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SUMMARY Legi slat ive Developments Some important recent legislative developments at feet the training programs authorized by the National Research Service Awards (NRSA) Act of ~ 974. In the "Biomedical Research and Training Amendments of 1978, " Congress renewed the NRSA Act for 3 years and made the following amendments. l. At least 15 percent of training funds must be expended for individual awards, and at least 50 percent must be expended for institutional awards . Previously, the law required that a minimum of 25 percent of the funds be allocated for individual awards and specif fed no minimum for institutional awards . 2. The maximum period of support was extended to 5 years for predoctoral students and 3 years for postdoctoral appo intees . 3. The Secretary of DHEW is required to cons ider cos t-of - living changes in setting stipend leve ~ s . 4. A maximum of 4 percent of the total training funds obli- gated in any f iscal year may be used for short-term training ~ not exceeding 3 months ~ for which the recipient does not incur a servi cc/payback obl ig a t ion . 5. Applications for individual NOSH awards no ~ anger have to be reviewed by National Advisory Councils. 6. The length of service required to discharge the payback orb igation was made uniform for all types of payback` activities (research, teaching, or health care delivery). Also, full credit now is provided for periods of service that constitute only partial fu~fill~nt of the payback obligation. The conditions under which the payback requirement may be wa ived were made more lenient . 7 . The reports formerly issued by this Commi t tee on an annual basis are now required at least once eve ry two years . The details of these and other changes to the NRSA Act and its administration are presented in Chapter 1. Endicott House Conference At a 2-day conference on November 30 and December 1, 197S, at Endicott Louse, the Committee reviewed a number of fundamental topics re ~ ating to the federal role in training for biomedical and behavioral research. The issues were examined in detail and led to the development of several high priority items on the Com- mittee's future research agenda. These high priority research items are: ~ a ~ problems involved in training clinical invest iga- tors; (b ~ the relationship between training grants and the quality of training in the biomedical and behavioral f ields; ~ c the expected decline in opportunities for academic careers and its potential impact on research productivity; and (d ~ determina- 1

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tion of priority f ields for training . A more complete summary of the Endicott House conference is presented in Chapter l. The details of the on-going and pi anned studies designed to investi- gate these issues are outlined in Chapter 2. Training Data for FYI97 8 The number of training grant appointments and fed lowship awards made by NIH, ADAMHA, and HRA in FYI978 ~ the latest availabl e data) were 13,204, slightly under the is, 775 recommended by the Committee, but up ~ percent from the ~ 977 level of 12,261. The FYI978 appropriations for training grants and fel low- ships from NIN were up almost 18 percent over the FYl977 leve ~ . But because of increased training costs, the number of awards made by the NIH increased only ~ O percent from the prior year. For ADAMEA, the FY~ 978 appropriations for training grants and fel ~ owships were down ~ percent from the FYI977 levels and ~ hence, the number of training awards made by that agency dec ~ ined by almos t 5 percent O In terms of training area s, the largest percentage in- creases in training awards occurred in the clinical science and nursing research fief ds. The basic biomedical sciences had a moderate 9 percent increase O The largest decrease occurred in the behavioral sciences due primarily to a decline of 30 percent in behavioral science training awards at NIH. While the deck ine in predoctora, awards in the behavioral sciences is in line with the Committee 's recommendations, the swi tch to postdoctoral training has not occurred as fast as the Committee has recom- mended. Heal th services research awards also declined slightly. A pi an to raise training stipends has been announced by the agencies. Starting on July I, ~ 980, stipends will be increased to $5r040 for predoctoral trainees, and to a base ~ ever of $13, 3 8 0 for pos "doctoral trainees wi th incremental al lowances made for prior experience O The 25 percent 1 imit for institu- tional al Jowances on training grants will be replaced by a pi an that allows a maximum of $3, 000 for each predoctoral trainee and $5, 000 for each postdoctoral trainee. For postdoctoral fellow- ships, the maximum institutional allowance wil ~ be $5,000 per 1 2-month period at nonfederal institutions and $2, 000 at federal institutions . Other Adm~nistrat ive Issues The Committee is pleased to note that in accordance with its recommendation, an Inter-Institute Review Commi t tee has been established at NIlI to coordinate predoctoral research training among the Ins titutes . 2

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Effective January I, 1980, ADAMHA no ~ anger requires two or more years of graduate work as an eligibi lity requirement for appo intments of predoctoral trainees under NRSA institutional grants. The Committee has recommended such a step as one means of improving opportunities for minorities to enter doctoral . . . raining programs . Amendments have been made to the Health Services Research, Health Statistics and Medical Technology Act of ~ 978 (PL 95-623 ~ to permit the use of NRSA support for training in heal th services research . Committee Recommendations The Committee has made no change in its numerical reco~nr~nda- tions for training from those that appeared in its 1978 Report and, in general, has also affirmd its nonnu~rical recomT~nda- tions made last year wi th regard to the separate areas of re- search training. 3