes encode for some 300,000 separate proteins in humans. The need for advanced informatics tools to be applied to this new science of genomics necessary to integrate and correlate huge numbers of data have driven the age of bioinformatics. Simultaneously, there has been a recent recognition that children should be incorporated into clinical trials. Under the auspices of the Food and Drug Administration Modernization Act of 1997, incentives are in place that encourage drug companies to perform studies in children. At the NIH, leadership has been put in place that represents the voice of pediatric intensivists not only at the National Institute of Child Health Development (NICHD) but also at other branches of the NIH, such as the National Heart, Lung, and Blood Institute (NHLBI) and General Medical Science (NIGMS). Networks, such as the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) group and virtual PICU (vPICU), are evolving with the goal of uniting academic divisions of pediatric critical care in order to devise strategies by which clinical trials can be designed through sharing of resources, revenue, and patient data. At the same time, a general consensus exists that there is a critical shortage of pediatrician–scientists [3,4]. Finally, as the understanding of the pathogeneses of diseases reaches the cellular and molecular levels, the gap between medicine and molecular biology will disappear. It is imperative that all physicians caring for critically ill children in this new era have a thorough understanding of the applicability of molecular biology to clinical medicine. The challenge for the physician–scientist in the year 2006 and beyond will be to bring these new fi ndings from the bench to the bedside. Thus, in this exciting time, the potential for enormous research growth exists. It is imperative that the pediatric Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 A “Call to Arms” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Newly Revised Requirements for Subspecialty Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 What the New Proposals Suggest . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 What Specifi cs to Look for in a Program or Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Where Can One Find Funding Opportunities? . . . . . . . . . . . . . . . 76 Features that Characterize the Successful Researcher . . . . . . . . . 77