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I I . THE TRAINING PROGRAMS RELATION TO RESEARCH AND BETTER HEALTH CARE FOR THE NATION The primary purposes of the research training programs sponsored by the NIH, ADAMHA, and HRA are, first, to ensure the quality of the research training effort and, secondly, to provide a cadre of highly trained individuals to conduct research in the biomedical and behavioral fields. Ample evidence has been cited in other sources7 to show that research advances made in bioscience and behavioral science have improved our health-care system. Of great long-range concern to the Committee is the question of the cost to the nation from inadequate expansion of knowledge upon which reduction of illness and disease ultimately depends. Such research requires a continuing supply of trained biomedical/behavioral research personnel. Training programs have helped to establish in uni- versities and medical schools a mechanism for bringing together scientists from diverse backgrounds and disciplines into programs which can provide important interdisciplinary training for the trainees and from which emerge significant new fields and specialties. Evidence of the effects of the NIH training programs on the career patterns of bioscientists has been examined in a study recently completed by a committees of the National Research Council. This chapter provides a brief description of those aspects of the training programs that are especially relevant to the pur- poses of this report. DEFINITIONS This section is devoted to the definition of terms used throughout the report and to a list of disciplinary categories. Most of these will 7Scientific and Educational Basis for Improving Health, Report of the Panel on Biological and Medical Science of the President's Science Advi- sory Committee, Executive Office of the President, Office of Science and Technology, Washington, D.C., 1972. The Impact of the NIH Training Programs on the Career Patterns of Bio- scientists, National Research Council, in press. 20

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be well-known to those familiar with biomedical/behavioral research personnel issues, but we define them here for ready reference and for the benefit of the general reader. Training Mechanisms The federal training programs have consisted of fellowships awarded to individuals and training grants which provide support to individuals and institutions for graduate and postdoctoral education in the biomedical/ behavioral fields. Predoctoral and postdoctoral. In predoctoral training, emphasis is placed on the~acquisition of fundamentals; comprehension of basic disci- plines is essential to do research. The predoctoral student needs the breadth and integration provided by departmental programs. The post- doctoral scientist, however, while continuing to acquire fundamental ex- perience, tends to specialize his efforts under the guidance of a senior mentor. Although most postdoctorate work in major research centers, some have been trained well in outstanding laboratories of principal investi- gators in small institutions. It is in postdoctoral work that the cancer researcher, neurobiologist, or clinical statistician, focuses on his or her field of emphasis. It should also be noted that concomitantly with his or her further training, the postdoctoral accomplishes research also and thereby adds to knowledge in that field. Fellowships are awarded to individuals applying through institutions in nationwide competitions administered by the sponsoring agencies. The successful applicants are provided with stipends geared to the individ- ual's level of education and experience, plus allowances for tuition, dependents, travel, and supplies. m e fellowship has been awarded at three levels: 1. Predoctoral - granted to students whose goal is the Ph.D. degree and to medical students pursuing re- search on a part-time basis. (This program was phased out beginning in 1970.) 2. Postdoctoral- granted to holders of the Ph.D. or the M.D. are seeking additional research training. 9 throughout this report, the term "Ph.D." refers to all research doctorates (Ph.D., D.Sc., D.P.H., D. Eng., etc.) and "M.D." is the generic term used for all professional doctorates (M.D., D.V.M., D.D.S., D.O., etc.) 21

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3. Special Fellowships granted to scientists with some training or experience to allow for a period of additional training, generally at the post- doctoral level. Training grants are awarded to one or more departments of a uni- versity, medical school,or research institution upon application to strengthen an existing program for training predoctoral and/or post- doctoral trainees in a specified discipline. The awards are made after external peer review in national competition, and contain funds for trainee stipends and tuition, and for partial support of the academic environment (faculty salaries, equipment, supplies, etc.) in the depart- ment in which the training takes place. Trainees under the grant are appointed by the department, which then assumes the responsibility for providing a high-quality training program subject to peer review for ex- tension. The training grant can provide support to any mixture of pre- doctoral and postdoctoral trainees. Full-time - refers to a training period equivalent to at least one - academ~c year. Research Assistants - usually predoctoral or postdoctoral students supported by funds from a research grant or contract. Teaching Assistants - predoctoral or postdoctoral students may be supported by their institutions as teaching assistants because of their contributions to teaching programs. These teaching assignments are usually at the undergraduate level and are available generally at insti- tutions with large undergraduate teaching responsibilities. 2. Research Fields Referred to in This Report The fields in which biomedical and behavioral research is carried out cover a very wide spectrum of the sciences. There is no standard system of classification of fields used by the various organizations that collect manpower data. The Office of Education, the National Science Foundation, the National Research Council, the National Insti- tutes of Health, and the Association of American Medical Colleges all use taxonomies that are perhaps suitable to their own purposes but differ from the others in important respects. 22

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Although any scheme developed by one organization will probably not satisfy all the requirements of another. it has been necessary in this - , study to begin to establish a taxonomy for biomedical/behavioral man- power. This has been done by utilizing the departmental classification scheme of the Doctorate Records File maintained by the NRC, augmented in the clinical sciences by the discipline/fie~d/specialties list used by the NIH. An important consiaerAt-iOn ; n Hat ; phi not oh; ~ -1 Act; a; _ _ ~ ~ ~ ~ ~ . _ ~ _ . . . ~ . . _ . ~~l phoneme Is anal many or One Data required tor this study are collected using either the Doctorate Records File or the NIH structure. For purposes of this report, a tentative taxonomy has been established which consists of four broad fields, within each of which a number of subfields are included. These are as follows: Basic Biomedical Sciences - Anatomy Biochemistry Biomathematics Biomedical Engineering Biophysics Cytology Embryology Genetics Immunology Microbiology/Bacteriology Molecular Biology Parasitology Pathology Pharmacology Physiology Basic Biomedical Sciences Other Other Fields Included with Basic Biomedical Sciencesl Botany Ecology Entomology Environmental Sciences Anthropology Behavior/Ethology Clinical Psychology Comparative Psychology Counseling & Guidance Developmental Psychology Educational Psychology Experimental Psychology Gerontological Psychology Human Engineering Behavioral Sciences Hydrobiology Nutrition/Food Science Pharmaceutical Sciences Zoology Industrial & Personnel Psychology Personality Psychology Physiological Psychology Psychometrics School Psychology Social Psychology Social Statistics Sociology Psychology, Other 10Certain specialties within these rather large fields are a part of the basic biomedical sciences, but others are only marginally related. For this reason, these subfields are put in a special category. 23

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Clinical Sciences Dentistry Medicine & Surgery Allergy Anesthesiology Geriatrics Internal Medicine Cardiovascular Diseases Clinical Nutrition Connective Tissue Diseases Denmatology/Syphilology Diabetes Endocrinology Gastroenterology Hematology Neurology Neuropsychiatry Obstetrics/Gynecology Ophthalmology/ Op tometry Oto rhino laryngo lo gy Pediatrics Preventive Medicine Psychiatry Radiology Surgery Veterinary Medicine Clinical Sciences, Other Health Services Research Biometrics /Biostatis tics Epidemiology Health Economics Infectious Diseases Liver Diseases Metabolic Diseases Nuclear Medicine Oncology Pulmonary Diseases Renal Diseases Tropical Medicine Internal Medicine, Other Hospital Administration Public Health There is no intent in this report to restrict training to those Outfields explicitly shown in the above list. The Committee recognizes that a number of suLfields Important to biomedical and behavioral re- search, currently supported by the NIH/ADAMHA/HRA- such as orthopedics, osteopathy, urology, neurosurgery, and systems analysis are not shown in this taxonomy, which was constructed from the classification schemes mentioned above mainly as an aid to the organization and collection of data. Although this report is concerned,prim~rily with recommenda- tions for the four broad categories, the allocation of training support to each subfield within a more detailed classification scheme will be discussed in the next report under the continuing study. 24

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GROWTH OF TRAINING Although the first fellowships were awarded in 19~ ,the training programs did not begin to grow significantly until late in the 1950's. Up to that time, the programs were providing support to a few hundred postdoctoral fellows annually at funding levels not exceeding $10 million per year. After 1955, the training grant became firmly established as a support mechanism, and under it, the predoctoral program emerged and began to take on added importance as an NIH training component. Federal funds for scientific research grew from less than $1 billion in 1958 to over $5 billion in 1966.12 The physical sciences and engineering re- ceived most of the increase, but the life sciences also received a large share. The research training programs of the NIH and the NIMH grew even more rapidly than the research budget from $18 million in 1958 to $157 million in 1966 (TABLE 1~. It was during this period that the support of predoctorals on training grants became numerically the largest single component of the NIH programs. About 10 percent of all the NIH trainees and fellows who started training during 1956-60 were pre-Ph.D. students. During the period 1966-72, this figure was about 40 percent.13 Another significant component contributing to the growth was the post- M.D. trainee group which went from less than 500 new starts (5 percent of all new starts) during the 1956-60 period, to over 10,000 new starts (23 percent of all new starts) during 1966-72. By contrast, the post- Ph.D.'s constituted 10 percent of new starts during 1956-60 and only 8 percent during the 1966-72 period. Around 1968, the training programs began the transition from a period of growth to a period of consolidation. As FIGURE 1 and TABLE 1 show, the growth rate of the NIH/ADAMHA research training programs in actual dollars was about 11 percent per year from 1960 to 1968. From 1968 to 1974, there has been considerable apparent variation from year to year in the level of expenditures for these programs; the growth rate varies quite widely depending on how it is calculated. In 1974, the obligation level was at a record high primarily because funds im- pounded in FY 1973 were released in FY 1974. Therefore, the actual change from 1968 to 1974 shows an increase. But a more realistic way of calcu- lating the growth during this period is by using a least-squares smooth- ing process. When this is done, as in FIGURE 1, the series exhibits a 11See Appendix C for the legislative and administrative history of the training programs. 1 Federal Funds for Research Developmen* and Other Scientific Activities, l National Science Foundation, Washington, D. C., Volume XVIII, 1969. 13These data were derived from the Master File of NIH Trainees and Fellows developed for NIH in 1974 by the Commission on Human Resources of the National Research Council. See TABLE 2. 25

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TABLE 1 NIH/ADAMHA Obligations-:for-Research Training Grants and Fellowships, 1960-74 Fiscal Year TG F TG & F 1967=100 _ NIH obligations for research ADAMHA training excluding NIMH TG F TG F only) Millions of 45.9 12.9 1.9 1.9 68.5 14.9 2.5 2.0 76.5 15.8 3.8 2.9 -90.2 17.9 5.1 4.1 96.9 17.2 6.7 4.9 108.3 19.3 8.0 5.1 120.8 21.5 9.5 5.1 131.7 25.3 11.2 5.6 132.9 27.7 12.3 5.6 139.6 29.8 14.6 5.9 128.9 22.7 13.0 5.7 130.1 23.9 13.0 3.7 137.2 21.6 13.7 3.5 122.2 30.6 13.7 1.5 NIH/ADAMHA Consumers Price Index NIH/ADAMHA . TG & F Constant $ dollars 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 973-74 47.8 14.8 62.6 71.0 16.9 87.9 80.3 18.7 99_0 95.3 22.0 117.3 103.6 - 22.1 125.7 116.3 24.4 140.7 130.3 26.6 156.9 142.9 30.9 173.8 145.2 33.3 178.5 154.2 35.7 189.9 141.9 28.4 170.3 143.1 27.6 170.7 150.9 25.1 176.0 135.9 32.2 168.0 88.6 89.6 90.6 91.7 92.9 94.5 97.2 100.0 104.2 109.8 116.3 121.3 125.3 140.4 70.7 98.1 109.3 127.9 135.3 148.9 161.4 173.8 171.3 173.0 146.4 140.7 140.5 119.7 TG = Training grants F = Fellowships (excludes Research Career Awards) Source: Training grant data derived from Basic Data Relating to NIH, 1974, p. 22, adjusted to reflect NIH research training only by subtracting out NIMH data supplied by the Special Projects Branch, Office of Legislative Analysis/Office of the Director of NIH for 1960-66. The NIMH data tabulated by NIH include clinical training grants and research training grants. The ADAMHA data for 1960-69, which were prepared by the Manpower Analytic Studies Branch, ADAMHA, /19/75 . contain only research training Grants. ADAMHA data for 1970-74 were _, , , _ , _ supplied by the Office of the Assistant Administrator tor extramural Programs, 5/6/75. iSome training funds were impounded in FY 1973 and released in FY 1974. To smooth out the erratic fluctuations caused by these actions, 1973 and 1974 data have been averaged. The actual totalfor NIH/ADAMHA was $126.4 million in 1973 and $209.6 million in 1974. 26

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FIGURE 1 _ NIH/ADAMHA Obligations for Research Training Grants and Fellowships, 1960-74 Approximate Average Annual Growth Rates: $ million 200 190 180 170 160 150 140 130 120 110 100 90 80 70 60 _ // 1/ I t t 1960 61 Source: TABLE 1 actual $ constant 1967 $ Constant 1967 $ ,/ ~7 ,/ ~ Actual $ f ~ f - i/ by/ ~ t ~ ~ 62 63 64 65 66 67 Y E A R ~7 1960-68 1968-74 11% 11% A -1% [calculated on a _5% least-squares basis) * I. _ r '\ t 68 69 70 71 72 73-74

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decline of about 1 percent per year in actual dollars. Taking inflation into account, the decline is almost 5 percent per year in real terms. The deflator used in this case was the consumer's price index, 1967=100. Information about the level of expenditures for pre- and post- doctoral programs separately is not available and cannot easily be estimated The reason is that although both ore- and Postdoctoral ~ , _ _ trainees are supported on training grants, the agencies do not break out these funds by academic level. It may be possible in the future to derive a reasonable estimate based on the number of trainees in each academic level, but this calculation has not yet been made.l4 Over 94 COO people had participated in the NIH training programs through 1972~5 about half of them in the basic biomedical sciences. The most heavily supported fields were biochemistry, microbiology, and physiology. The clinical sciences were next largest with about 30 per- cent of all trainees, and the balance was distributed among other health-related fields, the physical sciences, and psychology. About two thirds of the people supported by NIH have started on training grants, one third on fellowships. The proportion of graduate students in the biosciences supported by NIH reached a peak of 28 percent in 1964 and has gradually declined since then to about 18 percent in 1971. In the health professions, the 1967 peak of 16 percent has declined to about 10 percent in 1971. SOME CHARACTERISTICS OF NIH TRAINEES AND FELLOWS 16 The length of support provided by the NIH depends on the academic level of the trainee. Those who were seeking a Ph.D. were supported for a longer period than others because of the more extensive study required to attain the Ph.D. The typical pre-Ph.D. received 22 months of support from the NIH while the typical post-Ph.D. received about 16 months of support. 4See also TABLE ~ for information about support of training in these fields by other agencies. 15The data cited here are given in more detail in the report The Impact of the NIH Training Programs on the Career Patterns of Bioscientists, loo. cit. . 16The data cited in this section do not include ADAMHA or HRA trainees and fellows. 30

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Since these figures describe the average experience fellows supported by the NIH during the period 1938 of all trainees and through 1972, it is to be expected that considerable variation exists In the data. About 19 percent of all pre-Ph.D. trainees have had more than four years of support, while 39 percent have had only one year or less, including those who complete the program and those who drop out. In many cases, teaching and research assistantships have supplemented the funds provided by the NIH. For the 1966-70 period, the total cost to NIH for a typical pre- Ph.D. fellow during the course of his training averaged about $8,100; for a post-Ph.D fellow, it was about $11,500. These figures include the sti- pend and dependency allowances, which go to the fellow, and allowances for tuition and supplies, which go to the institution. The amount of support has increased irregularly at an average rate of about 4 percent per year, just about the same as the increase in the cost of university education. Pre-Ph.D. trainees in the 1960's began their supported training on an average of 2.5 years after the B.A. Post-Ph.D. support typically began between one and two years after the Ph.D. Post-M.D.'s received their first support generally after the residency, about 4.5 years beyond the M.D In the biological and physical sciences, those individuals with predoctoral traineeships or fellowships attained the Ph.D. more fre- quently and in less time than those without such support. Differences in ability, however, may account for some or all of the differences in Ph.D. attainment rates and in the shorter tome lapse from B.A. to Ph.D. The pre-Ph.D. trainees supported by NIH in the biosciences between 1956 and 1965 had a Ph.D. attainment rate of 66 percent compared to 42 percent for the nonsupported group during the same period. NIH pre-Ph.D. fellows had an attainment rate of 91 percent in the bio- sciences. The fellows do somewhat better than the trainees in terms of Ph.D. attainment, partly because they are a more highly selected group, and partly because they have received their fellowships at a later stage in their education. On ~ ~ one average, one pre-~n.~. trainees received their first support two -and one-half years after the B.A. while the fellows received theirs three and one-half years after the B.A. 31

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ACTIVITIES OF FOUR NIH T~I=ES AD FELLOWS One of the tasks set by the National Research Service Award Act for the continuing study is to "identify the kinds of research positions Available to and held by individuals completing such [training] pro- grams." The Committee will deal with this subject in greater depth in the course of later studies, but presents here some of the facts now known about how former NIH trainees and fellows use their training. A little more than 70 percent of former NIH post-Ph.D.'s whose employment was known listed research as their primary work activity during 1968-70. Another 24 percent of this group listed teaching as the primary activity. This compares with postdoctorate not supported by the NIH who were split 45 percent into research and 46 percent in-to teaching, and with Ph.D.'s without postdoctoral support, of whom 41 percent were primarily in research and 36 percent primarily in teaching. The M.D.'s who have received NIH support do not have as high a rate of participation in research as the NIH-supported Ph.D.'s, but the M.D.'s tend to remain in research longer whereas the Ph.D.'s tend to move sooner into other activities, principally teaching and administration. Of the M.D.'s~who formerly had received post-M.D. support from NIH, about 22 percent listed research and development as their primary work activity during 1968-70, and about 10 percent listed teaching. For the oldest cohort of this group (those whose B.A. was prior to 1941), 26 percent reported research as their primary activitity in 1968-70. For the younger cohort (those whose B. A. was during 1951-60), this figure was about 21 percent. For M.D.'s, the attainment of the Ph.D. degree is also an important factor in career outcomes. Only 20 percent of the M.D.'s with NIH post- M.D. support prior to 1972, but no Ph.D., were engaged primarily in re- search in 1968-70, whereas almost 50 percent of those with NIH post-M.D. support and the Ph.D. were so engaged. Over all years of experience and at almost all degree levels, re- search and teaching were less highly paid in 1970 than the alternative work activities of management, administration, or professional services to individuals. Given the same number of years of experience, the median salary of M.D.'s in research was about 30 percent higher than that of Ph.D.'s in research. In teaching, M.D.'s were paid about 60 percent more than Ph.D.'s. This in a sense is a measure of the premium in the form of salary differentials and of the incentives such as training support that must be paid in order to attract M. D.'s into research or teaching careers. Scientists who worked for educational institutions in 1970 32

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were paid considerably less on the average than those who worked in pri- vate industry or government or were self-employed. PRESENT LEVELS 0E TRAINING- NTH, ADAMHA, AND HRA The current number of people participating in the research training programs of NIH, ADAMHA, and BRA are shown in TABLE 3. The 1974 data can be taken as reasonably accurate, 1975 figures are estimates, and 1976 figures are projections based on administration budget requests. There are two special circumstances concerning the administration of the training programs that must be noted. The first is that training grants are "forward financed," which means that trainees on duty in a fiscal year are supported from funds obligated in the previous year. Thus, variations in the funding of the training grants have a delayed reaction on the number of trainees supported. Secondly, successful fellowship applicants are allowed up to one year after they receive the award to activate the fellowship. The result of this is that the number of awards given in a fiscal year is not necessarily the same as the number of fellows on tenure in that year, although the two are usually approximately equal. Except for ADAMHA, the data in TABLE 3 were derived from the numbers of trainees on tenure in a given fiscal year, and the number of fellowship awards made in that fiscal year. In other words, the table shows the approximate number of trainees and fellows on tenure in each fiscal year for NIH and HRA. For ADAMHA, it was not possible to provide exactly comparable data. What the agency has provided instead is the number of trainees funded in each year, which is the best avail- able estimate although not the same as the number on tenure in that year. TRAINING LEVELS IN THE PRESIDENT'S FY 1976 BUDGET Recent trends in the reduction of funds for health research train- ing programs are continued in the administration's proposed budget for FY 1976. The budget proposes allocations of approximately $124 million to NIH for research training, down from roughly $156 million in FY 1975. For ADAMHA, $16 million is proposed (down from $22 million to previous fiscal year) with no provision for new starts. For HRA, the FY 1976 proposal contains no funds for new starts and $900,000 for continuations. Just as important as the absolute dollar amounts are the proposed changes in the type and level of support provided. In NIH, all pre- doctoral training support is scheduled for phaseout, and only 1,000 new postdoctoral trainees are being proposed in the FY 1976 budget. In the 33

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TABLE 3 Approximate Number of Full-time NIH/ADAMHA/HRA Trainees and Fellows on Duty, Current and Projected through 1976 Agency Basic Biomedical Sciences - , Fiscal Academic Year of Level Support Predoctoral 1972 Postdoctoral Total , Predoctoral 1973 Postdoctoral Total . Predoctoral 1974 Postdoctoral Total Predoctoral 1975 Postdoctoral Total , Predoctoral 1976 Postdoctoral Total , , Predoctoral 1974 Postdoctoral Total Predoctoral 1975 Postdoctoral Total Predoctoral 1976* Postdoctoral Total ~ B_ D ~ ~ ~ Predoctoral 1974 Postdoctoral Total Predoctoral 1975* Postdoctoral Total Predoctoral 1976* Postdoctoral Total . . . . Predoctoral 1974 Postdoctoral Total Predoctoral 1975 - Postdoctoral Total _ Predoctoral 1976 Postdoctoral Total Behavioral Sciences Clinical Sciences Health Services Research Total , 1 1 - 1 4696 2834 7530 4636 2097 6733 NIH1 5 ADAMHA HA 6 GRAND TOTAL NIH/ ADAM/ HRA 617 196 813 581 84 665 4403 2575 6978 5484 2905 8389 4598 2727 7325 505 148 653 629 167 796 527 157 684 811 2933 3744 695 2749 3444 115 2856 2971 143 3223 3366 120 3025 3145 . ~ . _ _. _ 267 223 490 _ 244 171 415 _ 181 127 308 _ O O O _ _ O O O O . . , 4670 2798 7468 5728 3076 8804 _ 4779 . 2854 _ 7633 *FY 1975 and 1976 figures are estimates. 34 1281 130 1411 1166 91 1257 863 67 930 o o o o o o o o o 1786 278 2064 1795 258 2053 1390 224 1614 522 199 721 - 453 108 561 196 63 259 244 71 315 205 66 271 o O . o o o O O O . O O O O O o o o o 115 2856 2971 143 3223 3366 120 3025 3145 6646 6162 12808 6365 5038 11403 5219 5642 10861 6500 63662 28663 5450 5975 114254 1 160 73 233 95 10 106 71 78 338 28 366 300 12 312 215 221 1708 426 2134 1506. 272 1778 1115 201 1316 .- 338 28 366 ) 300 2 12 2 312 215 6 . 221 694 164 858 640 93 733 491 79 570 7265 6096 13361 8306 6650 14956. 6780 6182 2962

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NOTES TO TABLE 3 ~ IH data represent trainees on duty and fellowships awarded in each fiscal year. 2Assumes all fellowships are postdoctoral. 3The total of 12866 is composed of 11000 trainees and 1866 fellows of which 1179 are continuations and 687 are new starts under the assumption that 25 percent of new funds totaling $41.2 million are allocated to fellowships and 75 percent to training grants. The Committee is aware that changes in this ratio may still be instituted, but regards the data cited as the most probable estimates as of the date of preparing this report. The total of 11425 is composed of 9800 trainees and 1625 fellows of which 1010 are continuations and 615 are new starts. These figures are based on the assumption that 25 percent of new starta~and continua- tion funds will be allocated to fellowships and 75 percent to training grants. The continuation budget in FY 1976 is estimated at $25.4 million, and the FY 1976 competing budget is estimated at $11.3 million. 5ADAMHA data represent trainees funded and fellowships awarded in the fiscal years shown. ADAMHA does not have data on trainees on duty in each fiscal year. FY 1975 data were based on estimated obligations of $21.8 million including $2.0 million in FY 1973 funds recently released; FY 1976 data were based on the administration's budget request of $16.2 million (continuations only, no new awards). ADAMHA does provide support for the research training of M.D.'s and other personnel with a clinical sciences background (clinical psychologist, social workers, etc.) but such trainees are included in disciplinary areas other than clinical science in the above table. 6HRA data represent trainees on duty and fellowships awarded in the fiscal years shown. The 1975 data are based on the actual awards made in that year; the 1976 data are estimates based on the administration 1976 budget request of about $900,000 for continuations, and no new starts. SOURCE: Data taken from special tabulations prepared by each agency: NIH: Office of Research Manpower, Division of Research Grants, Table 1, 5/1/75 ADAMHA: Office of the Assistant Administrator of Extramural Programs, Table 1, 5/7/75 HRA: Office of Academic and Intergovernmental Affairs, NCHSR, table dated 4/24/75 35 ~ s

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behavioral science, training for which has been traditionally concentrated at the predoctoral level, elimination of ADAMHA support will sharply curtail training support. For NIH and ADAMHA,the import of these policy and funding changes trainees, $14 million is that most FY 1976 funds will go toward supporting continuing i.e., those who had begun their training in prior years. Only out of the proposed $124 million for NIH is targeted toward new starts. It should be noted, too, that the type of support recommended differs from that of previous years. According to administrative guidelines, the portion of the training grant that can be utilized for program expenditures has been cut back from an average of 45 percent of the training grant (in- cluding indirect costs) to approximately 33 percent, with the result that a larger portion of the training grants are being allocated to trainee costs. The impact of these changes on the number of fellows and trainees supported is difficult to assess given the uncertainties in the distribu- tion of funds between fellowships and training grants, predoctoral and postdoctoral awards, and the portion of training grants devoted to trainee costs. What does seem certain, given the President's FY 1976 budget pro- posal, is 1) an overall decline in fellowship and training grant support; 2) a sharp reduction in predoctoral support; and 3) a concentration in fellowships rather than in training grants. 36 -