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BIOMEDICAL AND BEHAVIORAL RESEARCH SCIENTISTS: THEIR TRAINING AND SUPPLY Volume I: Findings Committee on Biomedical and Behavioral Research Personnel Office of Scientific and Engineering Personnel National Research Council in colIaboration-with the Institute of Medicine NATIONAL ACADEMY PRESS Washington, D.C. 1989

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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Frank Press is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Robert M. White is president of the National Academy of ~ engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Samuel O. Thier is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Frank Press and Dr. Robert M. White are chairman and vice chairman, respectively, of the National Research Council. This study was supported by contract N01-OD-2109 between the National Academy of Sciences and the National Institutes of Health. Copies available from: Studies Section Office of Scientific and Engineering Personnel National Research Council 2101 Constitution Avenue, NW - Room OR 402 Washington, DC 20418 Printed in the United States of America

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BIOMEDICAL AND BEHAVIORAL RESEARCH SCIENTISTS THEIR TRAINING AND SUPPLY Volume 1: Findings

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COMMITTEE ON BIOMEDICAL AND BEHAVIORAL RESEARCH PERSONNEL Gerald S. Levey, Chair Professor and Chair Department of Medicine School of Medicine University of Pittsburgh Robert Barker Senior Provost Cornell University Joe Claude Bennett Professor and Chair Department of Medicine University of Alabama - Birmingham Grace Carter Senior Policy Analyst Rand Corporation Robert Dauffenbach Professor and Director Bureau of Business and Economic Research Oklahoma State University Leodis Davis Associate Vice President for Academic Affairs: Budget and Planning University of Iowa Pe Herbert Leiderman Professor of Psychiatry and Behaviora 1 Sciences School of Medicine Stanford University J. Scott Long Professor of Sociology Indiana University Thomas Andrew Reichert Vice President of Medical Affairs Becton Dickenson Corporation Peter Henry Rossi Acting Director Social Demographic Research Institute University of Massachusetts Liaison from OSEP's Advisory Committee on Studies and Analyses Charlotte Kuh Executive Director Graduate Records Examination Program Education Testing Service Staff Robert McGinnis, Study Director Joe G. Baker, Associate Study Director Michael G. Finn, OSEP Advisor Yupin Bae, Research Associate Dimitria Satterwhite, Secretary v

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PREFACE This is the ninth report examining issues related to the NRSA research training program. The first committee was convened in 1975 as a result of the National Research Service Award (NRSA) Act of 1974, which mandated that postdoctoral training programs funded by the National Institutes of Health (NIH) and the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) be restricted to trainees intending to enter a career in research. The NRSA Act was passed at a time when the Office of Management and Budget was challenging the need for postdoctoral research training programs. Although a proposal to phase out funding for all research training programs was unacceptable to the Congress, substantial reforms within the training process were made, including a payback provision for trainees who subsequently selected a career outside of research after the training fellowship. Another stipulation of the NRSA Act was for the National Academy of Sciences to conduct an ongoing study of training programs and periodically report national needs for biomedical and behavioral research personnel. In the eight previous reports mechanisms were developed to analyze market demand in order to estimate the work force needed to ensure the future viability of biomedical and behavioral research. Consequently, an extensive data base has been developed in addition to analytical models designed for quantitative analyses. This committee was co-evened in November 1988 and given only eight months to prepare a report. It has proven to be a most exciting undertaking at a particularly critical time for the biomedical and behavioral sciences in the United States. Significant advances are occurring, and the future is filled with promise for even greater developments in biomedical research leading to an understanding of the fundamental causes of a variety of diseases--from Alzheimer's to cancer--as well as to developing advanced therapies based on this understanding of the etiology and pathophysiologic mechanisms of disease. There is much work to be done, but will there be sufficient personnel, sufficiently trained, to do it? Factors to be considered in answering the question include: o the quality of the American school system in educating and encouraging students toward a career in the sciences; o identifying and correcting the reasons for a continuing dearth of minorities entering careers in research; and o assessing the relative value and effectiveness of training programs and institutional training grants in producing successful researchers. The desirability of selecting a career in research also must be examined. Present and future budgetary projections, resulting in decreasing numbers of grants funded by NIH, almost certainly will have a detrimental effect on the attractiveness of an academic research career. It is also necessary to evaluate the effect of the emerging biotechnology industry on the demand for scientists trained by NIH and universities; the impact of industry on standard biomedical and behavioral science research programs; and the role of industry in the training process. Budgetary constraints have also focused interest on health services research because of the size of the health care industry, its proportion of the gross national product, and the intent of government to decrease the amount of money being spent on health care. 1111

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Given this environment and the limited time and resources available, this committee sensed that it should do something different from the other committees to date. Specifically, the committee wanted to: o o o o lo. reexamine and improve the labor market models used to analyze future requirements for research personnel, review the literature concerning NRSA program evaluations and evaluation methodology and develop a foundation for future NRSA program evaluations; review literature and existing data sets to better define scientific productivity--in-academe as well as in industry--as a means to measure NRSA program success; call attention to issues related to the program of study for physician/scientists; and reflect upon the role of the committee itself and make recommendations for future studies. Essays addressing these special interests accompany the projections of national needs for biomedical and behavioral research scientists. Thus, Chapter 1 contains a discussion of primary and secondary school education and the points where career decisions are formulated; models are presented to aid in understanding the interventions that must be developed for increased recruitment of minorities into careers in the sciences. Chapters 3 and 5 contain a discussion of the role of the physician/scientist and call attention to the need to carefully examine the program of study of the institutional training grants that serve as the single largest source of research training for the physician. In addition, special papers were commissioned to buttress the committee's deliberations and recommendations. Lloyd H. Smith has provided a concept paper regarding the training and role of the physician/scientist in the modern research arena; Georgine Pion has assessed the evaluation of training programs sponsored by NIH; Elizabeth McGlynn has contributed an overview of health services research; and Helen Gee has addressed the complex task of defining scientific productivity, which is so important for the evaluation process. The committee hopes that it has achieved its goals and that the reader will find this an interesting and provocative report--one that will stimulate new areas of interest for the committee and perhaps new areas of research. As chairman of the committee, I express my appreciation to the staff members who have worked long and hard within extraordinary time constraints to accomplish our assigned task. I also express my appreciation to the committee members who have given unselfishly of their time by participating in the three meetings in Washington and in the writing, rewriting, and analyzing of this report. The entire committee thanks all those other individuals and organizations who have contributed to our discussions and data base. Gerald S. Levey, M.D. Chairman, Committee for Biomedical and Behavioral Research Personnel ~ V111

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ACKNOWLEDGMENTS Many individuals contributed to this report. We wish to thank in particular the following individuals and their organizations for their contributions. National Institutes of Health Charles Sherman, John Norvell, Ronald Geller, Robert Moore, Nicholas Moriarity, Norman Braveman and William Pitlick Alcohol, Drug Abuse, and Mental Health Administration Walter Schaffer National Science Foundation John Gawalt Quantum Research Corporation Mary Look, George Nozicka A pplied Management Science Howard Garrison Cornell University Mary Hornbuckle, Careen Arsenault 1X

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