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CONTENTS 1. INTRODUCTION AND SUMMARY OF NUMERICAL RECOMMENDATIONS, FISCAL YEARS 1980-82 OBJECTIVES OF THE 1978 REPORT SYNOPSIS OF PREVIOUS REPORTS TRAINING GRANTS AND THE QUALITY OF TRAINING Future Research TRAINING FOR WOMEN MIDCAREER TRAINING OVERALL RECOMMENDATIONS FOR FEDERAL SUPPORT Mechanisms of Support Numerical Recommendations ADDENDA REVIEW OF CURRENT ACTIVITIES Solicitation of Views from the Public Dissemination of Market Information Survey of Biomedical and Behavioral Science Departments Surveys of Doctoral and Pending Doctoral Programs for Nurses Survey of Health Services Research Conference on Health Personnel Services Research Meeting on Veterinary Research Meeting on Dental Research Meeting on Psychiatry Research X1 PAGE 1 1 2 4 8 9 10 11 11 11 21 22 22 23 23 24 Personnel Personnel 25 25 25 26 26

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PAGE RELATED STUDIES Study of Postdoctorates NIH Market Survey NIMH Professional Training FOOTNOTE 2. BASIC BIOMEDICAL SCIENCES ASSESSMENT OF THE CURRENT MARKET FOR BASIC BIOMEDICAL SCIENTISTS THE 1978 OUTLOOK FOR PH.D.'S Assessment IMPACT OF LOST TRAINING GRANT SUPPORT Impact on Enrollments Impact on Program Activities Impact on Training Quality PRIORITY FIELDS FOR RESEARCH TRAINING Biomathematics/Biostatistics Toxicology Other Fields RECOMMENDATIONS Predoctoral Training Levels Postdoctoral Training Levels Training Grants and Fellowships Priority Fields and Announcement Areas Predoctoral Training Postdoctoral Training Coordination of MIH Support for Predoctoral Training ~ X11 26 26 27 27 29 30 30 33 42 42 44 45 46 and Epidemiology 4 7 48 49 50 50 51 53 53 53 55 55

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PAGE Multidiscip' inary Training Grants Fe l lowship Appl ications FOOTNOTES 3. BEHAVIORAL SCIENCES INTRODUCTION OUTLOOK FOR THE BEHAVIORAL SCIENCES Ph. D. Production Postdoctorals Academic Labor Force Enrollments Pro j ections of Academic Demand FINDINGS FROM THE SURVEY OF BEHAVIOBAL SCIENCE DEPARTMENTS Labor Market I s sue s Factors Inf ~ uencing Predoctoral Support Impact of Lost Training Grant Support THE MARKET FOR BEHAVIORAL SCIENCE PERSONNEL 57 57 58 59 59 60 61 61 63 63 63 67 67 68 68 69 RECENT TRENDS IN RESEARCH ON BEHAVIOR AND HEALTH 7 3 RECOMMENDATIONS Predoctoral/Postdoctoral Support Trainee ships/Fe! iowships Minority Research Training Support CLINICIANS IN MENTAL HEALTH RESEARCH Classif ication of Predoctoral Applications by ADAMHA Clinical P psychology Psychiatry X111 74 74 77 77 79 80 81 82

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PAGE Recruitment Sites for Training FOOTNOTES 4. CLINICAL SCIENCES Disincentives 83 84 86 89 DEFINITION/CLASSIFICATION OF CLINICAL SCIENCES 91 Need for Clinical Investigation Classification of Clinical Sciences THE 1978 OUTLOOK FOR THE CLINICAL SCIENCES 92 92 93 Revisions to Demand Model for Clinical Faculty 93 Revised Projections 96 Supply of Clinical Investigators 100 Training for Clinical Investigators 101 RECOMMENDATIONS Medical Scientist Training Program RESEARCH AGENDA 103 105 106 Supply of Clinical Researchers 106 Role of Non-M.D. Investigators Dental Research Personnel Attitudes of Students and House Staff 107 107 108 Personnel Needs for Veterinary Scientists 109 FOOTNOTE S 5. HEALTH SERVICES RESEARCH PERSONNEL I NTRODUCTION DEFINITION OF HEALTH SERVICES RESEARCH AND TRAINING XIV 110 111 111 113

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PAGE CURRENT FEDERAL EFFORTS IN HEALTH SERVICES RESEARCH TRAINING NRSA Authority NIH ADAMHA Divi sion of Nurs ing Other Federal Ef forts FINDINGS FROM THE INVITATIONAL CONFERENCE ON HEALTH SERVICES RESEARCH PERSONNEL Estimating the Number of HER Personnel Estimating Employment Opportunities in HSR Impact of Lost Training Grant Support RECOMMENDATIONS Predoctoral/Postdoctoral Training Traineeships/Fellowships Midcareer Research Training FOOTNOTES NURSING RESEARCH PERSONNEL INTRODUCTION TRENDS IN DOCTORAL EDUCATION FOR NURSES FINDINGS FROM THE SURVEYS OF DOCTORAL AND PENDING DOCTORAL PROGRAMS FOR NURSES RECOMMENDATIONS Predoctoral/Postdoctoral Training Trainee ships Fellowships Midcareer FOOTNOTES Research Training xv 116 116 116 117 118 118 119 119 120 121 122 122 125 125 127 128 128 130 131 138 138 140 141 142 143

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PAGE BIBLIOGRAPHY 145 MEMBERSHIP OF ADVISORY PANELS AND COMMITTEE ST~F 161 APPENDIXES . XVI 167

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TABLES TABLE 1. i NIH/;AD~HA/HRA Trainee and Fellowship Awards for FY 1977 PAGE 14 1.2 Committee Recommendations for NIH/ADAMHA/HRA Traineeship and Fellowship Awards for FY 1980-82 15 l.3 Percentage Distribution of Recommended NIH/ADAMHA/ HRA Traineeship and Fellowship Awards for FY 1980-82 17 1.4 Estimated Cost of Recommended NIH/ADAMHA/HRA Programs for FY 1980-82, Based on FY 1976 Costs 18 1. 5 Authorization ~ Appropriation / and Corrunittee Recommendations for Training Expenditures, 1975-82 19 2.l Assessment of the Current Market for Biomedical Scientists--Department Survey and NTH/Westat Survey Results 2.2 Current Trends in Supply/Demand Indicators for Biomedical Science Ph.D.'s 2.3 Projected Growth in Biomedical Science Ph.D. Vacua by' 1976-83, Based on Projections of Enrollment and R and D Expenditures 34 35 41 2.4 Panel Recommendations for NIH and ADANHA Predoctoral and Postdoctoral Traineeship and Fellowship Awards in the Basic Biomedical Sciences 52 2.5 NIH and ADAb5HA Postdoctoral Traineeship and Fe] lowship Awards, ~ 975-77, in the Basic Biomedical Sciences 3.l ,^ Current Trends in Supply/Demand Indicators for Behavioral Science PheDe ~ s a 2 Pro jected Growth in Nonclinical Behavioral Ph.D. Faculty, 1976-83 `, Based on Pro jections of Enrollment and Faculty/Student Ratios 3O3 Work Activities of 1971-7 5 Behavioral Science Ph. D. Recipients by Employment Sector 3.4 Health-relatedness and Source of Support for Research Conducted by 3971-75 Behavioral Ph.Dots by Employment Sector xv 54 70 71

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PAGE 3.5 4.1 4.2 5.1 6.1 6.2 6.3 6.4 Committee Recommendations for NIH and ADAMHA Predoctoral and Postdoctoral Awards in the Behavioral Sciences Current Trends in Supply/Demand the Clinical Sciences Indicators in Projected Growth in Clinical Faculty, 1976-83, Based on Projections of Medical School Enrollment, Clinical R and D Expenditures, and Medical Service Income in Medical Schools Committee Recommendations for ADAMHA Predoctoral and Postdoctoral Awards in Health Services Research 78 90 99 124 Schools of Nursing with Doctoral Programs, 1977-78 132 Selected Schools of Nursing with Doctoral or Pending Doctoral Programs Total Number of Doctoral Students and Research Faculty Number of Federally Financed Research Grants and Contracts in Selected Schools of Nursing with Doctoral Programs (October 1977) Committee Recommendations for BRA Division of Nursing Predoctora] and Postdoctoral Awards in Nursing Research ~ xv ~ 133 136 139

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FIGURES F IGURES 1.1 2.1 2.2 3.1 4.1 4.2 4.3 5.1 6.1 Summary of Committee recommendations for NIH, ADAMHA, and HRA research training awards Ph. D. faculty/student ratio in the bioscience f ields as a function of life science R and D expenditures in colleges and universities, 1962-76 Biomedical enrollment, R and D expenditures and academic employment 1961-76, with projec- tions to 1983 Behavioral science (psychology, sociology, and anthropology) enrollment' R and D expenditures, and academic employment, 1961-76, with projec- tions to 1983 Comparison of the Committee's projections made in last year's report with recent data on medical school enrollments, R and D expenditures, and clinical faculty Medical service income and medical school R and I) expenditures, 1 961-76, with projections to 1983 Medical student enroll Iment and Cal inical faculty, 1961-7 6, with pro jections to 198 3 . Pr imary disciplines of health service s research training and ma j or research problem areas Schools of nursing with doctoral or pending doctoral programs, 1977-78 x'x PAGE 16 38 39 65 97 .98 1 1 J 134

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ABBREVIATIONS NEBHE NHLBI NIA N IAAA NICHE NIDA NIDR N I EMS AAAS American Association for the Advancement of Science AAMC Association of American Medical Colleges ADAMHA Alcohol, Drug Abuse, and Mental Health Administration AMA Ameri can Medical Association APA American Psychological Association CHR Commission on Human Resources (NRC) CIC Committee on Institutional Cooperation CMHC Community Mental Health Center DHEW Department of Health, Education, and Welfare EPA Environmental Protection Agency F/S Faculty/Student ratio FY Fiscal Year HCFA Health Care Financing Administration HRA Health Resources Administration HSA Health Systems Agency HER Health Services Research IOM Institute of Medicine J AMA Journal of the American Medical Association MSTP Medical Scientist Training Program NAS National Academy of Science s NCHSR National Center for Health Services Research (Office of the Assi stant Secretary for Health, DHEW) New England Board on Higher Education National Heart Lung and Blood Institute (NIH) National Institute on Ag i ng ~ N IH ~ National Institute on Alcoholism and Alcohol Abuse (ADAMHA) National Institute of Child Health and Human Development (NIH) National Institute on Drug Abuse (ADAMHA) National Institute of Dental Research (NIH) National Institute of Environmental Health Sciences (NIH) NIGMS National Institute of General Medical Sciences (NIH) NIB National Institutes of Health NIMH National Institute of Mental Health (ADAMHA) NLM National Library of Medicine (NIH) NRC National Research Council NRSA National Research Service Award NSF -National Science Foundation OSTP Office of Science and Technology Policy PBB Polybrominated Biphenyls PHS Public Health Service R and D Re search and Development SREB VA WCH EN WICHE Southern Reg ionaI Education Board Veterans Admin i strat ion Western Council for Higher Education for Nursing Western Interstate Commission on Higher Education xx