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1. Introduction and Summary
We are concerned here about the qual.it~ of biomedical
and behavioral research conducted in this Coventry and
the role that federally supported research training
plays in deveZoping and maintaining it. Evidence
about the ~ual.itp of research and the scientists who
conduct it often becomes available only over a rather
long period. Hence, we must be aware of the long-term
effects of the training programs. We must also tori to
anticipate future research personnel needs tin a
quantitative sense. Thus a major part of this report
is devoted to an assessment of the current and
projected supply of and demand for scientists in the
biomedical and behavioral fields.
Two fundamental principles underlie the work of this Committee
over the past 8 years:
2.
vigorous research activity is the key to continual progress
in most scientific and technical fields and
an adequate flow of well-trained new scientists is necessary
to maintain the quality and vitality of research conducted in
these fields.
With these principles in mind, the Committee has attempted to
respond to the task presented to the National Academy of Sciences
tNAS) by Congress in the National Research Service Award (NRSA) Act of
1974 (P.L. 93-348) and amendments. The NAS was asked to determine the
nation's need for biomedical and behavioral research personnel and to
assess the research training programs offered through the National
Institutes of Health (NIH), the Alcohol, Drug Abuse, and Mental Health
Administration (ADAMHA), and the Division of Nursing of the Health
Resources and Services Administration (HRSA).
In the previous six reports issued since 1975, the Committee has
outlined its methodology, formulated conceptual models of how the
market works in these fields, and developed analytical models that
have proved useful in monitoring the system and making projections.
In the process, we have compiled a substantial body of relevant data,
most of which is presented in the Appendix.
1
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2
The Committee has interpreted national needs primarily, but not
exclusively, in terms of the number of positions expected to be
available in both the academic and nonacademic sectors for doctorate-
level biomedical and behavioral investigators. The number of positions
available reflects the market demand for scientists and depends on an
array of economic, political, and sociological factors, one of the
most important of which is the availability of funds to support
research. We have attempted to define the appropriate level of
training to be supplied by the above-mentioned federal agencies on the
basis of projections of supply and demand, considerations of how the
system works to produce trained researchers and teachers, and by
examination of employment patterns and practices.)
Although these short-term market projections have weighed heavily
in our deliberations, we also have been influenced by a perception
that training support contributes not only to the quantity of students
entering a field, but also to the quality of the training environment
and the competence of the program graduates. The immediate effect of
training support for a field is to increase the number of students
entering the field. In the longer term, the probable effect is to
increase the quality of research.
We believe that much of the recent progress made in biomedical
research in this country can be traced to the strong federal
commitment to research and training that emanated from the National
Cancer Act of 1937 and subsequent legislation. That commitment has
been instrumental in establishing a powerful and effective biomedical
research enterprise based on a cooperative arrangement between the
federal government, acting principally through the NIH, and the
universities. This enterprise is a national resource that has
provided this country with a superb base for health related services
and technological leadership in many biomedical and behavioral
fields. Developments during the past 30 years have transformed our
knowledge and understanding of biology. Achievements of research in
many disciplines' curing this period have led to new technologies
contributing to a flood of discoveries in molecular biology,
biochemistry, physiology, and medicine.
Recombinant DNA technology, which makes possible the transfer of
hereditary units from one species to another, represents a significant
addition to the "new biology. n It permits, for example, bacteria to
become n factories" that produce substances of biological and medical
importance. It has already led~to the synthetic production of human
insulin, somatostatin, and growth hormone. The effectiveness of these
substances in treating insulin-dependent diabetes and certain types of
dwarfism is now undergoing clinical trial. Techniques for combining
genes can also yield large quantities of pure antigen which in the
For an extended discussion of the system by which biomedical and
behavioral scientists are trained and absorbed into research
positions, see Chapters 3 and 4 and also the 1981 Report of this
Committee (NRC, 1975-81, pp. 10-15).
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3
near future may be used to produce safer and more potent vaccines for
immunization against specific infectious agents.
Substantial progress has been achieved in understanding of the
immune system. Scientists have uncovered genetic mechanisms that
control the immune response to such invaders as cancer cells,
transplanted organs, and environmental agents that cause allergies.
Involved here is the discovery of the major histocompability complex
(MCH). A region of this "super gene" appears to be the major
regulator of the immune response to foreign substances or antigens.
Disorders such as multiple sclerosis, juvenile diabetes mellitus,
systemic lupus erythematosus, and myasthenia gravis may be associated
with certain recognition antigens on the surface of cells--antigens
located under the directions of MHC. Further knowledge of MHC can
result in more effective means for supplementing natural resistance to
these diseases, as well as better techniques for organ and tissue
transplantation.
Highly specific antibodies can now be produced in the laboratory
through a procedure that consists of fusing in culture a myeloma cell
with single lymphocytes from an immunized animal. The resulting
hybridoma yields clones of lymphocytes that emit monoclonal antibodies
which have the potential for development of specific vaccines,
diagnostic tests, and treatments for many diseases. Recently, for
example, investigators have used human lung cancer cells to immunize
animals and then prepare monoclonal antibodies which can distinguish
human tumor cells from normal cells. This technology makes possible
the detection of cancer at a very early stage. Eventually, clinicians
may be able to attach radioactive or chemotherapeutic agents to the
antibodies and thereby kill cancer cells without harming surrounding
healthy tissue.
The detection and isolation of oncogenes has provided a new
paradigm for cancer research. Oncogenes are dominant genetic elements
whose expression within a normal cell leads to malignant trans-
formation. Some major questions remain to be answered. At what point
in the processes leading to malignancy do oncogenes act? What are the
functions of these oncogenes and by what mechanisms do they effect
cell transformation? Knowledge of the metabolic pathways in which
genes and their products interact could ultimately lead to the
development of rational strategies for the treatment and prevention of
malignant cells.
The developments described above may be viewed as dividends on
past federal investment in biomedical research and training. But it
is critically important to recognize that the federal commitment to
support biomedical research and training means that federal budget
decisions have great impact on these activities, although other
sources of funds are available to some extent.
The rationale for government support of biomedical and behavioral
research "derives from its responsibility for the general welfare to
do that which is necessary whenever other mechanisms do not suffice"
(NRC, 1975-81, 1979 Report, p. 19~. Research training is a necessary
and vital adjunct to the research program. The Committee's
recommendations for research training have been formulated to promote
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stability in the market for biomedical and behavioral research
personnel, while preserving the quality of the training program and
ensuring that adequate numbers of well-trained scientists are
available to meet the nation's needs.
PRIORITY FIELDS
One of the most difficult components of the Committee's task has
been that of determining the appropriate allocation of training grant
and fellowship funds among fields. For purposes of this study, the
biomedical and behavioral fields have been divided into five major
categories as shown in the following table along with the distribution
of National Research Service Awards made in the last 6 years and the
Committee's recommended distribution through 1987:
Distribution of National Research Service Awards
Categories
Actual 1977-82 Recommended 1982-87a
. . _
1) Biomedical Sciences 56% 57%
2) Behavioral Sciences 10% 9%
3) Clinical Sciences 32% 30%
4) Health Services Research 1% 2%
5) Nursing Research 1% 2%
100% 100%
aAwards in the short-term (3-month) training program for health
profession students have been calculated at 1/4 of a full-time
equivalent award. An average of 1,600 such awards per year from
1982-87 (400/yr. on an FTE basis) have been included in the clinical
sciences in this table.
Although the boundaries between these categories are not always
clearly drawn in practice ,2 conceptually they define fairly distinct
sets of problems. Each major category has been analyzed separately,
and our recommendations have generally been directed to the allocation
of training awards among these major categories e
It has proven to be an especially difficult task to identify
priority fields within each major category. The Committee has in the
past identified certain fields such as biostatistics, biomathematics,
epidemiology, toxicology, environmental health, and the clinical
sciences as meriting high priority for training support. However, we
2 See Appendix Table D5 for the taxonomy used to define the
categories.
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s
have refrained from being more specific because basic research is such
a fluid and unpredictable activity. We have found no way of accu-
rately predicting precisely where and when the important scientific
developments will occur and we have no recent data to indicate that
some or all of the earlier conclusions are still valid. The
Committee's position is that the peer review system continues to
provide the best available method for distributing training funds
within the general guidelines we recommend. Those guidelines are
based on the informed judgment of the panelists and Committee members,
who have considerable experience relevant to the task and who have
reviewed extensive analyses of the current and projected market for
scientists in each area and other relevant information.
SUMMARY OF CURRENT OUTLOOK
In previous reports the Committee has called attention to the
sustained growth in the number of biomedical Ph.D.s occupying
postdoctoral positions. Although a period of postdoctoral training
has long been a traditional and accepted phase in a bioscientist's
career, the build-up of the postdoctoral pool was viewed as an
indication that the supply of biomedical scientists was growing faster
than the number of positions requiring their skills. Indeed, more
than 40 percent of the biomedical postdoctoral trainees who received
their doctorate degree between 1971 and 1975 reported that they
remained in postdoctoral status longer than they might otherwise have
done because they could not secure a more permanent position (NRC,
1975-81, 1977 Report, Vol 2, p. 31~.
There now are some indications that the postdoctoral pool of bio-
scientists may soon level off. Most important, the number of
bioscience graduate students has begun to drop, and this is likely to
result in fewer Ph.D.s produced and fewer of them entering the
postdoctoral pool. There has been very little growth in biomedical
Ph.D. production since 1972.
The Committee has expressed concern about the lack of interest in
research careers on the part of young physicians. The sustained
expansion of clinical faculties in medical schools since the early
1960s has contributed to the demand for clinical investigators, and
the growing number of unfilled positions is evidence of need. In
1981, the Association of American Medical Colleges (AAMC) reported to
the Committee that only about 21 percent of individuals newly hired to
fill vacancies on clinical faculties at medical schools were
physicians with some postdoctoral research training (NRC, 1975-81,
1981 Report, p. 2~. There is an increasing tendency to rely on
practice income generated by medical school faculty members to bolster
medical school and departmental budgets. This growing dependence
tends to detract from faculty members' commitments to clinical
investigation. To the extent that faculty members must help support
their salaries and expenses through clinical practice, the research
effort is weakened e
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Problems in our health care system are increasing while funds for
health services research and training are being sharply reduced.
There is likely to be additional pressure on federal agencies to
stress mission-oriented research and cost containment over other
issues of long range importance in the system.
The number of nurses with doctoral degrees in biomedical and
behavioral fields is increasing but only about 7 percent of these
individuals reported research as a major activity in 1980. There is
as yet no solid core of qualified investigators in the area of nursing
research.
In the behavioral sciences, the clinical fields are flourishing as
opportunities for careers as counselors and therapists have become
more attractive. Coverage of these services by health insurance plans
has spread in recent years. But most behavioral science research is
performed by nonclinical behavioral scientists, and enrollments as
well as Ph.D. production in the nonclinical fields are declining.
Only a few years ago most observers were projecting that Ph.D.
production would continue to increase until the early 1980s (Cartter,
1976; NSF, 1975~. The flattening out of the Ph.D. production curves
since the the early 1970's is a rather surprising event, one that
promises to produce more short-term balance in the market for Ph.D.s
than was earlier thought possible.
However, the demographic patterns that are emerging present
another set of problems. Perhaps the most serious is that biomedical,
clinical, and behavioral science faculties at colleges and universities
are not likely to expand at all for the rest of this decade. This
means fewer opportunities for research careers for young scientists in
these fields. Persons born during the baby boom that occurred roughly
between 1946 and 1965 are now largely past the prime college age
years, so enrollments in higher education are expected to decline
steadily for the next 10 or 12 years. Faculty size is determined
partly by enrollments and partly by the availability of R and D funds.
In the biomedical fields, we expect the latter to grow at modest real
rates of about 2 percent annually for the next few years. But this
probably will not be enough to offset the drop in revenues resulting
from declining enrollments. Hence, faculties will not grow and aca-
demic vacancies will occur mainly by attrition. Consequently, young
researchers will find it difficult in these circumstances to begin
their careers as independent investigators. Without adequate numbers
of young investigators, who typically are highly innovative and crea-
tive, where will the new ideas for advances in basic research come
from? Should progress in research be tied so closely to demographic
cycles? What policies can be invoked now that would tend to mitigate
the imbalances between supply and demand caused by the cyclical
demographic and social changes? How can this country's competitive
advantage in technological areas such as the new biotechnology be
maintained?
In our view, these problems are most likely to be solved by
greater expenditure of funds to support research. However, this
Committee has been asked to determine the nation's need for biomedical
and behavioral research personnel, and we have interpreted that task
as one of estimating the number of positions that are likely to be
available under realistic conditions. A market-based approach such as
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this is only one of several possible approaches that could be taken to
estimate national personnel needs. One alternative approach would
base personnel needs on a projected level of research expenditures
somehow tied to total health care costs. But this approach also has
problems, e.g., what will health care costs be in 5 years and what is
an appropriate ratio of research expenditures to health care costs?
No matter what criterion is used, there is always a danger that some
unforeseen development will negate the assumptions on which
projections are made and will lead to market imbalances--either
shortages or surpluses--and a misallocation of resources. There is no
known protection against that event. The training recommendations
described below have been formulated on the basis of our best judgment
as to what the demand for these scientists is most likely to be, given
the demographic trends, the most likely future levels of research
funds, and the financial conditions of our colleges and universities.
RECOMMENDATIONS
We direct the following recommendations concerning the level and
distribution of National Research Service Awards to fiscal years
1985-87. The analyses, background, and discussion leading to these
recommendations may be found in succeeding chapters of this report.
Clinical Sciences
1. The number of postdoctoral research training positions in the
clinical sciences should be about 2,600 per year from 1985 through
1987, and the number of physicians receiving research training
should be increased from the current level of less than 2,000 to
about 2,200, or 85 percent of these postdoctoral positions.
2. The training grant is the most appropriate mechanism for post-
doctoral training of physicians, most of whom have no prior
research experience. At least 85 percent of the clinical science
training positions should be on training grants, the remainder on
fellowships.
One of the most effective mechanisms for training physician-
scientists is the Medical Scientist Training Program {MSTP)
administered by the National Institute of General Medical Sciences
(NIGMS). The costs of MSTP as a share of total NIGMS funds for
predoctoral training have been increasing steadily. To ensure an
appropriate balance, we therefore recommend that MSTP'S share over
the near future not exceed 25 percent of NIGMS-predoctoral
training funds with a target goal of approximately 725 trainees.
We believe this can be accomplished without loss in quality by
introducing administrative changes, such as the recently adopted
limitation on length of MSTP support for an individual trainee (6
years). Other modifications now under consideration by the agency
have a potential for increasing output per MSTP dollar.
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4. We endorse the program of institutional grants that provides up to
3 months research training for health professions students without
incurring the payback provision, and recommend that it be
continued. If possible, the stipends should be raised to a level
which is competitive with other opportunities of these students
for summer earnings.
Basic Biomedical Sciences
Predoctoral training in these fields should be supported at a
level of about 4,250 trainees per year.
2. Postdoctoral training in the basic biomedical sciences should
continue to support about 3,200 fellows per year.
Behavioral Sciences
1. In view of the rapidly developing movement away from the research
fields and into the more clinical fields of the behavioral
sciences, the Committee recommends that research training support
not be further eroded. The number of predoctoral awards in the
behavioral sciences should be maintained at the 1981 level--about
650 per year.
2. The development of postdoctoral training programs should be
encouraged by gradually increasing the number of postdoctoral
research training awards from the 1981 level of about 350 to 540
by 1987.
3. About 80 percent of the behavioral science awards should be
traineeships and 20 percent should be fellowships.
Health Services Research
1. We recommend that 330 trainees and fellows be supported annually
in the catgory of health services research.
Earlier efforts by the Committee and others to develop adequate
data on health services research personnel and training should be
supplemented by further investigations. The Institute of Medicine
should convene a meeting of interested parties to review the
status of university-related centers for health services research
and to outline a plan for collecting additional data on potential
demand for investigators in this field.
Nursing Research
1. The number of training awards in nursing research should be about
300 per year.
2. A maximum of 15 percent of these awards should be at the post-
doctoral level.
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TRAINING DATA
To give perspective to the resources devoted to training by the
NIH, ADAMHA, and HRSA, we present below the training budgets as a
percentage of research expenditures by these agencies over the past 10
years. Training expenditures declined from almost 18 percent of
research expenditures in 1971 to 7 percent in 1981. This results from
a steady 4 percent per year increase in research expenditures and a 5
percent per year decrease in training expenditures over this period
after adjusting for inflation.
Training Expenditures as a
Percent of Research Expenditures
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
SOURCE: See Appendix Table D4.
17.7%
15.1%
10.4%
12.9%
10.5%
7.7%
7.4%
7.4%
6.4%
7.3%
7.0%
Nevertheless, the current number of trainees is in fact quite
close to that recommended by this Committee. The Point is that large
adjustments in_training programs have been occurring right along--
correctly, we think--in view of the ample number of biomedical and
behavioral Ph.D.s being produced annually and serving in postdoctoral
positions. A transition has been made from a period of high training
vels. What Is needed now is not a huge
. ~
infusion of funds for training but rather a reasonably stable program
geared to preserving the lon~-term quality of research.
By definition, there will always be a shortage of the best neoule
and it is in the sense of ensuring the
number of very good people for careers
research that NRSA programs are most useful.
_ ~ ,= _ _ ,= _ _ ~
availability of some minimum
in biomedical and behavioral
NATIONAL RESEARCH SERVICE AWARDS
FOR1981AND1982
In 1981 NIH/ADAMHA/HRSA made 13~325 awards under the NRSA program--
a slight increase over the 13,191 made in 1980. In 1982 the number of
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awards dropped to 12,907.
fields as follows:
The awards were distributed among the
1981
1982
Biomedical Sciences: 52.4% 55.6%
Behavioral Sciences: 8.0% 7.5%
Clinical Sciences:3/ 38.5% 35.8%
Nursing Research: 1.1% 1.1%
100.0% 100.0%
§/Awards in the short-term training program for health
professions students were counted as 1/4 of a full-time
equivalent award.
These distributions reflect an increased emphasis on the clinical
fields and away from the biomedical sciences and health services
research, compared to recent years. This shift occurred in part
because ADAMHA revised its classification of research training awards
in 1981. This change resulted in 114 additional awards in the
clinical sciences, up from none in 1980, and the elimination of any
awards in health services research.
Another reason for the increase in clinical sciences is that
awards in the short-term (3 months) training program for health
professions students increased from 911 in 1980 to 1,275 in 1981 and
1,339 in 1982.
Despite the apparent increase in training awards in the clinical
sciences category, the number of physicians and other health
professionals participating in the research training program was less
than 2,000 out of the nearly 2,800 clinical science postdoctoral
awards made by the NIH in 1981.3 The remaining awards went to
Ph.D.s.
. ~ ~
The following tables show the 1981 and 1982 research training
awards made by the NIH, ADAMHA, and HRSA under the NRSA program, and
the Committee's recommendations for 1985-87. Cost estimates for the
recommended programs are also provided.
Training grant awards are defined as the number of predoctoral or
postdoctoral training positions to be made available on the grant.
The number of awards is generally quite close, but not exactly equal
to the number of individuals trained, since some training grant awards
may provide support to more than one trainee during the year.
3 Special tabulation prepared by the Statistics and Analysis Branch,
Division of Research Grants, NIH. October 7, 1982.
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TABLE 1.1 Aggregated Numbers of NIH/ADAMHA/HRSA Traineeship and Fellowship Awards
for FY 1981 and FY 1982a
TOTAL
ALL Biomedical Behavioral Clinical Nursing
FIELDS Sciences Sciences Sciences Research
FY 1981 TOTAL 13,325 6,482 988 5,723 132
Predoctoral 7,264 3,708 639 2,791 126
Postdoctoral 6,061 2,774 349 2,932 6
Trainees 11,430 5,047 861 5,506 16
Predoctoral 7,043 3,656 588 2,787 12
Postdoctoral 4,387 1,391 27 3 2,719 4
Fellows 1,895 1,435 127 217 116
Predoctoral 221 52 51 4 114
Postdoctoral 1,674 1,383 76 213 2
FY 1982 TOTAL 12,907 6,608 896 5,270 133
Predoctoral 6,989 3,673 516 2,669 131
Postdoctoral 5,918 2,935 380 2,601 2
Trainees 11,097 5,202 781 5,101 13
Predoctoral 6,784 3,6 20 484 2,667 13
Postdoctoral 4,313 1,582 297 2,434 0
Fellows 1,810 1,406 115 169 120
Predoctoral 205 5 3 3 2 2 1 18
Postdoctoral 1,605 1,353 83 167 ~
aThese are total numbers of awards for traineeships and fellowships. Data on the number of new starts for FY 1981 and
FY 1982 are not available. See Tables 1.2 and 1.3.
SOURCES: Office of the Administrator, ADAMHA (5/25/82 and 6/6/83); Division of Nursing, HRSA (4/9/81 and 10/1/82);
Division of Research Grants, NIH (9/22/82 and 7/12/83).
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TABLE 1.3 ADAM HA Traineeship and Fellowship Awards for FY 1981 and FY 1982
Biomedical Sciences
TOTAL Total Epidemiology
ALL Biomedical Biological and Behavioral Clinical
FIELDS Sciences Sciences Biostatistics Sciences Sciencesb
FY 1981 TOTAL 1,423 519 398 121 790 114
Predoctoral 808 235 158 77 524 49
Postdoctoral 615 284 240 44 266 65
Trainees 1,218 423 308 115 697 98
Predoctoral 721 203 127 76 473 45
Postdoctoral 497 220 181 39 224 5 3
Fellows 205 96 90 6 93 16
Predoctoral 87 32 31 1 51 4
Postdoctoral 1 18 64 59 5 42 12
FY 1982 TOTAL 1,246 486 365 121 648 112
Predoctoral 652 212 139 73 388 52
Postdoctoral 594 274 226 48 260 60
Trainees 1,095 409 292 117 584 102
Predoctoral 589 183 110 73 356 50
Postdoctoral 506 226 182 44 228 52
Fellows 151 77 73 4 64 10
Predoctoral 63 29 29 0 32 2
Postdoctoral 88 48 44 4 32 8
aThese are total numbers of awards for traineeships and fellowships. Data on the number of new starts for FY 1981 and
FY 1982 are not available.
bEffective FY 1981, ADAMHA has been using a different system for classifying their trainees and fellows. In prior years,
ADAMHA reported training in Health Services Research but none in Clinical Sciences.
SOURCE: Office of the Administrator, ADAMHA (5/25/82 and 6/6/83).
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TABLE 1.4 Committee Recommendations for NIH/ADAMHA/HRSA Predoctoral and Postdoctoral
Traineeship and Fellowship Awards for FY 1985-87a
TOTAL Basic Behavioral Clinical Sciences Health Nursing
ALL Biomedical SciencesC Other Services Research
FIELDS Sciences b Medical Clinical Research
Fiscal Scientist Science
Year Type of Program Program Programs
_
1985 TOTAL Total 12,495 7,450 1,090 725 2,600 330 300
Predoc. 6,070 4,250 650 725 d 190 25 5
Postdoc. 6,425 3,200 440 0 2,600 140 45
Trainees Total 8,475 4,250 895 725 2,230 250 125
Predoc. 5,755 4,250 535 725 d 140 105
Postdoc. 2,720 0 360 0 2,230 110 20
Fellows Total 4,020 3,200 195 0 370 80 175
Predoc. 315 0 115 0 0 50 150
Postdoc. 3,705 3,200 80 0 370 30 25
1986 TOTAL Total 12,545 7,450 1,140 725 2,600 330 300
Predoc. 6,070 4,250 650 725 d 190 2S5
Postdoc. 6,475 3,200 490 0 2,600 140 45
Trainees Total 8,515 4,250 935 725 2,230 250 125
Predoc. 5,755 4,250 535 725 d 140 105
Postdoc. 2,760 0 400 0 2,230 110 20
Fellows Total 4,030 3,200 205 0 370 80 175
Predoc. 315 0 115 0 0 50 150
Postdoc. 3,715 3,200 90 0 370 30 25
1987 TOTAL Total 12,595 7,450 1,190 725 2,600 330 300
Predoc. 6,070 4,250 650 725 d 190 255
Postdoc. 6,525 3,200 540 0 2,600 140 45
Trainees Total 8,560 4,250 980 725 2,230 250 125
Predoc. 5,755 4,250 535 725 d 140 105
Postdoc. 2,805 0 445 0 2,230 110 20
Fellows Total 4,035 3,200 210 0 370 80 175
Predoc. 315 0 115 0 0 50 150
Postdoc. 3,720 3,200 95 0 370 30 25
aThese are total numbers of recommended awards. See Table 1.1 for number of actual awards made in FY 1981 and FY 1982.
The number of new starts in any given vear is sensitive to fluctll~tionc in the folio le.v`~l end they ncr~ill~tPc murk ranirilu than
does the total number of awardees.
bRecommendations for biostatistics, epidemiology, community and environmental health, and other training fields not specifi-
cally shown in this table are included here.
CThe allocation of awards in the behavioral science fields between traineeships and fellowships is based on the distribution that
prevailed in FY 1976, i.e., 82~o traineeships, 18% fellowships.
dA program of short-term research training (3 months) for health professions students during summer and off~uarters was au-
thorized in 1978. The Committee has endorsed this program in principle but makes no recommendations for the number of
students to be supported under it. The 1978 amendments to the NRSA Act authorized evnentl't''r~c for thic nr^er~m nf''n tm
4% of appropriated training funds. In FY 1982 1,339 trainees were awarded stipends.
_ ~ C, ^~ v ~ -V &~ rat, ~~&
-Rae ~^ ~ ~- r A ~ fir ~
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15
TABLE 1.5 Estimated Cost of Recommended NIH/ADA~HA/HRSA Training Programs for FY 1985-87
(millions of dollars
Type of TOTAL Biomedical Behavioral ainica1 Sciences Health Nursing
Fiscal Program ALL Sciences Sciences Short-Term Services Research
Year FIELDS Total MSTP Trainingb Other Research
1985 TOTAL 202.7 107.5 18.2 68.0 10.8 2.1 55.1 5.1 3.9
Trainees 131.1 49.6 15.2 60.6 10.8 2.1 47.7 4.0 1.7
Fellows 71.6 5 7.9 3.0 7.4 - - 7.4 1.0 2.2
Predoc. 77.1 49.6 9.4 12.9 10.8 2.1 - 2.2 3.0
Pos~doc 125.6 S7.9 8.8 55.1 - - 55.1 2.9 0 9
1986 TOTAL 205.9 108.5 20.0 68.4 11.1 2.1 55.2 5.1 3.9
Trainees 134.0 50.6 16.7 61.0 11.1 2.1 47.8 4.0 1.7
Fellows 71.9 57.9 3.3 7.4 - - 7.4 1.1 2.2
Predoc. 78.6 50.6 9.6 13.2 11.1 2.1 - 2.2 3.0
Postdoc. 127.3 57.9 10.4 55.2 - - 55.2 2.9 0.9
1987 TOTAL 209.4 109.5 21.9 68.8 11.4 2.1 55.3 5.2 4.0
Trainees 137.0 51.6 18.3 61.4 11.4 2.1 47.9 4.0 1.7
Fellows 72.4 57.9 3.6 7.4 - - 7.4 1.2 2.3
Predoc. 80.4 51.6 9.9 13.5 11.4 2.1 - 2.3 3.1
Postdoc. 129.0 57.9 12.0 55.3 - - 55.3 2.9 0.9
_
aCalculations were based on 1982 average cost figures derived from NIH data and assumed the following: 1) a 5% increase in stipends
for FY 1983, held constant for later years; 2) a NO per year increase in tuition; and 3) a reduction in institutional costs to a maximum
per year of $1,500 for predoctoral trainees and fellows, $2,500 for postdoctoral trainees, and $3,000 for postdoctoral fellows. The sti-
pend increase and the reduction in institutional allowances are regulations that became effective in FY 1983.
bEstimate assumes 1,200 trainees.
ESTIMATED TRAINING COSTS PER AWARD IN FY 1982 (dollars)
Predoctoral
Clinical Sciences
Postdoctoral
Behav- Short- Health Behav- Health
Biomed. ioral Term Services Nursing Biomed. ioral Clinical Services Nursing
FY 1982 Sci. Sci. MSTP Training Research Research Sci. Sci. Sci. Research Research
Trainees 11,613 13,602 13,776 1,699 11,613 11,613 20,596 21,953 20,987 20,596 20,596
Fellows 11,613 13,602 - - 11,613 11,613 17,321 18,535 19,263 17,321 17,321
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16
ADDENDUM
It has been the Committee's practice following the publication of
its reports to hold a meeting at which interested persons can present
their reactions and comments to the Committee. The last report was
issued in 1981 and a public meeting was held in 1982. A number of
significant points were made which we feel deserve mention and further
consideration. The meeting is summarized below.
PUBLIC MEETING, JUNE 2, 1982
Following the publication of the Committee's 1981 Report, a public
meeting was held on June 2, 1982, to receive comments from the scien-
tific community. Twelve speakers representing a variety of organiza-
tions made brief statements about different aspects of the report to
the Committee and an audience of about 100 persons. The list of
speakers in order of appearance and their affiliations are as follows:
Gerald D. Shockman
James Ferguson Jr.
Frank G. Standaert
Robert W. Krauss
Thomas Kennedy
James M. Jones
Ora Strickland
Michael S. Pallak
Mortimer Appley
Edward J. Callahan
Martha Pitel
Mitzi Duxbury
American Society for Microbiology
University of Pennsylvania School of Medicine
Georgetown University
Federation of American Societies for
Experimental Biology
Association of American Medical Colleges
Minority Fellowship Program Director
American Nurses' Association
American Psychological Association
Clark University
West Virginia University Medical Center
American Association of Colleges of Nursing
University of Minnesota School of Nursing
Copies of prepared remarks from several of the speakers are avail-
able upon request to the Committee. Some of the major points made by
the speakers at the meeting are summarized below:
1. The Committee may have overlooked a growing demand for
certain types of bioscientists outside the academic
sector, especially in the new biotechnology industry.
The Committee's estimate of about 1,000 positions per
year opening up for biomedical Ph.D.s in industry is
probably too conservative.
The role of the M.D. in basic research should be
examined and encouraged. Medical students are often
insulated from basic research and researcher role
models.
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17
Data from the placement service of the Federation of
American Societies for Experimental Biology (FASEB)
show a stable number of job applicants and employers.
There is no evidence in these data that an oversunulv
of bioscientists exists.
Identifying physician scientists and enumerating them
remains a critical problem because of the absence of
any certification process. An accurate assessment of
supply or demand cannot be made without an accurate
count of physician scientists.
At least 85 percent of funds for training minority
students should be used at the predoctoral level.
6. The Committee is urged to reconsider its recOmm~n~A
tion for training in the behavioral sciences that
drastically shifts the emphasis to postdoctoral
training. Although it is recognized that the need for
postdoctoral training is growing in some behavioral
subfields, the magnitude of the recommended shift is
unrealistic. The decline in predoctoral support by
the agencies has been devastating. There is no
objection to increasing research training at the
postdoctoral level, but it should not be at the
expense of predoctoral training support.
The Committee should extend its horizons beyond the
short-term analysis it has traditionally employed. A
longer-term view is necessary because scientists
needed in the l990s are already in training. We need
to know what the situation will be in the l990s when
many people trained in the 1960s will be retiring.
Nursing research includes many more areas than health
services research and should not be combined with it
in the report. The Committee's support for Nursing
Research Emphasis Grants is to be commended. Although
progress has been made in providing training in the
area of nursing research, we still lack a substantial
nucleus of nurse researchers as principal investigators
engaged in nursing research programs.
4.
~ .-~—~
, ~ __~—.~ ~ _~
7.
8.
The Committee acknowledges these comments and appreciates the
constructive manner in which they were presented. The suggestions
have been given careful consideration in our deliberations and those
of the Panels. While perhaps not all of them are reflected in this
report to everyone's satisfaction, the comments are highly valued by
our members as representing important points of view on these
difficult issues.
Representative terms from entire chapter:
clinical sciences
