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THE NEXT GENERATION OF BIOMEDICAL AND BEHAVIORAL SCIENCES RESEARCHERS: BREAKING THROUGH Committee on the Next Generation Initiative Board on Higher Education and Workforce Policy and Global Affairs A Consensus Study Report of PREPUBLICATION COPY—UNEDITED PROOFS

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 This activity was supported by contracts between the National Academy of Sciences and The National Institutes of Health (#HHSN263201200074I, Order No. HHSN26300107) and the Bloomberg Philanthropies. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. Digital Object Identifier: https://doi.org/10.17226/25008 Additional copies of this publication are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. Copyright 2018 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. The Next Generation of Biomedical and Behavioral Sciences Researchers: Breaking Through. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25008. PREPUBLICATION COPY—UNEDITED PROOFS

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org. PREPUBLICATION COPY—UNEDITED PROOFS

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task. Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies. For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo. PREPUBLICATION COPY—UNEDITED PROOFS

COMMITTEE ON THE NEXT GENERATION INITIATIVE Members RONALD J. DANIELS (Chair), President, Johns Hopkins University NANCY C. ANDREWS (NAS/NAM), Dean and Vice Chancellor for Academic Affairs (Emerita), Duke University School of Medicine W. TRAVIS BERGGREN, Founding Director for the Stem Cell Research Core Facility, Salk Institute SUE BIGGINS (NAS), Associate Director in the Division of Basic Sciences, Fred Hutchinson Cancer Research Center, Investigator, Howard Hughes Medical Institute JOHN BOOTHROYD (NAS), Burt and Marion Avery Professor, Department of Microbiology and Immunology, Associate Vice Provost for Graduate Education, Stanford University DAVID R. BURGESS, Professor of Biology, Boston College KAFUI DZIRASA, Assistant Professor of Psychiatry and Behavioral Sciences, Duke University GIOVANNA GUERRERO-MEDINA, Executive Director, Ciencia Puerto Rico; Director, Yale Ciencia Initiative, Yale University JUDITH KIMBLE (NAS), Vilas Professor in the Department of Biochemistry, University of Wisconsin-Madison, Investigator, Howard Hughes Medical Institute STORY LANDIS (NAM), Former Director of the National Institute of Neurological Disorders and Stroke, National Institutes of Health KENNETH MAYNARD, Head, Global Patient Safety Evaluation (GPSE) Compliance, Standards and Training and GPSE Business Partners Relations, Takeda Pharmaceuticals International Co. GARY S. MCDOWELL, Executive Director, The Future of Research, Inc. JESSICA POLKA, Visiting Scholar, Whitehead Institute JOAN Y. REEDE (NAM), Dean for Diversity and Community Partnership and Professor of Medicine, Harvard Medical School LANA R. SKIRBOLL, Vice President of Science Policy, Sanofi PAULA STEPHAN, Professor of Economics, Georgia State University MARIA ELENA ZAVALA, Professor of Biology, California State University, Northridge Staff LIDA BENINSON, Study Director and Program Officer, Board on Higher Education and Workforce MARIA LUND DAHLBERG, Program Officer, Board on Higher Education and Workforce YASMEEN HUSSAIN, Associate Program Officer, Board on Higher Education and Workforce (Until July 2017) ELIZABETH GARBEE, Christine Mirzayan Science and Technology Policy Graduate Fellow, Board on Higher Education and Workforce (Until April 2018) LAYNE SCHERER, Program Officer, Board on Higher Education and Workforce v PREPUBLICATION COPY—UNEDITED PROOFS

JAY LABOV, Senior Advisor for Education and Communication IRENE NGUN, Research Associate, Board on Higher Education and Workforce ADRIANA COUREMBIS, Finance Officer, Division of Policy and Global Affairs AUSTEN APPLEGATE, Senior Program Assistant, Board on Higher Education and Workforce JAIME COLMAN, Senior Program Assistant, Board on Higher Education and Workforce (Until December 2017) THOMAS RUDIN, Director, Board on Higher Education and Workforce Consultants JOE ALPER, Writer JEREMY BERG, Consultant PHILIP SPECTOR, Consultant vi PREPUBLICATION COPY—UNEDITED PROOFS

BOARD ON HIGHER EDUCATION AND WORKFORCE Members RICHARD K. MILLER (Chair) (NAE), President, Olin College of Engineering LAWRENCE D. BOBO (NAS), W.E.B. Du Bois Professor of the Social Sciences, Department of Sociology, Harvard University ANGELA BYARS-WINSTON, Professor of Medicine, University of Wisconsin—Madison JAIME CURTIS-FISK, Scientist and STEM Education Program Leader, The Dow Chemical Company APRILLE ERICSSON, Capture–Mission Manager, NASA Goddard Space Flight Center RICHARD FREEMAN, Herbert Ascherman Professor of Economics, Harvard University PAUL J. LEBLANC, President, Southern New Hampshire University SALLY F. MASON, President Emerita, University of Iowa FRANCISCO RODRIGUEZ, Chancellor, Los Angeles Community College District SUBHASH SINGHAL (NAE), Battelle Fellow Emeritus, Pacific Northwest National Laboratory KUMBLE R. SUBBASWAMY, Chancellor, University of Massachusetts, Amherst SHELLEY WESTMAN, Principal/Partner, Ernst & Young, LLP MARY WOOLLEY (NAM), President and CEO, Research! America Staff LEIGH JACKSON, Senior Program Officer ASHLEY BEAR, Program Officer LIDA BENINSON, Program Officer MARIA LUND DAHLBERG, Program Officer LAYNE SCHERER, Program Officer YASMEEN HUSSAIN, Associate Program Officer (Until July 2017) BARBARA NATILIZIO, Associate Program Officer IRENE NGUN, Research Associate AUSTEN APPLEGATE, Senior Program Assistant ALLISON BERGER, Senior Program Assistant JAIME COLMAN, Senior Program Assistant (Until December 2017) FREDERIC LESTINA, Senior Program Assistant THOMAS RUDIN, Director vii PREPUBLICATION COPY—UNEDITED PROOFS

Preface The U.S. biomedical research ecosystem is one of the great engines of innovation in modern history. It is a wellspring of discovery and cures that has expanded the domain of human knowledge, improved and saved countless lives, and catalyzed job growth and economic prosperity in communities across the nation. The United States’ model for training and funding the biomedical workforce is widely credited with making it a global leader in scientific research, one that is emulated around the world. But there is nothing inevitable about the success of this enterprise. It requires constant vigilance and stewardship, to ensure that we are setting the optimal conditions and incentives for our scientists and the science they imagine, now and into the future. There have been warning signs for years that the enterprise may be calcifying—in ways that create barriers, in particular for the incoming generation of researchers. Multiple national reports have been penned about these warning signs, and they have proposed countless recommendations for reform. But many of the recommendations have gone unaddressed. And the problems have endured. Of late, the vulnerabilities in the biomedical enterprise have grown more evident, leading to renewed concern on the part of science policy leaders, professional organizations, funding agencies, and, above all, the U.S. Congress, which called on the National Academy of Sciences to conduct a comprehensive study of the policies affecting the next generation of researchers in the United States. This report is the outcome of that study. In developing it, we saw our task as two-fold: First, to identify reforms that are tailored to the evolving barriers facing the next generation of researchers. But, second, to do so in a manner that responds to the failure of many of the earlier recommendations to gain traction. The pages that follow chronicle a biomedical research landscape of remarkable promise, yet characterized by fissures and areas of stress. This report offers a set of recommendations that seek to engage those vulnerabilities and to build an ecosystem that is dynamic and fair, while setting in place the structures and conditions for sustained change, so that episodic reports start to fall away and policy change across the enterprise is ongoing and enduring, to benefit the next generation of researchers, as well as the generations of researchers yet to come. Ronald Daniels, Chair Committee on the Next Generation Initiative ix PREPUBLICATION COPY—UNEDITED PROOFS

Acknowledgments The committee would like to acknowledge the National Institutes of Health (NIH) and Bloomberg Philanthropies for their generous support of this study. In particular, the committee would like to acknowledge Phillip Spector, Yasmeen Hussain, and Amanda Field for their support to this project. The committee also acknowledges the contributions from Walter Schaffer, Jennifer Sutton, Silda Nikaj, Katrina Pearson, Deepshikha Roychowdhury, and Robert Moore of NIH for their support and responses to data requests. The committee would also like to acknowledge the University of California, San Francisco, The Johns Hopkins University, and Sanofi in Cambridge, Massachusetts, for hosting the committee’s meetings. We are also grateful for the contributions of James Burke, Gilbert S. Omenn Fellow at the National Academy of Medicine; Rona Briere, for her careful editing of the report; and Rebecca Morgan of the National Academies Research Center, for her assistance with fact-checking. ACKNOWLEDGMENT OF PRESENTERS The committee gratefully acknowledges the contributions of the following individuals: DAVID ASAI, Senior Director for Science Education, Howard Hughes Medical Institute ELIZABETH BACA, Senior Health Advisor, California Governor’s Office of Planning and Research SUSAN BASERGA, Professor of Molecular Biophysics and Biochemistry, Yale University MARC BONNEFOI, Head, R&D France, Sanofi GWYNETH CARD, Group Leader, Howard Hughes Medical Institute, Janelia Research Center DENNIS DEAN, II, R&D Scientist, Seven Bridges Genomics DEBORAH DUNSIRE, CEO, XTuit Pharmaceuticals KENNETH GIBBS, Program Director, Division of Training, Workforce Development, and Diversity, National Institute of General Medicine, National Institutes of Health RORY GOODWIN, Neurosurgery Resident, The Johns Hopkins University Hospital EVA GUINAN, Director of Translational Research, Radiation Oncology, Dana-Farber Cancer Institute STEPHEN HAGGARTY, Associate Professor of Neurology, Harvard Medical School, Director, Chemical Neurobiology Laboratory, Center for Genomic Medicine, Massachusetts General Hospital xi PREPUBLICATION COPY—UNEDITED PROOFS

xii ACKOWLEDGMENTS MISTY HEGGENESS, Chief of Longitudinal Research, Evaluation, and Outreach, U.S. Census Bureau SAMANTHA HINDLE, Assistant Professional Researcher, University of California, San Francisco STEVEN HYMAN, Distinguished Service Professor, Harvard University, Director, Stanley Center for Psychiatric Research, Core Member, Broad Institute BAHIJA JALLAL, Executive Vice President, MedImmune MARC KIRSCHNER, John Franklin Enders University Professor, Chair, Department of Systems Biology, Harvard Medical School MICHAEL LAUER, Director, Office of Extramural Research, National Institutes of Health ALAN LESHNER, CEO Emeritus, American Association for the Advancement of Science KAY LUND, Director of the Division of Biomedical Research Workforce, Office of Extramural Research, National Institutes of Health TERRY MAGNUSON, Vice Chancellor for Research, University of North Carolina at Chapel Hill SEAN MCCONNELL, Postdoctoral Scholar, University of Chicago PAUL MCGONIGLE, Director, Interdisciplinary & Career-Oriented Programs, Co-Director, Drug Discovery & Development Program, Drexel University JIM MULLEN, CEO, Patheon MARINA RAMON, Board of Directors, National Postdoctoral Association MICHAEL RICHEY, Associate Technical Fellow, Learning Sciences and Engineering Education Research, The Boeing Company LAWRENCE ROTHBLUM, Chair of the Department of Cell Biology, University of Oklahoma, President, Association of Anatomy, Cell Biology and Neurobiology Chairpersons NANCY SCHWARTZ, Professor, Department of Biomedical Sciences, University of Chicago SHIRLEY TILGHMAN, President of the University, Emeritus, Professor of Molecular Biology and Public Affairs, Princeton University DANIEL WILSON, Research Advisor, Economic Research Department, Federal Reserve Bank of San Francisco ACKNOWLEDGMENT OF REVIEWERS This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this report: Bruce Alberts, University of California, San Francisco; Georges Benjamin, American Public Health Association; Sherilynn Black, Duke University; Gregory Burke, Wake Forest University; John Burris, Burroughs Wellcome Fund; Deborah Dunsire, Xtuit Pharmaceuticals; Samantha Hindle, University of California, San Francisco; Timothy Ley, Washington University, St. Louis; Ross McKinney, Association of American Medical Colleges; Christopher Pickett, Rescuing Biomedical Research; Therese Richmond, University of Pennsylvania; Sally Rockey, Foundation for Food and Agriculture Research; Lawrence Rothblum, University of Oklahoma; Henry PREPUBLICATION COPY—UNEDITED PROOFS

ACKNOWLEDGMENTS xiii Sauermann, European School of Management and Technology, Berlin; Geoffrey Smith, Digitalis Ventures; and Wayne Yokoyama, Washington University, St. Louis. Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Olufunmilayo (Funmi) Olopade, University of Chicago and Charles Phelps, University of Rochester. Appointed by the National Academies, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution. PREPUBLICATION COPY—UNEDITED PROOFS

Contents Boxes and Figures xvii Acronyms and Abbreviations xix SUMMARY 1 1 INTRODUCTION AND OVERVIEW 11 Work of the Committee, 12 Scope of the Study, 14 Structure of the Report, 14 Reference, 15 2 THE LANDSCAPE FOR THE NEXT GENERATION OF RESEARCHERS 16 Doctoral and Medical Training In Biomedical Research, 16 The Postdoctoral Research Experience, 17 Transition to Independent Research Postitions, 23 Funding for an Independent Research Career, 27 Other Challenges in Pursuing Research Careers, 37 References, 40 3 TRANSPARENCY, SHARED RESPONSIBILITY, AND SUSTAINABILITY 43 Shared Responsibility, 43 Increasing Diversity and Inclusion, 47 Increasing Transparency, 48 Sustainability, 52 References, 54 4 TRANSITIONING TO INDEPENDENCE 56 Training and Support for All Postdoctoral Researchers, 57 xv PREPUBLICATION COPY—UNEDITED PROOFS

xvi CONTENTS Optimizing the Duration and Support Mechanisms for Postdoctoral Training, 60 Create Opportunities for Entrepreneurial Activity, 66 References, 68 5 BUILDING A BETTER ECOSYSTEM FOR INDEPENDENCE 70 References, 79 6 EXPERIMENTATION AND INNOVATION 82 References. 85 7 FINAL THOUGHTS AND SUMMARY OF RECOMMENDATIONS BY ACTOR 86 The Recommendations—By Stakeholder, 87 APPENDIXES A DEFINITIONS USED IN THE REPORT 91 B RESPONSES TO RECOMMENDATIONS IN PREVIOUS REPORTS ON BIOMEDICAL AND BEHAVIORAL RESEARCHERS 92 C DEAR COLLEAGUE LETTER 121 D COMMITTEE MEMBER BIOGRAPHIES 128 E COMMITTEE MEETING AGENDAS 135 PREPUBLICATION COPY—UNEDITED PROOFS

Boxes and Figures BOXES 1-1 Statement of Task, 13 2-1 Postdoctoral Researcher: 2018 Definitions and Characterizations, 18 3-1 NSF Data Surveys, 51 FIGURES 2-1 Percentage of U.S. trained biomedical individuals living in the United States, sector of employment by cohort and position, 1993-2013, 23 2-2 Proportion of NIH RPG direct cost dollars awarded by age group, 25 2-3 NIH appropriations in current and constant dollars, 1995-2017, 27 2-4 Success rates for competing type 1 R01 success rates for new and established investigators, 28 2-5 Individual applicants, awardees, and funding rates of NIH research project grants, 29 2-6 Number of investigators supported by NIH R01-equivalent awards by career stage, 31 2-7 Age at first-R01 equivalent by degree type, 32 2-8 Years to first R01-equivalent award since last degree award, 32 2-9 Average age over time to first R01, new (type 1) second R01, and renewal (type 2) second R01, 33 2-10 Age at first R01-equivalent award by NIH Institute, 34 2-11 First competing RPG award received from investigators 35 2-12 Academic science and engineering research and development expenditures, by source of funding, 37 2-13 Dropout of first-time R01-funded NIH investigators, 38 B-1 Trends in the K99 research career development award: Competing applications and awards between 2007 and 2016, 96 xvii PREPUBLICATION COPY—UNEDITED PROOFS

xviii BOXES AND FIGURES B-2 Trends in F32 Awards: The success rate for F32 applications by degree between 2011 and 2016, 97 B-3 Trends in F32 applications: Numbers of competing applications (top left: all applicants; top right: medical degree-holding applicants only) and percent of applicants with particular degrees (bottom—all applicants) between 2007 and 2016, 98 B-4 Trends in NRSA awards: (top) Competing applications, awards, and success rates between 1998 and 2016 for F32 postdoctoral fellowships; (bottom) Awarded NRSA training and fellowship positions by pre-doctoral and postdoctoral status between 1998 and 2016, 99 B-5 Trends in T32 Awards: Number of awards between 2007 and 2016, 100 B-6 NRSA postdoctoral salaries in nominal and constant dollars. Left: in constant 1975 and 2012 dollars since 1975; Right: in 2012 dollars since 2011, 102 B-7 Survey of health benefits for postdoctoral researchers, 103 B-8 Success rates for new (type1) R01-equivalent grants, by career stage of investigator, 113 B-9 Number of investigators supported on competing Research Project Grants, by career stage of investigator, 113

Acronyms and Abbreviations AAAS American Association for the Advancement of Science AAMC Association of American Medical Colleges AAU Association of American Universities ACD Advisory Committee to the NIH Director AMGDB Association of Medical and Graduate Departments of Biochemistry ARRA American Recovery Reinvestment Act ASBMB American Society for Biochemistry and Molecular Biology ASCB American Society for Cell Biology B.A. Bachelor of Arts BEA Bureau of Economic Analysis BEC Biomedical Enterprise Council BEST Broadening Experiences in Scientific Training BHEW Board on Higher Education and Workforce BLS Bureau of Labor Statistics BRAINS Biobehavioral Research Awards for Innovative New Scientists BRAINS Brain Research through Advancing Innovative Neurotechnologies BRAINS Broadening the Representation of Academic Investigators in Neuroscience B.S. Bachelor of Science BUILD Building Infrastructure Leading to Diversity CEC Coordination and Evaluation Center CFR Code of Federal Regulations CGS Council of Graduate Schools COMPASS Committee for Postdocs and Students COSEMPUP Committee for Science, Engineering, Medicine, and Public Policy COSWD Chief Officer for Scientific Workforce Diversity CPI Consumer Price Index CSR Center for Scientific Review CTSA Clinical Translational Science Awards xix PREPUBLICATION COPY—UNEDITED PROOFS

xx ACRONYMS AND ABBREVIATIONS DICP Harvard Medical School’s Office for Diversity Inclusion and Community Partnership DPC NIH Diversity Program Consortium EEI Early Established Investigator ESI Early-Stage Investigator FASEB Federation of Societies for Experimental Biology FLSA Fair Labor Standards Act FRLC Future Research Leaders Conference FY Fiscal Year HHMI Howard Hughes Medical Institute HHS U.S. Department of Health and Human Services HMS Harvard Medical School IDP Individual Development Plan IMPAC Information for Management Planning Analysis and Coordination IPUMS Integrated Public Use Microdata Series IRACDA Institutional Research and Academic Career Development Award IRIS Institute for Research on Innovation and Science LPR Loan Repayment Program LRP Loan Repayment Award MARC/RISE Maximizing Access to Research Careers (MARC) and Research Initiative for Scientific Enhancement M.B.A. Master’s of Business Administration M.D. Medical Doctorate MERIT Method to Extend Research in Time MIRA Maximizing Investigators’ Research Award MIT Massachusetts Institute of Technology M.P.A. Master of Public Administration M.P.H. Master of Public Health M.Sci. Master of Science M.S. Master of Science NAS National Academy of Sciences NCI National Cancer Institute NEI National Eye Institute NGRI Next Generation Researchers Initiative NGRI-DS Next Generation Researchers Initiative Diversity Supplements NHLBI National Heart, Lung, and Blood Institute NIAID National Institute of Allergy and Infectious Diseases NIBIB National Institute of Biomedical Imaging and Engineering NIDCR National Institute of Dental and Craniofacial Research PREPUBLICATION COPY—UNEDITED PROOFS

ACRONYMS AND ABBREVIATIONS xxi NIDDK National Institute of Diabetes and Digestive and Kidney Diseases NIGMS National Institute of General Medical Sciences NIH National Institutes of Health NIMH National Institute of Mental Health NINDS National Institute for Neurological Disorders and Stroke NPA National Postdoctoral Association NRC National Research Council NRMN National Research Mentoring Network NRSA Ruth L. Kirschstein National Research Service Award NSCG National Survey of College Graduates NSERC National Science and Engineering Research Council NSF National Science Foundation NSF ADVANCE National Science Foundation Increasing the Participation and Advancement of Women in Academic Science and Engineering Careers NSF GRP National Science Foundation Graduate Research Program NSRCG National Survey of Recent College Graduates ORCID Open Researcher and Contributor Identification PD/PI Program Director/Principle Investigator Ph.D. Doctorate of Philosophy PI Principle Investigator PV Pharmacovigilance R&D Research and Development RBR Rescuing Biomedical Research RPG Research Project Grant RPPR Researcher Performance Progress Report S&E Science and Engineering SACNAS Society for the Advancement of Chicanos/Hispanics and Native Americans in Science SBIR Small Business Innovation Research SDR Survey on Doctoral Researchers STEM Science, Technology, Engineering, and Medicine STTR Small Business Technology Transfer SWD Scientific Workforce Diversity UCSF University of California, San Francisco UIDP University Industry Demonstration Partnership UMBC University of Maryland Baltimore County UNC-CH University of North Carolina-Chapel Hill URM Underrepresented Minority PREPUBLICATION COPY—UNEDITED PROOFS

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Since the end of the Second World War, the United States has developed the world’s preeminent system for biomedical research, one that has given rise to revolutionary medical advances as well as a dynamic and innovative business sector generating high-quality jobs and powering economic output and exports for the U.S. economy. However, there is a growing concern that the biomedical research enterprise is beset by several core challenges that undercut its vitality, promise, and productivity and that could diminish its critical role in the nation’s health and innovation in the biomedical industry.

Among the most salient of these challenges is the gulf between the burgeoning number of scientists qualified to participate in this system as academic researchers and the elusive opportunities to establish long-term research careers in academia. The patchwork of measures to address the challenges facing young scientists that has emerged over the years has allowed the U.S. biomedical enterprise to continue to make significant scientific and medical advances. These measures, however, have no resolved the structural vulnerabilities in the system, and in some cases come at a great opportunity cost for young scientist. These unresolved issues could diminish the nation’s ability to recruit the best minds from all sectors of the U.S. population to careers in biomedical research and raise concerns about a system that may favor increasingly conservative research proposals over high-risk, innovative ideas.

The Next Generation of Biomedical and Behavioral Sciences Researchers: Breaking Through evaluates the factors that influence transitions into independent research careers in the biomedical and behavioral sciences and offers recommendations to improve those transitions. These recommendations chart a path to a biomedical research enterprise that is competitive, rigorous, fair, dynamic, and can attract the best minds from across the country.

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