Personnel Needs and Training for Biomedical and Behavioral Research Volume 1 (1977) / Chapter Skim
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5 Clinical Sciences
5 Clinical Sciences
Pages 110-127
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From page 110... ...
CLINT CAL SC] ENCES Mode rn c ~ ini ca ~ i nve s t ig ati on i s ba sed or the concept that the d eve lonmen ~ of e f f ectiv" mea sures to prevent or treat human is Iness requires a knowledge of the manifestations of a di spasm, as well as an understanding of its cause and mechani sms.
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From page 111... ...
Another financial disincentive reported by training program directors is the unrealistically low fellowship stipend. At current levels, many first-year rem ear ch fellows earn less than they di ~ in the pre ceding yea r a s res idents .
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From page 112... ...
$393 million $490 million 5.7% Medical service funds (1967 $) $ 94 million $193 million 19.7% Budgeted vacancies: Clinical departments 982 1,564 12.3% Basic science departments in medical schools 508 609 4.6% Labor force: M.D.'s primarily engaged in research 10,898 7,944 -7.6% Full-time faculty in clinical departments 1S,451 26,280 9.2% Enrollment: Medical students 40,487 53~143 7.0% Other medical student equivalents 57 r 525 89,095 11.6% Total 98,012 142 r238 9.8% .
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From page 113... ...
There is an absence of data to document or to measure the changes that may be occurring in the supply of clinical investigators. Unlike internships and residencies, fed lowships and other advanced training programs in the clinical sciences are not approved by an accreditation body with record-keeping responsibilities.
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From page 114... ...
R and D expenditures n medical schools are expanding at more than 5 Percent per year, medical student enrollment is up more than 7 percent per year, and total medical school enrollment including graduate student enrollment in basic scam ences programs, nursing programs, and students in the ails ed health professions, is Growing even faster. In ~ he following sections a model is presented for estimating the future needs for cot inical faculty in medical schools.
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From page 115... ...
Tab, e 5.2 shows the pro jected size and growth rate of clinical faculty under the nine assumptions due to faculty expansion alone. Provision must also be mad" for replacement needs, in Table 5.3, using Cartt~r's (1976)
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From page 116... ...
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From page 117... ...
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From page 118... ...
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From page 119... ...
The s e f indin gs ~ ead to ~ he i nf erenc e that the subs ~ antiart faculty expansion in academic medical centers was related to the provi sion of clinical car" and added responsibility for the teaching of other heal th professions students. For the s e rea son s, ~ he Commi ttee be ~ i eves it import ant in its future studies to distinguish between clinical investigators, as the essential variable to be predicted, and total clinical faculty.
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From page 120... ...
That possibility Ied the committee to recommend f or FY ~ 977 a ~ O percent increase in the number of trainees and fellows at the postdoctoral eve1, compared with the number funded by NIH/ADAM~ in FY 1975. The Comma -tee finds cause for concern in the fact ~ hat actual postdoctoral awards by NIH in the clinical sciences in FY ~ 976 provided for a total of 1, 682 trainees and fed lows, compared with the recommendation for 2,675, a reduce ion of 37 percent from the recommended level (Table 5.
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From page 121... ...
TABLE 5.4 NIH Post-M.D.
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From page 122... ...
2000 1600 1200 800 400 o (a) Budgeted Vacancies / / ' ^ ~IinI=l ^, Depts.
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From page 123... ...
TABLE 5.5 Committee Recommendations for NIH and ADAMHA Predoctoral and Postdoctoral Traineeship and Fellowship Awards in the Clinical Sciences Fiscal Year Agency Awards and Committee Recommendations 1975 1976 1977 1978 1979 1980 1981 Actual awards Total 3095 2289 Pre 543 607 Post 2552 1682 1976 recommendations Total 3256 3400 3400 Pre 581 600 600 Post 2675 2800 2800 1977 recommendations Total 3500 3500 3500 Pre Post 2800 2800 2800 aFY 1976 awards were reported in 1977 subsequent to the release of the 1976 report of the Committee.
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From page 124... ...
Recommendation . The Commi ttee recommends that program announcements be worded in a manner that expl icitly encourages applications for training in the clinical sciences .
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From page 125... ...
For these individuals, the purpose of training in the cat inical science is more to instill the method ogles and techniques of research than ~ o expand or sharpen cools the' have already been acquired. That purpose i s best served through a mechani sm that strengthens the research environment by providing funds for courses, seminars, specie, lectures, and supple es and equipment.
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From page 126... ...
Discs plinary lines can be crossed to utilize, for example, the programs of a basic science department and the research ef f ort of a clinical specialty. Sponsored by the NIGMS, the Melt Cal scientist Training Program has expanded slowly since its start in ~ 96 4-6 5 to a total of 23 grants, which provide approximately 600 tray neeship positions.
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From page 127... ...
(MRSD_3) , where CF = size of full-time clinical faculty in medical schools, M = medical student enrollment, and MRSD_3 = R and D expenditures in medical schools, lagged three years (millions of 1967 S)
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