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CONTENTS SUMMARY 1. INTRODUCTION RECENT DEVELOPMENTS IN LEGISLATIVE HISTORY - AND COMMITTEE RECOMMENDATIONS Min imal Percen t ages for Ind iv idual and Ins t i but tonal Awards Durat ion of El ig ibil i ty Cost-of-Living Adjustments in Stipend Allowances IRS Tax Liabil ity of Awards Limit on Institutional Support from Training Gran t Awards Short-Term Training Without Payback Ob] igation Deletion of Requirement for National Advisory Counc i ~ s ' Rev few o f Ind iv id ual NRSA ' s Removing Inequity in Service an] Payback Requiremen ts Reports on Studies of Needs for Research Personnel Determination of Subject Areas for Awards-- The Advisory Role of the NAS/NRC Commi t tee Decl ining Interest of Physicians in Cl inical Research Career s COMMITTEE'S ENDICOTT HOUSE CONFERENCE The Training of C1 inical Investigators Training Grants and the Qual ity of Training Research Productivity and Academic Careers Identification of Priority Fields for Training Other Topics Discussed at the Endicott House Con f erence Summary X1 PAGE 4 4 4 6 6 7 7 8 8 9 18 21

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PAGE 2 . HIGHLIGHTS OF CURRENT STUDIES AND RESEARCH CLINICAL SCIENCES Supply and Demand Stud ies Supply Studies Study of " Recent Deciders" The Role of Ph.D. Investigators in Cl inical Research Medical Scientist Training Program Demand Stud ies Model ing of Demand 23 23 26 27 27 27 28 28 28 Ve ter inary Re search Personnel 2 9 Invi tational Conference 29 Commi t tee Recommend at ions BAS IC BIOMEDICAL SCIENCES BEHAVIORAL SCIENCES HEALTH SERVICES RESEARCH SUGGESTIONS FROM THE PUBL IC NOTES 3. ADMINISTRATIVE ISSUES AND POLICY CHANGES SHORT-TERM TRAINING STI PEND LEN7E LS INSTITUTIONAL SUPPORT COMPONENT OF THE TRAINING GRANT COORDINATION OF NIEI PREDOCTORAL SUPPORT ~ X11 30 31 34 36 37 41 41 42 44 45

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PAGE TRAINING POLICIES OF Ar)AMHA CLINICIANS IN MENTAL HEALTH RESEARCH HEALTH SERVICES RESEARCH UNDER THE NRSA AUTHORITY NOTES 4. NUMERICAL RECOMMENDATIONS TRAINING DATA FOR 197 8 BASTC BIOMEDICAL SCIENCES Training Levels BEHAVIORAL SCIENCES Predoctoral/Po s tdoc toral Suppor t Traineeships/Fe] lowships Red uc t ion in Be hav for al Sc i ence Awa rd s CLINICAL SCIENCES HEALTH SERVICES RESEARCH NURSING RESEARCH Predoctoral/Po stdoc toral Awards Fel lowships Sen for Inve s t ig a tor s NOTE S REFERENCES MEMBERSHIP OF ADVI SORY PANELS AND COMMITTEE STAFF APPENDIXES A. NATIONAL RESEARCH SERVICE AWARD AUTHORITY A.~: Publ ic Law 93-348, as Amended A.2: Pulalic Law 95-622 A.3: Legis~ ative History 45 47 47 49 50 50 55 55 58 58 59 59 61 61 62 62 63 65 69 77 79 80 86 88 ~ X111

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PAGE B . SUMMARY OF RECOMMENDATIONS FROM THE 1 9 7 8 COMMITTEE REPORT C. AGENCY ANNOUNCEMENTS FOR NATIONAL RESEARCH SERVICE AWARD PROGRAMS NIH National Research Service Awards For Ins t i but tonal Gr an ts ( December 8, 197 8 ~ For Individual Postdoctoral Fellows (January 29, 1979) C . 3: Shor t-Term Training: Students in Heal th Professional Schools (October 26, 1979 C.4: Stipend Increases (October 26, 1979 ~ C.5: Non-Trainee Expense--Institutional All owances (October 26, 1979) ADAMHA National Research Service Awards C. 6: For Institutional Grants C. 7: For Individual Fellows BRA Nat ions Research Service Award s C. B: For Institutional Grants C . 9: For Predoc toral and Pos tdoc tor al Nurse Fellowship Program D. CONFERENCES D . 1: Program for Publ ic Hear ing, March 8, 1979, Washington, D.C. D. 2: Program for Invitational Conference on Issues in the Clinical Sciences, June 5, 1979, Chicago Program and List of Participants for Workshop on Establ ishing Research Training Programs in Behavior and Health, January IS, 1980, Washington, D. C. E. QUESTIONNAIRE: SURVEY OF HEALTH SERVICES RESEARCH PERSONNEL CONDUCTED BY THE NATIONAL RESEARCH COUNCIL x~ v 95 99 101 112 122 125 L26 127 142 150 152 155 156 15~7 161 167

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TABLES PAGE I.] Number of Personnel Participating in NIH Research Grants in 1973, by Field of Employment Id 2.l Distribution of NIH Traineeship and Fellowship Awards, 1971-1978 24 4.1 NIH/ADAMBA/HRA Traineeship and Fellowship Awards for FY1978 51 4.2 Committee Recommendations for NIH/ADAMHA/ HRA Traineeship and Fellowship Awards for FY1980-1982 52 4.3 Estimated Cost of Recommended NIH/ADAMHA/ BRA Training Programs for FYI980-1982 Under Announced Stipend Increase 54 1 4.4 Committee Recommendations and Actual Awards by NIH and ADAMHA in the Behav- ioral Sciences ~ 56

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INDEX TO RECOMMENDATIONS Basic Biomedical Sciences Chapter 4, p. 55 Behav Coral Sc fences Chapter 4 f pp. 57, 58 Clinical Sciences Chapter 2 ~ p e 3 0 ; Chapter 4' p. 59 Health Services Research Chapter 4, p. 60 Nursing Research Chapter 4 ~ pp i 61 ~ 6 2 Other Institutional Support of the Training Grant Chapter 3, p. 44 xv~ . :

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ABBREVIATIONS AAMC Association of American Medical Colleges ADAMHA Alcohol, Drug Abuse, and Mental Health Administration AMA American Medical Association DHEW Department of Heal th, Education, and Welfare FY Fiscal Year HRA Heal th Resources Administration HSR Heal th Services Research IRS Internal Revenue Service MARC Minori ty Access to Research Careers MSTP Medical Scientist Training Program NAS National Academy of Sciences NCHSR Nat tonal Center for Heal th Services Research ~ Of f ice of the Ass i s tan t Secre tary for Heal th, DHEW) NHLBI National Heart, Lung, and Blood Institute (NTH) NIA National Institute on Aging (NIH) NIAID National Institute of Allergy and Infectious Diseases (NTH NIAMDD National Institute of Arthritis, Metabolism, and Digestive Diseases (NIH) NICHD National Institute of Child Health and Human Development (NIH) NIGMS National Institute of General Medical Sciences (NIH) NIH National Institutes of Heal th NIMH National Institute of Mental Health (ADAMHA) NRC National Research Council HRSA National Research Service Award NSF National Science Foundation R & D Research and Development ~ X1711

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