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EXECUTIVE SUMMARY
The subject of this report is He nation's future need for
biomedical and behavioral research scientists and the role
the National Research Service Awards CURSE) program can
play in meeting those needs. The report has been prepared
under the auspices of P.L. 93-348 (as emended), the Na-
tional Research Act of 1974, which specifies that the Secre-
tary of the Department of Health and Human Services shall
request that the National Academy of Sciences conduct a
continuing study of the nation's need for biomedical and
behavioral scientists, the subject areas in which they are
needed, and the kinds and extent of training which should
be provided them. This is the tenth in the continuing series
of reports to the National Institutes of Health (NIH) and the
U.S. Congress on this subject.
The committee's deliberations and recommendations
centered on three major activities. First, a Panel on Estima-
tion Procedures was established to provide numerical analy-
sis of educational and employment prospects and national
needs for biomedical and behavioral research personnel.
The panel concluded that existing mathematical models are
inadequate to predict need and their recommendations for
alternative strategies are presented in Chapter 2. Second,
the committee convened a public hearing to gather views
from a broad constituency associated with NRSA programs.
Both written and oral testimony were considered by the
committee and our conclusions are reflected in the recom-
mendations that follow.) Third, the committee met as a
group on four separate occasions and, as a panel of experts,
discussed and debated information and recommendations.
The consensus of these meetings forms the basis for the
recommendations included in this report.
Through all He deliberations, one theme was constant:
although the NRSA program may be relatively small as re-
gards total numbers of trainees (less Can 15 percent of the
total number of graduate students training in the biomedical
and behavioral sciences are supported by NRSA funds in
any year), it is enormously powerful in its ability to change
research emphases and to attract the highest quality individu-
als to research careers. It is viewed as a prestigious, highly
competitive program. It is clear that initiatives, if introduced
through the NRSA program, could have a powerful impact on
intended new research directions or constituencies. In other
words, the force of the NRSA program in determining re-
search initiatives and directions in programs is enormous and
clearly out of proportion to He relatively small place it occu-
pies in the total research training portfolio.
ESTIMATING NATIONAL NEEDS
FOR RESEARCH SCIENTISTS
The committee recognized early in its work that defining
the nation's needs for biomedical and behavioral scientists
is difficult and imprecise. However, the committee also
recognized there are certain forces and opportunities that
will have an impact on the needs for research personnel
and, therefore, cannot be ignored. These include health care
reform, major advances in fundamental research, and the
demands of the marketplace. Recommendations for estab-
lishing the size and scope of He NRSA program represent
the committee's best judgment concerning the continuation
of a strong, health-related, scientific work force based on a
consideration of these forces and opportunities.
Health Research as a National Priority
The expansion of national support for health research
that occurred over He past few decades may be expected to
continue although at a slower rate. Reapportionment of
research and development funding between academia and
industry has had and will continue to have an important
OCR for page 2
MEETING THE NATION' S NEEDS FOR BIOMEDICAL AND BEHAVIORAL SCIENTISTS
effect on employment prospects for biomedical and behav-
ioral scientists, although the effect will vary by field, as we
discuss elsewhere in this report.
We expect continued national support for basic biomedi-
cal and behavioral research. However, research supported
by federal funds may be expected to be closely relevant to
social and economic needs and more readily adaptable for
use in the private industrial sector. Furthermore, as society
shifts away from product-intensive industries toward a ser-
vice-oriented industrial base, He role of research in ~mprov-
ing the quality and reducing the costs of health services will
be closely scrutinized.
Unknown Effects of Health Care Reform
As forces converge to shape and change the delivery of
health care in the United States, we expect a dramatic effect
on research training. On He one hand, the potential flatten-
ing of reimbursement for clinical care will curtail a revenue
stream (clinical income) that, in many medical schools and
academic health centers, subsidizes the support for research
training. A reduction in this revenue stream may shrink
research training opportunities in academic health centers.
On the over hand, increased emphasis on the maintenance
of health, the outcome and quality of care, and the assess-
ment of the impact of technology provide unique opportuni-
ties for prevention and health services research. Over
changes in health care reform stress the need for increased
activity in areas related to behavioral, nursing, and health
services research.
Advances in Research
It is difficult, of course, to gauge He effect of the ad-
vancement of science on personnel needs. On He basis of
our familiarity win the goals of He NRSA program, the
range of expertise among our committee members, and the
contributions of many individuals participating in our delib-
erations throughout the year, we have identified some fruit-
ful areas of inquiry Hat also have the potential of engaging
young scientists in careers that are both productive and re-
warding.
Major advances in basic biomedical and behavioral re-
search are ripe for application to address the causes, diag-
nosis, and treannent of human disease. These major re-
search findings also provide the opportunity to bring new
technologies to the marketplace.
Demand of the Marketplace
Employment conditions for biomedical and behavioral
scientists were relatively robust throughout the 1980s. Dra
2
matic changes have occurred, however, with regard to sec-
tor of employment with a greater fraction of Ph.D.s em-
ployed in industry and other nonacademic jobs than in ear-
lier years.
The nation's need for research scientists has also been
affected by demographic changes: He number of individu-
als from racial and ethnic minority groups is increasing but
not as fast as might be expected given federal efforts to
encourage He participation of minorities in this area. The
work force of He future will consist of an increasing pro-
portion of women and minorities; it is important that these
changes are reflected in the biomedical and behavioral sci-
ence work force.
RECOMMENDATIONS
Considering the major forces that have an impact on na-
tional needs for research and the unfolding of the research
career, the committee recommends the following changes
in He NRSA program to meet those needs.
Stipends
Raise the real value of stipends to more competitive
levels by fiscal 1996: approximately $12,000 per year
for predoctoral clwardees and approximately $25,000
for postdoctoral awardees with less than 2 years of
research experience. Maintain the real value of these
stipends (i.e., the nominal value adjustedfor ink ationJ
through annual increases of 3 percent per year (the
assumed annual rate of inflations.
It is disturbing to note that stipend levels for predoctoral
trainees in the NRSA program have remained unchanged
since 1991 at $8,800 taxable salary per year. The existing
structure of a $700 monthly stipend is simply not sufficient.
Many state university stipends start at $11,000 and He Na-
tional Science Foundation currently pays $14,000. Hence,
we recommend an increase in the inflation-adjusted value
of predoctoral stipends to $12,000 by fiscal 1996 to provide
an incentive for graduate students not only to seek but also
to complete training at the doctoral level.
Postdoctoral NRSA awarders do not fare much better,
earning approximately $18,600 in their first year of train-
ing and $19,700 in their second. It becomes very difficult
at this important period of training to entice a clinician or
Ph.D., already burdened with debt, into research training.
Thus, the committee recommends that the NRSA stipends
at the first-year postdoctoral level be increased to $25,000
in inflation-adjusted dollars by fiscal 1996. This expan-
sion in stipend support should be achieved through the
addition of funds to the current NRSA training budget
(Appendix H).
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EXECUTIVE SUMMARY
Numerical Recommendations
Between fiscal 1991 and 1993, the total number of NRSA
awards grew from just over 14,000 to over 15,000 (Sum-
mary Table 1~. The basic biomedical sciences were esti-
mated to have the largest fraction of support in fiscal 1993
at about 9,633 awards, followed by 3,000 awards in the
clinical sciences [excluding 822 awards for combined M.D.-
Ph.D. training through the Medical Scientist Training Pro-
gram (MSTP)~. To meet the nation's future needs for bio-
medical and behavioral scientists, we believe the overall
NRSA program should expand from 15,112 slots in fiscal
1993 to 16,260 slots in fiscal 1996, with that growth occur-
ring mainly through modest expansion of NRSA support
for research training through the MSTP program, in the be-
havioral sciences, oral health research, nursing research, and
health services research (Summary Table 2~. With full
implementation of the recommendations that follow the
number of NRSA awards would have expanded by about 10
percent between 1993 and 1996 with support for basic bio-
medical sciences representing 59 percent of the total in
1996, behavioral sciences about 9 percent of the total, the
MSTP-program 6 percent, other clinical sciences (including
oral health research) 20 percent, nursing research 3 percent,
and health services research 2 percent.
Recommended changes in the size and scope of theNRSA
program within each broad field are summarized below.
Basic Biomedical Sciences
Maintain the annual number of predoctoral awards in
the basic biomedical sciences at 1993 levels, or ap-
proximately 5,175 awards, clad the number of post-
doctoral awards at 3,835.
On the basis of input from a wide variety of sources
about current and anticipated market conditions and in con-
sideration of pressing national research needs, the commit-
tee endorses the continuation of federal support through
predoctoral awards in He basic biomedical sciences (see
Chapter 34. The committee is concerned, however, that the
current low levels of stipend support will not attract the
most talented students to careers in research. To under-
score the depth of our concerns, we recommend that
predoctoral awards in the basic biomedical sciences be
maintained at fiscal 1993 levels until further assessment of
funding priorities and national needs can be made. The
committee recognizes Hat these recommendations are made
in an era of fiscal restraint. Should additional funds be-
come available for predoctoral research training in the basic
biomedical sciences, NIH might wish to consider expand-
ing NRSA support in this area.
Postdoctoral research training is also an important com
ponent in the preparation of productive investigators in the
basic biomedical sciences. Postdoctoral training increases
the technical skills of the doctoral-level scientist and en-
sures the success of Heir independent research careers.
Here, too, the committee is concerned that persistent low-
level stipends may discourage qualified applicants from
seeking postdoctoral training through the NRSA support.
Thus, to permit NIH to introduce further and more realistic
changes in stipend levels at the postdoctoral level, the com-
mittee recommends that the number of postdoctoral awards
be maintained at fiscal 1993 levels. Again, however, should
additional program funds become available for postdoctoral
research training in the basic biomedical sciences, NIH
might wish to increase the number of these awards.
Behavioral Sciences
Increase the clanual number of NRSA awards for re-
search training in the behavioral sciences from 1,069
to 1,450 between 1993 and 1996.
On He basis of continuing gains being made by behav-
ioral scientists in areas of national interest and on antici-
pated demand for behavioral research relative to heals
goals, He committee urges He continued expansion of fed-
eral support through predoctoral awards in the behavioral
sciences (see Chapter 44. Predoctoral awards permit the
preparation of investigators familiar with the broad range of
research techniques and theories Hat characterize doctoral
preparation in the behavioral sciences. As is ache case in
other areas, the committee is concerned that current low
stipend levels for NRSA awardees do not attract the most
able scientists to research careers in health-related fields.
Thus, the committee has tempered its call for expansion in
total support from 672 predoctoral awards in fiscal 1993 to
900 by fiscal 1996 in recognition of He competing need to
increase stipend support.
Postdoctoral research training Trough He NRSA pro-
vides the nation with an unusual mechanism for attracting
He most skilled scientists to address areas of national need.
Because of differences in He evolution of research careers,
postdoctoral research Gaining has played a greater role in
some behavioral science fields than others. Nonetheless,
postdoctoral study increases He technical skills of the in-
vestigator and strengthens the pool of talent available to the
nation for research. Thus, the committee recommends that
the number of postdoctoral trainees and fellows supported
annually in the behavioral sciences increase from approxi-
mately 349 awardees in fiscal 1993 to 500 in fiscal 1996.
Clinical Sciences
Increase the number of MSTP awards from 822 in
1993 to 1,020 by 1996 and the number of postdoctoral
3
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MEETING THE NATION'S NEEDS FOR BIOMEDICAL AND BEHAVIORAL SCIENTISTS
SUMMARY TABLE 1 Aggregated numbers of NRSA supported trainees Ad fellows for FY 1991, I;Y 1992, Ad FY 1993.a
Fleck Type
Year of Program
TOTAL Basic Medical Oral Health
ALL Biomedical Behavioral Clinical Scientist b Health c Nursing d Services C
0 ~FIELDS Sciences Sciences Sciences Truning Research Research Research
1991 TOTAL Total14,0859,0219022,894783218255 12
Predoctoral6,9484,59351975578378220 0
Postdoctoral6,5253,8613382,139014035 12
MARC Undergraduate612567450000 0
Trainees Total11,8507,1997752,81478318693 0
Predoctoral6,4494,3134727367837867 0
Postdoctoral4,7892,3192582,078010826 0
MARC Undergraduate612567450000 0
Fellows Total2,2351,82212780032162 12
Predoctoral499280471900153 0
Postdoctoral1,7361,54280610329 12
_
1992 TOTAL Total14,6079,3179082,970806213257 94
Predoctoral7,2654,77753481980677217 35
Postdoctoral6,6613,9103232,151013640 59
MARC Undergraduate681630510000 0
Trainees Total12,3657,4777902,887806178103 82
Predoctord6,7614,4874818008067775 35
Postdoctoral4,923 f2,3602582,087010128 47
MARC Undergraduate681630510000 0
Fellows Total2,2421,840118830351S4 t2
Predoctoral504290531900142 0
Postdoctoral1,7381,550656403512 12
1993 TOTAL Total15,1129,6331,0692,974822224236 96
Predoctoral7,8355,17167285582297188 30
Postdoctoral6,6033,8363492,119012748 66
MARC Undergraduate674626480000 0
Trainees Total12,8197,7409302,877822201112 79
Predoctoral7,2654,8116048268229676 30
Postdoctoral4,880g2,3032782,051010536 49
MARC Undergraduate67462648O000 O
Fellows Total2,2931,89313997023124 17
PredoctoralS70360682901112 0
Postdoctoral1,7231,533716802212 17
-
NOTE: Data from IMPAC data system was prepared by the information and Statistics Branch, Division of Research Grants, and
the National Institues of Health, RTSPO/OEP/OER. About 230 positions in FY 1991 and 576 positions in FY 1992 were not
coded for disciplines in IMPAC datafiles. These positions were assigned to cluster disciplines using departmental affiliations and
grant titles.
a Units are full time training positions (FTTPe). Short term training positions are included, but the number of appointments
have been divided by four to convert to F T1 Ps.
b Positions designated as Medical Scientist Training Program (MSTP) for purposes of this table are all considered to be in
biomedical disciplines.
c Positions supported by the National Institute of Dental Research MAR).
d Positions supported by the National Institute of Nursing Research (NINR).
e Positions supported by the Agency for Health Care Policy and Research (AHCPR).
f Includes 42 postdoctoral kaineeship8 in 1992 for training in Primary Care Research supported through the Health Resources
and Services Agency (HRSA).
g Includes 58 postdoctoral traineeships in 1993 for training in Primary Care Research supported through the Health Resources
and Services Agency (HRSA).
4
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EXECUTIVE SUMMARY
fellows in the clinical sciences from 68 in 1993 to 160
in 1996. To achieve this expansion, we recommend
that the annual number of postdoctoral trainees in the
clinical sciences be decreased slightly from 2,051 to
·,805 between 1993 and 1996.
Studies have consistently shown that a substantial frac-
tion of graduates from the MSTP program remain produc-
tively engaged in research, often with greater success in
securing research support than those M.D.s who pursue
post-M.D. research training not leading to a doctorate (see
Chapter 5~. Current support for MSTP training provides for
about 820 awards. Given the success of this program in
contributing workers to the national research effort, we be-
lieve this program should be expanded to provide 1,020
awards by fiscal 1996.
Furthermore, because of the urgent need for clinical sci-
entists familiar with patient-based research techniques we
urge the NIH to increase the number of postdoctoral NRSA
fellowship awards from 68 in fiscal 1993 to 160 by fiscal
1996 to permit the preparation of patient-based investiga-
tors.
To permit the expansion of the pool of MSTP trainees
and postdoctoral fellows, we believe modest reductions
should be made in the number of postdoctoral awards made
through institutional training grants in the clinical sciences.
NIH reports that 2,051 awarders were supported in fiscal
1993 through this mechanism. We believe a gradual de-
crease in the number of awards to 1,805 should occur by
fiscal 1996.
Remaining Fields
Increase the number of awards in oral health research
to 430 by 1996, in nursing research to 500 by 1996,
and in health services research to 360 by 1996, to
allow for their efficient absorption by the system crater
which the number of awards is stabilized cat the new
levels.
Oral Health Research. There is an acute need for clini-
cal dental researchers and oral health research workers in
general. The National Research Council's 1985 report
called for 320-400 new clinical dental research trainees an-
nually, but the National Institute of Dental Research (NIDR)
has been unable to carry out this recommendation because
funds have not been available. A significant increment in
training would substantially alleviate the shortage of oral
health research personnel. There is need and rationale for a
tripling or quadrupling the training of oral health research-
ers. Realistically, however, the need is better met incre-
mentally rather than abruptly. The committee recommends,
therefore, Hat the total number of training positions avail-
able for preparation in oral health research increase from
s
approximately 224 positions in fiscal 1993 to 430 positions
in fiscal 1996 and remain steady Hereafter (see Chapter 6~.
The MSTP program offers an integrated program of
medical and graduate research training leading to the com-
bined M.D. and Ph.D. degrees. The success of that pro-
gram, coupled with the demonstrated success of such joint
degrees as the D.D.S./Ph.D. and D.M.D./Ph.D., suggests
that oral health research would benefit from the develop-
ment of a Dental Scientist Training Program (DSTP) that is
analogous to the MSTP under the auspices of the NRSA
legislation. The committee recommends, therefore, that
one-quarter to one-half of the new positions available for
training in oral health research in fiscal 1994 and beyond be
used by NIDR to establish a DSTP program under the
NRSA act.
Nursing. Win the proposed changes in health care re-
form, continued development of a strong scientific base in
nursing research for practice is essential to prepare advanced
practice specialists to care for the rapidly changing needs of
high-risk and underserved patient populations (see Chapter
74. The committee recommends that the number of posi-
tions available for preparation in nursing research increase
from approximately 236 awards in fiscal 1993 to 500 in
fiscal 1996. These positions should be phased in on a yearly
basis as properly qualified candidates and training sites
present themselves.
Because nursing research is a developing field of sci-
ence, Here is a critical need to have an increased number of
highly trained nurse researchers at He cutting edge for nurs-
ing practice and health care. Support for research training
must be expanded at the predoctoral level to allow further
expansion at the postdoctoral level. As the number of
NRSA positions increase by the year 1996, Here should be
a progressive shift toward an eventual balance between the
proportion of funding for predoctoral and postdoctoral sup-
port.
Health Serrices Research. Health services research is a
relatively young field that uses interdisciplinary approaches
to examine the impact of organization, finance, and use of
technology on the utilization, cost, and quality of care (see
Chapter 84. This field of research will need to grow sub-
stantially to meet He ever-expanding demands for informa-
tion by policymakers, administrators, providers, and con-
sumers. The questions raised regarding what impact
different proposals for health care reform will have on ac-
cess, cost, and quality of care are largely questions Hat will
be addressed by this field of research. To meet these needs,
the committee recommends that the number of NRSA posi-
tions allocated to He Agency for Health Care Policy and
Research (AHCPR) increase from about 96 in fiscal 1993 to
360 in fiscal 1996.
Institutional training grants permit He development of
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MEETING THE NATION' S NEEDS FOR BIOMEDICAL AND BEHAVIORAL SCIENTISTS
SUMMARY TABLE 2 Committee Recommendations for NRSA Trainees and Fellows for FY 1994 through 1999.
Fiscal
Year
TOTAL Basic Medical Oral Health
Type ALL Biomedical Behavioral Clinical Scientist b Heals c Nursing d Services e
of Program FIELDS Sciences Sciences Sciences Training Research Research Research
1994 RECo Total15,4159,6401,1952,975890260340 115
Predoctoral8,1755,175745895890125290 55
Postdoctoral6,5603,8354002,080013550 60
MARC Undergraduate680630500000 0
Trainees Total12,9757,7451,0402,875890200130 95
Predoctoral?,4904,81567087589010095 45
Postdoctoral4,8052,3003202,000010035 50
MARC Undergraduate680630500000 0
Fellows Total 2,440 1,895 155 100 0 60 210 20
Predoctoral 685 360 75 20 0 25 195 10
Postdoctoral 1,755 1,535 80 80 0 35 15 10
. .
1995 REC. Total 15,835 9,640 1,325 2,910 955 345 420 240
Predoctoral 8,600 5,175 825 895 955 210 360 180
Postdoctoral 6,555 3,835 450 2,015 0 135 60 60
MARC Undergraduate 680 630 50 0 0 0 0 0
Trainees Total 13,165 7,745 1,150 2,780 955 230 160 145
Predoctoral 7,730 4,815 740 875 955 130 120 95
Postdoctoral 4,755 2,300 360 1,905 0 100 40 50
MARC Undergraduate 680 630 50 0 0 0 0 0
Fellows Total 2,670 1,895 175 130 0 115 260 95
Predoctoral 870 360 85 20 0 80 240 85
Postdoctoral 1,800 1,535 90 110 0 35 20 10
1996 REC. Total 16,260 9,640 1,450 2,860 1,020 430 500 360
Predoctoral 9,010 5,175 900 895 1,020 290 430 300
Postdoctoral 6,570 3,835 500 1,965 0 140 70 60
MARC Undergraduate 680 630 SO O O O O O
Trainees Total 13,355 7,745 1,260 2,680 1,020 265 195 190
Predoctoral 7,965 4,815 810 875 1,020 160 145 140
Postdoctoral 4,710 2,300 400 1,805 0 105 50 50
MARC Undergraduate 680 630 SO O O O O O
Fellows Total 2,905 1,895 190 180 0 165 305 170
Predoctoral 1,045 360 90 20 0 130 285 160
Postdoctoral 1,860 1,535 100 160 0 35 20 10
a Units are full time training positions (FITPs). Short term training positions are included, but the number of appointments
have been divided by four to convert to ~-~~~-rs.
b Positions designated as Medical Scientist Training Program (MSTP) for purpose of this table are all considered to be in
biomedical disciplines.
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EXECUTIVE SUMMARY
SUMMARY TABLE 2 (continued).
TOTAL Basic MedicalOral Health
Fiscal Type ALL Biomedical Behavioral Clinical Scientistb Health C Nursing Services c
Year of Program FIELDSSciences Sciences Sciences Training Research Research Research
1997 REC. Total 16,260 9,6401,4502,8601,020 430 500 360
Predoctoral 9,010 5,1759008951,020 290 430 300
Postdoctoral 6,570 3,8355001,9650 140 70 60
MARC Undergraduate 680 6305000 0 0 0
Trainees Total 13,355 7,745 1,260 2,680 1,020 265 195 190
Predoctoral 7,965 4,815 810 875 1,020 160 145 140
Postdoctoral 4,710 2,300 400 1,805 0 105 50 50
MARC Undergraduate 680 630 50 0 0 0 0 0
Pellowe Total 2,905 1,89S 190 180 0 165 305 170
Predoctoral 1,045 360 90 20 0 130 285 160
Postdoctoral 1,860 1,535 100 160 0 35 20 10
1998 REC. Total 16,260 9,640 1,450 2,860 1,020 430 500 360
Predoctoral 9,010 5,175 900 895 1,020 290 430 300
Postdoctoral 6,570 3,835 500 1,965 0 140 70 60
MARC Undergraduate 680 630 50 0 0 0 0 0
Trainees Total 13,355 7,745 1,260 2,680 1,020 265 195 190
Predoctoral 7,965 4,815 810 875 1,020 160 145 140
Postdoctoral 4,710 2,300 400 1,805 0 105 50 50
MARC Undergraduate 680 630 50 0 0 0 0 0
Fellows Total 2,905 1,895 190 180 0 165 305 170
Predoctoral 1,045 360 90 20 0 130 285 160
Postdoctoral 1,860 1,535 100 160 0 35 20 10
1999 REC. Total16,2609,6401,4502,8601,020430 500 360
Predoctoral9,0105,1759008951,020290 430 300
Postdoctoral6,5703,8355001,9650140 70 60
MARC Undergraduate68063050000 0 0
Trainees Total 13,355 7,745 1,260 2,680 1,020 265 195 190
Predoctoral 7,965 4,815 810 875 1,020 160 145 140
Postdoctoral 4,710 2,300 400 1,805 0 105 50 50
MARC Undergraduate 680 630 50 0 0 0 0 0
Fellows Total 2,905 1,895 190 180 0 165 305 170
Predoctoral 1,045 360 90 20 0 130 285 - 160
Postdoctoral 1,860 1,535 100 160 0 35 20 10
c Positions supported by the National Institute of Dental Research (NIDR).
d Positions supported by the National Institute of Nursing Research (NINR).
e Positions supported by the Agency for Health Care Policy and Research (AHCPR).
7
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MEETING THE NATION' S NEEDS FOR BIOMEDICAL AND BEHAVIORAL SCIENTISTS
innovative interdisciplinary research Gaining programs, an
essential feature of research in this area. However, given
the anticipated growing demand for skilled specialists in
health services research, the committee concludes that
AHCPR should place emphasis on the award of individual
fellowships in the next few years in order to encourage
qualified individuals with some experience in the area of
health care policy to pursue advanced training.
Minority Access to Research Careers
Hold Minority Access to Research Careers (MAR CJ
awards constant atpscal 1993 levels, or approximate
ly 680 awards, pending the outcome of the present
NIH evaluation study.
The NRSA program plays an important role in attracting
minority group members to careers in the basic biomedical
and behavioral sciences. This is achieved primarily through
the MARC program (see Chapters 3 and 4~. The core of
this program is the Honors Undergraduate Program
launched in fiscal 1977 to support college juniors and se-
niors (see, for example, Garrison et al., 1985~. In fiscal
1993 about 674 slots were set aside by NIH for preparing of
MARC undergraduates, most for training in the basic bio-
medical sciences. The committee is aware that NIH re-
cently launched an 18-month study of the career outcomes
of MARC program graduates. The committee endorses this
effort and recommends a continuation of support for the
MARC program at fiscal 1993 levels until the NIH assess-
ment is complete.
It is well documented that certain minority groups (Afri-
can Americans, Hispanics, Native Americans) are vastly
underrepresented in the biomedical and behavioral sciences.
To address this problem, He obvious solution should be to
increase opportunities for these groups to receive Gaining in
biomedical and behavioral sciences. This can only be ac-
complished by providing research training opportunities
through such programs as MARC. It will be important that
the NIH act swiftly to review and modify the size and scope
of the MARC program in light of its findings.
In recent years, the NIH has undertaken a number of
important studies of minority research and Gaining. For
example, the Office of Minority Health in 1993 reported on
Phase I of an assessment of minority training programs
(NIH, 1993~. This report lays out a plan of action for re-
viewing NIH programs in this area and discusses the limita-
tions of current NIH data collection procedures for tracking
individuals who receive research and/or Raining support.3
The range of programs to be addressed by this assessment is
impressive, and includes such programs as: Minority Bio-
medical Research Support (MBRS), National Predoctoral
Fellowship Awards for Minority Students, Minority Access
8
to Research Careers (MARC), Research Centers in Minor-
ity Institutions (RCMI), and Research Supplements for
underrepresented minority individuals.
The committee looks forward to having more detailed
information in the coming years on the outcome of these
various assessments to facilitate the development of a fuller
review of minority research Gaining needs and the role of
the NRSA program in meeting those needs.
ENlIANCING TO EFFECTIVENESS
OF THE NRSA PROGRAM
Flexibility in Career Training at the Postdoctoral Level
Examine research training opportunities for women
through the NRSA program and strengthen the role of
postdoctoral support to assist women in establishing
themselves in productive careers as research scien-
tists.
In May 1993 we convened a public hearing to invite
suggestions for increasing the effectiveness of the NRSA
program. Most of those testifying on the role of He NRSA
program in recruiting women said Hat the NRSA program
must be more flexible in He areas of reentry Paining, fam-
ily leave, and geographic location of Raining sites. Com-
mittee members have also been concerned, however, that
there is a clear disparity between the number of women
receiving NRSA Raining and the number of recipients of
NIH research grants (see Chapter 9~.
Women appear to be leaving science between He time
they receive their doctorate and the time that they fully es-
tablish themselves in a research career Back. The NRSA
program can play a role in fostering He careers of these
scientists. There is a need, then, to reshape NRSA awards
at He postdoctoral level to encourage women to fully utilize
Weir research talents. NRSA awards should allow re~ain-
ing and career reentry to help women who have stopped out
of research to update skills and move into emerging areas.
Monitoring Progress Toward NRSA Goals
Review NIH databases as management information
systems and introduce changes in data collection,
analysis, and dissemination to permit more elective
tracking of NRSA award recipients. Emphasis should
be given to the analysis of minority participation in
research and training. New funds should be directed
to the evaluation of NRSA program outcomes.
Perhaps one of the most significant findings of this com-
mittee is the general lack of information about He outcome
of the NRSA program given almost two decades of support.
Very little serious evaluation of the NRSA program has
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EXECUTIVE SUMMARY
been undertaken through NIH support except for a few stu-
dent outcomes studies undertaken by earlier NRC commit-
tees. Nowhere is the need for accurate information more
evident than in our inability to track the participation of
underrepresented minorities in He biomedical and behav-
ioral research effort. We cannot underscore strongly enough
the need for follow-up information to assess program out-
comes. In part, this involves the organization of existing
files at NIH to permit the analysis of program outcomes
(see Chapter 9~. In part, the analysis that is needed will
require serious review of data collection and analytic capa-
bilities at the NIH and the development of new strategies to
assess program outcomes.
Improving the effectiveness of He NRSA program will
require attention to issues not new to the research commu-
nity. However, with He inevitable changes that will occur
with health care reform and budget deficit reduction, NIH
may find itself in a position of justifying its support for
Gaining programs. Well-designed career outcomes studies
can provide the kind of feedback that is needed to assure
that the NRSA program is both efficient and effective given
constraints being placed on the federal funding effort. Fu-
ture committees would benefit, furthermore, from more
9
studies of the impact of NRSA support on the recipient
institution's total pattern of Raining support.
NOTES
1. The public testimony from the hearing will be available in a sepa-
rate report, through the National Academy Press, Washington, D.C.
2. In addition to the studies described here, the Director of the Nation-
al Institutes of Health has also commissioned a study of NIH efforts to
recruit and retain minority scientists among its intramural staff. A report
on that topic is being prepared by the Directory NIH/EEO Executive Ad-
visory Group. (Personal communication, 1994)
3. The NIH Minority Programs Evaluation Committee recommended
changes in the NIH data system to permit more effective tracking of indi-
viduals, similar to the changes recommended by this committee (see Chap-
ter 9).
REFERENCES
Garrison, H.H., P.W. Brown and R.W. Hill
1985 Minority Access to Research Careers: Art Evaluation of the
Honors Undergraduate Research Training Program. Wash-
ington, D.C.: National Academy Press.
National Institutes of Health (NIH)
1993 Assessment of NIH Minority Research/Trainir~g Programs:
Phase I. Bethesda, MD: National Institutes of Health.
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Representative terms from entire chapter:
basic biomedical
