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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