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Meeting the Nation's Needs for Biomedical Behavioral Scientists Committee on National Needs for Biomedical and Behavioral Research Personnel Studies and Surveys Unit Office of Scientific and Engineering Personnel National Research Council NATIONAL ACADEMY PRESS Washington, D.C. 1994
NATIONAL ACADEMY PRESS · 2101 Constitution Avenue, N.W. · Washington, DC 20418 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 competencies and with regard to appropriate balance. This report has been reviewed by persons other than the author 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 National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also spon- sors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Robert M. White is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth Shine is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy' s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce Alberts and Dr. Robert M. White are chairman and vice chairman, respectively, of the National Research Council. This material is based on work supported by the National Institutes of Health. Library of Congress Catalog Card Number 94-66477 International Standard Book Number 0-309-05086-3 Additional copies of this report are available from: National Academy Press 2101 Constitution Avenue, NW Box 285 Washington, DC 20055 800/624-6242 202/334-3313 (in the Washington Metropolitan Area) B-452 Copyright 1994 by the National Academy of Sciences. All rights reserved. Printed in the United States of America.
NATIONAL ACADEMY OF SC! ENCES 2101 CONSTITUTION AVENUE. NW WASHINGTON. D. C. 20418 OFFICE OF THE PRESIDENT The Honorable Donna E. Shalala Secretary of the Department of Health and Human Services 200 Independence Avenue, SW Room 615-F Washington, D.C. 20201 Dear Secretary Shalala: June I, 1994 It is a pleasure to present to the Department of Health and Human Services a copy of the 1994 report of the Committee on National Needs for Biomedical and Behavioral Research Personnel. This is the tenth in a series of reports undertaken by the National Research Council pursuant to Title I of the National Research Act of 1974 (P.L. 93-348 as amended). The work has been supported under Contract NOl-OD-2-2116/C with the National Institutes of Health. The Act states that the purposes of the continuing study are to: "all establish (A) the Nation's overall need for biomedical and behavioral research personnel, (B) the subject areas in which such personnel are needed and the number of such personnel needed in each such area, and (C) the kinds and extent of training which should be provided such personnel; (2) assess (A) current training programs available for the training of biomedical and behavioral research personnel that are conducted under this Act at or through the institutes...and (B) other current training programs available for the training of such personnel; (3) identify the kinds of research positions available to and held by individuals completing such programs; (4) determine, to the extent feasible, whether the programs referred to in clause (B) of paragraph (2) would be adequate to meet the need established under paragraph (~) if the programs referred to in clause (A) of paragraph (2) were terminated; and (5) to determine what modifications in the programs referred to in paragraph (2) are required to meet the needs established under paragraph all." Previous NRC reports have provided guidance to the NIH and the Alcohol, Drug Abuse and Mental Health Administration and to the U.S. Congress about the appropriate size and composition of the NRSA program given national needs for these highly skilled scientists. In addition to the core activities stipulated by the National Research Act, the agency directed the NRC to review the mathematical projection moclels of supply and demand used by previous NRC study committees and to establish their adequacy in addressing "national needs" issues in the 1990s.
The Honorable Donna E. Shalala Page Two This report includes a new approach to modeling supply which should be regarded as exploratory. As a result, the Committee's recommendations for award levels are based more heavily on expert judgment than has been the case in the past. The Committee's Pane! on Estimation Procedures, I should add, will prepare a report for release later this year which addresses the more general matter of mathematical approaches to the estimation of "need". Through a combination of a variety of information gathering activities and Committee deliberations, the Committee has concluded that the nation's need for these scientists remains strong and that the NRSA program, while small compared to the many other sources of doctoral and postdoctoral support, is enormously powerful in terms of its ability to change research emphases and to attract the highest quality individuals to research careers in the basic biomedical, behavioral and clinical sciences. The Committee has described in this report the next steps that are needed to assure that the NBSA program fulfills its intended role in fostering and maintaining a strong human resource base for health research. We hope the present report will be helpful and would be pleased to discuss it with you and your staff. ~ncerely7 W.. ~ Enclosure a? 44..~< ~ ,\ ce M. Alberts President
NATIONAL RESEARCH COUNCIL Office of Scientific and Engineering Personnel Studies anti Surveys Unit COMMITTEE ON NATIONAL NEEDS FOR BIOMEDICAL AND BEHAVIORAL RESEARCH PERSONNEL Ira J. Hirsh, Co-chc~ir Washington University (Retired) Central Institute for the Deaf Helen M. Berman Department of Chemistry Rutgers University Francis J. Bullock Arthur D. Little, Inc. Edwin C. Cadman Department of Medicine Yale University School of Medicine Nancy E. Cantor Department of Psychology Princeton University Eli Ginzberg Eisenhower Center for the Conservation of Human Resources Columbia University Robert Hill* Department of Biochemistry Duke University Medical Center R. Duncan Luce Institute for Mathematical and Behavioral Sciences University of California at Irvine * Resigned March 1994. v John D. Stobo, Co-chair Department of Medicine The Johns Hopkins University Rum McCorkle School of Nursing University of Pennsylvania Raymond Nickerson Bolt Beranek & Newman (Retired) Mary J. Osborn Department of Microbiology & Biology University of Connecticut Health Center Cecil Payton Department of Microbiology & Biology Morgan State University Richard Ranney School of Dentistry University of Maryland at Baltimore Michael Rothschild Division of Social Sciences University of California at San Diego Donald Steinwachs Department of Health Policy and Management Johns Hopkins University Richard Thompson Program for Neural, Informational, and Behaviora Sciences University of Southern California
COMMITTEE ON NATIONAL NEEDS FOR BIOMEDICAL AND BEHAVIORAL RESEARCH PERSONNEL PANEL ON ESTIMATION PROCEDURES Michael Rothschild, Chair Division of Social Sciences University of California at San Diego Eugene Hammel Department of Demography University of California at Berkeley Alan Krueger Woodrow Wilson School of Public and International Affairs Princeton University Robert Mare Center for Demography and Ecology University of Wisconsin Aage Sorensen Department of Sociology Harvard University NRC PROJECT STAFF Alan Fechter, Executive Director Office of Scientific and Engineering Personnel Pamela Ebert Flattau Director, Studies and Surveys Unit Jeffrey E. Kallan Staff Officer Elaine Lawson Research Associate Anne L. Gallagher Administrative Assistant V1
NATIONAL RESEARCH COUNCIL OFFICE OF SCIENTIFIC AND ENGINEERING PERSONNEL ADVISORY COMMITTEE Linda S. Wilson, Chair President Radcliffe College Ernest Jaworski, Vice Chair Monsanto Company (Retired) Betsy Ancker-Johnson Chairman World Environment Center David Breneman Graduate School of Education Harvard University David L. Goodstein Vice Provost Professor of Physics and Applied Physics California Institute of Technology Lester A. Hoel Hamilton Professor of Civil Engineering Duke University Juanita M. Kreps Department of Economics Duke University Donald Langenberg Chancellor University of Maryland System Judith S. Liebman Department of Chemical and Industrial Engineering University of Illinois at Urbana-Champaign Barry Munitz Chancellor The California State University Kenneth Olden Director, National Institute of Environmental Health Sciences National Institutes of Health Ewart A.C. Thomas Department of Psychology Stanford University Annette B. Weiner Dean, Graduate School of Arts and Sciences New York University William H. Miller (Ex-o~icio) Department of Chemistry University of California . . V11
PREFACE In 1994 we mark the twentieth anniversary of the National Research Act of 1974 (P.L. 93-348), which estab- lished the National Research Service Awards (NRSA) pro- gram. Intended from the outset to augment federal pro- grams of research support, the NRSA program was designed to increase the capability of the National Institutes of Health (NIH) and the Alcohol, Drug Abuse and Mental Health Ad- ministration (ADAMHA) to maintain a "superior program of research into the physical and mental disease and impair- ments of man...." Through a combination of training grants to institutions and the direct support of qualified individuals as research fellows, the NRSA program remains a signifi- cant force in the health research effort. We cannot emphasize too strongly the significant impact the NRSA program has had on the federal system of predoctoral and postdoctoral training at U.S. universities. The 1974 legislation repealed existing research training and fellowship authorities of NIH and ADAMHA-one of which dated to the National Cancer Act of 1937 and con- solidated research training under a single, new authority. In other words, He National Research Act of 1974 established a coherent system of support for recruiting individuals into health research and launching them into productive careers. Coupled win a variety of mechanisms to support training and education at all stages of the scientific career from high school Trough midcareer-NIH provides the largest research training effort in the federal government, the cen- terpiece of which is the National Research Service Award. In its 20 years of operation, the NRSA program has made it possible for many thousands of talented individuals in the basic biomedical, behavioral, and clinical sciences to sharpen their research skills and to apply those skills to topics of special concern to the nation, such as: aging, hy- pertension, the genetic basis of disease, acquired immune deficiency syndrome (AIDS), cancer, environmental toxi 1X cology, nutrition and health, and substance abuse. Surpris- ingly, few systematic studies are available of the career out- comes of NRSA trainees and fellows. Studies that are avail- able, however, consistently note a distinctive role for NRSA trainees and fellows in the national health research effort. Nonetheless, many questions remain about the career out- comes of NRSA trainees and fellows, arid it is our hope and that of our colleagues on the committee that NIH place high priority in the coming years on He careful analysis of career outcomes of NRSA graduates, determining to the extent possible the contributions of the NRSA program to health research relative to other forms of federal and private sup- port for research training. The continuing need for highly trained specialists to con- duct research to meet the health needs of He country is as great today as it was 20 years ago. However, because of changes in patterns of research funding and He structure of the marketplace, the nature of this need has changed some- what in recent years. Today there is a greater demand than in the past for talented health scientists to provide leader- ship in industrial research settings, in federal government laboratories, and in hospitals and clinics. The NRSA pro- gram continues to play a critical role in the preparation of many of those scientists. It was within the context of these changing research op- portunities that the National Research Council (NRC) agreed in 1992 to undertake this study of the NRSA pro- gram. In December 1992, the NRC appointed the Commit- tee on National Needs for Biomedical and Behavioral Re- search Personnel, which we have been privileged to chair. It was our committee' s task to establish the nation' s overall need for biomedical and behavioral research personnel, the subject areas in which such personnel are needed, and the number of such personnel needed In each area for 1994 and beyond.
PREFACE The committee was assisted by the Panel on Estimation Procedures, ably chaired by Michael Rothschild and staffed by Jeffrey Kallan. Through their careful collection and re- view of available statistics and various mathematical mod- els, the panel provided us with a refreshing, alternative look at degree production and employment patterns in the many fields addressed by this study. The work of the panel con- tinues beyond this report. We look forward with interest to the outcome of their deliberations, which should provide us with further insights into possible new approaches for as- sessing the nation's need for biomedical and behavioral sci- entists. The work of the panel was augmented by information gathered by the committee through a public hearing and a series of commissioned papers. We are indebted to the many experts who offered valuable suggestions about pos- sible new directions for the NRSA program. In addition to these contributors, a number of people en- sured a successful outcome of our efforts. Walter S chaffer, Research Training and Research Resources Officer at NIH, skillfully offered important information about the history and status of He NRSA program in his capacity as project officer. Dr. S chaffer arranged for numerous briefings by his colleagues at NIH. We are especially grateful to Rum Kirschstein, Deputy Director of He NIH, who met with the committee in its early stages of discussion and offered help- ful comments about areas of special concern to He NIH. We would also like to thank members of the NIH project oversight team for the information they provided, including Drs. David Chananie, Suzanne Feetham, Leonard Lash, James Lipton, John Norvell, James F. O'Donnell, and Carl Roth and Ms. Valerie Pickett. The committee would also like to thank Carola Eisenberg x who served as liaison from the NRC/OSEP Committee on Women in Science and Engineering and Ernest Jaworski who served as liaison from the Advisory Committee for the Office of Scientific and Engineering Personnel (OSEP). Both contributed in important ways to the deliberations of the committee. Kenneth Shine, President of He Institute of Medicine, also offered suggestions for analyses in the early stages in our work. The committee would especially like to acknowledge the efforts of Alan Fechter, OSEP Executive Director. Together with Jeffrey Kallan, technical consultants Farrell Bloch and Peter Tiemeyer, and OSEP's date processing staff, mostno- tably Marinus van der Have, Mr. Fechter effectively orga- nized the labor force information contained in the basic bio- medical and behavioral sciences chapters. The committee would also like to thank the staff of the Survey of Earned Doctorates and the Survey of Doctorate Recipients for their technical assistance, especially Delores Thurgood, Daniel Pasquini, and Prudence Brown. Pamela Ebert Flattau, Di- rector of OSEP's Studies and Surveys Unit, guided the completion of this report and played a significant role in overseeing He coordination of the committee's overall study plan. Elaine Lawson contributed at key points in the study by gathering and summarizing a wide variety of material addressing national needs in the clinical sciences. Anne Gallagher, the committee's administrative assistant, worked tirelessly to coordinate the production of this volume. To these people, we express our gratitude for Heir efforts. IRA J. HIRSH JOHN D. STOBO, Co-Chairs Committee on National Needs for Biomedical and Behavioral Research Personnel
CONTENTS EXECUTIVE SUMMARY Estimating National Needs For Research Scientists, 1 Recommendations, 2 Enhancing the Effectiveness of the NRSA Program, 8 1 INTRODUCTION Origins of the Study, 11 Charge to the Committee, 12 The Committee's Study Plan, 12 Organization of the Report, 14 2 APPROACHES TO TElE ESTIMATION OF NATIONAL NEED Health Research as a National Priority, 17 Advances in Research, 19 Marketplace Requirements, 20 3 BASIC BIOMEDICAL SCIENCES PERSONNEL Advances in Research, 24 Assessment of the Current Market for Basic Biomedical Scientists, 25 Outlook for Basic Biomedical Scientists, 30 Ensuring the Diversity of Human Resources, 32 The NRSA Program in the Basic Biomedical Sciences, 32 Recommendations, 33 4 BEHAVIORAL SCIENCES PERSONNEL Advances in Research in the Behavioral Sciences, 38 Assessment of the Current Market for Behavioral Scientists, 40 Outlook for Behavioral Scientists, 45 Ensuring the Diversity of Human Resources, 49 The NRSA Program in the Behavioral Sciences, 49 Recommendations, 50 X1 11 17 23 37
CONTENTS 5 PHYSICIAN-SCIENTISTS Advances in Clinical Science, 56 Assessment of the Current Market for Clinical Scientists, 56 Outlook for Clinical Scientists, 57 Ensuring the Diversity of Human Resources, 59 The NRSA Program in the Clinical Sciences, 60 Recommendations, 62 6 ORAL HEALTH RESEARCH PERSONNEL Advances in Oral Health Research, 65 Assessment of the Current Market for Oral Health Research Personnel, 65 Outlook for Oral Health Research Scientists, 66 Ensuring Diversity of Human Resources, 67 National Research Service Award Program for Oral Health Research, 67 Recommendations, 69 7 NURSING RESEARCH PERSONNEL Advances in Nursing Research, 73 Assessment of the Current Market for Nursing Research Personnel, 75 Outlook for Nursing Research Personnel, 75 Ensuring Diversity of Human Resources, 76 The NRSA Program in Nursing Research, 76 Recommendations, 77 8 HEALTH SERVICES RESEARCH PERSONNEL Advances in Health Services Research, 81 Assessment of the Current Market for Health Services Research Personnel, 83 Outlook for Health Services Research Personnel, 84 Ensuring Diversity of Human Resources, 86 The NRSA Program in Health Services Research, 86 Recommendations, 87 9 RECOMMENDATIONS AND REMAINING CONSIDERATIONS Stipend Issues, 89 Enhancing the Effectiveness of the NRSA Program, 90 APPENDIXES A Historical Overview B Classification of Fields C Public Hearing on National Needs for Biomedical and Behavioral Research Personnel D Report Contributors E Sources of Information for the National Research Service Award F Data Tables G Multistate Life Table Methodology and Projections H Procedures Used to Estimate Awards, Stipends, and Costs I Biographical Sketches X11 55 65 73 81 89 ~5 103 105 113 115 117 149 153 161