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OCR for page 89
CHAPTER NINE
RECOMMENDATIONS AND
REMAINING CONSIDERATIONS
The key feature of the National Research Service Award
(NRSA) continues to be its ability to influence the quality
and direction of research training within the biomedical and
behavioral sciences. Its ability to promote multidisciplinary
training provides a multiplier effect within graduate pro-
grams. That is, the organization of the Paining experience
within a program under the auspices of the NRSA can bring
several disciplines to bear on the training of a single indi-
vidual. The NRSA is also able to leverage the recruitment
of minorities and women into research careers and influ-
ence the issues that will be taken up by He research com-
munity and the way in which that research will be con-
ducted. In areas such as the behavioral sciences, where
students have depended heavily on teaching assistantships
to provide for graduate support, the NRSA reduces the ne-
cessity for those commitments and can thereby facilitate the
completion of doctoral studies in those fields.
The committee notes, however, that there are significant
weaknesses in the design of the NRSA program. For ex-
ample, NRSA stipends are not competitive with other sti-
pend sources, and training grant directors find themselves
further frustrated by their inability to supplement those sti-
pends with federal funds. These stipends are taxable, which
further devalues these awards. Sensing some of these short-
comings, the U.S. Congress and the National Institutes of
Health (NIH) have introduced changes in the NRSA pro-
gram in recent years designed to respond to emerging edu-
cation and employment challenges. In 1993 the U.S. Con-
gress authorized an increase in the number of NRSA
trainees in response to the an increase in the number of
students dropping out of doctoral degree programs during
the previous decade. In the same Act (P.L. 103-43), Con-
gress revised the payback provision by restricting it to
postdoctoral support with the idea that the new arrangement
89
would encourage the participation and retention of physi-
cian-researchers. Likewise, aware of the diminishing com-
petitiveness of NRSA stipends in attracting the most able
scientists to health research, NIH recently proposed to the
Department of Health and Human Services that NRSA sti-
pends be increased at the predoctoral level to $10,000 and
at the f~rst-year postdoctoral level to $19,600.~
Each of these actions reflects a commitment on the part
of the federal government to enhance the effectiveness of
the NRSA program. The committee shares this commit-
ment and has identified further modifications to the NRSA
program to increase its effectiveness in meeting national
needs for biomedical and behavioral scientists. The fea-
tures of the NRSA program that merit immediate consider-
ation are stipend support, multidisciplinary training, and
flexibility in postdoctoral awards.
STIPEND ISSUES
Although interest in doing research and long-range em-
ployment prospects supply compelling reasons for pursuing
a research career, more immediate incentives, such as sti-
pends, play an indisputable role. With that in mind, we find
it disturbing to note that stipend levels for predoctoral train-
ees in the NRSA program have remained unchanged since
1991 at $8,800 taxable salary per year.2
Numerous speakers at our public hearing in May 1993
voiced their concerns about the inadequacy of NRSA sti-
pends. The existing structure of a $700 monthly stipend is
simply not sufficient. Many state university stipends, for
example, start at $11,000 and National Science Founda-
tion currently pays $14,000. According to some speakers
at our public hearing, most universities must work hard to
supplement predoctoral stipends to raise them to $14,000
OCR for page 90
MEETING THE NATIONS NEEDS FOR BIOMEDICAL AND BEHAVIORAL SCIENTISTS
because supplementation from other federal sources (e.g.
research grants) is not allowed. When universities are
unable to augment stipends, trainees are forced to seek
other forms of part-time employment drawing them away
from their academic program and extending their time to
degree.
Postdoctoral awarders do not fare much better, earning
approximately $18,600 in their first year of training and
$19,700 in their second. It becomes very difficult at this
important period of training to entice a clinician, already
burdened with debt, into a research career with a consider-
able reduction in compensation in order to pursue prepara-
tion as a scientist. Not only should stipend levels be in-
creased to make them competitive, but the training budget
should be sufficient to allow annual cost-of-living adjust-
ments computed into each training grant's continuation
base, with due consideration to differences in costs by re-
gion, as suggested by public hearing participants.
RECOMMENDATION: The committee recommends
the NRSA stipend support at the predoctoral level be
increased to $12,000 and f~rst-year postdoctoral stipends
increased to $25,000 (both adjusted for inflation) by fis-
cal 1997. In addition, there should be a yearly cost-of-
living increase in NRSA stipends. This expansion in
stipend support should be achieved through the addition
of funds to the current NRSA training budget.
Estimating Program Costs
The committee has developed cost estimates for imple-
menting these stipend increases, and balanced consideration
of stipend increases against its numerical recommendations.
In developing these estimates, the committee has had to
make certain arbitrary decisions. First, we chose fiscal year
1993 as the base period because it is the most recent year
for which reliable program data are available. Second, we
developed numerical recommendations for the period 1994
through 1999 to overlap with the next assessment of the
NRSA program scheduled for release in 1998.
Much of the increase in program costs which result from
our recommendations is concentrated in the years 1994-
1996, during which time stipend costs rise at an average
annual rate of 7.8 percent per year. This results from the
Committee' s recommendations to increase both the number
of awards and stipend levels during that period. Annual
growth in program costs from 1997 through 1999 is about 2
percent each year. This reflects the committee's recom-
mendation to keep the number of awards constant and to
limit stipend increases to the expected rates of inflation.
Details regarding these calculations may be found in Ap-
pendix H.
90
ENHANCING TEIE EFFECTIVENESS
OF THE NRSA PROGRAM
Flexibility in Career Training at the Postdoctoral Level
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 the NRSA
program in recruiting women said that the program must be
more flexible in the areas of part-time training, reentry train-
ing, family leave, and geographic location of training sites.
Committee members have also been concerned, however,
that there is a disparity between He number of women re-
ceiving NRSA training and the number of recipients of NIH
research grants. For example, women account for over 40
percent of the Ph.D.s produced in the life sciences, but they
make up only 15 percent of the funded principal investiga-
tors. The problem would seem to lie not with talented
young women moving into science, but rawer with He de-
velopment of Heir careers.
Women appear to be leaving science between the time
they receive their doctorate and the time Hat Hey fully es-
tablish themselves in a research career Rack. Women are
slightly less successful than men in obtaining FIRST
awards, and proportionately fewer women apply for fund-
ing at certain career stages (NIH, 1993a). Therefore, Here
is a need to foster a supportive environment for career de-
velopment. Institutional responsibilities should include
mentoring, career advising, grant-writing training, and ad-
vising on transitions along the career path. The NRSA pro-
gram can clearly play a role in fostering the careers of these
scientists.
There is a need, then, to reshape NRSA awards at the
postdoctoral level to encourage women to fully utilize their
research talents. NRSA awards should allow retraining and
career shifts to help women who have stopped out of re-
search to update skills and move into emerging areas. More
reentry options should be provided through NRSA pro-
grams.
RECOMMENDATION: The committee recommends
that the NIH examine research training opportunities for
women through He NRSA program and s~eng~en the
role of postdoctoral support to assist women in establishing
themselves in productive careers as research scientists.
Monitoring Progress Toward NRSA Goals
The NRSA is one of many sources of support available
to individuals pursuing advanced preparation in research at
the doctoral or the postdoctoral level. Designed to augment
Federal support through the research assistantship, the
NRSA program was designed to select qualified candidates
from the pool of graduate students and postdoctoral person
OCR for page 91
RECOMMENDATIONS AND REMAINING CONSIDERATIONS
net, provide them with a period of intense and advanced
training, and launch them into productive research careers.
Perhaps one of the most significant findings of this com-
mittee is the general lack of information about the outcome
of the NRSA program given almost two decades of support.
Very little serious evaluation of the NRSA program has
been undertaken with the support of NIH, except for a few
student outcomes studies undertaken by earlier NRC com-
mittees (Appendix A). We cannot underscore strongly
enough the need for follow-up information to assess pro-
gram outcomes. In part, this involves the organization of
existing files at NIH to permit the analysis of program out-
comes. In part, the analysis that is needed will require seri-
ous review of data collection and analytic capabilities at
NIH and the development of new strategies to assess career
outcomes. Nowhere is the need for accurate information
more evident than in our inability to track the participation
of underrepresented minorities in the biomedical and be-
havioral research effort.
Data on Minority Parficipatton in Science Careers
Present NIH data-collection procedures make it difficult
to assess minority participation in various programs and to
evaluate program effectiveness.3 From this perspective,
four data concerns emerged:
1) NIH does not have a standard taxonomy for race and
ethnic origin. The Public Health Service Form 398, which
is used for competing research grants and for NRSA institu-
tional training grants, specifies the following categories:
American Indian or Alaska Native, Asian or Pacific Is-
lander, black (not of Hispanic origin), Hispanic, and white
(not of Hispanic origin). However, the information col-
lected on the Statement of Appointment Form 2271 splits
the Asian category into Asian (not a Pacific Islander) and
Pacific Islander. This is a useful distinction because Pacific
Islanders are generally considered to be underrepresented in
biomedical research whereas other Asians are not. The dif-
ferences in categories are puzzling.
2) The format of the tear-out page in the Gaining grant
and fellowship applications on which applicants identify
their race and/or ethnic origin and gender appears to result
in varied and often very low response rates. Applicants are
not obligated to respond and, moreover, are told that the
sheet will be separated from the application and that the
information will be entered into the central NIH database
and used for aggregate statistical analyses.
3) Once the racial and ethnic data are encoded in the
NIH master file, it is not readily available to program of ricers.
One cannot, for example, obtain a racial and ethnic break-
down of NRSA predoctoral fellows from the program of-
fice. The only information that program offices have comes
from an institutional certification that a fellow is an
91
underrepresented minority but does not specify which
group.
4) A fourth problem common to many programs within
NIH and in other agencies is ambiguity about whether the
terminology should focus on minority or underrepresented
minority. Although, application materials usually specify
"underrepresented minority" (in targeted programs), it is not
clear that the distinction is made consistently. Applicants
for NRSA institutional training grants frequency mention
Asians in reporting information although they are not one
of specified target groups in the Minority Recruitment Plan.
The distinction is crucial. Discussion in the NIH databook
on minorities in extramural grant programs5 states that mi-
norities received over 8 percent of total research grants but
underrepresented minorities received only 2.7 percent of
such awards (NIH, 1993b). The committee concludes that
many of these shortcomings could be addressed if all ques-
tionnaires designed to collect information about NRSA re-
cipients use the same racial and ethnic categories.
The Need for Well-Designed Career Outcomes Studies
Improving the effectiveness of the NRSA program will
require attention to issues not new to the research commu-
nity. However, with the inevitable changes Hat will occur
with health care reform and budget deficit reduction, NIH
may find itself in a position of justifying its support for
evaluation research. The NRSA program goes hand in hand
with the government's role in financing fundamental re-
search. This combination of research and Paining support
has considerable and continuing benefits to He health and
welfare of He citizens of our country. Well-designed ca-
reer outcomes studies can provide the kind of feedback that
is needed to ensure that the NRSA program is both efficient
and effective given constraints being placed on the federal
funding effort.
The Need for Studies of Institutional Impact
NRSA institutional Paining grants play an important role
in providing funds to universities for student support. The
committee heard testimony at its public hearing in May
1993 which suggests, however, that NRSA support may
have the effect of inducing academic institutions to reduce
(or not expand as much as they would otherwise) their own
institutional funds devoted to the support of graduate stu-
dents. Research by Ehrenberg, Rees, and Brewer (1993)
suggests that this type of behavior can have a small but
substantial effect on patterns of support. "Compensation"
of this sort is particularly likely to happen at large research
universities. Future committees would benefit from more
studies of He impact of NRSA support on the recipient
institution' s total pattern of training support.
OCR for page 92
MEETING THE NATION' S NEEDS FOR BIOMEDICAL AND BEHAVIORAL SCIENTISTS
RECOMMENDATION: The committee recommends
Cat Be NIH review its data bases as management infor-
mation systems and introduce changes in data collection,
analysis, and dissemination to permit more effective
tracking of NRSA award recipients. Emphasis should be
given to He analysis of minority participation in research
and Gaining. New funds should be directed to the evalu-
ation of NRSA program outcomes, including studies of
the impact of institutional support on graduate student
support patterns at U.S. universities.
NOTES
1. The results of that request were not available at the time of com-
mittee discussion.
2. The committee notes for comparison that the federal government
set the `'poverty level" in 1990 at $6,257 for a one-person household below
age 65, according to the U.S. Census Bureau, 1992.
3. In 1989 the NRC study committee outlined in detail a strategy for
evaluating the NRSA program, but NIH was unable to initiate any evalua-
tion studies until 1993, when a study of the Minority Access to Research
92
Careers (MARC) program was launched. The MARC program has served
and should continue to address the important goal of strengthening the
training capabilities of undergraduate minority institutions as well as train-
ing minority students who might choose research careers in the biomedical
and behavioral sciences.
4. The information in this section was drawn from a commissioned
paper by Sharon Bush. See Appendix D for a list of other contributors.
5. For a copy of this report, contact Marie Chang, Division of Re-
search Grants, National Institutes of Health, 301/594-7328.
REFERENCES
Ehrenberg, R.G., D.I. Rees and D.J. Brewer
1993 How would universitites respond to increased federal support
for graduate students? In Studies of Supply and Demand in
Higher Education, ed. C.T. Clotfelter and M. Rothschild,
pp.l83-206. Chicago: University of Chicago Press.
National Institutes of Health (bIH)
1993a NIH Data Book: 1993. Publication No. 93-1261. September.
Bethesda, MD: National Institutes of Health.
1993b Minorities in NIH Extramural Grant Programs, Fiscal Year
1982-1991. SAKS, ISB, DRG of NIH. Bethesda, MD: Na
tional Institutes of Health.
Representative terms from entire chapter:
public hearing
