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1 . INTRODUCTION AND SUMMARY OF NUMERICAL RECOMMENDATIONS,
FISCAL YEARS 1979-81
Th i s i s the thi rd in a series of annua ~ report s that the
Commit tee ha s prepared in response to the request of the
Congress under Ohm National Research Service Award Act of
1974 {NBSA) "to assess the national needs for biomedical and
behavioral research personnel" and to "recommend the kinds
and extent of training to be provided" under federal
programs.
In its second annual report (National Research council,
1976~), the Committee provided a brief "Historical
Overview," which reviewed both the federal interests and
involvement in biomedical and behavioral research and the
specific charges that the Congress established for a
continuing study of research personnel needs in these
fields. That overview, together with the Act and a summary
of several important redated questions that emerge from the
legislative h story of the NRSA Act, are reproduced in
supplements 1-3 at the end of this volume. These and the
synopsis given in supplement 4 of the major findings and
recommendations of the 1976 report place the present report
and its recommendations in perspective.
For purposes of carrying out its responsibilities in its
second annual report (1976), the Committee divided the
biomedical and behavioral sciences into four broad areas--
basic biomedical sciences, behavioral sciences, clinical
sciences, and health services research. The Committee made
a number of recommendations for adjustments in the number of
predoctoral and postdoctoral awards for research training
under the programs of the National Institutes of Health
(NIH) and t he Alcohol, Drug Abuse, and Mental Health
Administrated on (ADAMHA} in each of these four areas for
fiscal years (FY) 1976, 1977, and ~ 978. In that report the
Committee set target goals for FY 1976, realizing that they
woul ~ come too ~ ate f o r the f unding agen ci e s to be ab ~ e to
make ma jor changes toward implementation. The first
specific recommendations made by the Committee, which
permitted the agencies suff icient time for implementation,
were made for FY 1977; these are summarized in Supplement 4.
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OBJECTIVES OF THE 1977 REPORT
The ob j ective s f or the current repo rt are to ~ ~ ~ revi ew,
update, ant] extend the Committee' s specific previous
recommendations about the numbers of predoctorals and
postdoctorals who should receive federal support within each
o f the broad area s ink o which the biomedica ~ and behavioral
sciences have been aiviaea; ~ 2} make recommendations
concerning appropriate usage of the different support
me chant sms f or ea ch of the s " ar ea s; ( 3 ) speci f y, whe re
possible e, the sub ject matter or training fields that the
C omm i -t ee be ~ i eve s de s e rue s pe cia ~ empha s i s at thi s tire;
(4) assess the current training programs of the agencies
covered by NBSA, including for the first time the nursing
research program of the Heal ~ h Resources Administration
tHRA), which was brought within the scope of the NFSA
~ eggs anion when the Act was amended in ~ 976; (5) identify
the kinds of research positions that are available to and
he 1 ~ by recent graduate s of f ederal ly supported training
programs; and (6) propose modifications in the
administration of the NRSA program in order to achieve its
ob j ectives more f us ly.
Beyond these primary ob jectives, the committee this year
uncle recook ~ study of ca reer pa stern s of Li omed i Cal and
behavioral research personnel. This report summarizes data
on the pos+--raining activities of both former trainees and
former fed lows from federally supported predoctoral and
postdoctoral programs and of those not so supported
(Chapters 3 and 4 ~ .
The Committee al so begins to addre ss the i s sue s o f
whether there are alternatives to federal support programs
available to students planning research careers in these
fields, and whether there are more appropriate and ef festive
alternatives to the training grant and felic~wshiF
mechanisms. Because the studies relating to these issues
have not been completed, the results will be reported next
year (see Chapter ~ O. "Federal Support and Training
Qual ity") .
Iwo other areas of responsibility manifested in the
~egisla' ive history of NESA are touched upon by the
Committee this year, bu ~ not explored in depth. One is the
que s tion o f whet her the f ed e ra ~ government provide s
disproportionate support for ~ raining in the biomedical and
behavioral sciences than in other areas in relation to the
gave rnment ' s ove ra ~ ~ i nv" stme nt i n re s ea rc h in tho s e area s .
The Comma tte" has included some readily availatIe data
pertinent to this topic (Supplement 7~. The second issue is
whet her the net rate of return to individuals trained in
certain f ields that are hea~ri ly supported by ADAMHA, HRA, or
NIH i s of such a magnitude as to make it reasonable to
require them to bear the cost s of their Own training. This
matter is left for future consideration except for citations
to scone recent studies (Scuffler, 1977~.
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In surmnary, ~ he Commit' ee's report this year addresses a
number of the points within its Aegis ativ" charge, and, for
the first time, precepts data about the underlying issue of
training and career patterns that, although no' expi icitly
included in the s tatute, emerged during the ~ egislat~ve
debate about the MESA Act.
NURSING RESEARCH
In the spring of ~ 976 the Congress passed the Health
Re search and Health Services Amendments of ~ 9 7 6, Title II of
which extended the NRSA authority to include the research
train' ng programs of the Division of Nursing of the HRA.
The Committee responded to ~ his Congressional action by
appointing nurse investigators as members of three of its
f ive advi very panels (Behavioral Sciences, Clinical
Sciences, and Health Services Research), and ty estate, ishing
nursing research as a f if th broad area for study by the
committee. The current report ~ bus presents for the first
time a discussion of and specific recommendations for
advanced training in the area of nursing research (Chapter
7) .
SOT ICITATION OF VIEWS FROM THE PUBLIC
Prior to the issuance in May 1976 of the second annual
report, the Ccmmit~ee both formal ly and informal ly had
invi ted the viewpoints of others with regard to the i ssues
posed by the legislation and how best to conduct the
continuing study no as to accomplish the several Casks set
for it. Many useful comments were received, but the number
of performs having opportuni' y to comment was small . AS a
resul t of the heightened interest in the work of the
coon i ttee that a ro se a f t er the wide di s tribut i on o f the ~ 9 7 6
report, the Committee decided to solicit reactions and
comments from a broader pubs ic on a more formal basis.
Accords ngly, a public hearing was held for this Purpose on
November 4, ~ 976, in Washington, c. C., at the National
Academy of sciences (NAS), approximate ly f our months after
the Committee ' s ~ 976 report had become generals y available
(S upplemen~ ~ ~ .
The purpose of this hearing was to receive the views of
representatives of professional societies, academic
institutions, ~ ay organizations, and individual citizens as
the Commi ttee proceeded to work toward i ts ~ 9 7 7 report . The
committee requested criticism of any aspect of its ~ 976
report. The Committee specifics ly solicited any
quantitative evidence that would ~ help verify or refute the
array of anecdote' information that always surfaces when
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manpower issues are discussed. In addition, the Committee
sought sugge stions f or improving it s procedure s and
performance ire carrying out its responsibilities.
During a full day and evening session, the Committee
heard from 36 scheduled speakers and an additional ~ 6
persons who presented brief statements from the fig oor during
open discussion periods. The points raised and opinions
of fered touched on virtual ly every ma jor topic either
addressed in the ~ 976 report or planned for inclusion ire
future reports. These included access by minorities and
women to research training opportunities, the importance of
distinguishing the research -raining needs for behavioral
scientists from those f or health services research, the
specificity with which numerical recommendations for
research training ~ evels should be made by the Committee,
the significance of mul tidisciplinary training programs, the
training needs in the emerging areas of nursing research and
health services research, the impact that new health
legislation frequently has upon manpower needs, problems
related to the NRSA payback provision, the emphasis given to
a number of specific fields, and the division of fields
among the Committee's disciplinary panels.
All documents submitted to the Committee in connection
with the public hearing have been reviewed by the
appropriate advisory panels and the Committee and are a part
of a file available to the public. The viewpoints and
recommendations expressed have assisted the Committee in
reaching its conclusions on various policy issues.
As noted in Chapters 3-8, representations were made at
the hearing on the need for additional training of research
personnel in a number of selected fieJ ds. However, the
quantitative evidence produced at and subsequent to the
hearing was insufficient to support specific proposals.
In this report the Committee has not attempted
specifically to address each individual's views as expressed
at the hearing. Rather, the Committee and its advisory
panel s have reviewed the opinions presented there and have
attempted to take them into account in making their f indings
and recommence ons. The influence of the hearing was most
clea rly shown in ~ he Committee ' s speci al ef for ~ s to study
the needs for increa sed opportunities for women and
minorities, to clarify the re lationships between the
training of behavioral scientists and that of health
services researchers, to review whether emphasis should be
given to particular fields identified for priority
consideration by various participants, and to assure that
all fields are given adequate review by one or more of the
appropriate discipl inary panels.
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RE37I EW OF CORRENI STUDI ES
The issues that the committee has beer asked to consider
cannot adequa ~ ely be addressed f ram data that heretof ore
have been available. Consequently, the Committee conducted
three special nationwide surveys in order to obtain needed
data. One questionnaire collected information from
i ndi vidua ~ inve st i gator s i n the b iomedica ~ and behavi ore
s ci ence s, an othe r f r om unive r s ity depa rtment s in t he
biomedica ~ and behaviora ~ sciences in which all predoctoral
training and most of the postdoctoral training is provided,
and a third from personnel who had received federal support
for graduate training in health services research. Also, a
study was conducted by the AS sociation of American Medical
Colleges (AAMC} on the research training of M. D. ' s in
medi cal cent ers and teaching hospitals .
These three studies provided extensive inf oruration that
added significantly to the data previous y available to the
committee f ram net ~ anal surve y data f i le s main t a in ed by the
National Research Council (ARC, ~ 95 8-76} . In addi tion,
specialized program data were provided by the federal
agencies that administer the NRSA program (ADAMHA, BRA, and
NIH). Other data from the National Science Foundation (NSE,
1972-75) and nonfederal organizations, including the
American Medical Association (AMA) and AAMC, also were very
helpful to the Committee and panels .
The Commi tte e a l so reviewed and ana l yz ed thr e e ct he r
sour ce s o f inf orma ti on: ~ ~ ~ the comprehen sive stu dy by
Cart ter ~ ~ 976 ~ on the pro jected supply of scientists and the
future demand for them within the academic sector, (2) the
results of a special study conducted for the Ccm~r,ittee t:y
Freeman ( 1977) on the development of manpower models in the
biomedical sciences and psychology, and (3} an ongoing
market study sponsored by NIH that uses periodic surveys to
assess the current supply and demand for biomedical and
clinical investigators ~ n both academic and nonacademic
employment settings (We s tat, Inc., ~ 977) .
Together, the se surreys and Saudi e s have provi deaf the
Committee with a Such broader ba se of information upon which
to develop the present recommendations than previously has
been avai fable . Bec ause of the scope and pertinence of the
thre e net ion a ~ que st i onnai re s urvey s ~ eve ~ ope ~ by the
committee, a brief overview of each is provided below.
Survey of Recent Doctorate Recipients,
197 1-75
The purpose of this survey was to collect current
information on the training and subsequent work activities
of recent Ph. D. recipients in biomedical and behavioral
fields. This information is valuable in determining the
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impact that declining market conditions flay have had in
these fields. Of particular interest were data on the
number of graduates taking postdoctorals and the extent to
which these appointmer.8s had been prolonged because of
cliff iculty in finding employment. From the survey findings
the committee also hoped to be able to differentiate among
the employment opportunities for graduates in particular
biomedical and behavioral fields. Findings from this
survey are reported in Chapters 3 and 4.
Special efforts were made to survey nurses who had
earned doctorate s between ~ 9 7 ~ and ~ 97 5. Many of these
individuals received degrees in f ields other than the
biomedica ~ and behaves ore ~ sciences (e. g., education} .
Survey re sul t s f 0 r thi s group a re reported in Chapter 7 .
Survey of Biomedical and Behavioral
Science Departments
Whil e much i s known about the demographi c characteristics of
trainees and training programs, little firm data are
available about the role and impact of f ederal training
support on academy c departments . For examp, e, the NSF' s
annua' departmental survey of graduate science student
support and postdoctorals is not sufficiently disaggregated
to prove de the detailed information about individual
agencies and types of support {fellowships and traineeships)
needed by the Committee. Therefore, a questionnaire survey
was undertaken to obtain objective data about the academic
depar-=ner.+ as a training environment and about the pattern
of funding for pre- and postdoctoral trainees. The survey
also inquired about sources of nonfederal funding in order
to estimate the posse ble impact of the loss of training
grant support on departments. Among other issues examined
were (~) recent trends in graduate enrollments arid
pos+doctorals, (2) substitutability of alternative sources
of support for loss of training grant support, and (3}
importance of training grants for supporting high-quality
training. In addition, information was solicited on
departmental perceptions of the current job market,
anticipated future faculty needs, the possible lengthening
of the postdoctoral training period, and the impact of a
worsening job market.
Although some preliminary findings are available to the
Committee, the task of making a complete analysis of the
survey's results for publication could not be completed in
time to be included in this year's report. The Committee
expec' s to continue analysis of the data and include it in
the ~ 978 report.
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Survey of Health Services
Research Personnel
The Comma ttee has found it difficult to assess the current
supple y of health services research personnel because an
adequate data base does not exist in this recently
established area . In order to make a start toward
constructing such a data base, the Committee conducted a
survey of personnel in health services research whose
training had been federally supported (Chapter 61. The
survey provided i nformation about training and current
employment expert ences . Whi le it is c tear that the persons
surveyed do not constitute a sample from which results can
be generalized to ~ he population of health services research
workers, the Committee believes that ~ hese fin dings are an
important first step toward a substantive analysis of needs
in thi s area . ~
OVERALL RECOMMENDATIONS FOR FEDE~L SUPPORT
In the following sections the Committee presents ~ ~ ~ its
views and recommendations with regard to the two program
mechani sms by which the agencie s pro,7i tle support f cr
research training, and (2) a discussion of the basis for and
a summary of its numerical recommendations for FY 1979-~1
for each of the four broad areas into which the study has
been ding deaf. Additional recommendations concerning
selected policy ~ ssues and the administration of the NRSA
program will be f ound in Chapter ~ and Chapter 9 .
Mechanisms of Support
As the ma jor supporter of health-related biomedical and
behavioral science research, the federal government has
sought to promote excellence in research through high-
quality training. In its ~ 976 report, the Committee pointed
out that historically one goal of NIH/ADAMHA training policy
has been to increase the number of researchers; "another was
to bolster the quality of training programs and to ensure
that training was available in areas of national interest."
To this end, NIH and ADAM HA have followed two
complementary paths in fostering research tr~aining--
individual support of high-quality students through
fellowships, and the underwriting of superior training
programs through training grants. These paths converge.
Where quality training is conducted, the programs attract
and select ~op-quali ~ y students who, by their presence,
strengthen the programs designed to train them. The focus
of training support, the refore, has be en the department or
7
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program, directly through a training grant or indirectly
through an individua ~ f e llowship.
The Administration' s proposed termination of the NIH and
ADPMHA research training grant programs in FY ~ 978 is the
late st in a serie s of such actions in recent years to limit
supper ~ f or predoctora~ and postdoctoral research training
to f en lowships only . The Congres s has not accepted thi s
position and has maintained the training programs. The
Committee reaffirms the wisdom of Congress in maintaining
this tradition of federal support for high-quality research
training .
Within the context of the overall excellence of federal
training programs, there has been continuing debate over the
relative merits of training grants as compared with
fellowships . Thi s debate is one of the reasons Congress
request ed the study that this Committee undertook under the
provisions of the NRSA Act of ~ 974. Critics of the training
grant approach argue that such grants allow a limited number
of unit varsities to recruit students and expand faculty to
the d~ sadvantage of institutions that do not have training
grants. These critics also say that training grants limit
students ' freedom of choice, whereas an individual
fed 1 cowslip, awarded on the basis of personal excellence and
scientif ic promise, al lows the student to choose the
tra ining envi Convent be st suite ~ to hi s or her nee ds and
promotes a healthy competition among institutions.
On the other side, critics of the individual fellowship
argue that, at the predoctoral level at least, students'
interests are likely to be so unformed, and their knowledge
of training opportunities so limited, that they cannot make
truly informed choices . These critics contend that it is
expensive to administer individual fellowship competitions
on a nationwide basi s, and the balancing of awardees '
institutional preferences against available places is a
cumbersome and slow process. They also point out that
complete reliance upon individual f ellowships could lead to
erratic and unpredictable f ~ actuations in enrollment
pressures at ~ ndividual institutions, which would have a
destabilizing effect upon the training environment and would
imit ability to plan sound programs.
The Corrunittee has considered these and other arguments
carefully and at length. On balance, it is persuaded that
both fell owships and training grants are needed in an
ef festive national research training program and that each
has a role to play. Because the needs and problems of
re se arch trai ning di f f er among the var ious so ienti f i c area s
with which the Committee is concerned, recommendations about
the appropriate means and magnitude of support must be
particular to the area and level of training involved.
One aspect of this matter seems so signif icant that it
deserves specie 1 comment . The Committee strong ly holds to
the view that the training grant approach should not be
suddenly abandoned or drastically altered, as the training
8
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capabi' ities of university departments are not quickly or
cheaply r~const=' used. Dismantlement of the training grant
program could wed ~ impair the ability of some of the
nation's leading educational institutions to train high-
qual ity researchers for productive careers in the biomedical
and b~haviora ~ s cience areas .
Recommendation. The Commit' ee recommends that, while
saute on and a differential approach are called for, the
fedora goverurn~nt should conti rue to support and maintain
both training grant and fellowship programs in the
be Medical and behavioral sciences. More specific
recommendations f or each of the broad area s i s reported upon
in the for ~ owing chapters.
Basis for Committee ' s
Numerical Recommenda' ions
The numerical recommendations mad" in the present report are
derived in large mea sure f rom the much greater data base now
avail abet e to th" Comma thee. Interpretations of the data
have been di scus s ed and yes bed against -he inf orbed judgment
of the Commi' tee, with the cl ose advice and cooperation of
th e parse l s and the s ' a f f . P a rt i cular at tension ha s b e en
paid to assessing the quality imps ication of each suggested
eco~nendation or position in terms of the Committee' s
corclus~ on, stated i n the ~ 976 report, that ''in ad justing
public pol icy to reflect changing market conditions, federal
poll cy should seek to sustain and enhance this tradition of
high qual ity tra ining . "
The Committee' s judgments about the nation' s need for
by Medical and behavioral manpower are intimately and
necessarily linked to its forecast for the level of research
support. Admittedly, this forecas' is uncertain, and we
make it with hesitation, but make it we must. The
Cocci ~ tee ~ s view is that the amount of support for
biomedical and behavioral research is likely to continue at
about its current ~ evel {with some allowance for inflation}
in the next f "w years. Should the 1 evel of support change
greatly, either increasing or decreasing, personnel needs
would be correspondingly affected.
As to the appropriateness of the cu rent ~ ever of
support, the Committee takes no position, for it has not
studied this question, and indeed believes that it falls
outside ~ he Commit ~=e' s charge. Nevertheless, the Committee
no+ = s that many indi vi dual s and groups f am i l far wit h the
situation believe that the level of re search support is
currently inadequate. For instance, the President's
BE omedical Research Panel recommended a substantial increase
9
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in national expenditures on health-related R and D.
Secondly, many sc ienti st s se e enormous potent a ~ f or ba sic
anti applied research on unsolved problems. Thirdly, it has
been pointed out that the R and D expenditures in health and
medicine are now no more than 3 percent of the health care
expenditures, whereas it is not unusual for knowle<3ge-based
industries (such as medicine, aerospace, pharmaceuticals} to
sperd B- ~ 2 percent of their operating budget on R and D.
Others might contend that the current level of R and ~ is
adequate. Whatever the appropriateness of the current
level, the Committee must act on the basis of its estimate
of what ~ s likely to happen rather than on what should be
~ he case. On balance, the Committee believes that in
constant dol ~ ars the steady state win ~ continue in the short
run.
Summary Tats es of
Numerical Recomrnenda' ions
In its report last year, the Committee made specif ic
numerical recommendations for FY ~ 977 and set tentative
goals for FY ~ 978 for each broad area. At that time it was
intended to review during thi s pa st year the FY ~ 9 78 goals
and to make specific recommendations for FY ~ 978 in the
present report. However, with the passage of the Health
Research and Health Services Amendmer.ts of ~ 97 6, the date
for the submission of this and fu Lure annual reports was
advanced from March 31 to September 30. The net effect of
this charge, together with the change in the starting date
for the federal fiscal year from July ~ to October 1, which
was made last year, would have made ~ t impractical to make
recommendations for FY ~ 97S, as they would b" too late.
In the report this year, therefore, recommendations are
made for FY 1979, JUMBO, and 1981 for predoctoral and
postdoctoral traineeships and fellowships. The
recommendations for FY ~ 979 are considered f ire, whereas
those for FY 1980-~1 should be considered as tentative goals
that the Committee wi ~ ~ review during the coming year and
di scuss in its 1 978 report.
In Chap ~ ers 3 through 7 the Commit tee pre s ents its
f indings and specific recommendations covering each of the
fib ve aggregate areas into which this study is divided.
However , for the convenience of the reader, a background
informal ~, on table and a set of tables that summarize the
recommendations for all five areas have been provided: (~}
Table 1. ~ shows the number of NTH and ADAMHA trainee and
fellowship awards made in EY 1975-76 (including the
transition quarter, July 1, 1976 - September 30, 1976, which
occurred in 1976 when the start of the federal fiscal year
was advanced from July 1 to September 30; (2} Tables 1 .2 and
1. 3 give Comma ttee recommendations for numbers and
10
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decrease
~ 975. This
percentages of NIH/ADAMHA/HRA predoctoral and postdoctoral
trainee ships and fellowships by aggregate area for FY 1979-
81; (3) Table 1.4 gives estimated costs for the recommended
program levels for FY ~ 979-~1 , based on average cost data
for sty per.ds, Eric., for FY 1976 obtained from NIH; (4}
Figure 1. ~ provides graphs of the Comnittee's
recommendations for each aggregate
Note should be made in Table ~
in numbers of awards made
-~ occurred because of a Decrease in the
appropriations provided for the program for FY 1976. For
comparisons between the numbers of awards the agencies made
in FY 1976 and the targe ~ goals recommended by the committee
last year for each broad area, the reader is referred to the
following tables: Basic Biomedical Sciences, Chapter 3,
Table 3.16; Behavioral sciences, Chapter 4, Table 4.14;
Clinical sciences, Chapter 5, Table 5.5; Health services
Research, Chapter 6, Table 6.3.
Of
14
area.
.1 of the significant
in FY 1976 compared to FY
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-
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us
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(a) Total
O 1 1 1 1 1 1
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FISCAL YEAR
800
In
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0 400
UJ
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z
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FISCAL YEAR
(eJ Health Services Research.
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FISCAL YEAR
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O:.l I I 1_ 1
1975 1977 1979
FISCAL YEAR
(b) Basic Biomedical Sciences
en
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1981
1977
FISCAL YEAR
(d) Behavioral Sciences
- -- Total
~~ Predoctoral
—~ Postdoctoral
FIGURE 1.1 Summary of Committee recommendations for NIH and ADAMHA research training awards. Training grant
awards are made at the end of a fiscal year and support trainees on duty in the subsequent fiscal year. Fellowship awards
are made throughout the fiscal year in which Me training occurs and in this report it is assumed that the fellowship
awardee starts his training in the fiscal year of the award. Predoctoral training in the clinical sciences refers to the Medical
Scientist Training Program leading to the combined M.D./Ph.D. degree. See Table 1.2 and NRC (1976a, p. 15).
16
Representative terms from entire chapter:
training grant
