genomics, epidemiology, biostatistics, clinical trial design and analysis, etc. These programs appear to be very attractive to medical students and may encourage them to pursue careers as physicians in clinical research.

Clearly, identifying optimal training mechanisms for attracting medical students to clinical research, and then structuring effective training programs to prepare the students and graduates for successful clinical research careers, remains a large challenge for the biomedical community and the funding agencies. Toward this end, the recent adoption by the ACME and the ACGME of recommendations from the AAMC’s Task Force II on Translational and Clinical Research, viz., that medical students and residents should be exposed to the basic principles of translational and clinical research and to the research challenges and opportunities therein, may over time increase the population of medical graduates with a keen interest in pursuing clinical research careers. Finding mechanisms that will encourage students in these dual-degree programs to conduct clinical research continues to be a challenge.

Recommendation 5–1: The total number of NRSA positions awarded should remain at least at the 2008 level. Furthermore, training levels after 2008 should be commensurate with the rise in the total extramural research funding in the biomedical, clinical, and behavioral and social sciences. A decline in extramural research would also call for a decline in training.

Recommendation 5–2: The NIH, in consultation with academic medical leadership, should exercise leadership in identifying better training mechanisms for attracting medical students into translational and clinical research, and the NIH should fund pilot programs designed to implement promising new approaches to accomplishing that objective.