ADVANCING THE NATION’S HEALTH NEEDS

Committee for Monitoring the Nation’s Changing Needs for Biomedical, Behavioral, and Clinical Personnel

Board on Higher Education and Workforce

Policy and Global Affairs

NATIONAL RESEARCH COUNCIL OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS
Washington, D.C.
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Advancing the Nation’s Health Needs ADVANCING THE NATION’S HEALTH NEEDS Committee for Monitoring the Nation’s Changing Needs for Biomedical, Behavioral, and Clinical Personnel Board on Higher Education and Workforce Policy and Global Affairs NATIONAL RESEARCH COUNCIL OF THE NATIONAL ACADEMIES THE NATIONAL ACADEMIES PRESS Washington, D.C. www.nap.edu

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Advancing the Nation’s Health Needs THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Contract/Grant No. N01-OD-4-2139, TO#104, between the National Academy of Sciences and the National Institutes of Health, Department of Health and Human Services. Additional support was provided by the Agency for Healthcare Research and Quality Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the Committee for Monitoring the Nation’s Changing Needs for Biomedical, Behavioral, and Clinical Personnel and do not necessarily reflect the views of the organizations or agencies that provided support for the project. International Standard Book Number 0-309-09427-5 Library of Congress Catalog Card Number 2005928995 Additional copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu Copyright 2005 by the National Academy of Sciences. All rights reserved. Printed in the United States of America

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Advancing the Nation’s Health Needs THE NATIONAL ACADEMIES Advisers to the Nation on Science, Engineering, and Medicine The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Wm. A. Wulf are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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Advancing the Nation’s Health Needs COMMITTEE FOR MONITORING THE NATION’S CHANGING NEEDS FOR BIOMEDICAL, BEHAVIORAL, AND CLINICAL PERSONNEL Gordon G. Hammes, Ph.D., Committee Chair, University Distinguished Service Professor of Biochemistry, Duke University Michael M. E. Johns, M.D., Vice-Chair, Executive Vice President for Health Affairs, Director, Robert W. Woodruff Health Science Center, Emory University Richard M. Shiffrin, Ph.D., Vice-Chair, Luther Dana Waterman Research Professor, Director, Cognitive Science Program, Indiana University Larry L. Bumpass, Ph.D., Norman B. Ryder Professor of Sociology Emeritus, University of Wisconsin Christine K. Cassel, M.D., President, American Board of Internal Medicine William T. Greenough, Ph.D., Swanlund Chair and Center for Advanced Study Professor of Psychology, University of Illinois, Urbana-Champaign James S. Jackson, Ph.D., Daniel Katz Distinguished University Professor of Psychology, University of Michigan Lynn T. Landmesser, Ph.D., Arline H. and Curtis F. Garvin Professor and Chair of the Neuroscience Department, Case Western Reserve University William Lennarz, Ph.D., Distinguished Professor and Chairman of the Department of Biochemistry and Cell Biology, Stony Brook University, State University of New York, Joseph B. Martin, M.D., Ph.D., Dean of the Harvard Faculty of Medicine, Harvard Medical School Barbara Meyer, Ph.D., Investigator, Howard Hughes Medical Institute, and Professor of Genetics and Development, University of California, Berkeley Georgine Pion, Ph.D., Research Associate Professor, Vanderbilt University Edward H. Shortliffe, M.D., Ph.D., Columbia Presbyterian Medical Center Professor and Chair, Columbia University Department of Biomedical Informatics Panel on Oral Health Robert Genco, Panel Chair, Distinguished Professor and Chair, School of Dental Medicine, Oral Medicine & Biomedical Sciences, University at Buffalo, State University of New York Charles Bertolami, Dean and Professor, School of Dentistry, University of California, San Francisco Chester Douglass, Professor, Harvard School of Dental Medicine Marjorie K. Jeffcoat, Dean, The Robert Schattner Center, University of Pennsylvania School of Dental Medicine Edward H. Shortliffe, Parent Committee Liaison, Professor and Chair, Columbia Presbyterian Medical Center Panel on Nursing Ada Sue Hinshaw, Panel Chair, Dean and Professor, School of Nursing, University of Michigan Sue Karen Donaldson, Professor, John Hopkins University School of Nursing Margaret M. Heitkemper, Chair, Professor, Department of Biobehavioral Nursing and Health Systems, University of Washington Marla Salmon, Dean and Professor, Nell Hodgson Woodruff School of Nursing, Emory University Michael M. E. Johns, Parent Committee Liaison, Executive Vice President for Health Affairs, Director, Robert W. Woodruff Health Science Center, Emory University

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Advancing the Nation’s Health Needs Committee Staff James Voytuk, Senior Program Officer Herman Alvarado, Research Associate Patricia Santos, Senior Program Assistant Elizabeth Scott, Office Assistant Board on Higher Education and Workforce Richard A. Tapia, Chair, Rice University Burt Barnow, Institute for Policy Studies, Johns Hopkins University Donald L. Bitzer, North Carolina State University Nancy Cantor, Syracuse University Ronald G. Ehrenberg, Cornell University Carlos G. Gutierrez, California State University, Los Angeles Nancy B. Jackson, International Security Center, Sandia National Laboratories Donald L. Johnson, Product & Process Technology, Grain Processing Corporation (retired) Claudia I. Mitchell-Kernan, University of California, Los Angeles Michael T. Nettles, Center for Policy Studies and Research, Research and Development, Educational Testing Service Debra W. Stewart, The Council of Graduate Schools Tadataka Yamada, GlaxoSmithKline Peter Henderson, Board Director

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Advancing the Nation’s Health Needs Preface This report is the twelfth assessment of the National Institutes of Health National Research Service Awards program. The research training needs of the country in basic biomedical, clinical, and behavioral and social sciences are considered. Also included are the training needs of oral health, nursing, and health services research. The report has been broadly constructed to take into account the rapidly evolving national and international health care needs. The past and present are analyzed, and predictions with regard to future needs are presented. This report represents a team effort of a diverse group of people. The primary committee consisted of experts from the basic biomedical sciences, clinical sciences, behavioral and social sciences, and demographics. In addition, subcommittees were constituted to assess research training in oral health and nursing, and an expert in health services research was consulted. Information was obtained from many different groups and individuals, including experts within the National Institutes of Health. The final report is a composite of the many viewpoints that were expressed. Although we attempted to base the final recommendations solely on factual information, we found that the data available were incomplete. Moreover, even with the best data, the research training venue is dependent on unpredictable events such as international politics and the federal budget. Consequently, the bases for the recommendations in the report are a combination of factual data and expert opinion. It is our general consensus that although the research training establishment is doing well, implementation of the recommendations would significantly improve research training. In addition, we believe that a process allowing continuous monitoring of the research training system would permit more rapid and well-tuned responses to a changing external environment. This report was made possible by funding from the National Institutes of Health and the Agency for Healthcare Research and Quality. In addition, staff members from each of these agencies were very helpful in providing information about their training programs. From the National Institutes of Health, Walter Schaffer and Walter Goldschmidts, the program officers for this project, Sharon Gordon, and Bill McGarvey provided details on their training support and other data relevant to the committee’s deliberations. Data and information about training in health services research were provided by Karen Rudzinski at the Agency for Healthcare Research and Quality and Pamela Flattau from Flattau Associates. A commissioned paper by Donald Steinwachs was also very helpful in addressing issues in health services research. The committee is also indebted to a number of people who made presentations at committee meetings: Ruth Kirschstein, Raynard Kington, Wendy Baldwin, Judith Greenberg, Patricia Grady, and Lawrence Tabak from the National Institutes of Health; Francis Chesley from the Agency for Healthcare Research and Quality; Marguerite Barratt, and Joann Roskoski from the National Science Foundation; Alan Kraut from the American Psychological Society; and Norman Anderson from the American Psychological Association. The committee also appreciates the work of the expert staff of the National Research Council. In particular, Jim Voytuk, the study director, did a magnificent job of gathering data, organizing the committee activities, and doing much of the writing. He was ably assisted by Herman Alvarado with the data collection, Elizabeth Scott with the arrangement of meetings and editing of the committee report, and Patricia Santos whose work in preparing and editing the manuscript, researching material for the committee, and general oversight of project activities was invaluable. We also greatly appreciate the work of Rodolfo Bulatao in analyzing the demographics of the workforce and drafting Appendix D of this report. As part of the normal procedure, this report was reviewed by a group of experts and was greatly improved as a result. In the final analysis, however, responsibility for the report resides with the primary committee. We trust that the recommendations presented will receive serious consideration from the National Institutes of Health and associated agencies.

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Advancing the Nation’s Health Needs A list of the committee, panel, and staff members who contributed directly to this report is given at the beginning of the report. As the committee chair, I commend and thank them all for their contributions. This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report: Irwin Arias, Tufts University; David Breneman, University of Virginia; Gerard Burrow, Yale University; Thomas Carew, University of California, Irvine; Susan Fiske, Princeton University; Maureen Henderson, University of Washington; Hedvig Hricak, Memorial Sloan-Kettering Cancer Center; Peter Barton Hutt, Covington and Burling; Paul Kincade, University of Oklahoma; Ruth McCorkle, Yale University; Michael Teitelbaum, Alfred P. Sloan Foundation; Richard Valachovic, American Dental Education Association; Bailus Walker, Howard University; and Nancy Fugate Woods, University of Washington. Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Charles Phelps, University of Rochester. Appointed by the National Research Council, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution. Gordon G. Hammes Chair

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Advancing the Nation’s Health Needs Contents     EXECUTIVE SUMMARY   1 1   INTRODUCTION   5      Historical Context,   5      National Research Service Award Program,   8      Study Origins and Related Activities,   11      Past Reports,   11      A Perspective on Research Training Activities,   14      The Present Study,   16 2   BASIC BIOMEDICAL SCIENCES RESEARCH   18      Biomedical Research Workforce,   19      Educational Progression,   19      Early Career Progression in the Biomedical Sciences,   19      A Portrait of the Workforce,   23      Physician-Researchers,   26      The National Research Service Award Program and Biomedical Training Support,   26      Research Labor Force Projections,   31      Conclusion,   33      Recommendations,   33 3   BEHAVIORAL AND SOCIAL SCIENCES RESEARCH   36      Behavior and Social Sciences Research Workforce,   37      Educational Trends,   38      Employment Trends,   41      Research Training and the National Research Service Award Program,   43      Research Labor Force Projections,   48      Conclusion,   50      Recommendations,   50 4   CLINICAL SCIENCES RESEARCH   51      Defining the Clinical Research Workforce,   52      Educational Background,   52      The Clinical Research Workforce,   54      Clinical Workforce Issues,   58      The Medical Scientist Training Program,   59      The Role of the National Research Service Award Program,   60

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Advancing the Nation’s Health Needs      Research Labor Force Projections,   62      Conclusion,   64      Recommendations,   64 5   ORAL HEALTH RESEARCH   65      The Shortage of Dental Scientists,   65      Potential Pool of Dental Researchers,   67      Resources for Research Training,   69      National Research Service Award Program and Other National Institutes of Health Programs,   70      Conclusion,   71      Recommendations,   71 6   NURSING RESEARCH   72      Changing the Career Trajectory for Nurse-Scientists,   73      Enhancing Sustained Productivity for Nurse-Scientists,   73      Responding to the Shortage of Nurse-Investigators,   75      Emphasizing Research-Intensive Training Environments,   76      Conclusion,   78      Recommendation,   78 7   HEALTH SERVICES RESEARCH   79      Federal Support of Health Services Research,   80      Current Market for Health Services Researchers,   80      Degree Production and Employment,   83      Outlook for Health Services Research Funding,   84      The National Research Service Award Program in Health Services Research: The Agency for Healthcare Research and Quality,   85      Conclusion,   86      Recommendations,   86 8   EMERGING FIELDS AND INTERDISCIPLINARY STUDIES   87      Interdisciplinary/Multidisciplinary Research,   87      Emerging Fields,   88      Training Implications,   89      Recommendations,   90 9   CAREER PROGRESSION   91      Postdoctoral Training,   92      Transition and Career Development,   95      Foreign Researchers,   98      Underrepresented Minority Scientists,   100      Conclusion,   101      Recommendations,   101 10   FINAL COMMENTS   103      Recommendations   104     REFERENCES   106

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Advancing the Nation’s Health Needs     APPENDIXES         A   Biographical Sketches of Committee and Panel Members   111     B   Ruth Kirschstein National Research Service Award Training Grants and Fellowships   116      Individual Awards,   116      Institutional Awards,   117     C   Classification of Ph.D. Fields   119     D   Demographic Projections of the Research Workforce, 2001–2011   120      Coverage and Data,   120      Current Workforce and Recent Trends,   121      Inflows of Migrants and Graduates,   131      Outflows and Changes in Status,   135      Workforce Projections,   137      The Growing Workforce,   138      Migrant Scenarios,   141      Employment Projections,   143      Bureau of Labor and Statistics Projections,   145      Workforce Versus Positions,   146      Sectoral Prospects and Postdoctorates,   149      Conclusion,   153     E   Characteristics of Doctorates   157     E-1   Characteristics of Doctorates in the Biomedical Sciences 1970–2003,   158     E-2   Employment Characteristics of Biomedical Doctorates from U.S. Institutions, 1973–2001,   160     E-3   Characteristics of Doctorates in the Behavioral and Social Sciences, 1970–2003,   162     E-4   Employment Characteristics of Behavioral and Social Sciences Doctorates from U.S. Institutions, 1973–2001,   164     E-5   Characteristics of Doctorates in the Clinical Sciences, 1970–2003,   166     E-6   Employment Characteristics of Clinical Doctorates from U.S. Institutions, 1973–2001,   168

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Advancing the Nation’s Health Needs Figures, Tables, and Boxes FIGURES 1-1   NRSA training and fellowship grants, 1975–2003,   9 2-1   First-year and total graduate enrollment in the biomedical sciences at Ph.D.-granting institutions, 1980–2002,   20 2-2   Academic research and development expenditures in the biological sciences,   20 2-3   Number of doctorates in the biomedical sciences, 1970–2003,   21 2-4   Postdoctoral appointments in the biomedical sciences by sector, 1973–2001,   22 2-5   Postdoctoral appointments in academic institutions in the biomedical sciences,   23 2-6   Academic positions for doctorates in the biomedical sciences, 1975–2001,   24 2-7   Age distribution of biomedical tenured and tenure-track faculty, 1985, 1993, and 2001,   25 2-8   Employment of biomedical scientists by sector, 1973–2001,   25 2-9   Mechanisms of support for full-time graduate students in the biomedical sciences, 1979-2002,   27 2-10   Graduate support from NIH, 1979-2002,   28 3-1   Graduate students in the behavioral and social sciences by gender, 1979–2002,   38 3-2   Graduate support in the behavioral and social sciences, 1979–2002,   39 3-3   Doctorates granted in the behavioral and social sciences, 1970–2003,   39 3-4   Doctorates planning postdoctoral training, 1970–2003,   40 3-5   Behavioral and social science workforce (excluding postdoctorates) by gender, 1973–2001,   41 3-6   Trends in postdoctoral appointments by sector, 1973–2001,   42 3-7   Behavioral and social sciences workforce by sector of employment, 1973–2001,   42 3-8   Age distribution of the behavioral and social sciences workforce 1985, 1993, and 2001,   43 3-9   Academic employment in the behavioral and social sciences, 1973–2001,   44 3-10   Percentage of women in academic positions, 1975–2001,   44 3-11   Funding sources for graduate education in the behavioral and social sciences, 1979–2002,   46 3-12   Graduate student support by NIH, 1979–2002,   47 3-13   Academic postdoctoral support in the behavioral and social sciences, 1979–2002,   48 4-1   Graduate students in clinical departments by gender, 1979–2002,   53 4-2   Type of support for graduate students in clinical sciences departments, 1979–2002,   53

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Advancing the Nation’s Health Needs 4-3   Doctorates in the clinical sciences by gender, 1970–2003,   54 4-4   Employment sectors in the clinical sciences, 1973–2001,   55 4-5   Academic appointments in the clinical sciences, 1975–2001,   56 4-6   Cumulative age distribution of the clinical research workforce,   56 4-7   Age distribution of research clinical faculty in medical schools, 2002,   57 4-8   Postdoctoral appointments in clinical departments by citizenship and degree,   57 4-9   NIH predoctoral support in the clinical sciences, 1979–2002,   60 4-10   Academic postdoctoral support in the clinical sciences, 1979–2002,   61 5-1   Unfilled full-time positions on dental school faculties, 1992–2002,   66 6-1   Training positions at the postdoctoral and predoctoral levels,   77 6-2   Publications, T32 versus non-T32,   77 9-1   Postdoctoral appointments in the three broad fields, 1973–2001,   92 9-2   Proportion of biomedical doctorates in academic postdoctoral positions by Ph.D. cohort year, 1973–2001,   94 9-3   Proportion of biomedical doctorates with postdoctoral appointments in all employment sectors by cohort year, 1973–2001,   94 D-1   The potential research workforce,   121 D-2   Trends in the U.S.-trained potential workforce by major field, 1973–2001,   125 D-3   Percent in conscience jobs by major field, 1973–2001,   126 D-4   Numbers unemployed and not in labor force for all fields combined, by sex 1973–2001,   127 D-5   Proportion of temporary residents among graduates and proportion of each group intending to stay in the United States,   129 D-6   Foreign-trained biomedical Ph.D.s: postdoctorates, postdoctorate entrants, and projected total stock,   130 D-7   Trends in Ph.D. graduates by major field and sex, 1970–2001,   132 D-8   Female behavioral graduates projected using various equations,   134 D-9   Proportion of all graduates intending to stay, and rising and constant projections, by major field and sex, 1990–2011,   135 D-10   Potential workforce as reported, and projected including and excluding foreign trained, medium scenario, 1973–2011,   139 D-11   Projected annual increase in the potential workforce in three scenario, by field, 2001–2011,   141 D-12   Projected percentage of workforce not active in research (out of science, not in the labor force, or unemployed) by field, 2001–2011,   143 D-13   Difference between numbers of employed males and females, by field, 2001–2011,   144 D-14   Age distribution (percent) of workforce by field, 2001–2011,   145 D-15   Trends in employment by major field and sector, 1973–2001,   147 D-16   Percent excess or deficit of u.s.-trained researchers in relation to various projections of research positions, 2006 and 2011,   151 D-17   Postdoctorates reported by graduate departments, by field, degree, and visa status, 1983–2001,   152 D-18   Postdoctorates compared from sector data and department reports, by field, 1973–2001,   153 D-19   Reported and projected U.S.-trained postdoctorates and postdoctorate positions, 1973–2011,   155 TABLES 2-1   Number of M.D.s and Ph.D.s with Grant Support from NIH,   26 2-2   NRSA Predoctoral Trainee and Fellowship Support in the Basic Biomedical Sciences,   28

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Advancing the Nation’s Health Needs 2-3   NRSA Postdoctoral Trainee and Fellowship Support in the Basic Biomedical Sciences,   29 2-4   Potential Workforce in the Biomedical Sciences by Employment Status, 1991–2001,   31 2-5   Projected Changes in U.S. and Foreign Doctorates Entering the Biomedical Workforce Between 2001 and 2011,   32 2-6   Projected Workforce by Status for the Median Scenario, 2001–2011,   33 3-1   Median Age Cohort for the Biomedical Sciences and the Behavioral and Social Sciences,   43 3-2   NRSA Predoctoral Trainee and Fellowship Support in the Behavioral and Social Sciences,   45 3-3   T32 Training Grants in the Behavioral and Social Sciences, 2002,   45 3-4   NRSA Postdoctoral Trainee and Fellowship Support in the Behavioral and Social Sciences,   47 3-5   Potential Workforce in the Behavioral and Social Sciences by Employment Status, 1991–2001,   49 3-6   Projected Workforce by Status for the Median Scenario, 2001–2011,   49 4-1   NIH Clinical Career Awards 1999–2002,   59 4-2   NRSA Predoctoral Trainee and Fellowship Support in the Clinical Sciences,   61 4-3   NRSA Postdoctoral Trainee and Fellowship Support in the Clinical Sciences,   62 4-4   Potential Workforce in the Clinical Sciences by Employment Status, 1991–2001,   63 4-5   Projected Workforce by Status for the Median Scenario, 2001–2011,   63 5-1   Vacant Faculty Positions in Dental Schools, 2001–2002,   66 5-2   Research Areas of Research Career Development Awardees, Fiscal Year 2002,   69 5-3   Research Areas of Institutional NRSA (T32) Programs, Fiscal Year 2002,   69 6-1   Nursing Doctorates from U.S. Institutions, 1991–2003,   76 6-2   Analysis of Pre- and Postdoctoral Fellows with Subsequent Funding,   77 7-1   AcademyHealth Ph.D. and Professional Degree Members’ Employment Sector, 2004,   82 7-2   Primary Field of AcademyHealth Members by Ph.D. and Professional Degree, 2004,   82 7-3   Health Services Research Funding by Major Programmatic Area, Agency for Healthcare Research and Quality, Fiscal Year 2004,   84 7-4   NIH 2004 Health Services Research Budget Estimate,   85 7-5   Field of Research Doctorate for AHRQ T32 Postdoctoral Trainees by Cohort,   86 9-1   Postdoctoral Stipends for the NRSA Program,   93 9-2   Sector or Type of Employment for Doctorates in Postdoctoral Position Two Years Earlier,   95 9-3   Median Salaries for Academic Postdoctorates in the Biomedical Sciences by Cohort Years from Doctorate,   95 9-4   Comparison of the Population Distribution of Researchers in the Biomedical Sciences and NIH Principal Investigators,   96 9-5   Number of Awards for Current K Grant Programs, 1994–2002,   98 9-6   Percentage of Doctorates by Citizenship Status, 1993–2003,   99 9-7   Stay Rates for Doctorates with Temporary Resident Visas at Time of Receipt of Doctorate,   99 9-8   Comparison of Doctorates Awarded to the Graduate Student Population, 1997–2002,   101

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Advancing the Nation’s Health Needs D-1   Potential Workforce of U.S.-Trained Ph.D. Graduates in Three Major Fields, by Employment Status and Sex, 2001,   124 D-2   Medical School Faculty by Major Field and Degree and Number and Percent Having Had an R01 Grant, 2000,   128 D-3   Potential Workforce of Foreign-Trained Ph.D.s in Three Major Fields, by Employment Status, 2001: Medium and High Estimates,   131 D-4   Regressions for Total Ph.D. Graduates by Major Field and Sex,   133 D-5   Proportion of Temporary Residents Among Graduates and Proportion of Each Group Intending to Stay in the U.S.: Means for 1997–2001,   134 D-6   Initial Employment Status and Status Two-Years Later: Percentages Based on All Cases In Each Field by Sex, Pooled 1993–2001 Data,   136 D-7   Projected Ph.D. Graduates in Three Major Fields by Sex: Medium, High, and Low Scenarios,   137 D-8   Projected Inflow of Foreign-Trained Ph.D.s by Major Field: Medium, High, and Low Scenarios,   138 D-9   Projected Workforce and Employed Researchers by Field, Three Main Scenarios, 2001–2011,   140 D-10   Projected Annual Growth Rates and Inflow and Outflow Rates (%) for the Potential Workforce by Major Field, Medium Scenario, 2001–2011,   141 D-11   Projected Workforce Not Active in Scientific Research by Major Field, Medium Scenario, 2001–2011,   142 D-12   Projected U.S.-Trained and Foreign-Trained Workforce and Employed Researchers by Field, Medium Scenario, 2001–2011,   146 D-13   Percent Foreign Trained, in Alternative Scenarios, Projected 2011 Total Workforce, and Comparisons of Total to Medium Scenario, by Field,   147 D-14   Linear Regressions for Trend in Employment in Various Sectors,   148 D-15   Positions by Sector and Increases From 2001 to 2011 in Alternative Projections, by Major Field,   149 D-16   Projected and Actual Growth Rates (%) for Various Occupational Groups,   149 D-17   Excess or Deficit of U.S.-Trained Researchers in Relation to Various Projections of Research Positions,   150 D-18   Projected U.S.-Trained Postdoctorates and Positions for U.S.-Trained Postdoctorates by Field, Alternative Scenarios, 2001–2011,   154 E-1   Characteristics of Doctorates in the Biomedical Sciences, 1970–2003,   158 E-2   Employment Characteristics of Biomedical Doctorates from U.S. Institutions, 1973–2001,   160 E-3   Characteristics of Doctorates in the Behavioral and Social Sciences, 1970–2003,   162 E-4   Employment Characteristics of Behavioral and Social Sciences Doctorates from U.S. Institutions, 1973–2001,   164 E-5   Characteristics of Doctorates in the Clinical Sciences, 1970–2003,   166 E-6   Employment Characteristics of Clinical Sciences Doctorates from U.S. Institutions, 1973–2001,   168 BOXES 1-1   National Research Act of 1974 (P.L. 93-348),   11 D-1   How Accurate Were Previous Projections?,   122 Table D-A   Comparison of Projected with Reported 2001 Workforce in Biomedical Research,   122 Figure D-A   Reported biomedical graduates and high, medium, and low projections from 1995, by sex,   123