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10. FUTURE DIRECTIONS I n thi s year ' s report the Committee again drew heavi ly upon existing data, but also obtained new information pertinent to a number of specific issues. The results of these studs es are included in part in this report. Other information will be made available during the coming year in ~ he form of technical reports. It is evident that further analyst s of recently con lected data and extension of the da ~ a base as a whole will improve the understanding of career patterns and research training needs in the biomedical, behavioral, and clinical sciences. As the Committee looks toward next year, the role of federal support in sustaining and enhancing the quality of trai ning programs looms as a centra ~ i ssue . The cliff iculties that can be anticipated in dealing with this issue and the Committee's approach to it are discussed below in the section entitled "'Federal Support and Training Quality. " Fo, lowing this discussion, an outline i s presented of the Committee' s plans for the coming year with rega rd to these additional priority i s sues: Fie 161 taxonomy and mobility. (2) Career patterns of federally supported- trainees and fellows. (3) Further development of models of supply-demand systems . (4} Dissemination of market information. In addition to the priorities listed above, the Comani~tee plans to broaden its data base, particularly in the areas of clinical sciences, health services research, and nurs ing research. ~4

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Federal Support and Training Quality In its 1976 report, the Committee stated its intention of exploring the effectiveness and appropriateness of federally supported training programs. Two central issues in this discussion are (~) the federal role In affecting the number of biomedical and behavioral research personnel and (2} the qualify of their training. How-essential is federal training support in producing a sufficient number of biomedical and behavioral science researchers? Does federal support provide opportunities f or training of such high quality that the recipients of this training are like ly to make greater contributions to research over the course of their careers? The f irst issue--training sufficient numbers of basic biomedica ~ and behavioral science researchers--can be addressed with r~asonab~ e certainty. Data presented in Chapters 3 and 4 indicate that, whir e recent Ph. D. recipients have not been substantially "underemp~ oyed, " it appe ars that the number of new graduates wi 11 be more than adequate to meet future demands created by expansion of academic labor market opportunities and attrition. Therefore, at ~ he present time, f ederal support in the basic biomedical and behavioral sciences does not appear to be justified by a need to increase the supper y of trained research personne ~ in these areas . The question of the need for f ederal support as a means of enhancing the qua lity of training i s much more cliff iced t--and important--to answer. Enrollment levels and Ph. D . production are easy to quantify; quality is not . Over the past two years, the Committee has sought inf rmation regarding training qua Q ity. The Committee notes that the training grant mechanism, with its institutional support component, is given very high marks by its recipients. The stability, capability for long-range planning, flexibility, and innovative benefits thought to be derivable from the training grant are praised by department chairpersons. In addition, much available information documents the impressive career outcomes of past recipients of NTH/ADAMHA/HRA training grants and fellowships. Recipients of tines ~ awards are more like ly to complete their doctoral programs qui ck~ y , enter res ea rch ca ree rs, and produce more publications and citations than other graduate students. ~ These f acts alone do not unequivocally demonstrate that i t i s the f edera ~ support of a program that ha s ma de the di f f erence in producing such superior career outcomes . Because they are high-quality students, enrolled in institutions and departments judged by peer review to be outstanding, many of these trainees and fellows might we, have f ound a Iternative s ourc e s of support and gene on to f ruitf u ~ re s ea rch ca ree r s if f ede ra ~ programs ha ~ not been avai fable . All that can be conf idently concl uded is that the system of national competition for individual

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fe 11 owships and training grants has succeeded in s electing many of the best student s and programs and produced many excellent scientists. DisentangI~'ng the relative importance of selection from program effects will be difficu~ t, perhaps impossible e. Deciding the significance of federal support for the compl ex trailling process may not be easier. The co~runittee di 5, however, seek to gauge the impact of ~ ost NIH/ADAMHA/HRA trainee ship/fellowship support on departments that have experienced such lasses In the recent pa s ~ . This was done by utilizing the NSF annual surveys of graduate sci ence student support and by initiating its own survey of biomedical and behavioral science departments. The resume ts from the Committee' s own survey have not been compiled in time for inclusion in this year' s report. NSF data Cal early demonstrate that, ove' the four-year period from ~ 972 to ~ 975, departments rated the highest in quality (by ~ he Roose-And~rs~n reputational survey} experienced ~ ess severe reduce ions in HEW fel~owships/traineeships than cuber departments, i.e., during this brief period most of the cutbacks were made in departments of ~ esser or unknown quad ity rating (Appendixes L and M) . Such information, however, begs the question of what would happen if NIH/ADAMHA/HRA cutbacks were to continue to the point where the ~ operated depar~nents' programs were severely reduced in funding. Such departments do receive a higher portion of their student support from these federal sources (Appendixes L and M). How would their training programs be impacted? could enroll meets drop? Wound ~ the stable, flexib~ e, and innovative quad ities ascribed to these training programs be curtailed or ~ ost? In initial ing its own survey, the Committee has sought to answer some of ~ hese questions. Part of the Survey of Biomedical and Behavioral Science Departments was intended to i dentify specifical ly departments that have lost NIH/ADAMHA/HRA training grant support. By matching these departments with the trend data available from the NSF surveys, the Committee will attempt to analyze the ef f ect of declining federal support on enrollments and patterns of support. In addition, the survey included questions concerning the impact of lost institutional support on the training activities of the department. Average department graduate record examination (ORE) scores of entering graduate -students have been requested in an attempt to see if falling federal support has adversely affected the quality of students enrolled. The Committee is aware that information derived from this survey may only begin to clarify the role of federal support in maintaining or improving the quality of training. The interrel ation strip of various funding sources ~ ~ a department' s training program is very complex, and it is not clear what the comparative advantages of particular training experiences or sequences are in providing preparation for 186

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research careers. Melded into these issues is the problem of identifying the distinct ve rol e that federal support may provide in enhancing the training process. The compel exiles of the se is sues make them di f f icult to addre s s in a survey questionnaire. The Commi' tee thus is corrunitted to further exp, ore' ion of the issue of the federal role in research tra i ni ng qua ~ it y in the comi ng ye ar . The f of ~ ow in g ob jectives wi l, be pursued: {1~ The impact of recent withdrawals of NIH/ADAMHA/HRA training funds. {2) The potential impact of such withdrawal on top quality departments. (3) The Recur far benef its, if any, of federal programs . (4} The adequacy of alternative support mechanisms to support high-quality training. Cogni zant of the complexities inherent in examining the is sue of qua 1~ ty, the Committee will pursue two courses of action. The first will be to analyze thoroughly the data already gathered in its own department survey. This analysis should lead to some conclusions about the impact of lost training-grant support. The second course to be pursued will be to examine in depth a more limited sample of departments, chosen with the aid of the department survey results, in order to probe the complex issues surrounding the role of and need for federal training programs. From this study, a more precise understanding of the role of federal support may emerge. Field Taxonomy and Mobility The discussion in Chapter 2 points out the difficulties of studying the manpower needs in the fields of the biomedical and behavioral sciences when no standard definition exists for these fields. A uniform system for classifying the f ie, ds would ~ be very helpful in the collection and uti ~ ization of data and would improve the pros Fect s f or understanding the trends that are taking place. DO scussions therefore will be initiated with training officers at the funding agencies concerning the establishment of a standard system of nomenclature. Of particular interest is the utility of a two-dimensional scheme such as that developed by ADAMHA for classifying trainees and fellows. The possibility of developing a similar scheme for fields of inte rest to NTH and HRA wi ll be explored . With regard to studying differences in field mobility patterns between training and employment specialties, the ~7

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Committee plans to examine data from the Commit~ee's Survey of Biomedical and Behavioral Scientists (NBC, 1976c) and from other available sources. In this examination ~ particular attention will be given to (~} the frequency with which recent biomedical and behavioral science Ph.D. recipients have switched from one particular specialty to another, (2) the extent tc which those switching fields consider the ir graduate training relevant to their employment, and ~ 3 ~ the importance of postdoc toral training in providing opportune ties for recent graduates to transfer into new fields of research. A further attempt wall be made to identify specialties in which there may be a current shortage of qua lifted research personnel. Career Patterns of Federally Supported Trainees arid Fell ows The studies in this report describing the e~rpicy~rent markets for biomedical and behavioral scientists have dealt with the opportune ties for all graduates in these areas. During the next year existing data sources will be used to focus on the training and employment of those graduates who have received either predoctoral or postdoctoral support from NIH and ADAMHA research-training programs. Consideration wall be go ven to (~) the leng' h of graduate and postdoctoral training, (2) the extent to which these graduates utilize their research ~ raining in subsequent employment, and (31 the numbers employed on federal research grants and contracts. Since those who have received" NTH and ADAMBA research-training support were generally considered to be among the best students, a comparative study of these graduates with o' her Ph.D. recipients will attempt to cant ro 1 f or the qua ~ ity of thei r graduate prog rare . In the clinical sciences area, -two closely related stud ie s wi l l addre ss the i s sue of " car eer out c ore s " o f former clinical research trainees supported by NIH/ADAMHA. ~ ~ ~ The AAMC Faculty Roster will be used to draw a random sample ~ of clinical faculty to examine the "research life" of clinical faculty members. Individuals will: - be asked to provide inf ormation on: . The proportion of time spent in various research categories at dif ferent times. Publication hi story. Tra ining received . Date of appointment, faculty advancement, eta .

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Phi s inf ormation wi ~ ~ be use fu ~ in explori ng the productive research life of an individual faculty member-- whether the research activity distribution for al, ages in 1977 is similar to ~ he research activity distribution from other times, whether it is possible to have substantial re search act ivity without re search training, whether certain type s o f re s earch train) ng expe riences yield more productive faculty researchers, and whether the research activity distribution is similar for NIH trainees and non-NIH trainees . ~ 2} NIH records on individuals who received NTH/ADAMHA- spon soled training will be compared with records of the AAMC Faculty Roster of current and inactive medical school f acute ty to determine both the total number of trainee s who have become facul. y members and the number who have a primary responsibi, ity in research. This will permit calculation of the cost of NIH/ADAMHA training grants per faced ty member produced or per faculty researcher. It will al so allow a comparison of the "success" rates of al ~ institutions that participated in NIH/ADAMHA training programs. Further Development o f Models of Supply-Demand systems The manpower pro Sections presented in chapters 3 and 4 were based on models of demand for biomedical and behavioral scientists i n the academic sector. One of the key elements in the overall research plan for this study is to improve these models and extend them if pos sible to the nonacademic sectors . In particular, the model of demand f or clinical Vacua fly, while providing some useful planning guidelines, has some important deficiencies (Chapter 5} that need to be corrected in order to improve its reliability. The conceptual bases of these models, as well as the data requ iced for thei r i mplementati on, mus t underg o f u rther deve lopment. In this regard, the committee will continue to monitor trends in enrollments and degrees. The Office of Education, the Nationa ~ Science Foundation, the National Research Counc' I, and other organizations systematically collect basic data on enrollments and degrees ire higher education. One of the important functions of this study is to examine these data in the fields of interest to the Committee and to moni tor the trends with a view to making short term pro j ect i ons of the out ~ oak f or biomedi ca ~ and behaviora scientists. The rate at which Ph.D.'s can be absorbed in nontraditional employment posits ons is an important item that is not well documented at present. A considerable portion of the f acuity positions in ~ he biomedical and behaviora ~ s c fence s ha s not been f illed by Ph . D . ' s but may ~9

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be in the future. In medical schools, some of the positions vacated by M.D. 's who enter private practice may be filled by Ph.D. 's. Similarly, nonacademic post' ions are expected to become a more important source of employment for biomedical and behavioral doctorates. Additional information is needed, and will be sought in the coming year, on the rate at which these substitutions can occur. several years of data are now available on the personnel contributing in a paid or unpaid status to the research grants of NIH. This inf ormation is an important resource for studying the staffing requirements of these grants and thereby allowing estimates to be made of future staff ing patterns by field and degree-type. The Committee will continue the effort it began this year to review these data and develop a pro jection methodology based on them. As sta ~ ed in Chapter 4 in the behavioral science recommendations, ADAMHA is urged to collect similar information on its research grants and program pro jects. Dissemination of Market Information The Corrunittee plans to issue a technical report based on the basic biomedical science findings of the recent study. This report wi 11 focus on the scientists with postdoctoral appointments, since data on this group appear to be a sensitive indicator of the employment opportunities in these fiel ds. It wit ~ examine the role of postdoctoral appointments and other nontenured research positions in the academic sector. Data on the number taking these positions, the length of time in these positions, and the subsequent careers of ~ hose in such appointments will be reported for fields in the basic biomedical sciences. As discussed in Chapter 3, the Committee believes that efforts should be made to inform all involved in the training of biomedical scientists of the market conditions, and this report will assist in this effort. The basic biomedical sciences technical report will be submitted for publication to a journal with wide circulation as soon as possible after the Comnittee's ~ 977 report is published. Because behavioral scientists who received NIH,ADAMHA predoctoral support represent only 30 percent of the total number of doctorates who graduated between 1971 and 1975, the Co~runittee views the information regarding their training and employment experience of particular importance to an understanding of future training needs. As a result, the Comnittee plans a separate technical report for the behavioral sciences that will examine the data on these trainees. 190

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FOOTNOTE ~ . For evidence of f avorable completion rates and publication- and citation rates of NIB trainees and fellows, see National Research Council ~ ~ 976b, Chapter 4) . For evidence of greater likelihood of entering research careers, see Appendixes BY and E4. 1. 191

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