I'm a MD/PhD student, and I already see the handwriting on the wall.  There isn't going to be the funding anymore.  The Powers that Be just don't care if America is the world leader in biomedical research anymore.  They'd rather it all be done by highly-skilled, dirt cheap labor from India and China.  Either way, they still get their life-saving cures.

It makes me sad, but it seems like those who stay behind will only be the well-established with strong links to corporate money.