Science Training Program (DSTP) that is analogous to the MSTP under the auspices of the NRSA legislation.
RECOMMENDATION: The committee recommends that one-quarter to one-half of the new positions available for training in OHR in fiscal 1994 and beyond be used by NIDR to establish a Dental Scientist Training Program (DSTP) under the NRSA act.
Additional suggestions for improving the NRSA for training OHR scientists have emerged in committee discussions. Some of these suggestions are similar to those from other fields and are included in the overall recommendations of this report. Other suggestions are unique to OHR, and are mentioned in the paragraphs that follow.
Legislated policy requires that individual awards comprise at least 15 percent of the total NRSA allocation by the funding institute, but there is no clear rationale for the policy. NIDR sometimes has difficulty meeting the 15 percent requirement for awards to individuals, and there is great demand for institutional awards. It is possible that institutions are competing for the best students through the institutional training mechanism, leaving relatively few students for the pool of individual applicants. The committee believes that the 15 percent requirement for individual awards for NIDR should be rescinded.
The long-term effectiveness of short-term exposure to research experiences needs to be evaluated. At present, the NIDR uses the T-35 mechanism to draw dental students into research careers. However, this particular mechanism is limited to 4 percent of the NRSA funds. The committee suggests that this limitation be evaluated not only for the long-term effect but also to explore whether the mechanism should be extended for other purposes, such as retraining, encouraging minorities and women to enter research tracks, and stimulating clinical research.
Completion of a Ph.D. after a dental degree generally requires more than 3 years. Also, other sources of support for continuing such studies (e.g., Howard Hughes Institute, clinical revenues) are not generally as available for dentists as they may be for physicians. The committee suggests that doctoral support be provided for 5 years and beyond for dentists making satisfactory progress toward a Ph.D. under an NRSA.
Finally, because of the disincentive for entering research training that is inherent to the heavy debt load of dental graduates (currently the highest of all health professional graduates at greater than $55,000, on average), loan forgiveness would provide an incentive. The committee believes that a loan-forgiveness incentive should be provided as a feature of NRSA programs.
In summary, what is particularly needed in OHR are appropriately trained personnel to carry out a broadened scope of research. There is an alarming personnel shortage of research-trained full-time dental faculty. Many challenges continue to arise as the twenty-first century approaches. These challenges require enhanced resources and flexibility as well as continued cooperation and collaboration among programs and institutions if they are to carry out the mandate of Congress to improve the oral health of the American people.
1. Much of the material in this chapter is based on the views of experts who convened a one-day workshop on July 9, 1993, in Washington, DC (Lathrop and Ranney, 1993).
2. There are two major programs for training OHR scientists through NIDR support, the NRSA and the Dentist/Physician Scientist Award (DSA). NIDR's portfolio in the NRSA includes the following:
F-32, individual postdoctoral fellowship;
F-33, individual senior postdoctoral fellowship for senior faculty members;
F-35, intramural training grant;
T-32, institutional training grant; and
T-35, short-term summer training grant.
The DSA/PSA programs include the following awards:
K-11, individual physician-scientist award for dentists;
K-15, individual dentist-scientist award; and
K-16, institutional dentist scientist award.
The F awards (fellowships) are all postdoctoral awards, either post Ph.D. or post clinical doctorates. These postdocs receive the traditional postdoctoral research training and, in the case of clinical doctorates, that may include earning a Ph.D. during postdoctoral training. The T awards (training grants) can include predoctoral students. These people have bachelor's or master's degrees and usually are in a program to obtain a Ph.D. In rare cases, such as in biomaterials or epidemiology, they stop at a master's level. The T-35 short-term grants are specifically for dental students. The physician-scientist award for dentists and the dentist-scientist awards appoint only dentists. All of these DSA appointees are in a program to obtain a Ph.D.
Kennedy, J.E. 1990 Faculty Status in a Climate of Change. Journal of Dental Education 54(5).
Lathrop, L. and R.R. Ranney 1993 Proceedings of Meeting on National Needs for Oral Health Research Personnel. National Academy of Sciences, Washington, D.C., July 9, 1993. Unpublished summary. September, 1993.
Littleton, P.A., L.J. Brown, and E.S. Solomon 1985 The Relationship Between National Institute of Dental Research (NIDR) Supported Research Training and Careers in Dental Research. Unpublished report. March, 1985.
Solomon, E.S. 1994 The Oral Health Research Work-Force. To be published in Journal of Dental Education.
Valega, T. 1993 Report to Meeting on National Needs for Oral Health Research Personnel, National Academy of Sciences, Washington, D.C., July 9, 1993. See Proceedings of Meeting (Lathrop and Ranney, 1993).