A Healthy NIH Intramural Program

Structural Change or Administrative Remedies?

Report of a Study by a Committee of the Institute of Medicine

Division of Health Sciences Policy

National Academy Press

Washington D.C.

1988



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About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be retained, and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. Washington D.C. 1988 National Academy Press Division of Health Sciences Policy Structural Change or Administrative Remedies? Report of a Study by a Committee of the Institute of Medicine A Healthy NIH Intramural Program i

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ii About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be retained, NOTICE: The project that is the subject 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 and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. the committee responsible for the report were chosen for their special competencies 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 Academy of Engineering, and the Institute of Medicine. The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist dis- tinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy’s 1863 congressional charter responsibility to be an advisor to the federal government and its own initiative in identifying issues of medical care, research, and education. This project (Evaluation Project No. NIH 88–310 for Contract Number NO1-OD-8-2104) received support from the evaluation set-aside Section 513, Public Health Service Act. 2101 Constitution Avenue, N.W. Washington, D.C. 20418 (202) 334-3300 IOM 88-08

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iii About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be retained, INSTITUTE OF MEDICINE and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. COMMITTEE TO STUDY STRATEGIES TO STRENGTHEN THE SCIENTIFIC EXCELLENCE OF THE NATIONAL INSTITUTES OF HEALTH INTRAMURAL RESEARCH PROGRAM HAROLD T.SHAPIRO, (Chairman), President, Princeton University, Princeton, New Jersey. MICHAEL S.BROWN,* Professor of Genetics, University of Texas Health Science Center, Dallas, Texas. JOHN T.DUNLOP,* Lamont University Professor, Emeritus, Harvard University, Cambridge, Massachusetts. GERALD D.FISCHBACH, Chairman of Anatomy and Neurobiology, Washington University, St. Louis, Missouri. MARIAN E.KOSHLAND, Professor and Chair, Department of Microbiology and Immunology, University of California, Berkeley, California. CHARLOTTE V.KUH, Executive Director, Educational Testing Service, Princeton, New Jersey. ROBERT I.LEVY,* President and Chief Executive Officer, Sandoz Research Institute, East Hanover, New Jersey. WALTER E.MASSEY, Vice President for Research and for Argonne National Laboratory, The University of Chicago, Chicago, Illinois. ROBERT G.PETERSDORF,* President, Association of American Medical Colleges, Washington, D.C. PAUL GRANT ROGERS,* Partner, Hogan & Hartson, Washington, D.C. BENNO C.SCHMIDT,* Managing Partner, J.H.Whitney & Company, New York, New York. LLOYD H.SMITH,* Associate Dean and Professor of Medicine, University of California at San Francisco, San Francisco, California. ELMER B.STAATS, Former U.S. Comptroller General, Washington, D.C. P.ROY VAGELOS,* Chairman and Chief Executive Officer, Merck and Company, Rahway, New Jersey. *Member, Institute of Medicine

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About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be retained, and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. ALAN L.DEAN STUDY STAFF MICHAEL FINN CONSULTANTS HAROLD SEIEMAN HELEN HOFER GEE ROBERT A.WALKINGTON MICHAEL L.MILIMAN, Study Director CARLOTTA C.MOLITOR, Research Associate JESSICA TOWNSEND, Associate Study Director WALLACE K.WATERFALL, Editor, Institute of Medicine RUTH ELLEN BULGER, Director, Division of Health Sciences Policy iv

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CONTENTS v About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be retained, CONTENTS and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. SUMMARY 1 INTRODUCTION 11 The Charge to the Committee 11 The Committee’s Interpretation of Their Charge 11 Scope of the Study 12 Conduct of the Study 13 Origins of the Study 13 Structure and Funding of NIH and Its Intramural Pro- 16 gram CHAPTER 1. MISSION AND PURPOSES OF THE NIH INTRA- 23 MURAL PROGRAM Role as a Government Laboratory 24 The Environment 24 Research Training 25 Basic and Clinical Research 26 The Application and Communication of Research 27 Long-Term Research 28 The Intramural Program in Relation to the Extramu- 28 ral Program Conclusion 29 CHAPTER 2. SCIENTIFIC EXCELLENCE OF NIH INTRAMURAL 33 PROGRAM Important Discoveries by Scientists in the NIH Intra- 33 mural Program Bibliometric Analysis of Publications in Scientific 35 Journals Peer Judgment of Scientific Contribution 38 New Young Talent 39 Administrative Measures to Strengthen the Current 40 Program Conclusion 44

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CONTENTS vi About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be retained, CHAPTER 3. SIZING UP ADMINISTRATIVE PROBLEMS 47 and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. Personnel 48 Compensation 49 Beginning Researchers 50 Mid-Level Researchers 53 Senior Researchers 59 Support Staff 63 Summary of Compensation Findings 64 The Personnel System 65 Barriers to a Productive Work Environment 68 Coping with a Changing Environment 72 Summary of Administrative Problems 73 Endnotes 75 Tables 83 CHAPTER 4. SOLVING ADMINISTRATTVE PROBLEMS 119 The Policy Background 120 Models for Organizational Reform 121 Addressing Problems that Exist under the Present 126 Organization Improving the NIH Managerial Environment 133 Conclusions and Recommendations 134 APPENDIXES A ORGANIZATIONS AND INDIVIDUALS PROVID- 143 ING TESTIMONY REGARDING THE NIH INTRAMURAL PROGRAM B NIH VISIT ON MAY 25, 1988 146 C SUMMARY OF ACHIEVEMENTS OF NIH INTRA- 148 MURAL PROGRAMS D BIBLIOMETRIC ANALYSIS 156

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FIGURES vii About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be retained, FIGURES and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. Figure I-1 NIH Organizational Chart 17 Figure 3-1 U.S. and Foreign Fellows, 1983 and 1988 51 Figure 3-2 Attrition Rates 1983–1987 for Tenured M.D.s and Ph.D.s 55 Figure 3-3 Salaries for M.D.s and Ph.D.s, 1987, NIH vs Academic Cen- 60 ters, Figure 4-1 NBS Personnel Management Demonstration Project 128 TABLES Table I-1 NIH Obligations by Institute 1977–1987 21 Table 2-1 Percent Papers Among Most Highly Cited 10 Percent 37 Table 2-2 Ratio Intramural to Academic Average Citations Per Paper 37 Table 3-1a Personnel Systems Under Which NIH Tenured Scientists 83 Are Employed Table 3-1b Salary Rates for Permanent NIH Scientists Under the Gen- 86 eral Schedule and Senior Executive Service Table 3-2 NIH Fellows by Title and Degree as of End of Fiscal Years 87 1983–1988 Table 3-3 Non-Tenured Intramural Employment 88 Table 3-4 Time Line for Trainees at NIH 90 Table 3-5 NIH Medical Staff Fellowship Program Statistics, 1977– 91 1988 Table 3-6a Rates of Conversion of NIH Staff Fellows to Permanent 92 GS and CO Appointments Table 3-6b Conversions of NIH Fellows to Full-Time Permanent 93 Appointments in General Schedule (GS/GM), Commis- sioned Corps (CO) Positions. Fiscal Years 1983–1987 Table 3-7 Grades Within Senior Investigator Category 94

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FIGURES viii About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be retained, Table 3-8 Selected Employment Data for Current Full-Time Perma- 95 nent NIH Tenured Scientists in Intramural Positions by and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. Grade, 1983–1988 Table 3-9 Selected Employment Data for Full-Time Permanent NIH 101 Tenured Scientists Who Left NIH Intramural Positions by Grade, Fiscal Years 1983–1987 Table 3-10 Attrition of NIH Full-Time Permanent Tenured Scientists 106 (M.D.s and Ph.D.s) in Intramural Positions by Grade, Fiscal Years 1983–1987 Table 3-11 Appointments of Scientists to NIH Intramural Positions by 111 Grade and Degree. Fiscal Years 1983–1987 Table 3-12 Appointment of Scientists to NIH Intramural Programs. 112 Distribution by Grade. 1983–1987 Table 3-13 Comparative Salaries of Research Scientists 113 Table 3-14 Change in Average Annual Salaries Reported by Doctor- 114 ates at NIH in 1981 by Type of Employer in 1987 Table 3-15 Comparison of Physician Compensation: NIH and Ameri- 115 can Medical Schools Table 3-16 Comparison of Ph.D. Pay: NIH and American Medical 116 Schools Table 3-17 Allied Health Specialists Salary Comparison— 117 Washington, D.C. Area. January 1988

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ACKNOWLEDGEMENTS ix About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be retained, ACKNOWLEDGEMENTS and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. The committee appreciates the cooperation and assistance it received from many individuals and organizations. Space prevents acknowledging them all, although every input contributed to the overall report. A few warrant special mention. More than 50 organizations and individuals (Appendix A) provided testimony to the committee regarding the NIH Intramural Program within a very brief timeframe; we offer them each our thanks. The National Institutes of Health responded to our many requests for data. We would like to thank Philip S.Chen, Associate Director for Intramural Affairs; Richard G.Wyatt, Special Assistant for Intramural Affairs; Kurt Habel, Chief, Program Planning Branch; John D.Mahoney, Associate Director for Administration; Norman D.Mansfield; Director, Division of Financial Management; and Robert T.Dillon, Chief, Staffing Management Branch, Division of Personnel Management, and his staff. Our thanks extend to the other NIH staff who generously provided insights for the committee, and especially to Sean Donohue, Office of Science Policy and Legislation, Program Planning Branch, who, by facilitating our many requests, smoothed project progress. Bradie Methany, Coordinator of the Delegation for Basic Biomedical Research, offered direction leading to staff interviews with private biomedical research laboratories, while Susan Racca, Director of Special Projects, Industrial Biotechnology Association, provided yet other insights into this sector. Representatives of a number of the nation’s most prestigious postdoctoral fellowships gave generously of their time for interviews: The American Cancer Society, Damon Runyon-Walter Winchell Cancer, Helen Hay Whitney, Jane Coffin Childs, Leukemia Society of America, Markey Charitable Trust, and the Pharmaceutical Manufacturers Association Foundation, Inc. A very special acknowledgement must go to Jean M.Haddock, Manager, American Society for Clinical Investigation (ASCI), who through a major effort made possible a survey of the more than 2,000 ASCI members, to which its membership responded overwhelmingly. Lynn Morrison, Director for Public Policy, American Federation for Clinical Research, provided the committee with additional perspectives.

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ACKNOWLEDGEMENTS x About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be retained, Paul Jolly, Associate Vice President for Operational Studies, Association of American Medical Colleges, provided valuable data. Mark Abramson, Executive and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. Director, Center for Excellence in Government, offered his observations. Among the staff of government agencies who shared their experiences with the IOM staff and committee, we wish to recognize Harold J.Reese, Chief, Labor Management Relations and Staff Services, National Bureau of Standards (presently the National Institute of Standards and Technology) ; Kenneth E.Kinnamon, Uniformed Services University of the Health Sciences; Charles Levine, Deputy Director of the National Commission on the Public Service; William M.Tolles, Associate Director of Research, Strategic Planning, Naval Research Laboratory, Washington, D.C.; and Sheldon B. Clark, Ph.D., Senior Research Scientist, Labor and Policy Studies Program; Manpower, Education, Research, and Training Division, Oak Ridge Associated Universities. Harold T.Shapiro Chairman Committee to Study Strategies to Strengthen the Scientific Excellence of the NIH Intramural Research Program