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APPENDIX D 69 research training areas. Success should be judged by the proportion of graduates of the research training program who continue to be engaged in research in their clinical careers. These are not new ideas, but it is my perception that some basic science laboratories are still operating on the principal of recruiting many trainees and relying on some form of Darwinism to determine which trainees will be designated successful, rather than trying to tailor the training to the abilities of the trainee and a broad vision of the problems to be solved in the future. A corollary to this would be to expect all M.D./Ph.D.s to enroll in a postdoctoral training program at the completion of their residency. If this became the norm it might lead to a more organized approach to career planning. The second cause of loss of clinician scientists is financial. It has been stated above that the most effective time for research training in this context is after completing clinical specialistsâ training. While there are numerous social and psychological pressures that may persuade individuals from seeking further training at this time, the most common one has been the perceived urgency of the need to repay debts accumulated by college and medical school tuition. If some form of debt repayment, perhaps akin to community service that is currently under discussion for the community at large, could be devised for those committed to research training, it would certainly have retained a significant number of talented physicians in the past who were otherwise suited to become clinician scientists, but did not. This is perhaps the most critical decision time because essentially none of those who leave academic careers at this time are able to come back later, even if they would like to. A modest investment that would retain people at this time might reap exceptional dividends later. The current uncertainty about future funding and career opportunities is certainly exacerbating these difficulties, but a new partnership between the academic community, federal and industrial funding, and the national priorities is evolving, and this is part of this process. A research career is more fraught with insecurity than one devoted to clinical practice, and although there will presumably always be those who choose this path, it would clearly be wise not to drive away potentially effective clinician scientists by too adversely weighting the scales. The third cause of loss of clinician scientists pertains to the striking loss of women. The anesthesiology residency program in my institution is probably typical in having approximately 30 percent women, and yet the number of female clinician scientists in the specialty as a whole remains small. This is not because of lack of ability, training, or interest, but first and foremost because of the extra responsibilities for child rearing and family matters that must still be shouldered by women. Those who have succeeded, in my experience, have done so with the help of a reliable relative or housekeeper, not just as babysitter or some other less experienced alternative, or have not had a family. It is not clear what the NRSA can do directly to correct this situation, but it does seem advantageous to recognize that it is a major factor in the failure of many professional women to fulfill their potential. Ways should be sought and remedies urged for this situation. With minorities, the problem in my field is the small number of motivated and qualified individuals. Role models are probably important, although difficult to quantitate, as a basis for career decisions, and there are presently so few of them that they must appear more as the exception rather than as a realistic ambition. Progress is being made with the emphasis on programs for minorities entering into ongoing research programs and this should be encouraged. In summary then, from my perspective, the NRSA Training Grant programs would be strengthened by encouraging more tuition reimbursement for trainees, emphasizing the collaborative aspects of basic science training for clinician scientists, enabling prospective Ph.D. candidates to complete the Ph.D. part of the training program and any postdoctoral work after the clinical specialty training, encourage industrial and commercial collaboration in training programs, and seek imaginative solutions to financial and family pressures felt by those engaged in training, which now extends into the fourth decade of their lives. STATEMENT BY PAT MCCLOSKEY I have two things I would like to share with you today. First are my concerns regarding the scientific job market. Secondly, I would like to outline a plan in which the scientific community can become a valuable partner in a community help program. Foremost is my concern for the dwindling job market in science. If the current trend continues, then
APPENDIX D 70 I will become very anxious about my prospects for obtaining a job using my scientific skills. In fact, I know many scientists currently completing post-doctoral training who are having a very difficult time finding employment. No doubt the soft economy is playing a role in this but there simply does not seem to be enough demand to support the amount of scientists being trained. I do not believe that we can continue to produce scientists at the present rate and expect to be able to put their skills to work. Therefore, we need to tailor our recommendations for future training needs to coincide with what we anticipate as our future demand for scientists. In summary, a crisis is developing in science due to lack of funding and also to an oversupply of scientists. I suggest that we strongly consider future demand in our recommendations for training needs. I share a view with many others that one of the largest demands for science will be in the technical fields. This brings me to my second point. I have an idea that would help fulfill the need for competent technicians. More importantly, and I stress this point, the plan I have in mind would provide a means for the scientific community to reach out and help others. I believe it is important to try to help others less fortunate, and it goes without saying that the more we reach out to help others the stronger we all become. The programâs aim is to provide a means for the less fortunate--and others who are caught in cycles of failure or dependency--with the resources to become self-sufficient. Many are minorities and women. I would like to help start a training program whereby disadvantaged adults and disillusioned youths are (1) taught two or three well-defined laboratory skills over a period of about three months. (2) During the training period their living costs would be taken care of and, most importantly, they would be removed from their present set of circumstances and put into a supportive environment. (3) The key to the success of the plan is to have placement guaranteed upon mastering the techniques and completing the course. The long term goal is to endow individuals with defined skills which would then allow them access to entry level laboratory jobs in both academics and private industry. Once placed in the lab they would then have the opportunity to learn new techniques which would increase their value to the laboratory. I feel one of the best aspects of this plan is the opportunity for individuals to become self-sufficient and for them to be in a position where their own enthusiasm and initiative are allowed to direct their interests. This may result in the pursuit of a higher education in science. To be more specific the training program would be a multifaceted approach to endow people with defined skills and enable them to have the poise and confidence to work in a complex environment. I stress the importance of a multifaceted approach because social and emotional stability are key to a positive learning environment. These individuals lack interpersonal skills as well as the ability to hold a job; often this is a reflection of poor self-esteem. It is impossible to address all these issues in a three month training course. However, in North Carolina programs exist that have already counseled individuals in the areas of self- confidence and interpersonal skills. These individuals are well prepared for the next step of learning new skills and entering the work force. The first reason I feel this program can be successful is the people. In many cases, poor academic performance in high school is due to circumstances having nothing to do with the intelligence of the individual. In conversations with Dr. Finley Rush, Director of the Learning Opportunities Skills Center in North Carolina, I have learned that many of these people come from broken homes where education is simply not valued. Dr. Rush states that once these people are taken away from their negative environments, they often become highly motivated individuals. Intelligence is not lacking but rather the desire to pursue an education. Once these people are put in a supportive environment and given opportunities, they have proven themselves willing and capable students. The second reason I feel this program can be successful is the support and enthusiasm I have received from educators, congressmen, and administrators. Preeminent amongst these supporters are those who have promised a position in their labs for people coming from this type of program. Many researchers feel that they want to do âtheir part,â and so have promised apprenticeship-style positions in their laboratories. Though this is not a guarantee of employment, it is encouraging enough that Mr. Joel New, Director of the Department of Laborâs Division of Employment and Training for North Carolina, was willing to pursue the idea and provide both personnel and funds. What I am proposing is an investment in human capital. This kind of investment has received strong support from the President and he characterizes
