Be honest. Has this ever happened to you? You are about to get out of the shower in the morning and suddenly ask yourself the question: "Did I shampoo my hair?" And you're not sure of the answer?
"The Mafia put a contract out on the life of Albert Einstein-he knew too much."
Vignettes like this happen to me, and reflect the fact that I am no longer a spring chicken. Specifically, I am over 35, by which age (it is said) all physicists if not all scientists have made their greatest contributions. Albert Einstein published his papers on relativity in his 20s. Bill Gates dropped out of college to start Microsoft.
Arnall Patz, MD, my department chairman when I was a resident, published the first randomized clinical trial in ophthalmology and showed that exposing premature infants to high levels of oxygen resulted in retinopathy of prematurity in 1952, at the ripe old age of 32, for which he received the Lasker Award. But he was delayed in performing this study because a review committee of senior scientists had reviewed his proposal and pronounced it "devoid of scientific merit."
Many older people have vibrant minds, but young minds are particularly likely to conceive great new ideas, challenge the status quo, and make dramatic contributions. Old minds, like mine, may not even reliably recall things that happened a few minutes ago.
Our nation is at war, and our budget deficit is large. As a result, funding by the National Institutes of Health (NIH) is projected to decrease, and the likelihood of a good research grant proposal actually being funded by The National Eye Institute is expected to decline from 40% (a few years ago) to 10% (a few years from now). This year, only the top 18% to 19% of scored grant proposals (many are deemed to have some flaw and therefore are not scored) will be funded. A grant application now has to be almost perfect to compete successfully for funding. For a young, beginning scientist or clinician-scientist, competing against established senior investigators with large laboratories and research teams, the challenge is daunting.
It appears that many young faculty are no longer even trying. According to the NIH, the percentage of applicants for NIH funding who are 35 or younger has plummeted over the last 2 decades (see Table 1). The percentage of applicants for NIH grant funding who are 35 years of age or younger has dropped from about one-fourth to almost zero. The 36-to 45-year-olds have also dropped as a percentage. Meanwhile, the percentage of researchers in the 46 to 55 and over 56 age categories has roughly doubled.
As my hairline recedes (and my waistline does the opposite), I become increasingly appreciative of the wisdom, maturity, and other fine qualities that come from being over age 46. On the other hand, I think it is a shame that many young scientists, at their creative peak, are being shut out of the NIH-funding mechanism, and hence shut out from careers as scientists and clinician-scientists.
Peter J. McDonnell, MD is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of Ophthalmology Times. He can be reached at 727 Maumenee Building, 600 North Wolfe St., Baltimore, MD 21287-9278 Phone: 443/287-1511 Fax: 443/287-1514 E-mail: firstname.lastname@example.org