Addressing the Nation's Changing Needs for Biomedical and Behavioral Scientists (2000) / Chapter Skim
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1. Introduction
1. Introduction
Pages 4-17
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From page 4... ...
oldest institutes marked their fiftieth anniversaries: the National Heart, Lung, and Blood Institute and the National Institute of Dental and Craniofacial Research. Since they were established as the second and third institutes in 1948, research has transformed the practice of both medicine and dentistry.
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As additional institutes were formed (the National Heart Institute and the National Institute for Dental Research in 1948, the National Institute of Mental Health in 1949, and the National Institute of Arthritis and Metabolic Diseases and the National Institute of Neurological Diseases and Blindness in 1950) , their training responsibilities were based to a large degree on those established for the National Cancer Instituted As a result, for much of its first two decades, NIH training support was divided between clinical and research training.
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took over responsibility for predoctoral training in the basic biomedical sciences, the categorical institutes increasingly focused on postdoctoral research training for Ph.D.s and physicians in the areas most closely allied with their missions. The only exception was the National Institute of Mental Health, which continued to support predoctoral training in the behavioral sciences.
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In their first full-length report, issued the following year, committee members concluded that Ph.D. production in the biomedical and behavioral sciences was more than adequate to meet existing demand.27 Indeed, with college enrollments leveling off and federal research expenditures growing at more modest rates than in the past, the committee called on the NIH to reduce the number of predoctoral students in the basic biomedical sciences by 10 percent and to limit postdoctoral support to existing levels.
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In contrast to its recommendation for the basic biomedical fields, the committee suggested that the NIH and ADAMHA devote most of their research training support in the behavioral sciences to training grants, even at the postdoctoral level, in order to encourage institutions to develop interdisciplinary approaches to training. The committee found the clinical research workforce more difficult to evaluate, partly because it could not effectively measure the supply of physician investigators, but also because it was a more diverse group of researchers.
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In the years since the NRSA program was established, funding for research training has grown much more slowly than the NIH budget,36 a result in part of recommendations from the studies of the research workforce conducted between 1975 and 1994. When the first NRSA awards were made for research training in 1975, the program supported 14,443 students and postdoctoral fellows.37 In 1998 the NRSA program supported 15,670 students and fellows, a number projecte(1 to increase slightly in 1999 to 15,681.38 To date, the NRSA program has provided research training in the biomedical and behavioral sciences to more than 130,000 students and young investigators through a combination of individual fellowship awards and institutional training grants at almost 750 universities, research institutes, and teaching hospitals.39 CHANGES IN THE NATIONAL RESEARCH SERVICE AWARD PROGRAM 9 Since its beginnings, NRSA research training has undergone a number of modifications as a result of steps taken by the Congress and the NIH, which in some cases were prompted by recommendations from committees convened by the National Academies.
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In the 1970s and the first part of the 1980s, NIH training grants and fellowships generally covered complete tuition and fees, but by the early l990s rising tuition costs led a number of institutes to choose to pay less than full tuition rather than cut the number of fellows and trainees. In 1996, to restore uniformity, the NIH announced a new standard for the NRSA program: It would cover 100 percent of tuition and fees up to $2,000 and 60 percent of those costs above that level.52 A PORTRAIT OF RESEARCH TRAINING TODAY As illustrated in Table 1-1, NRSA training support today is almost evenly divided between graduate students and postdoctorates, is concentrated in the basic biomedical sciences (70.7 percent)
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in 1998 than in the past, the shift to an emphasis on postdoctoral training recommended by previous NAS committees has not occurred. Today the typical duration of Predoctoral support is three years in the basic biomedical sciences and two years in the behavioral sciences.53 Although NRSA policy permits trainees and fellows to receive up to five years of Predoctoral funcling, many NTH institutes encourage more limited appointments, with the expectas3 Pion, Georgine M
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. The number of postdoctorates holding similar NTH- or DHHS-funded positions is not known but was probably the majority of the nearly 3,200 postdoctoral fellows in the biomeclical, behavioral, and clinical sciences supported by fecIeral research grants that year.s5 Among these were over 100 postdoctoral fellows, mostly from Western Europe, who were awarded fellowships from NIH's Fogarty International Center for study in the U.S.56 Close to 950 newly appointed faculty members received career development awards from the agency, allowing them an opportunity to polish their research skills before is Unpublished tabulation from the Survey of Graduate Students and Postdoctorates in Science and Engineering; on file in the archives of the Academies.
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Recommendations for expanding the number of NRSA training grants and fellowships in the behavioral and clinical sciences, oral health, nursing, and health services research were not acted on, prompting Congress to request a report on the agencies' progress in 1996. In explaining their actions to Congress, NIH, AHRQ, and HRSA officials indicated that they had focused initially on the highest-priority recommendations, and they expected to direct additional research training funds to stipends until NRSA stipend levels were comparable to other sources.
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It also encouraged the AHRQ to focus its training funds on areas in which researchers are in short supply, such as outcomes measurement, biostatistics, epidemiology, health economics, and health policy, and to provide a number of institutional training grants for innovative research training programs.70 In 1998, the AHRQ responded to the latter recommendation by granting "innovation awards" to 10 institutions to support the design and implementation of new models of health services research training.7~ Doctoral training in the basic biomedical sciences, and to a lesser extent, in the behavioral sciences, have also been the subject of multiple studies since 1994. In a study sponsored by the National Science Foundation 66"Mentored Patient-Oriented Research Career Development Award," NIH Guidefor Grants and Contracts, 6 April 1998.
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Subsequently, in 1997 the National Institute of General Medical Sciences announced new guidelines for its training grants in the basic biomedical sciences and urged graduate programs to provide opportunities for internships in industry and other settings and for experience in teaching.74 In addition, graduate programs were encouraged to supply trainees with information on career outcomes of graduates and to provide seminars and workshops on employment opportunities and career counseling. 72 National Academy of Sciences.
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Because the last committee to consider workforce needs in these fields concluded that models of supply and demand could not be relied on for valid forecasts and suggested that future committees be guided by a demographic analysis of the research workforce, many of the current recommendations are based on the results of such a demographic analysis. This analysis considered such factors as the average age of current investigators in the biomedical and behavioral sciences, the number of Ph.D.s expected to join the workforce in the years ahead, and the likely effect of retirements and deaths.
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The committee believes, however, that the research workforce will require continuing attention and change if its successes are to continue and increase. In particular, the committee believes that the NRSA program must increase its efforts to recruit and train investigators who will address the severe and too often neglected health needs of minority populations and investigators who will integrate and translate the rapidly increasing body of knowledge of fundamental science into programs to improve the health of Americans and people around the world.
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