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EXECUTIVE SU+ARY
Introduction and Summary of Numerical Recommendations,
Fiscal Years 1982-1985
In this year's report, we seek to advance our understanding of the
labor market for health research personnel, with special emphasis on the
clinical sciences; update our recommendations based upon an analysis of
the current market situation and projections for the next few years; and
discuss other relevant policy issues, including the stabilization of
federal support and the recruitment of minorities.
We emphasize the need to stabilize fundamental training in the basic
disciplinary areas at the predoctoral level and to use specialized
training at the postdoctoral level to meet short-tenm national research
priorities. We endorse the use of the training grant mechanism because
of the stability that it provides to departments and institutions.
In carrying out our charge to specify the nation's needs for
biomedical and behavioral research personnel, we have undertaken an
analysis of the current supply/demand situation and have made projections
to 1985. Since most of these scientists are employed in colleges and
universities, the projections are focused primarily on the academic
sector, but considerable attention has been given this year to the
fast-moving developments in the private sector. The models used to make
projections of academic demand have been updated and extended with the
most recent data.
In the last part of Chapter 1, we provide summary tables with overall
recommendations for FY 1982-1985 as regards numbers, levels, and types of
awards for each major area of research training, and estimates of the
costs attendant to their implementation.
Clinical Sciences
In light of the decline in recent years in the number of physicians
electing to pursue research training under NRSA programs, factors pre-
sumed to be influencing career decisions are examined in depth. Data
from two Committee-sponsored studies suggest that intellectual stimula-
tion and challenge of the search for knowledge are major incentives
for selecting a research career. A1SO significant is exposure to and
participation in research activities. Financial disadvantages of a
research career were not regarded as disincentives by young physicians
who recently chose an academic career. By contrast, income expectations
were of moderate importance to those who selected a career in private
practice. While the NRSA payback obligation appeared in several studies
not to deter research career plans, the evidence for such a view remains
inconclusive.
Graduates of four principal NIH-supported programs for the research
training of physicians are compared in terms of several performance
measures. All programs were highly successful in producing physician
investigators, although there were differences in persistence in
research, publication activity' and rate of advancement.
Labor market data show that personnel shortages continue in
clinical science fields, primarily because of the strong demand
medical schools for faculty members to conduct research as well
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the
an
as teach
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and provide patient care, and the difficulty in recruiting young
physicians for research careers. This situation has existed for some
tome now and has prompted us to recommend special emphasis on NRSA
training pro-trams in clinical fields.
.
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There are signs of improvement in market balance, but conflicting
trends make interpretation difficult. Funds available to support
clinical faculty in medical schools are not growing as fast now as in the
early 1970's, while teaching responsibilities have grown in recent years
at about 5 percent per year. Perhaps most Importantly, the nether of
M.D.'s and other health professionals participating in NIH research
training programs has not changed appreciably since 1976 and is currently
well below the level we consider appropriate.
In the next few years, we foresee somewhat slower growth in medical
student enrollments and very little real growth in clinical R and D
expenditures after adjusting for inflation. However, medical school
income from patient care should continue to show real growth of about 6
percent per year. As a result, clinical faculties are expected to expand
by almost 3 percent per year through 1985. The way the system operates
to produce the supply of clinical scientists governs to a large extent
the role to be played by NRSA programs.
Most of the individuals taking faculty appointments in clinical
departments of medical schools have not had a period of formal research
training--only about 21 percent of newly hired clinical faculty members
in recent years have had some postdoctoral research training. This
percentage formerly was much higher, and we view the reduction as
symptomatic of the problems facing medical schools in their recruitment
efforts. In developing our recommendations, we have attempted to
encourage a higher level of research capability for clinical
investigation. The intended result is that by 1985, at least one-third
of the individuals joining clinical faculties will have had some
postdoctoral research training.
Basic Biomedical Sciences
A review of recent data indicates that the demand for research
scientists in the basic biomedical sciences in the academic sector
remains generally favorable. We are therefore cautiously optimistic
about academic employment opportunities in these fields. Projections of
demand for academic research personnel are based on the dynamics of
faculty change and on assumptions of modest growth in enrollments and
research and development funds. Continued steady demand or modest growth
is projected through 1985. In addition, developments in some biomedical
science fields are creating expanded opportunities in the business
sector' but it is too early to make quantitative projections of this
demand. Because of the generally favorable outlook through 1985, we
reaffirm our recommendations for NRSA predoctoral and postdoctoral
support in the basic biomedical science fields through 1985.
In past years we have attempted to document the role of training
grants in improving the quality of both the training environment and
training programs. This year, we have undertaken in-depth reviews of
limited number of programs to ascertain the impact of losses of this
support on predoctoral programs. The findings indicate substantial
negative effects on such areas as recruitment, curriculum, and
intellectual vitality.
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Predoctoral and postdoctoral research training are primarily
conducted in the nation's leading research universities. To provide
high-quality, up-to-date training, it is essential that they have modern
instrumentation and facilities. Recent reports indicate that the quality
of research instrumentation and facilities, even at leading institutions,
has seriously declined. We discuss these reports and endorse the need to
improve research facilities and instrumentation.
Behavioral Sciences
The analysis of market conditions highlights differences between
clinical and nonclinical segments of the behavioral sciences, which
possess different training and employment characteristics. Market
indicators are examined, including changes in labor force size,
enrollments, and Ph.D. production; ability to find jobs; field-switching;
research activity; and utilization of postdoctoral training. Evidence
indicates that the market for the research-intensive nonclinical fields
remains soft overall, while the market for the practice-ariented clinical
fields remains strong. We have made projections of faculty demand
through 1985 and also report new projections of the number of NRSA
postdoctoral trainees needed to meet this academic demand. Based upon
these analyses and projections, we reaffirm our previous recommendations
to decrease predoctoral support and increase postdoctoral support.
Implementation of our past recommendations by AD~HA has been
hindered by budgetary constraints and slow acceptance by the professional
community. We continue to encourage the efforts by ADAMHA to effect the
recommendations. We are concerned also over reductions in research and
research training support in the behavioral sciences. While noting that
some reductions may be warranted as part of broader national policy, we
believe that cutbacks that are so deep that they disrupt high-quality
programs will risk long-tenm damage to these programs and to future
research. Another matter of concern has been recent attempts to
eliminate "social" research and research training. We discuss the
mistaken nature of this argument and instead recommend that the proper
basis for making awards, apart from quality, should be their
health-relatedness.
Health Services Research and Nursing Research
Health services research and nursing research were not studied in
depth this year. We do, however, review briefly the status of agency
training programs. Federal funding for both programs remains meagre, at
levels we believe do not permit the development of adequate numbers or
quality of training. The present report contains the highlights of the
1977 survey of health services research trainees and principal
investigators. The findings indicate that trainees and researchers
remain active in health services research, thus confirming the success of
prior federal support programs. In nursing research, we are concerned
about the growth in the number of doctoral programs in schools of nursing
without a strengthening of the training quality in existing doctoral
programs.
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Minorities in the Biomedical and Behavioral Sciences
We believe that the pool of students from which scientists come
should reflect the broad ethnic and cultural heritage of the nation.
This is not only a matter of equity; it is a matter of quality and talent
as well. In order to maintain the high quality and vitality of
scientific research in the future, it is important for the nation to take
full advantage of the talent of all its citizens. Thus, we support the
full participation of minorities in science as a necessary step toward
the fullest use of this country's human resources. From our review of
the literature from 1974 to 1980 on the participation of minorities in
the sciences, it is clear that a wide range of education-related problems
exists, beginning in the primary grades and continuing through post-
secondary levels. These problems, which discourage minorities from
pursuing science education, include cultural differences, lack of science
career information and vigorous recruitment, weak academic preparation,
inflexible college admissions criteria, and inadequate financial
resources.
We also have examined national data on enrollments and degrees that
demonstrate that the flow of minority students through the highest levels
of the education system remains limited. Those who have continued on
from the baccalaureate to earn the doctorate are concentrated in
conscience fields. Although minorities were gradually increasing as a
proportion of new doctorates in all fields from 1974 to 1980, Blacks and
Hispanics remain severely underrepresented in the biomedical sciences.
Despite significant growth, minorities are still underrepresented in the
behavioral sciences as well.
Current federal programs intended to increase the number of
minorities earning Ph.D.'s are examined. At this time their efficacy has
not been determined. In addition, it must be acknowledged that such
programs are ultimately faced with an impossible task unless accompanied
by efforts at earlier educational levels to increase the number of
minority students who are academically prepared and motivated to pursue
science careers.
Recommendations
General
The Committee recommends that federal support for research training
should be stabilized and provided at levels commensurate with the
scope of national needs. At the center of federal policy there
should be an irreducible number of trainees who are supported in the
basic disciplines regardless of fluctuations in demand for short-term
research needs. Additions and reallocations in support may be
undertaken as special needs come and go. In this way the benefits of
stability can be achieved while providing a flexibility to respond to
changing priorities in the nation's research needs. The level of
stabilization should be determined after reviewing available data,
findings, and recommendations, including those of this Committee.
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Clinical Sciences
1. The Committee recommends that 2,400 traineeships and 400 fellow-
ships be awarded annually for postdoctoral research training in the
clinical TIC' ences from FY 1982 through FY 1985. The Committee also
urges a greater emphasis on filling these training positions with
physicians. Most of the funding should be in the form of training
grants, which are particularly suited to meet the needs of the
physicians whose doctoral training usually involves only^limited
research participation and, as previously recommended, approximately
15 percent for individual fellowships.
2. The Committee recommends that an annual enrollment of 725 trainees in
the Medical Scientist Training Program (MSTP) should be maintained
through FY 1985 and high priority given to preserving this level
should it become necessary to reduce the overall number of NRSA
trainees.
Bat: Bic~medinal !::~i "n~.c
1. The number of predoctoral trainees and fellows supported annually in
the basic biomedical sciences should be maintained at 4,250 in each
year from the present through FY 1985.
2. The number of federally funded postdoctoral awards in the basic
biomedical sciences should be maintained at 3,200 annually for FY
1982-1985.
3. While training grants should continue to be awarded on the basis of
national competition, it should also be recognized that a minimum
nether of grant-supported trainees, the number of which will vary
with the specific training program, is essential to ensure the
critical mass necessary for a vital and effective training program.
Behavioral Sciences
1. While reductions in training support may be necessitated by overall
budget constraints, it is important that some training support be
preserved in the health-related behavioral and social sciences and
that this support be directed to the highest-quality programs.
2. All fields of the behavioral and social sciences continue to make
valuable contributions to the solution of health problems. Beyond
quality, the proper criterion for awarding behavioral and social
science training grants should remain the relevance of the
applications to the solution of health problems that are the
responsibility of NIH and ADAMHA.
3.
The Committee reaffirms its position that training in the behavioral
sciences shift its emphasis from predoctoral to postdoctoral. A
gradual phasing in is recommended so that a level of 390 predoctorals
and 910 postdoctorals will be supported annually by 1985.
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The training grant should be the predominant mechanism of support in
the behavioral sciences with an 80 percent/20 percent traineeship to
fellowship ratio. In addition, because of the importance of the
institutional support component of the award in planning and
administering health-related training programs in behavioral science
departments, the Committee strongly endorses the continuation of the
training grant mechanism.
Health Services Research and Nursing Research
\
1. It is recommended that 330 health services research trainees and
fellows be supported annually through FY 1985.
NRSA support for nursing research training should rise to 300
trainees and fellows annually from FY 1982 through FY 1985.
No more than 15 percent of these trainees should be at the post-
doctoral level.
Minorities
Current federal programs that recruit and train minority
students in the biomedic al and behaviors 1 sc ienc es should be
evaluated in order to identify the most successful approaches to
increasing minority participation in the sciences. Existing programs
should be continued pending the outcome of this evaluation.
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Representative terms from entire chapter:
services research
