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I particularly want to speak to the considerable increase in category 2, which is the so-called targeted research, from 1975 to 1978. This increase is due to a set of new programs which Congress legislated for our institute in 1974, namely, the National Diabetes Research and Education Act and the National Arthritis Act. These acts authorized, among other things, establishment of so-called multipurpose or comprehensive centers for research, training, education of patients and of the public, and studies of ways of improving the delivery of medical care by community projects. The funds that were added by these congressionally mandated programs to the NIAMDD appropriation (fortunately additions were made and we did not have to take the funds out of our research grants) entirely account for the increase, from $5 million to $18 million, shown by Bever. Such an increase is bound to cause a relative percentage decrease in category 1, or "fundamental" research. The absolute funding of category 1 research increased. I hope we shall in the course of the conference go on talking about ways that the NIH is starting to put into force or has ideas of putting into force means to improve the clinical research situation. We have looked ahead and seen that there is a need to do better by clinical research, to do much more for the training of clinical investigators, and to produce a larger clinical investigator pool. REFERENCES 1.Solomon Eskenazi (ed.). Extramural Trends, NIH, FY 1969-1978. Washington , D.C.: NIH, Statistics and Analysis Branch, Division of Research Grants, 1979. 2.James B. Wyngaarden. Presidential address presented at the annual meeting of the Assoc. Am. Physicians, Washington, D.C., May 6, 1979. Trans. Assoc. Am. Physicians, in press. Discussion Participants speculated on the reasons for the surprising result of Bever's analysis that clinical research is holding its own at NIAMDD contrary to perceptions in the clinical community about the total picture. Is NIAMDD atypical? Are the opportunities to do clinical research better in the disciplines supported by NIAMDD? The proportion of M.D. principal investigators has not dropped there and is higher than in the NIH as a whole; therefore it must have dropped more elsewhere in NIH. Whedon reported that during 1970-1978 the absolute number of Ph.D. recipients of individual research grants (ROIs) has increased at nine institutes of NIH and stayed level at three; the absolute number of S42 I G. Donald Whedon ¦ Research Support at NIH M.D. P.I.'s (as opposed to the proportion) has increased at four institutes , decreased at three, and stayed level at five. The aggregate numbers for all NIH grants, Douglass said (refer to Bever, table 6), show a 10 percent increase of M.D.'s and 33 percent increase of Ph.D.'s. It was noted that during the same period the number of academic M.D.'s nationwide has increased from 19,000 to 29,000, and there are three times as many M.D.'s as Ph.D.'s in academic medicine. Perspectives in Biology and Medicine ¦ Winter 1980 ¦ Part 2 S43 ...


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