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Rheumatology’s Architect

David A. Fox, MD  |  Issue: March 2008  |  March 1, 2008

At its January 2008 meeting, the REF board voted to create a new grant category, the Rheumatology Investigator Award, which will provide substantial support for career development of rheumatology junior faculty who are launching their research programs. Although a thorough review and overhaul of all REF grant mechanisms is underway, the REF board saw an urgent need for this new grant mechanism and put it on the fast track; the first round of proposals will be due this summer and will be funded in 2009.

Progress in the Within Our Reach campaign was also reviewed at the meeting. Halfway through the campaign, the REF has raised nearly $20 million dollars, more than 60% of its goal. Fifteen two-year grants were awarded in 2007, representing an expenditure of $6 million dollars, and another round of applications has already been received for review. The REF is still building its base of patient-donors, a process in which all members of the ACR can participate. And the ACR’s Committee on Research is beginning to develop the REF’s next targeted research initiative, which is due to be presented to the combined boards of the ACR and REF in August 2009.

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The decision to embark on large-scale targeted research was a bold step for the ACR and the REF, but it did not come at the expense of our training and career development programs. Indeed, the REF, blessed by assets fourfold greater than it had just five years ago, has created an endowment to guarantee permanent funding of its core missions, and is on target to build that endowment to $25 million by 2010. New goals will be framed as we near that initial target. Don’t be surprised if we set our sights on a $100-million endowment by 2020 or sooner.

You might wonder why an endowment of such proportions is necessary. Consider that much of the growth of the REF has been fueled by the pharmaceutical and biotechnology industries’ interest in strengthening the field of rheumatology through participation in the REF Industry Roundtable. Becoming a roundtable member requires significant contributions to the REF. It’s difficult to know how long these companies will be willing or able to provide this support, and it would be a serious error to assume that it will continue in perpetuity. Consider also that expenditures by the NIH and charitable foundations for rheumatologic research include only limited—and shrinking—funding for rheumatology trainees. And consider that our manpower projections (which the REF board studied carefully in January) compel us to create mechanisms to train more rheumatologists than we are currently. The issue is not whether we need an endowment, but how large we can make it.

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Everyone Can Help

If you are one of the majority of ACR members who is engaged in clinical practice outside of an academic unit, you might wonder why the REF is important to you. The activities of the REF are essential to the health of the academic rheumatology units, which, in turn, is the key to sustaining our profession. In addition to guiding young physicians and health professionals towards a career in rheumatology and preparing them for clinical or academic practice, specialized disease-focused centers localized in academic institutions provide education, referral opportunities, and clinical research that defines best practices for our most challenging patients. Only a few years ago, barely more than 100 trainees per year were entering rheumatology fellowships, including few U.S. medical graduates. By developing new mechanisms to fund training for clinical fellows and expanding research training support, the REF played a major role in addressing this crisis. Today, about 180 physicians enter rheumatology fellowship programs each year, most of whom are U.S. medical graduates, and the number of fellows training in pediatric rheumatology units has more than doubled. We all know that a significant workforce shortfall exists nonetheless, and will get worse unless we take further action—but just imagine how much worse this might be if not for the vision of the REF leaders, the aggressive implementation of new programs, and the generous support of those who have donated to the REF.

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Filed under:Meeting ReportsPresident's PerspectiveProfessional Topics Tagged with:AC&REducationFellowsREF NewsResearch and Education Foundation

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