Furthermore, the committee recommends that training levels after 2003 be commensurate with the rise in the total extramural research funding in the biomedical, clinical, and behavioral and social sciences.
Although manpower models have been developed in this report, they are not particularly useful in assessing the role of NRSA support in particular, as this represents only a small fraction of the total training support in the biomedical sciences. Available information, however, suggests that the system is in reasonable balance. Stipends clearly should rise over time, but this should be accomplished by the allocation of additional funds, not by decreasing the number of trainees. The relatively low unemployment among Ph.D.s in the biomedical sciences, an almost constant number of U.S.-trained doctorates from 2001 to 2003, and the fact that the pool of postdoctorates appears to be stabilizing or declining justify the suggested level, which should not fall below that of 2003.
The year 2001 is the last one for which reasonably accurate data were available for awards specific to the biomedical sciences. However, the total number of NRSA awards continued to rise (Figure 1-1) in 2002 and 2003, and it is assumed that the awards in the biomedical sciences have also increased. Using the percentage increase from 2001 to 2003 from Table 1-1 and the actual awards data for 2001 in Tables 2-2 and 2-3, the predoctoral and postdoctoral traineeships in the biomedical sciences in 2003 are estimated to be 5,390 and 1,740, respectively. Fellowship data for 2002 appear to be more complete and show that awards at the postdoctoral level are somewhat below those of 2001. Based on the totals for NRSA predoctoral and postdoctoral training in 2001 and 2003, the estimated levels for fellowships in 2003 for the biomedical sciences are 425 and 1,450, respectively.
The primary rationale for NRSA is to attract high-quality people into specific research areas and to set the training standards for major research fields. NRSAs should be a paragon for quality training and have served this role admirably. NRSA programs are an important investment in the future to ensure the health of the research enterprise and should be made by all NIH institutes and centers.
Beyond the monetary requirements of maintaining NRSA training numbers, this committee does not recommend that support be shifted from research grants to training grants (contrary to the recommendation of the previous committee). A balance is needed between research and training grants for the productive support of students and postdoctorates. Research grants offer an alternative training venue, and students and postdoctorates are essential for accomplishing the research specified in research grants. Moreover, a variety of support mechanisms for training is desirable. The NRSA provides multiple pipelines into the research endeavor, most notably for foreign students and postdoctorates. In certain technical areas, insufficient numbers of U.S. citizens are available to train in and carry out national research efforts in critical areas. The training of foreign scientists on research grants has also significantly enriched the talent pool in this country, as they often join the workforce for extended periods of time, including permanent residence.
Although two earlier National Academies committees23,24 have recommended that some NIH research funding be shifted to training grants and fellowships, our committee has concluded—based on the uncertainty about the rate of future growth in employment opportunities in industry, and perhaps other sectors, and the considerations discussed above—that the number of graduate students supported on NRSA training grants should not increase any faster than NIH research funding, which is a principal determinant of employment demand. With regard to postdoctoral support, another National Academies committee25 has recommended that foreign scientists be permitted to receive training grant and fellowship support—thereby increasing the size of the eligible pool—and that some research funds be transferred to training budgets. However, consideration of the current restriction on supporting foreign scientists on NRSA training was outside the scope of this study and was not discussed by our committee.
At the present time, the committee does not recommend a shift in the overall proportion of training dollars spent on NRSA versus other training vehicles but does suggest that the ratios of research dollars to fellows/students be maintained in approximate alignment for the different areas and that training efforts be supported by all NIH institutes and centers. Better coordination of training efforts across institutes is needed. The committee recognizes, however, that the balance may vary from field to field and will evolve over time.
Recommendation 2-2: This committee recommends that the size of MSTP programs be expanded by at least 20 percent and that the scope be expanded to include the clinical, health services, and behavioral and social sciences.
Available evidence suggests that it is increasingly difficult for physicians to move into research because of the high cost of medical training and graduates’ enormous debt load. Nevertheless, the committee believes that it is very important to attract physicians into research and that MSTP programs have done so with remarkable success; the excellent record of these programs’ M.D./Ph.D.s in obtaining research grants and remaining in research is well documented. This would increase the number of trainees from the 2003 level of 933 to about 1,120.
As has been the policy, MSTP grants should be confined to institutions where high-quality medical and research train-