SUMMARY OF ISSUES AND SUGGESTIONS FROM SPEAKERS

On May 3, 1993, the National Research Council’s (NRC) Committee on National Needs for Biomedical and Behavioral Research Personnel convened a public hearing to gather the views of colleagues on the future direction of the National Research Service Awards (NRSA) program. In preparation for the hearing, the committee formulated a set of questions to be addressed by respondents and consulted with the staff of the National Institutes of Health in compiling a list of individuals and organizations to whom a letter soliciting a response to those questions could be sent. (See Appendix A .) A letter posing the following four questions was sent to over 1,000 individuals:

  • What is the most significant challenge we face today in the United States in maintaining an adequate supply of qualified scientists to sustain and advance health research?

  • What improvements might be made in the National Research Service Awards (NRSA) program to assure a continuing supply of skilled investigators in the biomedical and behavioral sciences in the coming years?

  • What steps might be taken to improve the effectiveness of the NRSA program in recruiting women and minorities into scientific careers?

  • What features of the NRSA training grant might be strengthened to assure the maintenance of high quality research training environments?

Respondents also addressed the need for biomedical and behavioral research personnel in nontraditional settings, such as industry. Approximately 200 responses were received ( Appendix B ) and guided the selection of issues that follows. In addition, from these 200 respondents, 35 individuals were invited to participate in a one-day public hearing convened on May 3rd in Washington, D.C. (See Appendix C .)

At a subsequent meeting of the committee, issues frequently mentioned by hearing participants were identified and discussed, including:

  • the need for realistic assessments of supply and demand;

  • the matter of attracting young people to careers in science;

  • the role of stable research funding in facilitating scientific careers;

  • the need to raise NRSA stipends;

  • reasons to expand the Medical Science Training Program;

  • the role of NRSA support for women in science;

  • the role of NRSA support in recruiting underrepresented minorities into science and technology careers; and

  • some ways to increase the effectiveness of the NRSA program.

This report summarizes the views of speakers at the 1993 public hearing organized around those themes.



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Meeting the Nation’s Needs for Biomedical and Behavioral Scientists: Summary of the 1993 Public Hearing SUMMARY OF ISSUES AND SUGGESTIONS FROM SPEAKERS On May 3, 1993, the National Research Council’s (NRC) Committee on National Needs for Biomedical and Behavioral Research Personnel convened a public hearing to gather the views of colleagues on the future direction of the National Research Service Awards (NRSA) program. In preparation for the hearing, the committee formulated a set of questions to be addressed by respondents and consulted with the staff of the National Institutes of Health in compiling a list of individuals and organizations to whom a letter soliciting a response to those questions could be sent. (See Appendix A .) A letter posing the following four questions was sent to over 1,000 individuals: What is the most significant challenge we face today in the United States in maintaining an adequate supply of qualified scientists to sustain and advance health research? What improvements might be made in the National Research Service Awards (NRSA) program to assure a continuing supply of skilled investigators in the biomedical and behavioral sciences in the coming years? What steps might be taken to improve the effectiveness of the NRSA program in recruiting women and minorities into scientific careers? What features of the NRSA training grant might be strengthened to assure the maintenance of high quality research training environments? Respondents also addressed the need for biomedical and behavioral research personnel in nontraditional settings, such as industry. Approximately 200 responses were received ( Appendix B ) and guided the selection of issues that follows. In addition, from these 200 respondents, 35 individuals were invited to participate in a one-day public hearing convened on May 3rd in Washington, D.C. (See Appendix C .) At a subsequent meeting of the committee, issues frequently mentioned by hearing participants were identified and discussed, including: the need for realistic assessments of supply and demand; the matter of attracting young people to careers in science; the role of stable research funding in facilitating scientific careers; the need to raise NRSA stipends; reasons to expand the Medical Science Training Program; the role of NRSA support for women in science; the role of NRSA support in recruiting underrepresented minorities into science and technology careers; and some ways to increase the effectiveness of the NRSA program. This report summarizes the views of speakers at the 1993 public hearing organized around those themes.

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Meeting the Nation’s Needs for Biomedical and Behavioral Scientists: Summary of the 1993 Public Hearing ISSUE 1 THE NEED FOR REALISTIC ASSESSMENTS OF SUPPLY AND DEMAND 1 Many speakers observed that maintaining an adequate supply of qualified scientists to sustain and advance health research is a significant challenge. The challenge arises from the unevenness of supply given demand, and from the lack of community consensus on what constitutes an “adequate supply.” The need for research personnel varies, furthermore, from field to field. In some specialty areas there are more qualified candidates than faculty positions. In other specialties and subspecialties, such as nursing, oral health and prevention research or microbial physiology, not enough scientists are trained to fill available positions in academia and industry. Numerous factors contribute to the shortage of trained researchers. Some identified by public hearing participants include the following: The scope of the research base is expanding in some fields. For example, as the population ages, there are new demands on health care services which in turn requires the development of information about the effective delivery of services to older citizens. Career opportunities in industry are increasing, with applications not only in medicine but also in agriculture, environmental remediation, and related areas. A large cadre of researchers is approaching retirement age. The time needed for training a researcher is longer than almost all other types of professional training, averaging 5 to 6 years for the Ph.D. and 3 to 4 years for postdoctoral studies. Some areas of research training, such as microbial physiology, have been neglected, while others, such as molecular biology and genetics, have grown. Perceptions of the adequacy of the applicant pool also vary, according to speakers. In some fields the pool appears to be sufficient while in others it is diminishing. Those who felt the pool was shrinking related the phenomenon to problems in the career path, noting that too few Americans graduate from high school with an adequate grounding in science or mathematics to pursue a career in research. Some speakers felt that information is also needed about the character of the applicant pool. For example, what is the current number of individuals available for training or the number of trainees who actually choose career paths other than research? A number of speakers noted that there is a general lack of physician-scientists. However, the need varies across subspecialties. In some areas, the pool of physician-scientist candidates is shrinking. In others, the pool may be adequate, but the loss of candidates to other career tracks is a problem. In some fields, the demand is far greater than the supply. The unpredictability of R&D funding is a significant factor in balancing the supply and demand of research personnel, according to a number of speakers. Another issue affecting supply arising from the lack of sufficient and/or stable resources is the diversion of scientists’ time and energy from research to grant application writing. Suggestions from Speakers Ongoing Assessments A number of speakers emphasized the need for ongoing evaluation of “national needs” in the face of these various factors affecting “supply” and “demand.” Such assessments should include examination subject areas in which personnel “needs” exist, whether training programs are meeting those needs, the current status of training of personnel, and areas in which training should be intensified. Speakers also suggested that realistic assessments of personnel needs ought to include a look at: 1   Material in this section drawn from testimony by: D. Brautigan, G. Cassell, P. Cozzi, J. Fielding, S. Gerbi, B. Giddings, R. Grand, A. Jacox, H. Kazemi, G. Kimmich, V. LiCata, D. Linzer, T. Malone, B. Marshall, P. Morahan, S. Persons, C. Pings, J. Pohl, D. Purpura, I. Sandler, P. Shank, J. Sheridan and J. McCormick, and H. Slavkin. See Appendix D .

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Meeting the Nation’s Needs for Biomedical and Behavioral Scientists: Summary of the 1993 Public Hearing employment conditions for working scientists, the ability of scientists to move between academic and industrial employment, attention to the educational and employment experiences of women and minorities, retraining opportunities for mid-career scientists and the types of retraining programs that could be pursued on a part-time basis, and innovative educational and employment programs between industry and academia. The Applicant Pool Suggestions for improving the applicant pool included: maintaining and expanding the availability of traineeships/fellowships, identifying predictors of success in research, and opening NRSA training to foreign nationals. Physician Scientists The importance of clinical research to national goals was emphasized by a number of speakers. Many suggested that high priority be placed by the NRSA program to meet the needs for these investigators. Research Support Numerous participants commented on the need for basic research in the biomedical and behavioral sciences. Other suggestions for stabilizing the research base included the need to foster communication within the community of scholars who can act as a support group and network with each other, especially through electronic networks. ISSUE 2 ATTRACTING YOUNG PEOPLE TO CAREERS IN SCIENCE 2 Young people are attracted to science for the excitement and challenge as well as the opportunity to build a stable and rewarding career. Yet, the loss of potential scientists occurs at every stage of the education path, from early childhood education through graduate school. According to some of the speakers, students think “science is neat,” but are discouraged by the long period of training. Science also suffers from an image of being boring, incomprehensible, or “not cool” and scientists are often seen as being uncaring and out-of-touch with society. Other problems people encounter along the scientific career path include: their early education in science and mathematics is inadequate: teachers are often poorly informed about these subjects and textbooks are outdated; and there is a lack of a realistic understanding of the job of a scientist: basic research requires enormous dedication, long hours, frustration, and sheer hard work. Students see mentors struggling to maintain a career in the face of inadequate funding and may decide a research career is not for them. Suggestions from Speakers Speakers offered a number of interesting suggestions for taking more effective action in recruiting students into science careers. 2   Material in this section drawn from testimony by: J. Fielding, B. Giddings, G. Kimmich, V. LiCata, D. Linzer, C. Lumeng, T. Malone , P. Morahan, P. Shank, H. Silber, H. Slavkin, O. Weisz, and M. Yamaguchi. See Appendix D .

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Meeting the Nation’s Needs for Biomedical and Behavioral Scientists: Summary of the 1993 Public Hearing Image Improve the image of the scientist as a person through the use of media such as children’s TV programs. Teaching/Learning Focus attention on the education of children because they are a large undeveloped resource. Increase and nurture their level of interest in science and encourage their desires to explore questions about nature, starting in elementary school. Make science attractive by inviting people in science to visit schools; use team discovery projects to foster an interest in science; develop science fairs, clubs, camps, and links with industry. Improve science education at elementary and grade school levels by providing better training and continuous retraining for teachers of science in grades K-12 and by having university faculty interact with elementary, middle school and high school teachers. Teach science and mathematics effectively beginning at age 6. The importance of fostering basic critical thinking skills was emphasized. Develop mentoring programs especially in high school and in college. A good mentor will critique work, teach new techniques, maintain high ethical standards, and encourage a young career. At the college level, take freshman science students into an undergraduate research group to motivate them and get them involved early. Provide well-paid summer research fellowships for undergraduates. Include salary, traveling expenses, and a small stipend. Collaborative Approaches Coordinate the teaching of science by exposing students to science in a variety of employment settings. Teachers should lay the initial foundation of information for the children. Industry and academia should provide opportunities for children to see that further pursuit of studies in science can lead to interesting careers. Dissemination of Information Develop and disseminate information, e.g., a directory of available science and mathematics scholarships. Develop a strong portfolio of diverse career options: include academic and industrial research, technology, teaching, and combinations of these. Develop widely visible materials on the spectrum of full time and part time career opportunities available for scientists and disseminate these options to undergraduate and graduate students. ISSUE 3 STABLE RESEARCH FUNDING 3 A number of speakers observed that attempts were made in the past to reduce funding to the National Institutes of Health (NIH). While these proposed cuts were consistently rejected by Congress, the annual budget battle inevitably created a great deal of uncertainty within the biomedical research community. Even when proposed cuts were rejected and increased funding was provided, there was still a significant shortfall in dollars needed to fund many qualified grant applications. Today, the NIH funds approximately 18 percent of its approved grant applications. Even those grants that are funded receive significantly less than the 3   Material in this section drawn from testimony by: D. Brautigan, G. Cassell, P. Cozzi, E. Jones, S. Gerbi, B. Giddings, R. Grand, A. Jacox, H. Kazemi, G. Kimmich, T. Krulwich, V. LiCata, D. Linzer, B. Marshall, P. McCloskey, T. Meyer, P. Morahan, S. Persons, C. Pings, J. Pohl, D. Purpura, I. Sandler, P. Shank, J. Sheridan and J. McCormick, H. Slavkin and O. Weisz. See Appendix D .

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Meeting the Nation’s Needs for Biomedical and Behavioral Scientists: Summary of the 1993 Public Hearing dollar amount requested and approved by the NIH Study Sections. This scenario has resulted in individual investigators applying for multiple grants on a variety of funding cycles, constantly wondering if the dollars will be there tomorrow for the research that is started today. Grants are vital to carry out research. Without improvement in long-term funding, we run the risk of losing the scientific primacy of the United States and, in the long run, our biomedical research endeavor will become totally commercialized. Science for the sake of science will no longer be performed by anyone, according to the speakers. Perceptions of insufficient resources for research discourage highly capable people from entering a research-oriented career track and encourage some who have already entered to change career directions. Other speakers noted that the uncertainty of renewals and resulting time spent revising applications interfere with the productivity of established research programs. In addition, many scientists are uncomfortable about competing with colleagues for limited resources. Moreover, the combination of constraints in funding and opportunities for success in rapidly changing fields conspire to make new investigators conservative. They tend to relate proposals to prior work at the parent postdoctoral lab because it is too risky to propose more individual and novel projects. This hurts the whole research enterprise. Suggestions from Speakers Stabilize biomedical and behavioral research funding. Provide sufficient funds for NRSA fellows to conduct pilot studies to develop their own initial programs of research as a bridge into a scientific career. Increase funding for seminars and research retreats for trainees. This would provide a relatively inexpensive exposure to real research application/support issues. Fund faculty to work with postdoctoral fellows and provide mentor salaries. The incentive to supervise training can make a critical difference in establishing new research and training programs, including interdisciplinary ones. ISSUE 4 NRSA STIPENDS AND STIPEND PACKAGES 4 While long-range prospects supply the most compelling reasons for pursuing a research career, more immediate incentives, such as stipends, play an indisputable role. With that in mind, speakers commented that it is disturbing to note that stipend levels for trainees in the NRSA program have remained unchanged since 1991. The stipends for predoctoral trainees and postdoctoral fellows are inadequate and insufficient to cover the cost of living. Awardees are supported below the poverty line and require supplementation to stipends to meet basic needs. Many trainees in all programs must work to supplement their income, thus reducing time and energy available for studying. NRSA stipends have not kept pace with salaries of M.D.s in practice or Ph.D.s recruited into industry. Nor are NRSA stipends commensurate with those of some other programs. With tuition and stipend payments assured throughout their schooling, students in the Medical Scientist Training Program, for example, are clearly more insulated from financial pressures than other trainees. By graduation, their educational debt averages $23,000, while that of the typical graduating M.D. is $56,000, more than twice as much. Most universities augment NRSA stipends, which requires them to divert resources from other university functions. When universities are unable to augment stipends, trainees are forced to take out loans or work to meet their living expenses. Loans increase already considerable debt burdens incurred in undergraduate education, and working to earn a living income draws students away from their academic program, extending their time to degree. As a nation, 4   Material in the section drawn from testimony by: D. Brautigan, G. Cassell, S. Gerbi, B. Giddings, R. Grand, A. Jacox, G. Kimmich, D. Linzer, T. Malone, S. Persons, C. Pings, J. Pohl, D. Purpura, I. Sandler, J. Sheridan and J. McCormick, and H. Slavkin. See Appendix D .

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Meeting the Nation’s Needs for Biomedical and Behavioral Scientists: Summary of the 1993 Public Hearing we will attract our “best and the brightest” only by offering stipends that show them that we value a research career as highly as we value other types of professional employment. Suggestions From Speakers Addressing stipend inequities should be a high priority for the NRSA research training program. Speakers specifically suggested attention to these issues: Increase the Stipend Predoctoral stipends should be increased into a range that is competitive with stipends paid by other state and federal agencies, e.g., most state university stipends start at $11,000 and NSF currently pays $14,000, and the U.S. Department of Education now pays $14,000 annually. Stipend levels should be increased for individuals seeking careers in clinical research. Stipend increases should reflect inflationary changes, and the training budget should be sufficient to allow cost-of-living adjustments to be made annually and computed into each training grant’s continuation base. Other mechanisms should be established such as private sector partnerships to ensure that stipends reach competitive levels. Additional Support Change the policy preventing supplementation of NRSA trainee support with funds from a federal grant. Money should also be added to NRSA support for laboratory training expenses such as research supplies and equipment. Innovative Program Support Institute a one year research support program in which students receive: credit for research performed, living expenses, support for interest due on loans, a modest amount for lab fees. ISSUE 5 EXPANDING THE MEDICAL SCIENTIST TRAINING PROGRAM 5 The Medical Scientist Training Program (MSTP) awards both the M.D. and the Ph.D. degrees after a rigorous course of study. This is recognized as the most successful NIH training program, according to many speakers. A 1992 study of graduates of the Johns Hopkins University’s M.D./Ph.D. program found that all of those who had completed their training were actively involved in research at that time: 81 percent in academia, 14 percent at research institutes, and 5 percent in the biotechnology industry. Some speakers expressed concern, however, that the program could do more to encourage its trainees to pursue problems in human disease--a research area for which they should be uniquely qualified, but, by some indications, are disinclined to pursue. While the goal of the MSTP program is to train both basic and clinical researchers, Washington University’s Carl Frieden and Barbara Fox reported in 1991 that 83 percent of their MSTP graduates were engaged in full-time basic research. Similarly, in a 1990 analysis of the research publications of a sample of MSTP graduates, Edward Ahrens found that 75 percent of their work focused on nonclinical research. The findings of Frieden, Fox, and Ahrens suggest that at least some portion of MSTP trainees should be considered as pursuing basic science careers rather than clinical science careers. If further study confirms that MSTP graduates gravitate toward narrow areas of research, an effort should be made to broaden training. Suggestions From Speakers The following suggestions for expanding the MSTP program were offered by speakers: 5   Material in this section drawn from testimony by: D. Brautigan, S. Gerbi, C. Lumeng, and T. Malone. See Appendix D .

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Meeting the Nation’s Needs for Biomedical and Behavioral Scientists: Summary of the 1993 Public Hearing Raise the total number of MSTP trainees to 1,000 by adding 250 slots. Examine the cost effectiveness of the program relative to other forms of training support. ISSUE 6 WOMEN IN RESEARCH 6 The number of women in the life sciences has increased dramatically in the last 20 years. Over 40 percent of the Ph.D.s produced in the life sciences are women. At this stage they are not really underrepresented. The difficulty occurs later when employment opportunities are limited by geographical considerations or by family obligations. Some say recruiting women into science is a problem, a symptom of our society and the way we approach science. Others say recruitment is not the problem, but professional advancement is the problem. The number of women who successfully graduate into independent positions in science and are promoted into the higher ranks is small. Suggestions From Speakers Although some speakers considered the problems of recruitment and professional advancement to be beyond the purview of the NRSA program, some offered suggestions related to outreach and incentives, administrative and program flexibility, and mentoring and support groups through NRSA support. Outreach and Incentives Reconsider NRSA’s support structure to increase options and access to scientific careers by providing incentives for completing studies early; increasing the length of time allowed for support on NRSA awards; and allowing more employment hours than at present. Improve access in geographic terms, e.g., programs in nursing have limited locations and they need to be more accessible to increase participation of women in advanced training in this area. Provide small grants for undergraduate research by women. Give attention to M.D./Ph.D. programs as a strategy to attract female scientists into research careers. These fellowships may be more attractive than those that are limited to graduate and postgraduate training. Use innovative training programs that guarantee placement on completion of the course. Flexibility Increase flexibility in NRSA programs by developing formal policies for family leave and part-time training. Develop ways to help with child care support by provision of government subsidies or grants from private foundations for child care. Target funds to develop mid-career mechanisms for re-entry to a career track. NRSA should specifically encourage applications from women who have taken time off in early or mid-career to raise children. Individual fellowship support for these women would be especially effective in providing them with opportunities . Create new mechanisms to make postdoc opportunities compatible with lifestyle issues, e.g., a program for younger faculty similar to NSF’s Women Scholars Program of several years ago. Support Systems Establish a mentor system through the NRSA program. Augment existing individual project grants so that principal investigators take on 6   Material in this section drawn from testimony by: D. Brautigan, G. Cassell, S. Gerbi, A. Jacox, A. Kraut, V. LiCata, D. Linzer, T. Malone, B. Marshall, P. McCloskey, S. Persons, J. Pohl, D. Purpura, J. Sheridan and J. McCormick, H. Silber, and O. Weisz. See Appendix D .

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Meeting the Nation’s Needs for Biomedical and Behavioral Scientists: Summary of the 1993 Public Hearing the dual role of recruiter and mentor of young scientists. Establish support groups that are visible and integral parts of the training environment. Organizational Linkages Link training with the private sector, e.g., private sector intern programs, at various stages in the educational process including predoctoral NRSA training. ISSUE 7 MINORITIES IN RESEARCH 7 African-Americans, Hispanics, and Native Americans account for no more than a couple of percent of all Ph.D.s in the life sciences. These numbers have been constant for two decades, and show little sign of improvement. Most under-represented minorities with a desire to work in the life sciences are not entering Ph.D. programs. Instead, they are going to medical school. The Association of Medical Colleges (AAMC) reported that in 1991, 918 black Americans, 46 Native Americans, and 362 Hispanic Americans graduated from medical school. By comparison, according to the National Science Foundation, only 6 black Americans received Ph.D.s in biochemistry in 1991, and only 44 Ph.D.s were awarded to black Americans in all the biological sciences combined. Likewise, 10 Native Americans and 78 Hispanic Americans received a Ph.D. in the life sciences. Thus, there were 10 M.D.s for every Ph.D. earned by members of these groups. Much has been done to try to improve minority recruitment. Predoctoral training grants require a proactive stance on the part of the schools they fund; the Minority Access to Research Careers Program (MARC) tries to support the pool from which minority applicants will come; recent policy changes permit supplements for minority students supported by research grants; and there is a new program of individual minority predoctoral fellowships. Despite these efforts, many of the same forces drive both minority and majority students: the best students often choose an M.D. over a Ph.D. because it offers a more secure job at a better salary. Many universities have used the MARC program to identify promising undergraduates and provide them with summer research internships and related activities to interest them in and prepare them for graduate study. The quality of the research program and the extent of faculty mentoring are major determinants in the success of institutional programs, and these attributes should continue to play a determining role in awarding grants in any expanded program. Some problems identified by speakers that affect minorities making careers of research in health fields include: Recruiting underrepresented minorities into science is a problem. It is a symptom and reflection of our society and the way we approach science (See Issue 2: Attracting Young People to Science Careers ). Some feel that the pool of available applicants is so small that recruitment efforts are simply “reshuffling the deck.” The number of trainees funded on the individual minority predoctoral fellowship program is declining due to the lack of special budget appropriations. In some fields, such as microbiology and anesthesiology, minority representation is very poor. The structure of the NRSA predoctoral awards is restrictive, underfunded, and fails to recognize the diversity of highly qualified minority applicants (Report of American Society for Microbiology Committee on the Status of Minority Microbiologists). The NRSA award criteria are heavily weighted toward student performance on standardized examinations. 7   Material in this section drawn from testimony by: D. Brautigan, G. Cassell, S. Gerbi, L. Goldman, R. Grand, J. Jones, A. Jacox, H. Kazemi, T. Krulwich, V. LiCata, D. Linzer, C. Lumeng, T. Malone, B. Marshall, P. McCloskey, T. Meyer, S. Persons, C. Pings, D. Purpura, P. Shank, J. Sheridan and J. McCormick, H. Silber, H. Slavkin, and O. Weisz. See Appendix D .

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Meeting the Nation’s Needs for Biomedical and Behavioral Scientists: Summary of the 1993 Public Hearing In addition to issues of recruiting and retaining ethnic and racial minorities, there are similar issues involving lesbian and gay people. Many lesbian and gay scientists choose not to disclose their orientation for fear of harassment, limited choice of employment location, or dismissal. Others choose not to focus on lesbian and gay issues in their research for fear their careers may suffer. Suggestions from Speakers A number of suggestions were offered for increasing the participation of minority group members through the NRSA program. Outreach Target specific numbers of NRSA awards for early intervention programs for minority groups. Train NRSA program directors to be more effective in minority outreach efforts. Require (and fund) the principal investigator of each institutional NRSA to attend one meeting during every five-year cycle specifically to recruit minority medical students or house staff into research careers. Promote the MSTP program to minority undergraduates as a way of solving two problems at one time: minority students could attain their medical degrees and would also be trained to do research. The MSTP program could also be promoted to minority students after they have entered medical school, and this would be an especially promising way to capture them for careers in research. Financial Set aside a fixed percentage of training funds for minority students to encourage appointment to NRSA programs. Share the funding load with other federal funding agencies or federally funded university training programs. Increase flexibility of incentives for principal investigators to hire minority graduate and undergraduate students. Early Research Expose undergraduates to research early in their educational experience through creative course work and independent study. Encourage such experience by providing small grants or NRSA awards for undergraduate research. Provide well-paid summer research fellowships for undergraduates that include salary, traveling expenses, and a small stipend. Expanding Programs Encourage, support, and expand successful programs, e.g., MARC Program, which has proven to be highly effective in drawing talented minority students into careers in biomedical research. Expand programs such as special grants for minority students. Organizational Linkages Develop linkages between minority institutions, organizations, and research intensive institutions. Link training with the private sector, e.g., an NRSA minority intern program. Administration NIH institutes should rigorously review summaries of minority recruitment and retention, and enforce requirements under NRSA provisions. Evaluate programs such as the MARC and Minority Biomedical Research Support (MBRS). Use innovative training programs that

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Meeting the Nation’s Needs for Biomedical and Behavioral Scientists: Summary of the 1993 Public Hearing guarantee placement on completion of the course. Support Systems Develop special support mechanisms through the NRSA program to help retain even the best minority students. Provide role models during training. Sponsor seminars for minority scientists. Seminars might include discussions on ethics, discussions with faculty and students on the apprenticeship system of research training and the responsibilities of mentors to all trainees. Provide mentors who give encouragement and guidance at critical times. Mentoring may include the more formalized participation of research faculty from research-intensive institutions as mentors to young faculty/students at smaller, more teaching-oriented institutions with funded minority programs. With respect to lesbian and gay issues, these too reflect our society and are basically social problems. Legislation of a civil rights law for lesbian and gay people and legal recognition of their relationships should be pursued. There is a pressing need for researchers knowledgeable about lesbian and gay issues, e.g., AIDS research. Funds should be earmarked for lesbian and gay studies. ISSUE 8 INCREASING THE EFFECTIVENESS OF THE NRSA PROGRAM 8 Institutional training grants tend to improve the quality of the entire predoctoral program in a department for both trainees and non-trainees. They induce an interdisciplinary focus and provide the broad training necessary to meet changing manpower needs. Training grants provide the leverage that would be impossible on individual research grants to influence programmatic aspects, e.g., influence schools to provide training on ethical issues and be proactive in minority recruitment. Various opportunities are emerging for research scientists in industry and other new settings. These emerging research opportunities make it increasingly important for trainees to have broad-based scientific training. NRSA programs must be designed to train the full range of biomedical and healthcare scientists needed for the future. The ideal preparation for the future of biomedical and behavioral research personnel is to equip people with thinking skills and understanding of the basic forces and structures of life to address changing challenges in a rapidly changing environment. To train a scientist in a “targeted” way, with an eye toward a specific (applied) research setting, is to severely limit that scientist’s potential. It limits the ability to change with the rapid changes in such applied fields as biotechnology. The biggest problem with the research training environment today, according to many speakers, is related to underfunding and the fierce competition for scarce resources. Mentors must spend less time in the laboratory directly supervising trainees and more time writing grant applications. This also results in less time spent on lecture preparation as well as fewer seminars and advanced courses being offered at most institutions. In addition, because the laboratory work of trainees is directly linked to external funding sources, there is more pressure for trainees to produce results at a faster rate and, in many cases, to publish prematurely. Most NRSA fellows are based at only a few academic institutions, with the result that postdoctoral trainees become concentrated in labs with many other postdoctoral students where they do not receive much attention and have limited interaction with faculty. Usually a predoctoral traineeship is in the first two years of graduate school when the student is taking courses and research rotations. Research grant support should be provided when the student is more advanced and time is focused on research rather than on course work. 8   Material in this section drawn from testimony by: D.Brautigan, G. Cassell, P. Cozzi, S. Gerbi, L. Goldman, J. Jones, H. Kazemi, A. Kraut, T. Krulwich, V. LiCata, D. Linzer, T. Malone, B. Marshall, P. Morahan, S. Persons, C.Pings, J. Pohl, D. Purpura, P. Shank and H. Slavkin. See Appendix D .

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Meeting the Nation’s Needs for Biomedical and Behavioral Scientists: Summary of the 1993 Public Hearing The amount of paperwork involved in applying for the NRSA fellowship far exceeds that required for any other postdoctoral fellowship. Suggestions From Speakers Numerous suggestions were offered, which included treatment of the following topics: Individual Awards Examine the issue of whether a cap should be placed on the number of individual NRSA fellows per lab. Access Increase the flexibility and access to programs throughout the country and in a wide variety of institutions. Curriculum Train Ph.D. scientists who know basic science and have awareness of clinical problems and an ability to work with physicians as well as basic “wet lab” skills. Include training in patient-oriented outcomes research and research at the interface between laboratory discoveries and clinical applications. Provide a broad-based and interdisciplinary curriculum, including a solid background in general biochemistry and molecular biology rather than a focused program such as biotechnology which can be obsolete before the degree is awarded. Emphasize interdisciplinary approaches that pair the biomedical sciences with chemistry, engineering, and computer science as well as patient-oriented clinical research, clinical epidemiology, biostatistics, outcomes research, and health services research. Examples of interdisciplinary researchers are demographers and sociologists trained in aging research; epidemiologists with a background in economics; psychologists interacting with engineers to help frail older adults live independently at home; and neuroscientists, who consistently utilize knowledge and techniques in several disciplines including neuroanatomy, physiology, neurochemistry, and molecular genetics. Periodically establish new training grants in cross-disciplinary interfaces. Both pre- and postdoctoral students should complete courses in experimental design, statistical analysis, grant writing, oral scientific communications, and public science policy. They should also be exposed to grant accounting, management, and a minimal amount of teaching experience. Collaboration Develop team research and multi-university relationships. Establish training programs that are jointly sponsored by academic institutions and industry. Review Use the NRSA annual progress report as a basis for evaluating productivity and continued financial support. Develop criteria for measuring the effectiveness of mentors and training programs. Administration Streamline guidelines. NIH and subspecialty boards should come to a better understanding of their aims so that together they can provide a meaningful national program for training biomedical researchers who can participate in both clinical and basic research. Streamline the paperwork involved in applying for a fellowship. Maintain the non-trainee expenses allocated to predoctoral training grants for such activities as a graduate program seminar series and research day retreats.

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Meeting the Nation’s Needs for Biomedical and Behavioral Scientists: Summary of the 1993 Public Hearing Have yearly national meetings of individual NRSA recipients. Restructure NRSA programs to encourage a review the individual testimony in Appendix D for a full or modified Ph.D. training program for fuller view of specific suggestions. physicians. This brief summary captures only a few elements of the rich set of ideas submitted by speakers at the 1993 public hearing. Readers are encouraged to