committee was charged, as were the past few, with the task of examining the current workforce and projecting the need for additional personnel in the biomedical, behavioral and social, and clinical sciences as they pertain to the research mission of the NIH. Individual chapters of this study report are devoted to these fields, and special attention was given to the clinical fields of oral health, nursing, and health services research, with the inclusion of separate chapters, as required in the Statement of Task.

In assessing the characteristics of the past and current workforce, datasets from the National Science Foundation and the Association of American Medical Colleges were used. An additional dataset that became available near the end of the study came from the National Research Council Study of Research Doctorate Programs. The value of these datasets depended on whether the study fields were included in their taxonomy or data were collected on degree types. In particular, the clinical sciences posed a problem, since data are not readily available on researchers with medical degrees, and it is difficult to distinguish between basic and clinical research in medical school departments.

Projections for the size of the future workforce are provided in Appendices D and E using a life-table model and a systems dynamics model, respectively. The projections were based on different estimates of researchers entering the workforce from doctoral programs and through U.S. immigration and emigration. The task of projecting the workforce was particularly difficult because of the state of the current economy and the unknown future demand for researchers.

RECENT DEVELOPMENTS

When the study committee first met, the economy was showing the first signs of a downturn that would deepen to a recession and eventually dramatically affect employment and economic development around the world. As the committee reviewed the state of research training in subsequent meetings, it became clear that a projection of the future research workforce in the biomedical, behavioral, and clinical sciences would be difficult to develop from available data and would furthermore be risky, given the uncertain duration and severity of the recession. The workforce was contracting with a decline in industrial employment, especially in the pharmaceutical area, and academic institutions had slowed their expansion of faculty and research facilities in response to the reduced values of endowments and state appropriations as well as the overall economic uncertainty. At the same time, faculty members were delaying retirement, and this in turn was reducing the hiring of junior faculty members. These and other conditions might call for a reduction in research training, even though enhancements to training programs would be of great benefit.

Given the current economic realities, the committee recognized that the NIH budget would not allow for the implementation of recommendations that would require new funds. The only possibility was the reallocation of existing resources, and NIH was in the best position to realign their agenda. The committee debated how it could nevertheless fulfill its charge and assist NIH in its decision making, and it concluded that in order to maintain the high standards of the programs and continue to attract the best students into research careers, it would go forward with its recommendations to improve training programs but would prioritize the most important ones and identify the costs.

The committee was unanimous in its recommendations and prioritization except for the one recommendation that called for an increase in the indirect cost rates for NRSA awards (see below).

RECOMMENDATION ON NRSA POSITIONS

The primary task of this committee is to recommend the number of NRSA positions for 2010-2015. Based on the need to maintain a strong research workforce, we recommend that the total number of NRSA positions in the biomedical and clinical sciences should remain at least at the fiscal year 2008 level and that in the behavioral sciences they should increase back to the 2004 level. This increase will require the addition of about 370 training slots at a cost of about $15 million. The committee also recommends that future adjustments in the number of NRSA positions be closely linked to the total extramural research funding in the biomedical, clinical, and behavioral sciences. In recommending this linkage, the committee realizes that a decline in extramural research would imply that there should also be a decline in training.

PRIORITIES FOR OTHER RECOMMENDATIONS WITH LARGE COSTS IMPLICATIONS

In addition to the recommendation on the number of NRSA positions, there are several other recommendations in this report that require additional resources. Most call for modest increases and could be accomplished by a shifting of resources within an institute or center. Three, however, would require significant additional funds. They are listed below in order of priority. In prioritizing these actions, the committee considered both their costs and their merits as well as likely future constraints on the NIH budget.

First, NIH should reinstitute its 2001 commitment to increase stipends at the predoctoral and postdoctoral levels for NRSA trainees. This should be done by budgeting regular, annual increases in postdoctoral stipends until the $45,000 level is reached for first-year appointments, and stipends should increase with the cost of living thereafter. Predoctoral stipends should also be increased at the same proportional rate as postdoctoral stipends and revert to cost-of-living increases once the comparison postdoctoral level reaches $45,000. The estimated annual cost when fully implemented would be about $80 million, or 10 percent of the NRSA budget. If phased in over four years, the $20 million dollar annual



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