The biomedical workforce report (TRR-I)

Important? Yes. Flawed? Yes. Must we do better? Yes. So let’s give it a try.

Long-awaited, the NIH-sponsored report on US biomedical

Let’s give it a try! (Picture from Raisintoast)

research training finally appeared in June (1). Late in 2010 Francis Collins, director of NIH, gave marching orders to a panel of experts—the Biomedical Research Workforce Working Group (BRWWG), which is part of the NIH Advisory Committee to the Director. Replacing that ugly acronym with the names of the panel’s co-chairs (2), I shall call it the Tilghman-Rockey Report, or TRR. Collins asked the panel to develop “a model for a sustainable and diverse biomedical research workforce,” to help determine how many and what kinds of people the US should train to “advance science and promote health.” On the basis of this model, but “recognizing that there are limits to NIH’s ability to control the training pipeline,” the panel was asked to recommend actions “NIH should take to support a future sustainable biomedical research infrastructure” (1).

Many of us hoped the TRR would answer grave questions about PhD and postdoctoral training and outline a clear path to a better future. This report does no such thing. Parts of it are useful, but on the whole the report proves to be something of a disappointment, despite generous arrays of facts and recommendations. Many sets of critical facts, the report scrupulously admits, are unavailable, incomplete or wildly unreliable. Of TRR’s recommendations, the most crucial often come across as timid, feckless, or aimed at the wrong target.

These deficiencies reflect no lack of experience, intelligence, or diligence on the part of the report’s framers. Some stem from troubling data gaps, especially with respect to the population size and career paths of groups whose trajectories are not adequately tracked—for instance, postdocs who are not US citizens and graduate students not supported by NIH training grants. Other deficiencies result from tight constraints. Thus Collins’s charge confined the recommendations to actions within NIH’s mandate, and the working group explicitly chose not to detail how its recommendations should be implemented, pleading lack of adequate time and resources to tackle such complex issues.

To my mind, the TRR suffers from two more serious flaws: (i) failure to connect dots between proposed recommendations for change and the root causes of problems those proposals are designed to fix; (ii) too narrow a focus on training, despite its charge to recommend ways to make the entire biomedical research workforce sustainable. Blurring cause-effect connections weakened the report’s impact by permitting key recommendations to pull their punches, and the narrow focus led to ignoring obvious additional connections between training difficulties and other problems that bedevil research centers, research administrators, funding agencies, PIs, and working laboratories. Ignoring the latter connections not only obscures rationales for proposed remedies, but also systematically limits those remedies to unilateral actions by the NIH—despite the fact that every stakeholder in the biomedical research enterprise shares partial responsibility for its workforce problems, which cannot be fixed without cooperation among all the stakeholders (3-5).

By way of clearing the deck before we turn to specific concerns and recommendations of the TRR, let me remind readers of certain workforce issues that are too important to ignore. Conversations with PIs, administrators, and leaders of funding agencies, often revolve about this short litany of 21st century problems afflicting US biomedical research:

  1. Ever-fiercer competition among; scientists (both well established and beginners) wrangling for publications, positions, promotions, trainees, and grants.
  2. Similarly intense—and increasing—competition among research institutions vying for prestige, money, and scientists.
  3. Arbitrary evaluation of individuals, research findings, ideas, and proposed projects, increasingly focused on marginal rather than core qualities: e.g., indirect costs vs. creative science; fancy journals vs. original work; reams of corroborating data vs. new data that disturbs hoary assumptions (6).
  4. Progressive graying of PIs. Beginning PIs apply for their first grant in their forties, while their elders control large resources and distribution of rewards.
  5. A growing tendency of the best college seniors to opt for scientific careers outside biomedical research—especially distressing because it contrasts sharply with so many opportunities for new discoveries and real-world applications.

Each of these troubles is too important to ignore, because all of them profoundly affect PIs, trainees, and all other members of the US biomedical research workforce. Troubles 1-3, however, do not figure in the TRR and numbers 4 and 5 receive short shrift there. But all five can be traced, at least in part, to a single cause, addiction of the US biomedical research enterprise to rampant expansion (4). Expansionism was a natural response to steady increases in NIH funding (averaging 8% per year, 1970-1998, higher in 1999-2003; 7). Its first and best-known consequence was a long spate of exciting discoveries and clinical advances that benefitted scientists, patients, and the entire nation. At the same time, biomedical investigators and research institutions became gradually addicted to expansion, and in turn that expansion exacerbated our litany of troubles. The TRR fails to mention expansionism, and—with a single exception, noted below—ignores its most disturbing consequences. In contrast, Biomedwatch’s discussions of TRR recommendations will often remind us of the role expansionism plays in causing the problem targeted by a particular recommendation.

The TRR must have been hard to write, because it tackles many problems, all multi-faceted, interconnected, and replete with unavoidable details that must be explained to most audiences—including biomedical PIs and research administrators. In analyzing the 156-page TRR, Biomedwatch faces the same difficulties. Because the problems, their potential solutions, and the report itself are too important and complex for a single post, I shall divide my comments into separate parcels. Most succeeding posts will detail specific problems with the biomedical workforce and its training, analyze the TRR’s recommendations with respect to training, and amend or extend certain recommendations to make them more effective. Our next foray into TRR-land will focus on the exception noted above: soft-money salaries for research faculty, a major contributor to expansionism and a problem badly in need of a remedy.

NOTES

1. Biomedical Research Workforce Working Group Report. Pdf here.

2. The working group’s co-chairs were Shirley Tilghman, a molecular biologist and president of Princeton, and Sally Rockey, NIH’s deputy director for extramural research. The document refers to itself as the Biomedical Research Workforce Working Group Report, or BRWWGR.

3. HR Bourne and MO Lively, Iceberg Alert for NIH, in Science Express (for pdf, see the “Must read” section on this blogsite’s main page. This editorial will be printed in the July 27 issue of Science.

4. Why ignore those icebergs? (I).

5. Why ignore those icebergs? (II)

6. For a thoughtful critique of evaluations in academic science, see RD Vale, Evaluating how we evaluate, President’s Column, ASCB Newsletter, 1 May 2012. Pdf here.

7. D Korn, et al., The NIH Budget in the “Postdoubling” Era, Science 296, 1401 (2002).

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About biomedwatch
Professor Emeritus of Cellular and Molecular Pharmacology, University of California, San Francisco

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