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APPENDIX D 75 Detrimental impact of increased regulations on creative scientists. The increase in all kinds of regulations (e.g., safety, bioethics, financial reporting) is seriously dampening the desirability of the scientific research profession. The emphasis on inspection rather than preventive measures is particularly to be deplored. Not all of the above areas can be addressed solely by the NRSA program, yet many can be. One major approach would allow more flexibility in programs, and incentives to pilot innovative programs. An example might be inter-institutional training grants which benefit from the broader expertise of scientists, provide students with the opportunity for wider peer review as they take courses at other schools, provide more efficient use of faculty in teaching, and provide for sharing of equipment. An associated approach would be to have yearly meetings and electronic communication linkages among training grant directors to rapidly diffuse ideas that âworkâ, and share information on managerial issues (e.g., longitudinal database software, meeting organization procedures) to reduce unnecessary competition and re-inventing the wheel. STATEMENT BY SUSAN PERSONS My name is Susan Persons, and I am the Associate Director of Government Affairs of the Consortium of Social Science Associations (COSSA). COSSA represents over 90 professional associations, scientific organizations and universities. We welcome the opportunity to comment on ways in which the National Research Service Awards program might be strengthened to advance health research in the U.S. Identifying the most significant challenge for maintaining an adequate supply of qualified scientists to sustain and advance health research is not difficult. Clearly, the most critical issue is funding. For several years the budget for training researchers has not increased, resulting in the elimination of training slots, and the inability to fully fund existing slots. Eliminating training slots obviously decreases the number of scientists for the next generation. Underfunding the slots has various deleterious effects, including making training inaccessible to some people, and diverting the energies of training directors, as they are compelled to spend time seeking additional funding, rather than concentrating on the substance of the training program. Although your request was to identify the single most significant challenge to maintaining qualified scientists, I would be remiss if I did not at least mention two other very important challenges. First, ways must be found to channel research training opportunities to those disciplines with the most need. Nursing research, for example, is experiencing dramatic growth, while most of the cadre of nurse scientists will be of retirement age in 15 years. Adequate funding for research training is imperative in order to permit a sufficient number of qualified nurse scientists to be available to conduct health research. There is also an urgent need for doctorally-prepared nurses just to meet the basic need for doctorally-prepared faculty. In nursing baccalaureate and masters programs, nondoctorally-prepared faculty comprise 55 percent of the total. In doctoral programs, the percentage of nondoctoral faculty ranges from 76 percent to 0 percent, with an average of 37 percent. Second, it is important to recognize that the population of the United States is changing rapidly, and as new health concerns arise, new training will be required. For example, as the population ages, we will face new demands on health care, social security, pension plans, and social service needs. We cannot rely on a continuation of existing disciplines and the training opportunities within them. Instead, we must seek aggressively the kinds of training programs that will generate scientists knowledgeable and skilled in these changing problems. New research will be needed to estimate the long-term care needs of different ethnic groups, calculate how changing technologies will contribute to health care costs, explore new ways to keep frail older adults living independently at home, find ways to make the workplace friendlier to older workers, and explore the housing needs of new cohorts of older people. Two primary factors that influence the continued availability of investigators are trainee stipends and program flexibility. Few would dispute that in order to attract participants, stipends for training awards must increase. As you know, the stipend for the predoctoral NRSA is below the poverty level. Students are required to devote 40 hours per week to research training, but must also hold down a job to supplement their incomes. An extended 60-80 hour workweek for a period of several years is plainly not an incentive to
