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PERSONNEL NEEDS AND TRAINING FOR BIOMEDICAL AND BEHAVIORAL RESEARCH THE 1981 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 Press Washington, DeCe 1981

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NOTICE: The proj eat that is the subj eat 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. 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 Anaa~mv Engineering, and the Institute of Medicine. _ i, of The National Research Council was established 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 of advising the federal government. The Council operates in accordance with general policies determined by the Academy under the authority of its congressional charter of 1863, which establishes the Academy as a private, nonprofit, self-governing membership corporation. The Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in the conduct of their services to the government, the public, and the scientific and engineering communities. It is administered jointly by both Academies and the Institute of Medicine. The National Academy of Engineering and the Institute of Medicine were established in 1964 and 1970, respectively, under the charter of the National Academy of Sciences. ~ _ _ , ~ ~ The work on which this publication is based was performed pursuant to Contract No. NO1-OD-9-2112 with the National Institutes of Health of the Department of Health and Human Services. 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.~. Washington, D.C. 20418 Printed in the United States of America

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NATIONAL RESEARCH COU NC! ~ OFFICE OF THE CHAIRMAN 2101 CONSTITUTION AVENUE WASHINGTON, D. C. 20418 The Honorable Richard S. Schweiker Secretary of Health and Human Services Washington, D.C. 20201 Dear Mr. Secretary: January 29, 1982 It is a pleasure to present to the Department of Health and Human Services for transmittal to the Congress, the 1981 report of the Committee on a Study of National Needs for Biomedical and Behavioral Research Personnel. This is the sixth 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 for this report has been supported under Contract N01-0D~9-2112 with the National Institutes of Health. The Act states (Section 473 (a)) that the purposes of the study are to: "~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 number of such personnel needed in each such area, and (C) the kinds and extent of training which 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 meet the needs established under paragraph {1) if the programs referred to in clause (A) of paragraph (2) were terminated; and (5) determine what modifications in the programs referred to in paragraph (2) are required to meet the needs established under paragraph (1~."

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Since the submission of the 1979 report the Committee has made substantial progress in responding to the goals of the Act. This is particularly true for the area of inquiry concerning research manpower needs in the Clinical Sciences where much new information has been obtained and analyzed by the Committee. We hope the present report will be helpful and shall be glad to discuss it with you and your staff. Yours since ~ y, >~ // Are_ rank Press Chairman Enclosure

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. PREFACE This report of the Committee on National Needs for Biomedical and Behavioral Research Personnel is the sixth in a continuing study conducted in response to the National Research Service Award Act of 1974 and its amendments. In the Act, Congress re-authorized the training programs of the Nationa1 Institutes of Health (NIH) and the Alcohol no all,=" and Menta' Healtn Administration (ADAMHA), and requested the National Academy of Sciences (NAS) to conduct a continuing study of the nation's need for biomedical and behavioral research personnel. The study would establish the specific subject areas in which such personnel were needed and the kinds and extent of training to be provided. It was a difficult and challenging task. The Academy accepted the task proposed for it by Congress, and in 1975 this Committee was established within the Commission on Human Resources to accomplish it. Individuals were selected from a wide variety of fields of expertise to serve on the Committee. The members included persons from many of the biomedical and behavioral fields and from other quantitative fields, such as economics and statistics, as well. But it was recognized that assistance would be required from those with a wider range of knowledge, and so panels of experts were formed to advise the Committee in specific areas. Although the composition of the Committee and its advisory groups has changed over the years, this general structure has prevailed with only minor modification. The Committee and Panels, with the assistance of its staff and consultants--and occasionally with help from contractors--have conducted the studies reported in this and the previous five reports. Robert J. Glaser, M.D., was the first chairman of the Committee, serving from 1975 to 1977. He was succeeded by Henry W. Riecken, Ph.D., who served until 1980. The Comm; ttee has continued to develop the approach to the task and to refine its methods. We have accepted the interpretation that "national needs" should be determined largely he current 1 Her - mark - - demand and by our best judgment about the conditions that are likely to prevail in the near future. A substantial body of data has been developed during the course of this study to help us assess market conditions. To this we now have added the contributions of three major studies designed to broaden our understanding of critical issues in the clinical sciences area. In addition, the analytical models of the market that provide the basis for our projections have been updated and refined for the present report. One of the outcomes has been a revision of some previous assumptions about how these markets have been functioning. Most of the new studies and the overall emphasis in this year's report concern the clinical sciences area. In addition, however, the numerical recommendations for each of the five broad areas of research training previously reported upon--basic biomedical sciences, behavioral sciences, clinical sciences, health services research, and nursing research--have been re-examined and updated as appropriate. The resort contains a number of non-numerical recommendations concerning the specific subject matter areas. The last chapter deals with current federal programs for increasing the participation of underrepresented minority-group members in the biomedical and behavioral disciplines. v _~_ _

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The authorizing legislation, renewed and modified several times since 1974, was extended in August for 2 years through FY 1983 by passage of the Omnibus Budget Reconciliation Act of 1981 (Public Law 97-351. Three important changes made by this legislation were: 1) the waiver of payback obligation by recipients of NRSA support for the first 12 months of research training taken under this program; 2) the selective emphasis placed on recruiting more physicians into careers in biomedical research and clinical investigation; and 3) the elimination from coverage by the Act of the research training program of the National Center for Health Services Research. In closing I thank the many individuals who have served previously as members of this Committee and its advisory Panels for their contributions to the accumulated knowledge upon which the present Committee relied heavily in preparing this report. Robert L. Hill, Ph.D. Chairman vi

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ACKNOWLEDGMENTS As in its past reports, the Committee's work is the result of the efforts of many individuals and organizations. Among the many who provided assistance to us we wish particularly to acknowledge the staffs of the National Institutes of Health (NIH), the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA), and the Health Resources Administration (HRA). Our special thanks go to Dr. Donald Fredrickson, immediate past director of N7H and his staff, notably Drs. William Raub, Doris Merritt, and William Batchelor. In addition Dr. Charles Miller of the National Institute of General Medical Sciences (NIGHS), Dr. Bernard Lepovetsky of the National Cancer Institute (NCI), and Dr. Nicholas Moriarity of the Division of Research Grants (DRG) provided valuable data and information on training programs. The Committee also appreciates the generous assistance of Ms. Michele Harvey and Dr. Frank Sullivan of ADAMHA, Ms. Jo Eleanor Elliott, Director of the Division of Nursing, HRA, and her staff members, Drs. Marie Bourgeois and Adele Wood. In the pursuit of its major research effort this year in the clinical sciences, the Committee wishes to acknowledge the contributions of the following individuals and organizations: Drs. Thomas Morgan, Charles Sherman, and Paul Jolly of the Association of American Medical Colleges (AAMC); Drs. Martin Block and Scott Swisher of Michigan State University; and Dr. Richard Scheffler of George Washington University. Over the past two years, the Committee has conducted a series of site visits to predoctoral training programs in the basic biomedical sciences. The promise of confidentiality constrains us from naming specific institutions and individuals; however, the Committee wishes to pay special thanks to those university administrators, faculty, and students who contributed their time and effort to this activity. The Committee's work on minority participation in biomedical and behavioral research was aided by many individuals. Particular thanks are due to Dr. Harold Delaney, Executive Vice President of the American Association of State Colleges and Universities, for his guidance in many phases of this effort. In addition, our survey of federal programs for minority research training was assisted by staff members from the Department of Health and Human Services, the Department of Education, and the National Science Foundation. Within the Commission on Human Resources, Dr. Harrison Shull, Chairman, and Dr. William Kelly, Executive Director, have provided advice and assistance at all phases of the study. Mr. Porter Coggeshall, staff director of another study, has contributed frequently to the analysis of data. In addition, Mr. Herbert Soldz and the staff of the Data Processing Office have provided valuable support. The Committee is pleased-to recognize the capable work and many contributions made by all the members of its staff under the overall direction of Dr. Herbert B. Pahl, Staff Director. Specifically, thanks are accorded to the senior professional staff, Dr. Allen M. Singer, Study Director for Data and Analyses, and Drs. Russell Hilmoe, Robert G. Snyder, and Samuel S. Herman, Executive Secretaries of the Basic Biomedical, Behavioral, and Clinical Sciences Panels, respectively. The assistance of Dr. Pamela Ebert-Flattau, former Executive Secretary of the _ ~ , ,, _ Yii

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Behavioral Sciences and Health Services Research Panels, during the initial phase of this year's report is also appreciated. Special note is also made of the heavy administrative load carried this year by the Staff Director and Mrs. Kay C. Harris, Administrative Officer, particularly in connection with preparing this year's report concurrently with meeting other project responsibilities. Finally, the Committee is pleased to thank the following support staff: Mr. J. Richard Albert and Ms. Delores H. Thurgood for excellent technical assistance; and Mmes. Imani R. Ansari, Jacquelyn C. Johnson, and Janie B. Marshall for outstanding secretarial assistance and other support services . yiii

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COMMITTEE ON A STUDY OF NATIONAL NEEDS FOR BIOMEDICAL AND BEHAVIORAL RESEARCH PERSONNEL Chairman: Robert L. HILL, Ph.D. Chairman, Department of Biochemistry Duke University Medical Center Richard C. ATKINSON, Ph.D. Chancellor University of California at San Diego Robert M. BOCK, Ph.D. Dean, Graduate School University of Wisconsin-Madison John BRADEMAS, Ph.D. President New York University Eugene H. CORDES, Ph.D. Executive Director, Biochemistry Merck Sharp & Dohme Research Laboratories Rahway, N.J. Eugene H. COTA-ROBLES, Ph.D.* Professor of Biology University of California at Santa Cruz Linda F. DONALDSON, J.D. Professor of Law Georgetown University Law Center W. Lee HANSEN, Ph.D. Professor of Economics University of Wisconsin-Madison Lyle V. JONES, Ph.D. Director, The L. L. Thurstone Psychometric Laboratory University of North Carolina at Chapel Hill William N. KELLEY, M.D. Professor and Chairman Department of Internal Medicine University of Michigan Medical School- Charlotte KUH, Ph.D. District Manager, Long Range Forecasting American Telephone and Telegraph Company Murray Hill, N.J. Jerry MINER, Ph.D. Professor of Economics Syracuse University Gerald T. PERKOFF, M.D. Curators Professor School of Medicine University of Missouri-Columbia James B. WYNGAARDEN, M.D. Chairman, Department of Medicine Duke University Medical Center *Resigned ix

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BASIC BIOMEDICAL SCIENCES PANEL Chairman: Robert BARKER, Ph.D. Cornell University Harold AMOS, Ph.D.* Harvard Medical School Arthur Morton BROWN, M.D., Ph.D. University of Texas Medical Branch - Galveston S. . J. COOPERSTEIN, D. D. S. ., Ph.D. The University of Connecticut Health Center E. Peter GEIDUSCHEK, Ph.D. University of California at San Diego Lee V. LEAK, Ph.D. Howard University *Resigned Vernon R. YOUNG, Ph.D. Massachusetts Institute of Technology x H. George MANDEL, Ph.D. George Washington University Peter S. NOCE, M.D., Ph.D. Bio-Science Enterprise Van Nuys, Calif. Paul S. SYPHERD, Ph.D. University of California at Irvine F. Eugene YATES, M.D. University of California at Los Angeles

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BEHAVIORAL SCIENCES PANEL Chairman: Kenneth E. CLARK, Ph.D. University of Rochester Co-Chairman: Hubert Morse BLALOCK, Jr., Ph.D. University of Washington Lucy M. COHEN, Ph.D. Catholic University of America Ada K. JACOX, Ph.D. University of Maryland P. Herbert LEIDERMAN, M.D. Stanford University Medical Center xi Gardner LINDSEY, Ph.D. Center for Advanced Study in the Behavioral Sciences Brendan A. MAHER, Ph.D Harvard University Robert McGINNIS, Ph.D. Cornell University Jerome E. SINGER, Ph.D. Uniformed Services University of the Health Sciences Eliot STELLAR, Ph.D. University of Pennsylvania

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CL=ICAL SCI} :NCES PANEL Chairman: David R. COMMONER, M.D. St. Louis Uni~rersit`y Medical Center Ruby BRASSIER, M. ~ . University of Arizona Thomas B. C=RKSON, D.it.M. Wake Forest Uni~rersi~y Rody P . COX, M. O. Case Western Reserve University Roger 9ETELS, M.~. University of California at Los Angeles Robert B. EON, M. D . Eli ~ lay & Co - any Ir:diarapolis, ~d. Paul GOLDEABER, D ;D . S . Har~r~-d University School of Dental Medicine Olga JONASSON, M. D . O~,rersity of Ill~nois Morris A. LIPTON, M. D . University of North Carol ina at Chapel Hill John F. SON, Ph.D. Association of American Medical Colleges Scott N. SWISHER, M. D. Michigan State University Babette B. WEASEL, M. D . flew Yor}: Bospital~Cornell Medical Center s Danny PERRY, M.A. (consultants St. Louis University Medical Center Eli

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STAFF Herbert B. PAHL, Ph.D., Staff Director Panel Executive Secretaries Russell J. HILMOE, Ph.D. Basic Biomedical Sciences Panel Samuel S. HERMAN, D.D.S., Ph.D. Clinical Sciences Panel Robert G. SNYDER, Ph.D. Behavioral Sciences and Health Services Research Panels Research Assistant/Associate J. Richard ALBERT, B.A. Delores THURGOOD, B.A. Study Director for Data and Analyses Allen M. SINGER, Ph.D . Director, Graduate Education Studies Program Robert G. SNYDER, Ph.D Admini strative Officer . Kay C. HARRIS ~ B. S . Secretaries Imani R. ANSARI Jacquelyn C. JOHNSON Janie B. MARSHALL xiii

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