In conversation with Professor Michael Horowitz, Chair - Grants Advisory Committee, RACP Foundation

An endocrinologist engaged in translational clinical research, Professor Horowitz describes himself as a physician-scientist. Interestingly, he has spent his entire 40-year career at the University of Adelaide and the Royal Adelaide Hospital, less than 4kms from where he was born. His research continues to focus on the relevance of gastrointestinal function in relation to diabetes, appetite regulation, ageing, and critical illness. Since 2007, he has led the Centre for Research Excellence in Translating Nutritional Science to Good Health at the University of Adelaide. Professor Horowitz is also the Director of the Endocrine and Metabolic Unit at the Royal Adelaide Hospital, a position he has held since 1997.

Looking back on his career and long association (over 15 years) with the Foundation and the GAC, Professor Horowitz considers the training and mentorship of clinician-scientists as his key area of interest, having personally supervised more than 50 PhD or MD candidates from diverse backgrounds, including physicians and clinicians with previous training in nuclear medicine, nursing, and dietetics. He strongly believes that the involvement of clinician-scientists is fundamental for high-quality health and medical research to be pursued and translated successfully into improved approaches to disease prevention and management.

Unfortunately, in Australia and much of the Western world, the number of physician-scientists continues to decrease for various reasons, including the increasingly low success rate and relatively diminished resources of traditional funding bodies, such as the NHMRC in Australia. The plight of ‘endangered’ physician-scientists represents a major motivation for Professor Horowitz and his colleagues on the GAC. He credits mentors such as Professor Richard Larkins, who initially encouraged him to be involved in the support and development of physician-scientists through the RACP Foundation.

During his tenure, Professor Horowitz has seen the Foundation change and evolve substantially, including the emergence of the GAC. The GAC is an inclusive group, with 10 members representing the various divisions and faculties of the College. As it is a skill-based committee, members must have a sound understanding of research processes. The GAC reports to the College Research Committee (CRC). Review panels are constituted for each grant/award category and comprise experienced reviewers, as well as representatives from partner organisations, who evaluate and score some 250+ applications. Staff at the Foundation aggregate the scores of individual reviewers and provide a consolidated overview of all applications in each award category for discussion by the GAC. The process is both rigorous and time-consuming – as all grants are assessed by a minimum of three reviewers and any application where scores are inconsistent is discussed by the whole committee. Professor Horowitz is proud of the commitment of the GAC members and the high standards they have been able to achieve and maintain.

The GAC provides funding to support basic and clinical medical research, as well as research relating to medical education, health services, and population health, in accordance with the College Strategic Plan. The focus is support for early and mid-career physician-scientists to allow them to establish and develop their research careers. More than 50 fellowships, scholarships, and grants are available annually, amounting to $2.5 million in funding from the GAC.

Professor Horowitz clarified that the concept is to provide strategic support at crucial stages of a physician-researcher’s career. Research Entry Scholarships allow a research career to be initiated (often by pursuing a PhD or MD). Research Establishment Fellowships provide support to individuals who have in most cases recently completed a higher degree, while Career Development Fellowships are directed at the support of mid-career researchers. Physician-researchers at all stages of their career are currently under threat, but those in the research establishment phase are perhaps the most vulnerable. In part, this is because their capacity to transition the NHMRC system has recently diminished markedly – the success rate of applications is of the order of only 10 per cent. The GAC considers it both undesirable and illogical for such talented individuals to leave research when they have been highly successful, and their longer-term potential has been clearly established.

According to Professor Horowitz, the support of future clinician-scientists in Australia is an area in which the College should play a key leadership role and advocate for increased funding opportunities. He also observed that funding for research by teaching hospitals had, in many cases, been reduced substantially in response to increasing fiscal pressures, particularly those relating to clinical care. He considered that the relationships between teaching hospitals, universities, and research institutes be re-evaluated to foster the development of clinician-scientists. The College enjoys substantial goodwill via its Fellows that can be tapped into and the fundamental question to be asked is: Do we want to encourage outstanding physicians to pursue research?

Every time it is evident that the grant/award provided by the Foundation has had a successful outcome and facilitated career progression, it provides satisfaction to the members of the GAC, including Professor Horowitz. As a previous recipient of the Eric Susman Prize – a prestigious award presented by the College for the best contribution to the knowledge of any branch of Internal Medicine – he understands the significance of strategic support. He also knows that while becoming a physician-scientist is a career path for the minority, it an important, rewarding, and enjoyable one. He believes that good healthcare must be informed by research and that clinical research is arguably the greatest safeguard to care.

Finally, Professor Horowitz noted that he greatly enjoyed being involved with the GAC, interacting, and spending time with fellow members of the committee, and considers that his role as Chair was a privilege. He now counts a number of the members as friends and freely admits he’ll miss seeing them, as well as the outstanding administrative staff at the Foundation. He is confident that the GAC is in very able hands with Professor Graham Lieschke as the Chair. Professor Horowitz very much hopes that the current landscape for Australian physician-scientists will improve substantially in the immediate future.