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APPENDIX D 33 of child development are needed. A number of medical schools have increased the time from 4 to 6 years allowable for completion of undergraduate medical education. 4. What features of the NRSA training grant might be strengthened to assure the maintenance of higher quality research training environments? The biggest problem with the research training environment today is related to underfunding of research and the fierce competition for scarce resources. 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. Mentors must spend less time in the laboratory directly supervising trainees and more of their time writing grant applications. This also results in less time spent on lecture preparation and fewer numbers of seminar and advanced courses being offered at most institutions. Additional funding is required not only for NRSA training awards but also for research project grants in order to attract and retain the best students and to ensure an excellent training environment. Stipend levels should be increased, and money should be added for laboratory training related expenses such as research supplies and equipment. This would protect trainees from interrupted funding of the mentorâs research program. NRSA training program environments could be improved if all components of training were more rigorously reviewed. In addition to numbers of students and trainee publications, criteria should be developed measuring the effectiveness of mentors. Not enough attention is being given to coursework or actual teaching of research skills. Minimal criteria should be established for NRSA training programs. Every trainee (pre- and postdoctoral) should be required to complete a course in experimental design and statistical analysis, grant writing, oral scientific communications, and public science policy. To give students a well-rounded education, they should also be exposed to grant accounting and management and a minimal amount of teaching experience. The ASM supports the NRSA requirement for training in the responsible conduct of research. We would like to point out that the ASMâs Academy of Microbiology is planning a series of colloquia to assist faculty in the development of specific curriculum content for teaching scientific integrity to students, with specific reference to developing information on two of the most challenging issues, conflict of interest and collaborative research. STATEMENT BY PHILLIP J. COZZI, M.D. Thank you for your interest in my opinions on health research. My salary is supported by an individual NRSA. In response to your specific questions: 1. The most significant challenge in maintaining an adequate supply of qualified health researchers is enlisting top students and physicians in the face of financial disincentive and insecurity. I attended the University of Chicago Medical School, performed both internal medicine residency and chief medical residency at Northwestern University, and now I am a fellow in Pulmonary and Critical Care Medicine at the University of Chicago. I have enjoyed and participated in medical research at every stage of my education from college to the present. All of a sudden, however, life as a medical researcher is less attractive to me. This change is temporally and causally related to the birth of my second child. We have no savings, large debt and, as my family grows, ever-increasing financial responsibility. My wife is a stay-at-home mom; my monthly paycheck, six years after getting an M.D. degree, is $1843 and is entirely consumed each month. We live in a small apartment with no backyard in an industrial park in the western suburbs of Chicago. Although my wife and I were perfectly happy to live on a very tight budget, we want more for our kids. We hope to buy a house so that the kids can have a backyard and simply a place to be. With sheer optimism, maybe we can afford a house in 4 to 5 years. I love research but this ongoing financial deprivation may drive me out of academics. Aside from my concerns about the present, I am just as worried about the future. To keep an academic position at good universities today, independent funding is usually needed. If one loses their grant, they usually lose their position as well. I am reluctant to place my familyâs financial security at risk.
