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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 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 Academy of Engineering, and the Institute of Medicine.
The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished 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 was supported in part by funds from the National Institutes of Health, National Institute of Child Health and Human Development, Contract Number NO1-HD-0-2905. The Johnson and Johnson Foundation, the Burroughs Wellcome Fund, Syntex (U.S.A.), Inc., the Institute of Medicine, the Andrew W. Mellon Foundation, and the Richard King Mellon Foundation also supported this project.
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First Printing, April 1992
Second Printing, June 1992
Third Printing, December 1992
COMMITTEE ON THE RESEARCH CAPABILITIES OF ACADEMIC DEPARTMENTS OF OBSTETRICS AND GYNECOLOGY
RICHARD E. BEHRMAN (Chairman),* Executive Director,
Packard Foundation—Center for the Future of Children, Los Altos, California
EVERETT ANDERSON,** Professor of Anatomy and Cellular Biology, and Associate Director,
Laboratory of Human Reproduction and Reproductive Biology, Harvard School of Medicine, Boston, Massachusetts
C. WAYNE BARDIN,* Vice President, The Population Council, and Director,
Center for Biomedical Research, New York, New York
GERARD N. BURROW,* Dean,
School of Medicine, University of California, San Diego, La Jolla, California
SHIRLEY S. CHATER,* President,
Texas Woman's University, Denton
ARTHUR L. HERBST, Professor and Chairman,
Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois
ERNST KNOBIL,** Director,
Laboratory for Neuroendocrinology, University of Texas Medical School, Houston
PAUL C. MACDONALD,* Professor, Department of Obstetrics-Gynecology and Biochemistry, and Director,
Cecil H. and Ida Green Center for Reproductive Biology Sciences, University of Texas, Southwestern Medical Center, Dallas
DORIS H. MERRITT, Associate Dean,
Indiana University Medical Center, Indianapolis
RODRIGUE MORTEL, Professor and Chairman,
Department of Obstetrics and Gynecology, Pennsylvania State University, Hershey
MARY LAKE POLAN, Professor and Chairman,
Department of Obstetrics and Gynecology, Stanford University School of Medicine, Palo Alto, California
GLORIA E. SARTO, Professor and Chairman,
Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque
PAUL D. STOLLEY,* Professor and Chairman,
Department of Epidemiology and Preventive Medicine, University of Maryland Medical School, Baltimore
The work of this committee could not have been accomplished without the contributions of many people and organizations who provided assistance and information. The staff of the National Institutes of Health were especially generous with their time and expertise. Many individuals contributed, including Duane F. Alexander, Sumner J. Yaffe, Charlotte Catz, Michael E. McClure, Donald McNellis, Darlene D. Levenson, George E. Lewerenz, and many others at the National Institute of Child Health and Human Development who spent considerable time with us. A particular debt is also owed to Jerome G. Green and his staff at the Division of Research Grants who provided data that were crucial to the work of the committee. Our project officers were Pamela Wolf and Jeffrey A. Perlman.
Important help with data was also provided by Paul J. Friedman of the University of California, San Diego, who supplied special analyses of data on physician age distribution, and Warren H. Pearse of the American College of Obstetricians and Gynecologists (ACOG), who kindly allowed us to participate in a survey sponsored by ACOG and the Association of Professors of Gynecology and Obstetrics.
Individuals who participated at meetings of the committee include Florence Haseltine (who provided the inspiration for this study), Daniel R. Mishell, Lawrence D. Longo (who also contributed a background paper), Harold Pincus, and Frederick Naftolin.
We also wish to acknowledge the help of many members of departments of obstetrics and gynecology who welcomed staff and gave generously of their time and experience. Sites visited include the University of California at San Francisco, San Diego, and Irvine; the University of Pennsylvania; and Yale University.
The committee solicited input from chairs of departments of OB/GYN and others members of the profession. Their thoughtful responses gave us perspectives and information that provided important groundwork for our deliberations.
The research agenda, which constitutes Chapter 6, could not have been completed without the contributions of those who wrote background papers. Their names are listed in Appendix C, and our thanks go to each of them.
Finally I would like to thank my fellow committee members whose deliberations provided the basis for this report. On their behalf, I wish to express our gratitude to the Institute of Medicine staff. Jessica Townsend as study director managed all aspects of the study activities and report preparation. Dee Sutton provided secretarial support, and Paul B. Phelps edited the manuscript.
Richard E. Behrman