Letter on NIH Statement in
Response to the NAS Report: Addressing the Nation's Changing
Needs for Biomedical Behavioral Scientists
April 30, 2001
Walter Schaffer, Ph.D.
NIH Research Training Officer
Office of Extramural Research
6701 Rockledge Drive, Rm. 6184
Bethesda, MD 20892-7911
Dear Dr. Schaffer:
The Association of American Medical Colleges (AAMC) appreciates
the opportunity to respond to the "NIH Statement in Response
to the NAS Report: Addressing the Nation’s Changing Needs
for Biomedical and Behavioral Scientists." The AAMC represents
all 125 accredited U.S. medical schools, some 400 major teaching
hospitals and health systems, 91 academic and professional
societies representing over 100,000 faculty members, and the
nation's medical students and residents. The AAMC has long
been concerned about the status of graduate and postdoctoral
education with respect to the quality of the educational experience,
adequacy of institutional systems of support, duration of
program/fellowships, levels of compensation, and the pathways
available to students and fellows to achieve productive professional
careers. In particular, the AAMC’s Group on Graduate Research,
Education, and Training (GREAT Group) has addressed many of
these issues and continues to provide a national forum for
the exchange of information and ideas related to the improvement
of biomedical graduate education and postdoctoral training.
In general, the AAMC agrees with much of the content of the
NIH Statement. The AAMC has vigorously advocated increased
federal support for the training of biomedical and behavioral
research scientists. In addition, the Association is keenly
aware of the myriad research workforce issues and agrees with
many of the concepts expressed in the NIH Statement on this
subject. With regard to the reference to the AAMC and the
management and linkage of databases involving NIH information,
we are very eager to continue our collaborations with the
NIH in collecting data and sharing information on biomedical
research trainees.
The AAMC concurs with both the NIH Statement and the NAS
Report in acknowledging that the effective training of graduate
students and postdoctoral fellows is imperative to the sustenance
of a highly productive biomedical and behavioral research
enterprise. However, the AAMC, like the NIH, differs with
the NAS Report’s general approach for controlling the production
of research personnel and with some of the specific recommendations
for improving the National Research Service Award (NRSA) training
program. Specifically, the NIH Statement makes reference to
the NAS Report’s recommendations found in Chapter 2, Basic
Biomedical Scientists, and Chapter 5, Crosscutting Issues
in Research Training. Below, we provide our comments on the
NIH Statement about particular recommendations found in those
two chapters.
Chapter 2 Recommendations
Recommendation 2-1. There should be no growth in the aggregate
number of Ph.D.s awarded in the basic biomedical sciences.
The AAMC agrees with the NIH assessment that there exist tremendous
uncertainties in predicting the future workforce needs of
the biomedical research enterprise. The AAMC acknowledges
the workforce analysis by the NAS Committee, but like the
NIH, does not believe there is a need for NIH to establish
policies or take specific measures that would limit or restrict
enrollment of graduate students into the biomedical sciences.
The AAMC believes that the remarkable abundance of new
opportunities in biological inquiry make workforce predictions
hazardous, and that educational institutions, not the NIH,
should determine student enrollment into their biomedical
research programs based on the research capabilities, availability
of qualified students, and prospects for scientific contribution
and academic achievement.
Recommendation 2-2. Support for the NRSA training grants
and fellowships at the predoctoral and postdoctoral levels
should be gradually increased. At the predoctoral levels,
the NIH should seek to provide at least 50 percent of its
research training support through training grants and fellowships.
This recommendation proposes to shift the mechanism of support
for biomedical research trainees from research to training
grants. The AAMC concurs with the NIH Statement that "attempts
to manipulate these mechanisms (training vs. research grants)
for the purpose of controlling Ph.D. numbers would run counter
to their primary purposes." The AAMC believes that the
mechanism for supporting a student in a training program,
whether from a training or research grant, should continue
to be determined by the scientific need and capability at
the institutional level. With regard to NIH’s endorsement
of the concept that federal funding from any combination of
NRSA and/or research grants should not exceed six years for
graduate training and five years for postdoctoral training,
the Association supports the intent of the proposal, but strongly
urges that the NIH allow for some flexibility to accommodate
special circumstances. The AAMC suggests this could be
most easily accomplished by stating that "in the absence
of extenuating circumstances, federal funding from any
combinations of NRSA and/or research grants should not exceed
six years for graduate training and five years for postdoctoral
training."
Chapter 5 Recommendations
Recommendation 5-4. Stipends and other forms of compensation
for those in training should be based on education and experience
and should be regularly adjusted to reflect changes in the
cost of living. The Association supports the recommendation
found in the NIH Statement and the NAS Report to increase
NRSA stipends. The AAMC is pleased with NIH’s plan to develop
budget requests that will permit an increase in stipends of
10 to 12 percent per year for the next few years. However,
the AAMC is concerned that such an increase may still be inadequate
given the high levels of education and professional skills
of graduate students and postdoctoral fellows. Furthermore,
these stipend requests do not address the issues of providing
healthcare benefits for both graduate students and postdoctoral
fellows. Although the costs of healthcare benefits are allowable
under NIH research grants, they do not appear to be so with
NRSA training grants and fellowships. The AAMC is sympathetic
with the potential limitations on the NIH’s ability to provide
healthcare benefits, but we firmly believe that the NIH is
the appropriate agency to begin to force attention to these
issues.
The AAMC would like to note that the increased stipends would
require increased funds for trainees being supported on both
NRSA and research grants. With the anticipated doubling of
the NIH budget, commensurate increases on research grants
for increased stipends is necessary in order to establish
parity for all pre- and postdoctoral trainees, regardless
of their source of funding. Consideration should be given
to a mechanism to allow adjustments to research grants during
non-competing budget years. The AAMC strongly urges the
NIH to establish an appropriate mechanism to provide for the
increased trainee stipends being supported on research grants.
The AAMC has no disagreement with the other comments made
in the NIH Statement, and overall, is very supportive of NIH’s
response to the NAS Report. Once again, we would like to express
our appreciation to NIH for addressing the NAS Report and
for inviting the extramural community to offer comments prior
to implementation. We thank you for this opportunity to provide
our input and invite you to contact Andrew Quon, AAMC Division
of Biomedical and Health Sciences Research, 202-828-0485 if
we may be of further assistance.
Sincerely,
Jordan J. Cohen, M.D.
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