TABLE 5-6 Aggregated Numbers of NRSA Supported Trainees and Fellows in Clinical Sciences for FY 1991 through FY 1993

     

Type of Support

Fiscal Year

Level of Training

TOTAL

Traineeship

Fellowship

1991

Number of awards

2,894

2,814

80

 

Predoctoral

755

736

19

 

Postdoctoral

2,139

2,078

61

1992

Number of awards

2,970

2,887

83

 

Predoctoral

819

800

19

 

Postdoctoral

2,151

2,087

64

1993

Number of awards

2,974

2,877

97

 

Predoctoral

855

826

29

 

Postdoctoral

2,119

2,051

68

NOTE: Based on estimates provided by the National Institutes of Health. See Summary Table 1.

postdoctoral fellowships in the clinical sciences from 68 in fiscal from 68 in fiscal 1993 to 160 by fiscal 1996.

Institutional Training Grants in the Clinical Sciences

To permit the expansion of the pool of MSTP trainees and postdoctoral clinical science fellows, we believe modest reductions should be made in the number of postdoctoral awards made through institutional training grants. NIH reports that 2,087 awardees were supported in fiscal 1992 through this mechanism (Table 5-6). We believe a gradual decrease should occur in the number of awards (Table 5-7). This would be done to permit the expansion of the MSTP program (described above).

RECOMMENDATION: The committee recommends that the number of postdoctoral institutional traineeships supported through the NRSA program in the clinical sciences be slightly decreased from 2,051 to 1,965 between 1993 and 1996.

NOTES

1. Several studies, it must be added, have identified a lack of rigorously trained individuals who know how to perform patient-based research (e.g., Ahrens, 1992) as a special need at this time.

2. The clinical sciences are understood to include individuals holding degrees in a variety of health professions including: medicine, veterinary sciences, dentistry, nursing, clinical psychology, and social work. The research training needs of clinical psychologists have been addressed in chapter 4 of this report (“Behavioral Sciences”), dentistry needs are separately addressed in chapter 6 (“Oral Health Research”), and nursing addressed in chapter 7 (“Nursing Research”). The committee did not address research training needs in the veterinary sciences or social work, but recognizes that these fields contribute to the national research effort and merit support through the NRSA program.

3. A recent report of the Institute of Medicine, Careers in Research: Obstacles and Opportunities (1994) investigates ways to improve the quality of training for clinical investigators and delineates pathways for individuals pursuing careers in clinical investigation in nursing, dentistry, medicine and other health professions engaged in human research.

REFERENCES

Ahrens, E. H., Jr. 1992 The Crisis in Clinical Research: Overcoming Institutional Obstacles. New York: Oxford University Press.

Association of American Medical Colleges (AAMC) 1992 U.S. Medical School Faculty: 1992. Washington, D.C.: Association of American Medical Colleges.

Bradford, W.D., S. Pizzo, and A.C. Christakos 1986 Careers and professional activities of graduates of a Medical Scientist Training Program. Journal of Medical Education. 61: 915-918.

Fredrickson, D.S. 1993 Clinical Investigation. Paper prepared for the Committee on National Needs for Biomedical and Research Personnel.

Frieden, C. and B.J. Fox 1991 Career choices of graduates from Washington University's Medical Scientist Training Program. Academic Medicine. 66: 162-164.

Institute of Medicine (IOM) 1994 Careers in Clinical Research: Obstacles and Opportunities. Washington, D.C.: National Academy Press.

McClellan, D.A. and P. Talalay 1992 M.D.-Ph.D. training at the Johns Hopkins University School of Medicine, 1962-1991. Academic Medicine. 67(1): 36-41.

National Research Council (NRC) 1975 Personnel Needs and Training for Biomedical and Behavioral Research. Washington, D.C.: National Academy Press.

1978 Personnel Needs and Training for Biomedical and Behavioral Research. Washington, D.C.: National Academy Press.

1985 Personnel Needs and Training for Biomedical and Behavioral Research. Washington, D.C.: National Academy Press.

1989 Biomedical and Behavioral Research Scientists: Their Training and Supply, Volume I: Findings. Washington, D.C.: National Academy Press.



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