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PERSONNEL NEEDS AND TRAINING FOR BIOMEDICAL AND BEHAVIORAL RESEARCH % THE 1978 REPORT of the COMMITTEE ON A STUDY OF NATIONAL NEEDS FOR BIOMEDICAL AND BEHAVIORAL RESEARCH PERSONNEL COMMISSION ON HUMAN RESOURCES NATIONAL RESEARCH COUNCIL National Academy of Sciences Washington, D.C. 1978

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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 Engi- neering, and the Institute of Medicine. The members of the Committee responsible for the report were chosen for Their special competences and with regard for appropriate balance. 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 work on which this publication is based was performed pursuant to Contract No. NO1-OD-5-2109 with the National Institutes of Health of the Department of Health, Education, and Welfare. Support for this project came from Evaluation Set-Aside funds (Section 513 of the PHS Act), Evaluation Project No. NIH 75-1. Available from: . . . . . Commission on Human Resources National Research Council 2101 Constitution Avenue' N.W. Washington, D.C. 20418 Printed in the United States of America

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NATIONAL ACADEMY OF SCIENCES OFFICE OF THE PRESIDENT 2101 CONSTlTUtlON AVENUE WA S 1~ 1 F4 GTON , D. C. 2 0^ 1 ~ The Honorable Joseph Califano Secretary of Health, Education, and Welfare Washington, D. C. 20201 My dear Mr. Secretary: September 3 0, 19 78 It is a pleasure to present to the Department of Health, Education, and Welfare for transmittal to the Congress, the 1978 report of the Committee on a Study of National Needs for Biomedical and Behavioral Research Personnel. This is the fourth annual report in the continuing study undertaken by the National Research Council pursuant to Title I of the National Research Act of 1974 (PL 93-348 ~ . The work has been supported under Contract NOl OD ~ 2109 with the National Institutes of Health. The Act states (Section 473(a) ~ that the purposes of the study are to: n ~ 1 } establish (A) the Nation' s overall need for biomedical and behavioral research personnel, (B) the subject areas in which such personnel are needed and the newer of such personnel needed in each such area, and ~ C ~ the kinds and extent of training whi ch should be provided such personnel; (2) assess (A) current training programs available for the training of biomedical and behavioral research personnel which are conducted under this Act at or through institutes under the National Institutes of Health and the Alcohol, Drug Abuse, and Mental Health Administration' and (B) other current training programs available for the training of such personnel; ~ 3 ~ identify the kinds of research positions available to and held by individuals completing such programs; ~ 4 ~ determine, to the extent feasible, whether the programs referred to in clause (B) of paragraph (2) would be adequate to wet the needs established under paragraph { 1~ if the programs referred to in clause (A) of paragraph (2) were te:rmir~ated; and (5) determine what modifications in the programs referred to in paragraph ~ 2 ~ are required to meet the needs established under paragraph {~.-

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Since the submission of the 1977 report, the Committee has made substantial progress in responding to the goals of the Act. Through the conduct of recent survey`;, it Ad; significantly expanded the data on which estimates of labor market conditions and planning need'; me based. In addition, the Committee has' as it As asked to do, addressed train) ng needs in the areas of health services research and nursing research. In the year ahead, the Committee will seek father improv-'n~nt in its ability to a,;~;ist HEW and the Congress in meeting the Nation's training needs. We hope the present report ~11 be helpful and shal 1 be glad to di scuss it with you and your staf f . ( Sit_ Philip Handler President Enclos me .,

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PREFAC E This is, the fourth annual report prepared by the Committee on a Study of Nat tonal Needs for Hi omed ical and Behavioral Research Personnel. This continuing study was initiated in 1975 following the passage of Public Law 93-348, The National Research Service Award (NRSA) Act of 19740 The Health Research and Health Serv- ices Amendments of 1976 broadened the authority of the Act to include nursing research training ~ Append ix A) . In its reports the Committee has focused on its legi slat ive charge to assess the rol e of and need for federal training programs in the biomedical and behavioral sciences. Over the years the Committee has sought to identify and analyze: l ~ the evolution of federal support programs and the changing conditions underl ying this support; 2 ~ the nature of the dynamic system 1 inking training and employment in health-related research; 3) the definition of areas and fields of training need; 4 ~ the problem of involving women and minority scientists in health research; and 5 ~ administrative problems of realizing training ob; ect i ve s ~ To inform i tsel f about these i ssue s, the Commi thee has en- gaged in a variety of activities. It has: ~ ~ conducted surveys of individual scientists and departments to gather primary source information about current training and employment conditions; 2 Revel aped a statistical model for projecting employment demand; 3 ~ made site visits to recipients of federal train) ng grants and to professional societies; 4 ~ reviewed data and discussed issues with personnel from federal agencies concerning administrative practice; 5) convened conferences and- meetings to address train- ing and employment problems in particu] ar fields; 6 ~ invited the research community and the public at large to express views and give evidence at pubs ic hearings; and 7) monitored other studies, both within and outside the National Research Council (NRC) relevant to the Committee' s interests. In its previous reports ~1975, 1976, and 1977), the Committee discussed in some depth the various issues and factors rel ated to predoctora] and postdoctoral research training in the basic bio- medica1, behavioral ~ and clinical sciences and the disciplines related to health services research ~ In the 1977 report ~ in addition to making specific recommendations about the number of fellowship and traineeship awards that the federal agencies shoul ~ provide during FY 1979-~l, the Committee macle a number of recommendations about the administrative policies of the NRSA program. The reader i s re ferred to t' Synops i s of Previous Re- ports" (Chapter 1 ~ and to its previous reports for that back- ground in format ion O Subsequent to the distribution of each of its ~ 976 and 1977 reports, the Committee conducted well-publicized al 1-day public hearings on these issues. With this base of public knowl edge and understanding, the Committee this year reports its specific v

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recommendations for FY 1980 and its recommended target goals for FY 1981 and 1982. These target goals will be reevaluated in the Committee's next report. Of specific interest in this year's report are: 1) the results of surveys of the chairpersons of 1,324 basic biomedical science departments and 474 behavioral science departments in Ph.D.-granting institutions; 2) some changes in the models that the Commi thee has used to project future demand for doctorate- level faculty in the basic biomedical, clinical, and behavioral areas; 3) discussion of the special circumstances of the D.D.S. and D.V.M. holders in relation to supply and demand for training in the clinical sciences area; 4) an analysis of the work activ- ities of nonclinical behavioral scientists in academic and in nonacademic settings; 5) the identification of a limited number of specific fields within the basic biomedical, behavioral, and clinical areas that warrant special attention; 6) the results of on-site interviews with deans and faculty of schools of nursing that either have or expect soon to begin doctoral level research training programs. With regard to the recruitment, graduate research training, and employment of minority group members and women in the biomedical and behavioral sciences, the Committee notes that at both of its public hearings these subjects at- tracted considerable attention. Although special studies of these topics could not be carried out in time for this report, the Committee is planning a survesy of issues in graduate training in conjunction with the NRC's Committee on the Education and - Employment of Minority-Group Members in Sciences Similarly, the Committee looks forward to a collaborative effort with the Council's Committee on the Education and Employment of Women in Science and Engineering. In each instance the Committee believes that its work will benefit from the special expertise brought to these issues by the collaborating groups. Of particular interest to the Committee, although not limited to women and minorities, is the issue of midcareer training. This topic is discussed in a Separate section in Chapter 1. The Committee's annual report for 1978 consists of one intro- ductory, overview chapter and five chapters devoted to the vari- ous areas of research training. Chapter ~ provides a statement of the objectives for this year's report, a synopsis of previous Committee reports, dis- cusses the quality of the research training enterprise, recog- nizes the continuing issue of training needs of women and of midcareer training, sets forth one recommendation of a general nature, and gives the numerical recommendations of the Committee for federal support in each area of research training for fiscal years 1980-82. Addenda to this chapter also contain a summary of The Committee's 1978 public hearing and a description of this year's activities and other relevant studies. . Chapters 2 through 6 consider the pertinent issues and the Committee's recommendations for the basic biomedical sciences (Chapter 2), behavioral sciences (Chapter 3), clinical sciences t V1

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"Chapter 4), health services research (Chapter 5), and nursing research (Chapter 61. Finally, the Committee notes that all of the issues discussed in last year's report relative to the policies and administration of the NRSA program have been addressed by the responsible agen- cies, by Congress, or, in some instances, by both. These issues were: 1 ) the 3-year limitation on awards and the criteria for waiver of limitation; 2) payback provisions and waiver of the payback requirement; 3) stipend levels as these are affected by taxation and the increasing cost of living; 4) mu~tidiscip~i- nary training grants; and 5 ~ announcement fields. The first three points have been the focus of both executive agency and congressional scrutiny and action, the results of which are embodied in the pending renewal legislation. The latter two points have been explored in depth by representatives of the Committee and its advisory panels in discussions with senior officials of the Alcohol, Drug Abuse and Mental Health Adminis- tration (ADAMBA) and the National Institutes of Health (NIH), who now are reviewing these matters. In view of these developments, the Committee has concluded not to reiterate this year its earlier recommendations involving these issues. Of special interest to the Committed is the plan recently announced by the Secretary, Department of Health, Education, and Welfare (DHEW), for the Department to develop a new multiyear health research policy that, in addition to placing greater em- phasis on basic research, will her p to bring an important measure of stability to the research enterpri se . The Committee has noted in each of its reports that the level of federal support for bio- medical and behavioral research is the single 1 argest determinant of the need for research personnel in these areas. The work of the Committee will be facilitated shout ~ such a national heal th research pl an be developed and implemented. As Congress continues both to extent the NRSA program in t ime and to broaden its coverage, continued cooperation between federal agencies and the Committee will provide Congress and the public at large assurance that both the conduct of the program and its oversight will proceed in a heal thy and construct ive fashion . Henry WO Riecken, Ph. D . Chairman James B. Wyngaarden, M. D. Vice Chairman V11

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AC KNOWLEDGMENTS In developing this report, the Committee has benefited from the support and advice provided by many people and organizations. In particular, the Committee acknowledges the contributions of the chairmen and members of its four panels who compiled information, interpreted findings and formulated recommendations for the Committee' s consideration . Several agencies interested in this study supplied informa- tion and assistance. Financial support was provided by the National Institutes of Health. Donald S. Fredrickson, Director of the National Institutes of Health, Robert A. Butler, Director of the National Institute on Aging, and Gerald L. Klerman, Admin- istrator of the alcohol, Drug Abuse and Mental Health Adminis- tration met wi th the Commi t tee earlier this year and presented their views on the training programs. The Committee wishes to acknowledge fits appreciation to the senior staffs of NI-H and ADAMHA for several opportunities that have been provided to come together professionally to consider matters of policy, program administration ~ and other points of mutual interest and concern. William H. Eatchelor served as project director for the National Institutes of Health and maintains excel ~ ent liaison with the Committee and its staff. The Committee is pleased to acknowledge the assistance of both Nicholas CO Moriarity, Jr., NIH, who provided data on NIH training programs, and officials of the Alcohol, Drug Abuse and Mental Health Administration, the Divi- sion of Nursing of the Health Resources Administration, and the National Center for Health Services Research who provided s imilar assi stance . The Committee has maintained a close and act ive interest in the work of the President's Commission on Mental Health, under the chairmanship of Thomas E. Bryant. Four members of the Committee and its pane] s have served on the Commission or one of its task panel s. The Committee is particul arl y grateful to Beatrix Hamburg r Daniel XO Freedman, and B. Victor Pfeiffer for the time they devoted in keeping the Committee aware of the general progress of the Commi ssion. The Committee has also worked closely with the Institute of Medicine's Committee on Heal th Services Research`, under the chairmanship of Robert Ebert. The staffs of these two studies have been in close communication and have kept the Committee aware of discussion and developments relevant to research training needs in thi s area O The Committee i s grated for the contributions cuff Kathleen S. Dolan and Thomas E. Morgan, whose study of programs for the training of clinical investigators has been an important resource for this report. The Committee would like to thank Mary Kelly ~,ullane of the American Association of Col leges of Nursing ~ and Constance Holleran - of the American Nurses Association for their hel p in developing the present assessment of doctoral training needs in nursing research O . . . -as ~ ~

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Within the Commission on Human Resources, Harrison Shul 1, Chairman of the Commission and Will lam C. Ken ly, its Executive Director, offered helpful counsel and assistance during all phases of the study. Vat uable support was al so provided by - the staff of the Data Processing and Supporting Services Of f ices of the Commi ssion . The Committee' s staff, under the direction of Herbert 13. Pah1, supported the Committee and panel s by conducting the sur- veys and other data con 1 action activities, performing the ana- lyses, and preparing reports of the findings. A1 len M. Singer supervised the coil ection of data from the agencies and performed the analyses which led to the pro jections of aced emic ~ emend in the basic biomedical, behavioral, and clinical sc fences areas. camel a Ebert-Flattau coordinated the data coil ection and analyses in the areas of behavioral sc fences, health services research and nursing research. John C. Norvel ~ and Samuel S. Herman served as executive secretaries to the Basic Biomedical and Cl inical Sci- ences Panel s and supervised staff support of those panels' activ- ities respectively. Robert G. Snyder had pr imary responsibil ity for the conduct and anal ysis of the Survey of Biomedical and Behavioral Science Departments. Porter E. Coggeshal I, who early in the year assumed responsibility for a new Commission study on postdoctorals and doctoral research staff, continued to provide assistance with analyses and interpretations of survey f inklings . The Committee enj oyed superior administrative, technical and clerical support. Kay C. Harris Abe y hands ed administrative matters, while J. Richard Albert, Corazon A. Francisco, Rebecca C. Stuart, and Ingrid A. Wharton provided excellent research assistance. Imani R. Ansari, Marie A. Clark and Janie B . Marshall supplied outstanding secretarial support, often under considerable time constraint. To all these persons and organ) zations , the Committee ex- presses its warmest thanks. 1X

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