National Academy of Medicine

Training the Workforce for 21st-Century Science: A Vital Direction for Health and Health Care

By Elias Zerhouni, Jeremy Berg, Freeman A. Hrabowski, Raynard Kington, and Story Landis
September 19, 2016 | Discussion Paper

Continuing to improve human health at reasonable costs is one of the biggest challenges facing society in the 21st century. Prior scientific advances have led to longer life expectancies, which in turn have led to the emergence of chronic diseases often related to aging. Our health-care system was designed primarily for acute care, whereas today chronic disease is responsible for 80% of health-care costs. The current system is characterized by episodic care, fragmentation of services, and a less than-holistic view of the patient, all of which lead to a growth in inefficiencies and costs.

The need for more coordinated and seamlessly integrated multidisciplinary care is obvious. In parallel, advances in our knowledge of biologic systems and their complexity will require an unprecedented convergence of biologic, physical, and information sciences to solve the issues that we face. The life sciences are moving from an era of monodisciplinary and reductionist explorations of the fundamental elements of biologic systems to a multidisciplinary understanding of human biology and the course of disease. Given that evolution, the hope of precision medicine is unlikely to be realized without a transformation in how we educate and train a new generation of physicians, scientists, engineers, and population-health professionals. These experts need to be able to create and implement new ways of tackling complexity with the goal of reducing disease burden at a cost that society can afford.

Today, our biomedical educational and scientific training pathways are fragmented. Young talents are often discouraged because of the longer and uncertain pathways to a successful career, especially when they will be saddled with a much greater debt burden at the end of their studies than was the prior generation.

Over the last 100 years, the United States assumed a global position of unparalleled scientific achievement and has reaped the many health, economic, diplomatic, social, and military benefits of its preeminence. United States citizens have been awarded more Nobel prizes in physiology or medicine than those of any other country—by a factor of 3. Those accomplishments have contributed to remarkable improvements in human health, innovation, and economic success and to a great sense of national pride. Our preeminence, however, is now being challenged by external and internal factors.

About the Vital Directions for Health and Health Care Series

Vital DirectionsThis publication is part of the National Academy of Medicine’s Vital Directions for Health and Health Care Initiative, which called on more than 100 leading researchers, scientists, and policy makers from across the United States to provide expert guidance in 19 priority focus areas for U.S. health policy. The views presented in this publication and others in the series are those of the authors and do not represent formal consensus positions of the NAM, the National Academies of Sciences, Engineering, and Medicine, or the authors’ organizations.
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Suggested Citation

Zerhouni, E., J. Berg, F. A. Hrabowski, R. Kington, and S. Landis. 2016. Training the Workforce for 21st-Century Science: A Vital Direction for Health and Health Care. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. doi: 10.31478/201209p


Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.