Addressing the Nation's Changing Needs for Biomedical and Behavioral Scientists (2000) / Chapter Skim
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4. Clinical Scientists
4. Clinical Scientists
Pages 42-52
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From page 42... ...
Assessment of this workforce is also complicated by a lack of information about the research training and career paths of physicians and other health care professionals, who necessarily play a major role in the field of clinical research. The dearth of information about such health care doctorates as physicians, dentists, and other doctorallevel professionals without Ph.D.s is a longstanding problem, identified by the first NRC committee to examine the needs for biomedical and behavioral researchers in 1975 ~ and regularly cited as an obstacle by subsequent committees.2~3 Only in the last few years has more detailed information become available, after the National Institutes of Health (NIH)
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From page 43... ...
According to this new information, the pool of investigators conducting clinical research supported by the NIH and AHRQ includes many who were trained in the behavioral and social sciences and, to a lesser extent, the basic biomedical sciences. Among those whose fields of study could be identified, more Ph.D.s conducting clinical research received their degrees in clinical psychology (13.4 percent)
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From page 44... ...
Of course, this figure may well be an underestimate; it does not include dentists or other health care doctorates active in clinical research, about whom little is known, or Ph.D.s trained in the basic biomedical or behavioral and social sciences, some of whom are part of the clinical research workforce, at least part of the time. The two major groups of investigators in the clinical research workforce are quite different in character, except for their age.7~~2 In 1997 the mullion user of nEv.~i .
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From page 45... ...
students graduating in 1997 was considerably less and lower still for participants in the NRSA Medical Scientist Training Program; the latter had a mean debt of about $13,600 (Table 4-3)
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From page 46... ...
According to a 1997 study of the activities of medical school faculty, new faculty members in the most competitive health care markets were more likely to have patient care duties, spend more time teaching, and publish fewer papers than their peers in other parts of the country. Even in their own institutions, junior faculty in the most competitive health care markets had greater teaching responsibilities and were more likely to be assigned to patient care duties than their more senior colleagues.
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From page 47... ...
In contrast to postdoctoral NRSA awards, which require the recipient to be in fulll-time training and provide a maximum stipend of $41,26S,26 salaries for mentored career development awards generally range from $50,000 to $75,000 for a commitment of 75 percent time (although a few NIH institutes provide up to the maximum allowable under the salary cap, $141,3001.27 In addition, career development awards 26 "National Research Service Award (NRSA) Stipend Increase," NIH Guide for Grants and Contracts, 19 November 1998.
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From page 48... ...
In recent years the NIH has increasingly encouraged the use of career development awards for clinical research training. When the agency unveiled three new grant programs to foster the training and retention of ,soo 1'600 — 1 ,400 00 { ~a)
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From page 49... ...
training, recognizing that restrictions on student choice of training areas may limit their subsequent fields of investigation. In early 1997 the National Institute of General Medical Sciences issued new guidelines for its Medical Scientist Training Program, urging the medical schools with such training grants to extend their programs to give students "a breadth of doctoral research training opportunities," in fields including computer science, 3s Sutton, Jennifer, and Charles D
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From page 50... ...
programs may need to expand their rosters to encompass additional fields of study in the medical school, such as the Ph.D. programs in clinical research that Johns Hopkins and UCLA have introduced.37 Others may opt to forge ties with doctoral programs in departments outside of the medical school, as the University of North Carolina has done with the Department of Epidemiology in its School of Public Health.38 Still others may seek to establish links to neighboring universities, as Emory has with Georgia Tech for training in bioengineering.39 Finally, the extent to which Medical Scientist Training Programs sponsored by the National Institute of General Medical Sciences offer their students the opportunity to earn Ph.D.s in a broad range of fields in addition to the basic biomedical sciences may influence other dual-degree programs.
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From page 51... ...
is over 41 years, in marked contrast to the basic biomedical sciences, where NRSA recipients complete their Ph.D.s at a median age of 30, and the behavioral and social sciences receive their degrees at age 32.4~ The advanced age of nursing Ph.D.s stems, in part, from the norms of the profession, which encourages its members to acquire considerable professional experience before seeking research training. Although this practice ensures professional expertise, later research training inevitably limits the length of an individual's research career.
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From page 52... ...
The NIH, the Agency for Healthcare Research and Quality, and the Health Resources and Services Administration should sub stantially increase opportunities for dual-degree training in fields related to clinical research. The committee urges the agencies to work together to substantially increase opportunities for dual-de gree training (whether M.D.-Ph.D., M.D.-M.P.H., or dual-degree programs targeted to dentists and other health care doctorates)
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