Cardiovascular Research in Germany.

Introduction: Development of Cardiovascular Research German academic cardiovascular medicine has been traditionally rigidly separated into clinical cardiology, where the top clinicians had some early career basic science exposure but practiced exclusively clinical medicine, and classic basic science departments, that is, physiology, pharmacology, and pathology, where the chair had a cardiovascular focus. The institutional funding by the universities, which are, with few exceptions, state institutions in Germany, was sufficient to provide budget/resources for personnel, equipment and consumables to conduct basic research, and was in the range of 1 to 2 Mio € per year for such institutions. This situation has changed progressively but profoundly during the past 3 decades: almost all university clinics of cardiology now practice not only clinical cardiology but perform also basic science studies. They find it, however, increasingly difficult to recruit young physicians to a clinician scientist path of career. Basic cardiovascular science is no longer restricted to the classic university departments of physiology, pharmacology, pathology, but many chairs for experimental cardiovascular medicine under a variety of names/designations have been founded (>10 chairs in the past decade). Here, it has become extremely difficult to recruit young physicians into such basic science departments, and their personnel has now mostly a natural sciences rather than a medical background. Institutional funding for a basic cardiovascular research department has been restricted and now rarely exceeds 300 000 € to 600 000 € per year. Thus, there is an increasing pressure for competitive external funding. Along with these changes, the rigid hierarchical system of German academic medicine with a single professor and chair has become more flexible and more similar to the AngloAmerican system where many professors with a different specialization coexist in the same department. Such more flexible system has in part evolved because many clinicians and researchers have had exposure to the Anglo-American system in the form of international postgraduate training or fellowships. Quantitative data on the number of scientists working in Germany is not available to us. We assume, though, that the number of researchers organized in the German Cardiovascular Research Center (DZHK) provides a reasonable estimate. Currently, the DZHK has 1353 members, of whom 143 are principle investigators, 344 scientists (>7 years after PhD, >10 years after medical exam), and 866 PhD students or researchers ≤7 years after PhD or 10 years after medical exam. Assuming that the DZHK represents ≈40% of total cardiovascular science in Germany, the numbers would amount to 3383/358/860/2165. German scientists are traditionally organized in societies. The German Society for Circulation Research is the oldest cardiovascular society in Europe. It was founded in 1927 and initially had an academic and scientific focus. In the past decades, it has coevolved with the above discussed changes in German cardiovascular medicine and has been extended to clinical and public health-related interests. The German Cardiac Society (renamed 1994) is currently among the largest cardiovascular societies with >10 000 members. Still, the German Cardiac Society is a scientific stronghold, and its well-attended annual meeting in Mannheim remains an important forum for basic and translational cardiovascular research. Even though basic scientists make up <4% of all members, 6/29 Working Groups focus on basic and translational research and ≈20% (372 of 1880 accepted abstracts in 2017) were categorized as basic/translational research. The German Cardiac Society also publishes 2 prestigious journals, that is, Basic Research in Cardiology (IF 5.3) and Clinical Research in Cardiology (IF 4.7).