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CONTENTS EXECUTIVE SUMMARY Introduction and Suounary of Numerical Recommendations, Fiscal Years 1982-1985 Clinical Sciences Bas lo B domed ical Sc fences Behavioral Sc fences Health Services Resea rch and Nursing Research Minorities in the Biomedical and Behavioral Sc fences Recommendations 1. INTRODUCTION AND SUMMARY OF NUMERICAL RECOMMENDATIONS, FISCAL YEARS 1982-1985 OBJECTIVES OF THE 19 81 REPORT STABILIZATION OF RESEARCH TRAINING SUPPORT Recommendat ion TRAINING QUALITY PROSPECTIVE CHANGES IN RETIREMENT ESTIMATION OF PERSONNEL NEEDS TRAINING DATA EOR FY 1979 AND FY 1980 AND RECOMMENDED LEVELS FOR 1982-1985 Estimated Costs 2. CLINICAL SCIENCES THE TRAINING OF PHYS ICIAN INVESTIGATORS Medical School Residency Post-Residency DETERMINANTS OF CAREER CHOICE Career Plans of Medical Students xv PAGE 1 1 1 2 3 3 4 4 7 7 7 8 9 10 10 14 21 23 25 25 26 26 27 27

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PAGE Te st Score s Gender Experiences During Medical School Debt Factors Inf luencing Research Career Choice Plans of M.D./Ph.D. 's and Ph.D./M.D. 's Comparison with Earlier Graduates Economic Incentives/Disincentives Research Careers in Internal Medi Di scussion COMPARISON OF TRAINING PROGRAMS .c one RESEARCH TRAINING AND RESEARCH CAREER LONGEVITY RESEARCH INVOLVEMENT NON-M. D. SCIENTISTS IN CLINICAL INVESTIGATION Available Data Sources Variation by Clinical Specialty Future Outlook Need for Additional Inf ormation THE MARKET FOR CLINICAL SCIENTISTS Current Indicators Pro j ec t ions Th rough FY 19 8 5 "Graying" of the Faculty and Research Productivity RECOMMENDATIONS Traineeships and Fellowships Medical Scientist Training Program NOTES 27 27 27 28 28 28 28 29 30 31 32 34 36 36 37 37 37 37 38 38 38 47 47 47 48 50 xvi

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PAGE 3. BASIC BIOMEDICAL SCIENCES THE TRAINING OF BASIC BIOMEDICAL SCIENTISTS THE MARKET FOR BIOMEDICAL SCIENCE PH.D.'s Current Indicators Projections Through FY 1985 Basic Biomedical Science Faculty 52 52 56 56 57 57 Commercial Market for Basic Biomedical Scientists 65 Priority Fields Conclusions 67 68 ASSESSING PH.D. PRODUCTION IN THE BASIC BIOMEDICAL SCIENCES 69 POSTDOCTORAL TRAINEES AND ACADEMIC RESEARCH STAFF QUALITY IN GRADUATE TRAINING Case Studies of tbe Impact of the Loss of Training Grant Support on Training Programs TRAINING ENVIRONMENT Instrumentation Facilities Conc fusion RECOMMENDATIONS Predoctoral Training Levels Postdoctoral Training Levels Training Grant Awards NOTES 4. BEHAVIORAL SCIENCES THE TRAINING OF BEHAVIORAL SCIENTISTS THE MARKET FOR BEHAVIORAL SCIENCE PH.~.'s Current Indicators Nonclinical Behavioral Fields Clinical Behavioral Fields xvii 71 74 75 77 77 77 77 78 78 78 80 81 82 82 84 85 86 88

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PAGE Field Switching Research Activity Uti li Eat ion of Postdoctoral Traini ng Projections Through FY 1985 IMPLEMENTATION OF PRIOR RECOMMENDATIONS RECOMMENDATIONS Levels of Federal Funding for Research and Research Training Behavioral Science Versus Social Science Predoctoral and Postdoctoral Awards Training Grants and Fellowships NOTES 5. HEALTH SERVICES RESEARCH AND NURSING RESEARCH HEALTH SERVICES RESEARCH PERSONNEL Recommendation NURSING RESEARCH PERSONNEL Recommendation 6. MINORITIES IN THE BIOMEDICAL AND BEHAVIORAL SCIENCES MINORITY PH.D. 'S IN THE BIOMEDICAL SCIENCES Time to Complete the Doctorate Sources of Graduate Student Support Plans for Postdoctoral Study MINORITY PH.~. 'S IN THE BEHAVIORAL SCIENCES MINORITIES IN THE EDUCATIONAL "PIPELINE" CURRENT PROGRAMS FOR MINORITY STUDENTS RECOMMENDATION NOTES BIBLIOGRAPHY APPENDIX A APPENDIX B 88 90 90 92 96 98 98 99 100 101 104 105 105 108 108 109 110 111 113 114 114 115 115 118 124 125 127 135 151 X,Tiii

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TABLES CHAPTER 1 PAGE TABLE 1.1 Aggregated Numbers of NIH, ADAMHA, and HRA Traineeship and Fellowship Awards for FY 1979 17 1.2 NIH Traineeship and Fellowship Awards for FY 1979 18 1. 3 ADAMHA Traineeship and Fellowship Awards for FY 1979 and 1980 19 1.4 Committee Recommendations for NIH/ADAlSHA/HRA Predoctoral and Postdoctoral Traineeship and Fellowship Awards for FY 1982-85 1. 5 Estimated Cost of Recommended NIH/ADAMHA/HRA Training Programs for FY 1982-85 (millions of dollars) 20 22 Estimated Training Costs Per Award in FY 1980 22 CHAPTER 2 TABLE 2.1 Distribution of NIH Postdoctoral Trainees and Fellows by Degree Type, 1971-79 24 2.2 Length of Career as NIH Principal Investi- gator With and Without NIH Postdoctoral Training 35 2. 3 Current Trends in Supply/Demand Indicators in the Clinical Sciences 39 2.4 Projected Growth in Medical School Clinical Faculty, 1980-85, Based on Projections of Medical School Enrollment, Clinical R and D Expenditures, and Medical Service Income in Medical Schools 44 2. 5 Estimated Number of Clinical Research Post- doctoral Trainees Needed to Meet Expected Demand for Clinical Faculty Through 1985 Under Various Conditions 45 CHAPTER 3 TABLE Be 1 Current Trends in Supply/Demand Indicators for Biomedical Science Ph.D.'s 58 3.2 Projected Growth in Biomedical Science Ph.D. Faculty, 1978-85, Based on Projections of Enrollment and R and D Expenditures Ax 62

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CHAPTER 3 (cont.) TABLE 3.3 Estimated Number of Basic Biomedical Science Postdoctoral Trainees Needed to Meet Expected Academic Demand Through 1985 Under Various Conditions 3.4 Employment of Biomedical Science Ph.D. 's in Business and Industry, 1973-79 3. 5 Sources of Support for Full-Time Graduate Science Students in Ph.D.-Granting De- partments by Field and Year PAGE 63 66 72 3.6 Committee Recommendations for NIB and ADAMHA Predoctoral and Postdoctoral Traineeship and Fellowship Awards in the Basic Bio- medical Sciences 79 CHAPTER 4 TABLE 4.1 Employment Situations for Recent Pb.D. Recipients in the Behavioral Sciences 86 4.2 Current Trends in Supply/Demand Indicators for Behavioral Science Ph.D.'s 87 4.3 Net Field Switching by 1972 and 1978 Ph.D. Recipients in the Behavioral Sciences 89 4.4 Average Time Spent in Research in 1979 by 1972 Behavioral Science Ph.D.'s by Sector of Employment 90 4.5 Average Time Spent in Research in 1979 by 1972 Behavioral Science Ph.D.'s by Postdoctoral Experience 91 4.6 Projected Growth in Behavioral Science Ph.D. Faculty, 1978-85, Based on Projections of Enrollment and Faculty/Student Ratios 94 4.7 Estimated Number of Behavioral Science Post- doctoral Trainees Needed to Meet Expected Academic Demand Through 1985 Under Various Conditions 96 4.8 Committee Recommendations for NIH and ADAMHA Predoctoral and Postdoctoral Awards in the Behavioral Sciences 102 xx

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CHAPTER 6 TABLE 6. 1 PAGE Percent of Racial/Ethnic Minorities in the U.S Population 6.2 Sununary of Data on Blacks in the Educational "Pipeline" . 6.3 Summary of Data on Hispanics in the Educational ~Pipeline" 6.4 Profile of Federal Programs for Minority or Dis- advantaged Students in the Biomedical and Be- bavioral Sc fence s xxi 111 116 117 120

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FIGO=S CHAPTER 1 FIGURE 1. 1 CHAPTER 2 FIGURE 2.1 CHAPTER 3 FIGURE 3. 1 3.4 CHAPTER 4 FIGURE 4.1 Flow diagram of procedure followed in deriving recoTrunendations for postdoctoral training levels Clinical R and D expenditures in medical schools ( 1972 $) Service income reported by medical schools (1972 $) Medical students, interns and residents, and c linical f ellows 2.4 Clinical faculty in medical schools Ph. D. f acuity/student ratio in the biomedical science f ields as a lagged function of life science R and D expenditures in colleges and universities, 1962-77 3.2 Life science R and D expenditures, academic employment, and biomedical science enrollment, 1960-77, with projections to 1985 3.3 Trends in population and biomedical science degrees, 1960-79 Graduate enrollment and Pb. D. production in basic biomedical science f ields, 1960-79 Average annual growth in behavioral science labor force by broad f ield and employment sector, 19 73-79 Employment f ield of 1972-78 behavioral science Pb.l). 's in 1979 by field of training 4.3 Behavioral science (psychology, sociology, and anthropology) enrollment, R and D expenditures, and academic employment 1960-78, with projections to 1985 Xii PAGE 15 41 41 42 42 59 60 61 70 85 89 93

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CHAPTER 5 PAGE FIGURE 5.1 Primary disciplines of health services research training and major research problem areas 10 6 CHAPTER 6 FIGURE 6.1 1974-80 doctorate recipients in the biomedical sciences: U.S. citizens and permanent visa holders 112 6.2 1974-80 doctorate recipients in the behavioral sciences: U.S. citizens and permanent visa holders 6.3 Median age of 1974-80 Ph.~. ' s in the biomedical sciences: Blacks and non-minorities xxiii 112 113

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ABBREVIATIONS AAMC Association of American Medical Colleges AAU Association of American Universities ADAMHA Alcohol, Drug Abuse, and Mental Health Administration CHR Commission on Human Resources F/S *Faculty/Student Ratio FY Fiscal Year GMENAC Graduate Medical Education National Advisory Committee GNP Gross National Product BRA Health Resources Administration HSR Health Services Research MARC Minority Access to Researab Careers MISS Minority Biomedical Support MCAT Medical College Admissions Test MSU Michigan State University N/A Not Available NCHSR National Center for Health Services Research NIH National Institutes of Health NIMH National Institute of Mental Health NRC National Research Council NRE Nursing Research Emphasis NRSA National Research Service Award NSF National Sc fence Foundation PI Princ ipal Investigator R and D Researab and Development *Faculty, in this report, is defined as all Ph.D. 's, M.D. 's, and equivalent degree holders who are employed by an academic institution whether or not they are on regular f acuity appointments. Persons on postdoctoral appointments are not included.

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