Response to the Hiatt report of NRC "Bullish on Biomedical Science".

The Report of the National Research Council entitled “Addressing the Nation’s Changing Needs for Biomedical and Behavioral Scientists” (National Academy Press, Washington, DC 2000) is a thoughtful analysis of the workforce needs of the Biomedical Community in the United States (http://grants.nih.gov/training/nas _report/index.htm). The members of the Committee, chaired by Professor Howard Hiatt of Harvard Medical School, are respected authorities in their fields. The Committee did a great job of identifying areas that need attention. However, in my opinion, the Committee did not fully recognize all the possible scenarios for future needs. I agree with the Committee that there are sufficient numbers of PhD scientists in the biomedical sciences to meet today’s needs. There even appears to be a surplus of domestic postdoctoral fellows who are unable to find tenure-earning faculty positions. If, however, there is a true “surplus,” why do so many American graduate programs and research laboratories continue to invite international students and scholars to join their laboratories? I welcome the immigration of the international scientists to America, and I shudder to think where we would be today without these scientists. These students and scholars come to America to learn, train, and perform good biomedical science without consideration of a future tenure-earning faculty position. Many, but not all, of these international trainees, return to their native countries. Most of the faculty positions with tenure in the academic medical centers of the United States (which are still under severe financial pressures from government policy and HMOs) are occupied by the baby-boomer generation (at least for a few more years). Recently, the United States Senate, after hearing testimony from the leaders of the American business community, voted overwhelmingly to significantly increase the number of H-1B visas to internationals with technical talents needed by American industry. Do we have too many or too few biomedical scientists, as evidenced by our immigration practices and policies? I agree with the Committee that there are too few biomedical scientists from under-represented minority communities. This problem has been recognized for more than a decade. Numerous GREAT Conferences of the AAMC have discussed this problem and possible solutions. But despite the long and hard efforts of many of us, the numbers of graduate students, postdoctoral fellows, and faculty from under-represented populations remains a serious problem in search of new ideas and approaches. I am uncertain as to the need for more biomedical scientists with MD degrees for clinical and patient-oriented research. While it is true that fewer scientists with MD degrees are receiving R-01 grants from the National Institutes of Health, the K-23, K-24, and K-30 mechanisms designed to address this problem are too new for analysis of results. In a few years we shall know if these initiatives were successful. At some universities most of the clinical/patient-oriented research seems to be supported, not by the NIH R-01 mechanism, but by the pharmaceuti-