Revise the NIH intramural clinical research oversight structure.

• Create a single, high-level oversight committee to replace all existing governing bodies that have oversight responsibilities for intramural clinical research.

• Create an external advisory committee that reports to the NIH director to periodically and systematically consider the overall quality and vitality of the NIH Intramural Clinical Research Program.

• Strengthen the roles of the Office of the Director and institute and center leadership in clinical research.

Develop new training and career pathways in patient-oriented research.

• Strengthen career pathways and mentoring in the ICRP for patient-oriented research that culminate in tenure.

• Establish a premier, highly visible postdoctoral fellowship program in clinical research, administered by the CRC director, for individuals who have finished clinical residency training.

• Create an advanced research training program for extramural faculty members in AHCs who wish to take sabbatical at the CRC as a means of obtaining on-the-job experience in clinical research.

• Foster the recruitment and retention of innovative patient-oriented investigators in the ICRP by ensuring that salaries and benefits are competitive with those at AHCs.

• Foster an interactive and creative research environment that will attract outstanding postdoctoral fellows. Postdoctoral fellows will want to participate in programs that are conducting disease-oriented research or investigating timely clinical problems that cannot easily be studied in extramural AHCs.