Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
2. RESEARCH TRAINING IN TEE BIOMEDICAL BEHAVIORAL SCIENCES-A NATIONAL OVEF(t1IEW Research training in the health-related sciences is accomplished in the United States through a large and complex array cuff programs. This chapter will outline the nation purpose, and diversity of these programs. It wit ~ review the system of student support and discuss briefly the problem of determining the supply and demand for biomedical and behavioral research personnel. TElE RESEARCH TRAINING SYSTEM Formal research training is essentially a postbaccalaureate activity in the United States. The settings in which training occurs include university graduate schools; school s of medicine, dentistry, veterinary science, public health, and engineering; and associated laboratories, hospitals, mental health clinics, counseling centers, social agencies, and other field areas. Levels of Training In terms of their level, training programs may be divided into two broad classes -- predoctoral and postdoctoral. Predoctoral programs are aimed principally at individuals who are s ee king a research doctorate defined as the Ph. D. or equivalent. Postdoctoral train ding is provided for individua Is who hole either ~ research doctorate or a professional doctorate such as 14. D., D.~.S., or D.~.M. Predoctoral. Predoctoral training is generally carried on within the context of a specific scientific discipline, such as anatomy, biochemistry, microbiology, physiological psychology, ethology, psychopharmacology, or anthropology. The functional unit of predoctoral training is the disciplinary department or, in some instances, a structured multidisciplinary program. The predoctoral student characteristically progresses through a series of didactic and laboratory courses; learns to conununicate in small seminar groups; and, through continuing interaction with peers, postdoctoral f el lows ~ the 23
faculty, and visiting lecturers, gradually acquires the traditions, values, style, and research methodology of the particular discipline. This experience may be brought into sharper f ocus through experience as -a teaching assistant in an undergraduate course under the supervision of an experienced faculty member and in the pursuit of an original research pro ject. Although such a pro Sect may be a wholly independent endeavor, it is common practice in the biomedical sciences for the graduate student to conduct one phase of a large research program in the faculty mentor's laboratory, where he or she works as a member of a research group, utilizing all the research facilities in the laboratory and conferring f requently with mentor and colleagues. The predoctoral student in the behavioral sciences less often derives a dissertation topic from the large research pro ject calf the mentor, but this depends on the particular subfield of behavioral study. Laboratory- based studies of behavior resemble the biomedical tradition. More common ly, the di s s ertation i s undertak en v ery much on the student's own responsibility after a period of limited app~entices~p, usually as a research assistant, in connection with one car more research pro jects that are organized and executed }:y a senior member of the faculty. In all cases, somewhat more of the research methodology is learned didactically rather than on the job, although this again varies across the spectrum of the behavioral science suLfields. Less formal predcctoral research training programs are available to individuals who are pursuing a professional doctorate and are taking time out for research training. These individuals are for the most part undergraduate students in the health professions schools, who, having shown interest in the biologic phenomena underlying disease, have been encouraged to develop their res earch potential. For medical students, this research activity may be carried on part-time and concurrently with their regular studies, or full-time (luring an "off" quarter or during a year's release from medical training. - Predoctoral training in the basic biomedical and behavioral sciences generally requires 4 to 7 years of ful I- time work and study between receipt of the bachelor's degree and attainment of the Ph. D. degree. Approximately two- thirds of Ph. D. recipients in the biomedical and behavioral sciences were engaged in academic employment in ~ 973. The remainder in the biomedical pock were evenly divided among industry, the federal government, and other sectors. The nonacademically employed behavioral scientists worked in hospitals, clinics, social welfare agencies, or were self- employed. Postdoctoral. The Prague of postdoctoral training, . . both at the post-Ph. D. and postprofessional levels, has perhaps been most widely recognized in the biomedical sciences. In addition, postdoctoral training has become 24
almost a requirement for the physician wishing to pursue a career in academic medicine. The opportunity for M. D. and Ph.O. graduates to be trained to-tether during the postdoctoral period is widely regarded as a valuable aspect of this experience. Further, postdoctoral education is regarded as important for training graduates from the physical sciences who wish to utilize their special knowledge and capabilities for biomedical and behavioral research. Post-Ph.D. training is oriented toward specialized experience in a research topic rather than a discipline. Each year an increasing proportion of those who receive the Ph. D. degree have been going on to postdoctoral training to sharpen their research skills under outstanding mentors. In }'ioche~nistry, for example, the percentage of Ph. O. recipients taking immediate postdoctoral appointments rose from 36~2 to 58. ~ over the period 1962-67.t A large percentage of these Ph. D. holders seek such experience in settings other than those of their graduate school mentors in order to gain new perspectives and to respond to new opporttlnities, particularly in interdisciplinary an-d emerging research areas.2 In 1973, the number of biomedical and behavioral science post-Ph. O. ' s in the United States totaled ainaost 6, 000. 3 Research training for individuals holding a professional doctorate must take into account the difference between their educational background and that of the the post-Ph. D. Many college seniors with exceptional] y fine academic records elect to enter Lexical school instead of Ph. D. programs. To the extent that the 4 years calf medical school and subsequent years of residency training were designed to produce clinicians and not medical scientists, residents who then el ect to become clinical scientists requi re further scientific training. Since a proper mix of biomedical, behavioral, and clinical scientists is essential to initial aiscovery.and full application to clinical problems, it has become necessary to decibel ap new programs in school s of medicine to instill rigorous scientific discipline in the design of experiments, proper use of methods, and critical evaluation of data, as well as to provide a inroad background in the physical and biological sciences. These programs are demanding on toth the physician-trainee and the faculty, because of the trainee' s need to acquire in 2 to 3 years an extraordinary amount of new scientific knowledge, a variety of skills, and actual research competence. A highl y trained medical scientist today must have, in addlition to clinical training, a grasp of the snore basic areas, such as molecular structure and function of proteins and nucleic acids, the ultra-structure of various cell types that make up tissues and organs of the body, and the underlying behavior mechanisms calf the whole body. Further, although some post- M.~. Is may do only clinical investigation, others will 25
engage in research on basic biomedical problems whose solutions are essential to clinical progress, and many wall develop competence to do both clinical investigation and basic laboratory investigation. In ~ 973 the number of individuals with professional doctorates who were pursuing postdoctoral research training totaled more than 5, 000. Interaction among Basic Biomedical, Behavioral, and Clinical Scientists At the present time, there are two groups of scientists in biomedical research. The first consists of those with an intensive preparation in one of the physical, biological, basic medical, or behavioral sciences but with relatively little knowledge of clinical medicines These scientists are essential to elucidate the fundamental processes that overlie living systems. Because of the difference in perspective and training, however, they do not pose the types of <questions likely to be raised by a physician. Consequently, they do not often extend their basic research to the arena of cl inical medicine. The -second group is made up largely of physicians who have completed ~ or 2 years of research training following graduation from medical school. These clinical scientists are engaged in exploring the pathogenesis c: f disease and learning how to diagnose disease early and to prevent or treat it effectively. Mechanisms have been developed to ensure that the remarkab' e advances in physical, biological, and behavioral sciences are used by clinical scientists in their search for a deeper understanding of disease. The NIH-sponsored Medical Scientist Program is a mechanism that combines in one program the essential features of both research and clinical training. Interdis ciplinary training programs are another mechanism for developing a medical scientist capable of commun icating and interacting with basic physica ~ and biological scientists. Other methods include placing clinicians in basic science departments for their research training and providing experience on interdisciplinary res earch Fro j ects . - Sources of Trainee Support The f ive principal sources of financial support for individuals engaged in research training are fellowships, training grants, research assistantships, teaching assistantships. and private means.- Together these comprise a pluralistic system, including both private and public support and commonly embracing more than one source of support in a single institution. whil e more administratively cumbersome than a single source, the plural istic system is believed to have provided greater 26
flexibility to the institutions and departments involved in the training. Fellowshins. These are awards made directly to the individual, largely in the form of a stipend, from a variety of sources, such as the fevers government. voluntary health organizations, foundations, and universities. Fellowships have been used in support of training for many years as a means of encouraging excellence and reducing financial barriers to training. Except for local programs, the fellow may take the appointment at any host institution with appropriate facilities and where ~ suitable mentor is willing to supervise the training. Awards are made to both predoctorals and postdoctorals, selected in separate competitions. National fellowship programs permit utilization of a more uniform set of standards in the selection of fellows, and the awarder has wider latitude in the selection of a training site. The award, as in the case of NIH/ADANBA fellowships, may include a modest institutional allowance to help Be fray costs of training the fellow such as tuition and fees, research supplies, equipment, travel to scientific meetings, and related items. That allowance differs, however' from funds included in training grants for the specific purpose of strengthening the scientific milieu of the department in which the training is pursued. Training grants. These grants are awarded by the federal government to institutions for individual departments or a consortium of departments for training in a specific field. In addition to providing trainee stipends,-- these grants enhance the quality of training by providing funds to departments for salaries, special seminars, courses, supplies, and equipment. In contrast to departmental training grants, multidisciplinary grants make it easier for graduate students to anticipate emerging scientific fields and to select their dissertation topics accordingly, with access to appropriate faculty in re, ated sub ject areas across departmental lines. Programs supported by these grants may I:e devoted exclusively to either predoctoral or pcst~c~c~toral training levels, or Moth. :~:ndividual trainees are se:Lected; by faculty participants on the basis of credentials and letters of recommendation similar to those in fellowship programs. The grants are awarded through national competition, with continuing peer review to ensure that training i s conducted In departments of the highest quality. Res earch ass i stantships ~ Many graduate students and Fostdoctorals receive support for work performed on research pro jects. Of ten this work fits their scientific interests and training requirements anti hence serves as useful educational experience. In some cases, the student may conduct an original study, as part of the overall project, that is suitable for a dissertation and that contributes to the advance of research supported by the pro ject grant. As 27
a major source of support for research training, however, this mechanism has some drawbacks. Training for research, particularly at the predoctoral level, requires more than on-the- jot experience. When the student's support is tied to a research grant, there exists the possibility of a mismatch between educational ob jectives and the pro ject director' s primary interest in maximizing research output. In addition, competence in research by an individual project director does not necessarily parallel competence and interest in training. Experience with the research grant as a training instrument, in light of its advantages and risks, suggests the need for a-flexible mixture of the research assistantship and other types of support for research . . . :~n~ ng. Teaching assistant~h~n`: Graduate students and postdoctorals may be supported by their institutions as teaching assi stants because of their contributions to teaching programs. These teaching assignments are usually at the undergraduate leered, and, hence, opportunities for this type of support tend to be available only in institutions and departments with large undergraduate teaching responsibilities. The teaching assistant typically grades papers, sets up experiments for laboratory sessions, holds classes in which lectures given by senior faculty members are discussed and in which texts and other written material relating to the course are reviewed, and guides students in laboratory work associated with undergraduate courses. These duties commonly occupy one-half of the teaching assistant's time, in return for which a modest stipend i s provided and tuition fees are remitted. Val uable experience is acquired in the art of teaching, which for most Ph. D. hollers is an essential part of their future bobs. Private means ~ Many students, particularly at the predoctoral level, support their training through private resources, including family aid, private loans, part-time employment, and assistance from a working spouse. Excessive reliance on this type of support is undesirable, because many persons of superior potential cannot afford to undertake yes earch training. These different forms of support, properly administered. can be appropriately related to the various purposes and stages of the training process . For example, graduate students may be provided with fellowships or traineeships for the first 2 years, teaching assistantships for the third year, and research assistantships for the fourth and succeeding years until the dissertation is completed and the degree awarded. This pattern allows the student to prepare as rapidly as possible for teaching and research. Teaching is postponed until the student knows enough to be able to do it well f and We research assistantship is utilized at a time when the student is relatively free and well enough informed to make a sound choice of mentor whose research 28
program has an appropriate opening. under its auspices and support, the student can conduct the research needed for the dissertation while contributing to the n~entor's research program. TEE SYSTEM OF SUPPORT IN THE BIOMEDICAL AND BEHAVIOR SCIENCES The role of f ederal support in research training can best be understood when placed in the context of the overall system of support in the biomedical and behavioral sciences. Considering the diverse loci of responsibility for supporting graduate educat~c)n, it should not be surprising that the federal government supports only a relatively small fraction of al ~ biomedical and behavioral science graduate students. In postdoctoral study, the national interest in targeted research and the absence of ~ ocal university responsibility have meant that federal support here has assumed a larger coverall responsible ity. This section will first consider graduate and postdoctoral support in the biomedical and behavioral sciences and then discuss briefly support for clinical research training. Health services res earc h, which i s b a si call y a mul ti dis cip l i nary f i e ld f e d by diverse behavioral, biomedical, and clinical fields, cannot be adequately defined quantitatively at this time and thus will be omitted from this discussion. Graduate Student Support The federal government in ~ 974 provided the primary source of support for 29.1 percent of fulI-time graduate students in the biomedical sciences arid 20.9 percent of behavioral science students. This compares to 23. 7 percent of graduate students in all sciences (see Figure 2. ~ and Appendix II, Table lI.2) . Other primary source s of support were institution~state sources and personal resources {including self, family. and spouse}. In the biomedical sciences, institutional support comprises 4 2. ~ percent and self -support 2 ~ . 5 percent of primary sources of support. In the behavioral sciences, where federal funding Is less prominent, a larger portion (34. 0 percent) comes from self or fancily and 38. ~ percent from institutional and state sources. It is important to note that different systems of support utilize different mechanisms, depending on the ob jectives of the sponsor. Federal support for graduate students, which is intended primarily for research purposes, is made up of fe1 lowships, traineeships, and research assistantships. In the biomedical and behavioral sciences, support by the U. S. I,epartment of Bealth, Education. and 29
ALL SCIENCES 24% federal Fellow! A.:...... Trainee^....... [22,2,2h222,.. RA _~ ~ Other Bellow/ Oth:4 Types of Support: F:dbwsJliptrrair~h ip Research Assistantship (RA) Teaching Assistantship (TA) Other 2996 Federal BIOMEDICAL SCIENCES 76% Nonfederal RA Fellow/ Trainee Self 7t~ Nonfederal Other I LEGEND °~ ~ ~lo~ot~r Inst''ut~onai Fellow/ Train" a, ~ Other Trainee t" i';! Nonted~al BEHAVIORAL SOtENCES 21% Federal ~.~ I .2 .N by - FslJowl )` ........ Tra'~e ::: .:::::::: ::. ::: :::::: Vera ~ LA FelIc~w/ Other Trainee 79% Nonfederal , ~ Trainee //~/~ Other ;/4 RAT Fc''ow/ ~ Seit Trades \ - NOTE: See Tables 1 ' .2 and 11 .3 in Appendix I I for supporting data. SOURCE: National Science Foundation, Graduate Science Student Support and Postdoctorals Survey, t974 FIGURE 2.1 Primary Source and Type of Support for Full-time Graduate Students In the Biomedical and Behavioral Sciences, 1974 30 /
Welfare (DREW), primarily through NIR and ADAMEA, is concentrated in f ellowships and traineeships (over 70 percent}, in contrast to res earch assistantships ~ In agencies other than DREW federal support for research training in all sciences is provided primarily through research assistantships {see Figure 2. ~ and Appendix IT, Table II . 3) . Institutional~state support is composed of a wide diversity of types of support. Fellowships~traineeships, as well as research assistantships, are utilized, but by far the largest mechanism is the teaching assistantship, which reflects the primary interest of the individual institution and state government. Self-support, as noted above, is a significant source of support comprised of one' s own earnings, loans, and spouse and family support. In recent years, federal support has dropped off for the biomedical arid behavioral sciences and indeed for all sciences. Most recently, front 1972 to 1974, federal support has declined 17. ~ percent in all sciences, 13.6 percent in the biomedical sciences, and 18. ~ percent in the behavioral sciences (see Appendix II, Table IT. 2) ~ The mechanism of federal support most sharply cut back is the fellowship~traineeship. NIH support here in the biomedical sciences declined 13.2 percent from 1972 to 1974 (see Table 2. 1} . Federally supported research assistantships, however, sea rise to offset partially the severe fellow trainee cutbacks . Nonfederal sources rose considerably aur~g this time, at rates far exceeding overall federal declines. In the biomedical sciences, institution/state support rose 17.0 percent and self-support rose 19.9 percent (see Table 2. 1) . These increases account for the recent rise in graduate enrollments in spite of federal cutbacks. s All types of instituti on/eta te support-- f ellowshi Strain Reships, research assistantships, ~d teaching ass~stantships--shared in the overall in-crease. Self- support also rose substantially during this period. Postdoctoral Support The biomedical sciences have a strong tradition in postdoctoral study as a necessary step in gaining the knowledge and skills needed to conduct biomedical research. Because of the highly specialized nature of the training and its direct relation to federal agency goals for solving health research problems, the federal government has assumed a ma jor role in postdoctoral study in this area. The federal goverrunent provided approximately 75 percent of the primary sources of support for biomedical science postdoctorals in 1974. Of those federally supported, about 40 percent were f ellows~trainees and 60 percent were
TABLE 2. ~ Primary So~c~ and Type of Support for E ull-t~me Graduate Students in the Biomedical Sciences, 1972 and 1974 ~ ~ ~ Ch.~ce, 1972 1974 1972 1974 1972- 1974 Total 25205 26663 100.0 100.0 5.8 Fell/Tr 7541 6692 29.9 25.1 -11.3 RA 4925 5435 19.5 20.4 10.4 TA 6600 7376 26.2 27.7 11.8 Other 6139 7160 24.4 26.9 }6.6 Total Federal 8998 7770 35.? 29.1 -13~6 ; ~ . . . . ~ . ., ' - Fell/Tr 5830 4508 23.1 16.9 -22.7 ~ . ; RA 2671 2845 10.6 10.7 6.5 TA 108 119 .4 .4 10.2 .' Other 389 298 1.5 1.1 -23.4 NTH 5736 5244 22.8 19. ~ -8.6 . . Fell/Tr 4317 3746 17.1 14.0 -13.2 RA 1264 1364 5.0 5.1 7.9 TA 75 49 .3 .2 -34.7 Other 80 85 .3 .3 6.3 Total Nonfederal 162.07 18893 64.3 7Q.9 16.6 . . Fell/Tr 1711 2184 6.8 8.2 27.6 RA 2254 2590 8. g 9.7 . 14.9 TA 6492 7257 25.8 27.2 11.8 Other 5750 68G2 22. a 25.7 19.3 Institu~ion/state 97;8 Il41d 38.7 42.8 3~7. O . . .. Fell/Tr 1104 1522 4.4 5.7 37.9 BA 1754 2001 7.0 7.5 14.1 TA 6425 7237 25.7 27.1 12.6 Open 475 654 l.9 2.5 37.7 4785 5736 . 19~0 21~5 19 e 9 CODE: Fell/Tr = Fellowship/TraineeshIp' RA = Research Assistantship; TA = Teaching Assistantship; Other = Other Types of Support. NOTE: Data include persons enrolled in only those departments which responded to all three (1972-74) surveys, and hence do not represent population figures. SOURCE: National Science Foundation, Graduate Science Student Support and Pos tdoctorals S urvey ~ 1972- 74. 32
research associates, i. e., employed on research grants or contracts . ~ The behavioral sciences have not utilized postdoctoral support to the extent that the biomedical sciences have because their programs were designed primarily to add to the pool of basic researchers. For example, 40 percent of 1972 Ph.D. 's in the biomedical sciences entered into postdoctoral work, compared with 22 percent of behavioral science Ph. O. ' s. of those behavioral science Ph. D. ' s who sea enter postdoctoral work, approximately 50 percent were federally supported. NIB and ADANHA data indicate that they supported 2, 798 biomedical science postdoctorals in 1974 {2, 600 of which were from NIB) and 278 behav-iaral science postd`~torals 7 . Clinical Sciences Clinical science training is unique compared to biomedical and behavioral science training in three basic respects: (~) it deals primarily with M. D. ~ s and other professional degree recipients; (2) ~t is located almost exclusively at professional schools; and (3) it takes place almost entirely at the postprofessional ~ ever. Because medical schools are professional schools with no undergraduate departments an<] because professional students are generally trained as practitioners, there are virtually no teaching or research functions that prcfessional students serve. Clinical research training is thus concentrated at the postprofessional level. Typically, over 95 percent of NIH fellowship,traineesh~p support in the clinical sciences has been made at the postdoctoral level.~.According to ~ National Science F-oun<~ation survey, approximately 60 percent of clinical science postprof~ssxonals in ~ 974 were federally supported, of which 75 percent were fel lows~trainees and the remainder research associates. 9 :~BrE:RMI GINO THE: SUPPLY AN: D DEMAt1D (NEE:)) FOR BIOMEDICAL AND BEBA1JIORAI, RESEARCH PERSC)NNhL The HRSA Act of 1974 calls for assessment of the need for personnel to perform research in the biomedical and behavioral fields. The term "need'' can be given various interpretations, and the Committee has devoted considerable discussion to the appropriate definition for purposes of this study. In a general sense, there is a need to reduce the costs of the various it Inesses that prevail in our society today. In a very broad sense then, need could be interpreted as the manpower requirements that would result from a policy of investment in biomedical research based on the social costs of disease. This is a fairly unconstrained 33
approach, since it would require that research expenditures be somehow tied to a social-cost figure without regard to budgetary ~ imitations. The Commi tte e ha s a <30pte ~ a somewhat more di sci p li ned interpretation c>f the task set f orth in the Act. In the Conunittee's view, need is interpreted as the manpower requirements dictated by market demand at the prevailing salary levels. In cipher words, the task is interpreted as one of determining the number of positions that are expected to be available in the next f ew years for biomedical and behavioral scientists assuming that no significant changes In - their wage structure will occur. The number of available positions for these scientists in turn is believed to be governed by the likely future pattern of enrollments in higher education and biomedical and behavioral research expenditures. Most researchers perform some combination of research and teaching. The teaching component of demand is thus represented by enrollments in higher education, while the research component is represented by the amount of research funds available. Enrollments are fairly predictable, since they depend on demographic patterns that can be estimated from known birth rates. For example ~ correct predictions of increased college enrollment rates some 20 years later were made at the time of the post-WorId War I] baby boom. Conversely. research funds are allocated annually and are sub ject to the normal variations associated with economic conditions and political processes, making them a less predictable component. On the other side of the market picture is the expected supply of scientists available to perform biomedical and behavioral research. Demography also plays a role here, for while the short-run effect of increased enrollments is to increase the teaching component of demand, the long-run effect is to increase the supply of scientists. We thus view the market for research personnel in these fields as a dynamic system whose el ements are continually changing in response to demographic and economic factors. Superimposed on the demo: graphic cyst es are the variations i n research emphasis and funding that add tc' the difficulties of trying to assess the future supply and demand pattenas. It seems clear at this point that Me system has passed through a sustained period of rapid growth into one in which the growth is expected to be more moderate. The supply/demand balance in future years depends, in addition to the factors mentioned above, on students' reactions to perceived job opportunities for dc~ctoral-level scientists. The Committee feels that continual monitoring of trends in enrollments. research expenditures, and job opportunities provided by this study can furnish timely information to guide both individua l deci s ions and fed era l po li cy . A more det al led assessment calf manpower needs is presented in the next chapter. 34
FOOTNOTES 1. National Research Council, The Invisible University: Postdoctoral Education in the United States, D.C., National Academy of Sciences, 1969. Washington. 2. National Research Council, Mobility of Ph.~. ' s: and A f ter the Doctorate , Washington , D. C., National of Sciences, 1971. 3. National Research Council, and Engineers, ~ 973. Before Academy Survey of Doctoral Scientists 4. National Science Student Support and D.C., U.S. Government Printing Office, 1974. Foundation, Graduate Science Education: Postaoctorals. Fall 1973. Washington, 5. National Science Foundation, Graduate Science Student support and Postdoctorals Survey, 1972-74. 6. Ibid., 1974. 7. National Research Council, Commission on Human Resources, Personnel Needs and Training for Biomedical Behavioral Research. The 1975 Report of the Com:~et:ee study of National Needs for Biomedical and Behaviora Research Personnel, Washington. O.C., ~~ - ~ Sciences, 1975~ p. 34. 8. Ibid. and on a __ _ National Academy of 9. National Science Foundation, Graduate Science Student Support and Postdoctorals Survey, 1974. 35
