Providing the Platform for Discovery
Research Training and Career Development
The biomedical and behavioral research conducted and supported by NIH—ranging from basic to applied—has long been recognized as critical to advancing the quality of health care in the nation and the world. As a result of NIH research, diseases such as AIDS, stroke, heart disease, and diabetes are being treated or prevented more successfully. Further research undoubtedly will lead to new or improved medical therapies for a spectrum of diseases and disorders. However, new advances in prevention, diagnosis, and treatment largely depend on the creativity, insight, and resources of the best scientists, and for these benefits to continue, there must be a regular source of highly trained, well-equipped, and innovative new investigators. Research training is where it all begins.
NIH research training and career development programs are designed to prepare new researchers to meet the demands of emerging problems in medicine and health and ensure that diverse pools of highly trained scientists are available in sufficient numbers and with appropriate expertise to generate new discoveries, take advantage of rapidly moving scientific developments, and bring science to bear on complex and evolving health care challenges. By sponsoring research training and career development programs in universities, teaching hospitals, NIH laboratories, and other research-intensive settings, NIH expects that trainees and newly trained investigators will not only be exposed to the latest research findings and techniques, but also that they will be positioned to respond to developing national and international public health needs. NIH takes extra efforts to foster new investigators that focus on under-researched areas such as clinical and translational research, rare diseases, health disparities, and global health issues.
The task of assessing and predicting research personnel needs across the entire spectrum of health-related research— basic biomedical sciences, behavioral and social sciences, clinical sciences, oral health sciences, nursing research, health services research, and the interdisciplinary junctures between fields—is daunting. Aligning the requisite expertise with public health needs is complicated by the evolving nature of research; the time required for research training; the international nature of research; and the mobility of the global research workforce. Preparing for a career in research generally requires a commitment of 8–10 years or more of pre-doctoral and postdoctoral training and career development; in the meantime, science is advancing, new diseases are emerging, and existing diseases are becoming better understood, diagnosed, and prevented.
In determining how best to address the continuing need for biomedical and behavioral scientists, NIH is guided by regularly scheduled analyses of the research workforce. Chief among these assessments are recurring studies conducted by the National Academy of Sciences, which provide guidance on the fields in which researchers are likely to be required, as well as on the number of new investigators needed in the biomedical, behavioral, and clinical sciences. NIH also routinely evaluates the outcomes of its training programs, comparing the subsequent research involvement of students and postdoctoral scholars who participate in NIH research training with their counterparts who were trained through other sources. Beyond such agency-wide assessments, individual ICs determine the need for new scientific personnel in mission-specific research areas through targeted evaluations, input from extramural investigators, and guidance from their national advisory councils.
NIH offers a broad range of research training and career development opportunities in its extramural and intramural research communities, through institutional training awards and individual fellowships, individual and institutional career development awards, research education programs, workshops, research grants, and supplements to promote diversity or reentry into health-related research careers. Although its programs are largely directed toward graduate students and newly trained investigators, NIH offers a number of highly focused training and career development opportunities for individuals at other career stages, from college students to established scientists.
In response to the mandate under SEC. 403 (a)(4)(C)(iv) of the Public Health Service Act to provide catalogs of research training activities, Appendix E includes the following:
Training for a career in research typically requires a combination of specialized coursework and hands-on research experiences under the guidance of an established investigator. Most NIH-funded research training activities focus on predoctoral students and postdoctoral scholars and are provided either through training grants (T awards), which are awarded to institutions to support a coordinated program of training for a group of students or scholars, or fellowships (F awards), which directly support an individual’s training. The principal (in terms of size and breadth of coverage) NIH research training program for U.S. citizens and permanent residents is the Ruth L. Kirschstein National Research Service Award22 (NRSA) program. The goal of the NRSA program is to support promising students and postdoctoral scholars with the potential to become productive, independent investigators in fields relevant to NIH’s mission. Training activities can be in basic biomedical or clinical sciences, in behavioral or social sciences, in health services research, or in any other discipline relevant to the NIH mission, and always includes instruction in the responsible conduct of research. All ICs with funding authority award NRSA institutional research training grants and fellowships, except FIC and NLM. Reflecting the unique nature of their missions, these two ICs have distinct training authorities, separate from the NRSA program.
Through the NIH-wide program of NRSA institutional training grants and fellowships, NIH ICs supported over 16,000 graduate students and postdoctoral scholars at universities, teaching hospitals, and research centers in nearly every state in FY 2011. Institutional training grants form the core of NIH’s research training programs, providing support to more than 80 percent of all NRSA program participants. Training grants play a particularly important role at the predoctoral level: approximately 60 percent of trainees are graduate students, who are often engaged in coursework and laboratory rotations in preparation for identifying an area of research for in-depth study. (See Appendix E for a breakdown on the demographics of NRSA participants and a summary of the number and type of doctoral degrees awarded to predoctoral NRSA recipients.)
Individuals interested in research training in universities or departments that do not offer institutional training grants, as well as advanced students and postdoctoral scholars seeking tailored training opportunities, have the option of applying directly to NIH for an individual research training fellowship. NRSA fellowships provide recipients with valuable experience in initiating and testing their own research ideas before becoming full-fledged investigators.
Across NIH, NRSA training grants and fellowships help ensure the diversity of the research workforce by promoting research training opportunities for individuals from populations and backgrounds typically underrepresented in research. At the graduate and postdoctoral levels, NIH policy requires institutional training grant directors to take steps to recruit and retain trainees from underrepresented groups, including racial and ethnic groups and individuals with disabilities. Through the Ruth L. Kirschstein NRSA Individual Predoctoral Fellowship (F31) to Promote Diversity in Health-Related Research,23 NIH also provides graduate students from underrepresented groups with opportunities to pursue research training through individual fellowship awards. Because part of the inherent challenge of recruiting talented individuals into research training programs is to have a pool of prepared applicants from which to draw, NIH offers undergraduate research training to honors students who have an explicit interest in a research career and who intend to pursue postgraduate education leading to a Ph.D., M.D./Ph.D., or other combined research degree at selected institutions.
The relative diversity of research training participants reflects NIH’s commitment to cultivating a broad-based scientific workforce. Among FY 2011 trainees and fellows who reported their race and ethnicity, 66 percent were White, 15.3 percent were Asian, 7.7 percent were African American, 8.6 percent were Hispanic, 1 percent were Native American, and 0.6 percent were Native Hawaiian or Pacific Islanders. More than 52 percent of trainees and fellows in FY 2011 were women.
NRSA training grants and fellowships may target broad-based or field-specific research training, depending on the needs identified by the administering IC. In recent years, this flexibility has allowed the NRSA program to accommodate interest in greater integration of training activities across NIH in order to fulfill workforce needs shared by multiple ICs.
Notable examples include the training grants and institutional career development awards in clinical and translational research that have been incorporated into the growing network of Clinical and Translational Science Awards24 (CTSAs) administered by NCRR.25 Now active at 60 sites around the country, the CTSA program provides research training and career development opportunities in areas such as clinical research design, epidemiology, biostatistics, pharmacology, biomedical informatics, behavioral science, and ethics to over 900 NRSA trainees and new investigators annually. (CTSA trainees are included in the NRSA data provided in Appendix E.) NCRR also joined forces with NCI, NIDA, NIGMS, and NINR to provide career development opportunities for young investigators interested in cross-training in patient-oriented research, pharmacogenomics, and personalized medicine.
Another trans-NIH initiative is the Early Independence Awards.26 These awards, supported by the NIH Common Fund, provide newly-trained scientists who are ready and able to work independent of a mentor a chance to forgo the traditional period of postdoctoral training after receiving their doctoral degree and pursue their own program of independent research. The first group of 10 such new investigators to receive these awards was selected in 2011 and is being closely monitored to determine the effects of early research funding on innovation.
In addition to its formal research training programs, NIH supports graduate and postdoctoral research experiences on research grants. Though not an NIH "program" per se, the impact of this support is significant. Graduate students and postdoctoral scholars acting as research assistants—often before or after a NRSA training grant appointment or fellowship—gain knowledge, skills, and experience that help prepare them for careers in research.
To provide a better understanding of how graduate students and postdoctorate fellows contribute to research projects, NIH investigators were asked to identify all research project personnel on their annual progress reports, beginning with those due in FY 2010. After analyzing the first full year of data, NIH has calculated that more than 23,000 graduate students and 28,000 postdoctorate fellows are employed as research assistants or associates on research grants. As these personnel data continue to accrue, NIH plans further analyses to obtain a greater understanding of the staffing patterns of research grants and the biomedical research workforce supported by its funding.
22For more information, see https://www.nigms.nih.gov/Training/RuthKirschstein.
23For more information, see https://grants1.nih.gov/grants/guide/pa-files/PA-11-112.html.
24For more information, see https://www.ncats.nih.gov/research/cts/ctsa/ctsa.html.
25On December 23, 2011, President Barack Obama signed the Consolidated Appropriations Act, 2012 (P.L. 112-74). As part of this legislation, the National Center for Research Resources (NCRR) is dissolved and the National Center for Advancing Translational Sciences (NCATS) is established. Science Education Partnership Awards (SEPA) is now part of the NIH Office of the Director, Division of Program Coordination, Planning and Strategic Initiatives, Office of Research Infrastructure Programs.
26For more information, see https://commonfund.nih.gov/earlyindependence/
Because each NIH IC has its own particular research mission, individual ICs are responsible for determining how the workforce needs identified by the National Academy of Sciences and others apply to their specific scientific fields, selecting individuals and institutions for NRSAs or other research training awards to meet the needs identified, and reviewing annual progress toward building or enhancing capacity in the research workforce. Areas targeted for research training initiatives reflect the full array of NIH interests, from basic research training in biology and chemistry to clinical and translational research training in fields like cancer, infectious diseases, and aging. To ensure a supply of investigators attuned to the challenges of both research and patient care, a number of ICs also make awards for M.D./Ph.D. and other types of dual-degree training. The oldest and largest of these is the NIGMS Medical Scientist Training Program, which supports exceptional students pursuing an integrated program of graduate training in the biomedical sciences and clinical medicine.
Reflecting the FIC mission to foster global health research and build research capacity in low- and middle-income countries, FIC institutional training grants (D43s) differ from those offered by the NRSA program or by NLM by allowing a broader range of participants and emphasizing the development of institutional partnerships and collaborations between U.S. and international universities and scientists. Most FIC research training programs target individuals from low- and middle-income nations, but a number of selected programs provide opportunities to U.S. students and postdoctoral fellows interested in global health research. Ultimately, the aim of FIC’s research training programs is to strengthen sustainable research capacity in the developing world.
NLM’s research training portfolio generally parallels the structure and requirements of the NRSA program and reflects NLM’s unique role as the primary federal sponsor of biomedical informatics research and training. NLM prepares the next generation of informatics researchers and health information specialists through institutional grants27 (T15s), which support graduate and postdoctoral training in a broad range of topics, including health care informatics, translational bioinformatics, clinical research informatics, and public health informatics, as well as some specialized areas such as imaging or dental informatics. NLM also offers a clinical informatics research fellowship on the NIH campus designed to attract physicians and others to NIH to pursue research in clinical informatics. Unlike NRSA research training awards, some NLM training programs are open to master’s degree holders seeking further graduate-level coursework and hands-on training.
Given the ever-quickening pace at which science advances, investigators need opportunities to fully develop their scientific expertise and stay up to date. NIH Career Development Awards28 (K awards) address this need. Collectively, more than a dozen types of K awards support investigators as they establish their research careers, pursue new directions, or dedicate themselves to training and mentoring the next generation of scientists. Like the T and F training awards, some career development awards support institutional activities to nurture careers, and others directly support individual development.
Many career development awards are designed for researchers at specific career stages, particularly newly trained investigators. The NIH-wide Pathway to Independence Award29 accelerates the transition from mentored to independent research by providing a bridging mechanism of an initial mentored period of 1–2 years followed by an independent phase, during which awardees establish their own research programs and apply for independent research support. Other “mentored” career development awards provide support for a sustained period of “protected time” for intensive research career development under the guidance of an experienced investigator. The expectation is that, with this experience, awardees will be able to take the final steps toward establishing independent research careers and becoming competitive for new research project grant funding. At the other end of the career spectrum, a number of ICs provide career development opportunities to mid-career and established investigators. These awards provide salary support for outstanding senior scientists and recognized leaders so that they can focus intensively on their research and mentor new investigators.
Since the NRSA program was established in 1974, NIH training programs have been regularly reviewed and evaluated. The National Academy of Sciences has undertaken regular reviews of the medical research workforce and made recommendations for modifications in the size and focus of the NRSA program. In addition, NRSA program processes and outcomes are regularly assessed through recurring program evaluations and performance is evaluated annually using Government Performance and Results Act (GPRA) goals. These reviews have been coordinated by OER, which oversees the NRSA program.
NAS reviews. Over the past 30 years, the NRSA program has been the subject of more than a dozen studies by the National Academy of Sciences, which has provided expert guidance on the fields in which researchers are likely to be required and on the number of new investigators needed in the basic biomedical, behavioral, and clinical sciences. The most recent National Academy of Sciences report on research training, published in 2011, noted that the NRSA program has “set the standard” for research training.30 The recurring nature of these National Academy of Sciences studies ensures that NIH research training programs reflect changes in science and research needs that inevitably occur over time. In recent years, NIH has followed recommendations from National Academy of Sciences committees for enhancing stipend levels, promoting the early completion of research training, and improving workforce data collection and analysis.
Evaluation of NIH training and career development programs. Evaluations of the outcomes of NRSA research training routinely have found that graduate students participating in NRSA programs complete their degrees faster, are more likely to pursue research careers, and have greater subsequent success in research than do students not participating in NRSA programs.31 Similarly, assessments of NRSA postdoctoral training have found that NRSA postdoctoral fellows are more likely to successfully pursue research careers. In FY 2011, around 30 percent of former NRSA postdoctoral fellows who subsequently applied for a major NIH research grant received funding, compared to 17 percent of other postdoctoral fellows.32
Most recently, NIH evaluated the effects of its three most widely used types of mentored career development awards: K01, K08, and K23. Comparing similar groups of funded and unfunded applicants, those who received a career development award were more likely to remain in research, publish their research findings, apply for and receive major NIH research grants, and, for those whose careers were tracked for sufficient time, apply for and receive a grant renewal.33 While all investigators receiving these career development awards fared well, the opportunity for a mentored career development experience had the greatest impact on M.D.s and M.D./Ph.D.s.
Government Performance and Results Act (GPRA) measures. Every year, NIH reports on NRSA research training outcomes and program management using three GPRA measures. In the first two measures, NIH seeks to assess the quality of its programs and determine if substantial numbers of trainees and fellows are retained in research careers by comparing the proportion of former NRSA trainees and fellows who apply for and successfully receive NIH research grant support against their peers. Subsequent NIH support is one of several measures that reflect the impact of NRSA research training on participants’ ability to successfully pursue and sustain a research career. To date, NIH has generally met these GPRA measures because NRSA trainees and fellows consistently outperform their counterparts.
The third training-related GPRA measure assesses NIH progress in improving the efficiency of NRSA program management by developing and implementing the xTrain electronic system for appointing trainees to institutional training grants. The system was piloted in 2008, improved, and then required NIH-wide in mid-2011. By the end of FY 2011, 99.3 percent of trainee appointment forms were submitted electronically. In 2012, when the system is fully implemented, xTrain is expected to save substantial staff time and eliminate data entry errors while increasing NIH’s efficiency and enhancing the integrity of data used for program monitoring and evaluation purposes.
Institute and Center training evaluations. In addition to scheduled NIH-wide assessments of programs coordinated through OER, individual NIH ICs undertake periodic, targeted evaluations to improve implementation and assess outcomes of their own training programs. For example, as mandated by the NIH Reform Act of 2006 (Pub. L. No. 109-482), in 2010-2011, NCRR conducted an evaluation of the outcomes and effectiveness of CTSA training programs. The evaluation34 included surveys of trainees, scholars, and mentors and addressed pediatric clinical research training issues in particular.
27For more information, see https://www.nlm.nih.gov/ep/GrantTrainInstitute.html.
28 For more information, see https://grants.nih.gov/training/careerdevelopmentawards.htm.
29For more information, see https://grants1.nih.gov/grants/guide/pa-files/PA-11-197.html.
30 For more information, see https://grants.nih.gov/training/Research_Training_Biomedical.pdf.
31For more information, see https://grants.nih.gov/training/career_progress/index.htm.
32For more information, see https://www.hhs.gov/budget/performance-appendix-fy2013.pdf.
33For more information, see https://grants.nih.gov/training/K_Awards_Evaluation_FinalReport_20110901.pdf.
34For more information, see https://www.ctsacentral.org/sites/default/files/files/CTSANationalEval_FinalReport_20120416.pdf.
OER partners with ICs to coordinate and monitor awards for research training and career development across NIH. With active input from the ICs, OER establishes and implements policies and guidelines for each of the programs; determines broad national needs for basic biomedical, behavioral, and clinical research personnel; coordinates NIH-wide evaluations; develops trans-NIH research initiatives in which NIH ICs participate; and develops and maintains information systems to enhance program efficiencies. OER convenes monthly meetings of the NIH Training Advisory Committee to provide an agency-wide forum to identify and discuss issues related to research training and to provide opportunities to coordinate activities pertinent to the review, administration, management, and evaluation of training grants and fellowships.
The NIH intramural program provides opportunities for students, postdoctoral scholars, and clinicians to gain research experience within the more than 1,100 NIH intramural laboratories. A multifaceted array of programs provides a vibrant, scholarly environment and ensures strong research training experiences for future investigators and the continued professional development of intramural scientists.
Among the intramural program’s offerings are summer internships for high school, college, and graduate students. Recent college graduates who plan to apply to graduate or professional school also can spend a year engaged in biomedical research working side by side with NIH scientists. Current graduate students can spend a summer, or a year, as fellows engaged in biomedical research at NIH. The Graduate Partnerships Program35 enables students to pursue research at NIH toward their degrees in partnership with a participating academic institution. By linking academic environments with the breadth and depth of research at NIH, the Graduate Partnerships Program offers a unique graduate experience. Similarly, the Clinical Research Training Program36 provides research-oriented medical and dental students an opportunity to engage in a mentored clinical or translational research project on the NIH campus.
Training opportunities continue when scholars gain their graduate degrees. Year-round, NIH intramural laboratories employ fellows from the U.S. and abroad, creating a thriving, multidisciplinary intramural research community. The Postdoctoral Intramural Research Training Award37 provides the opportunity for recent doctoral degree recipients who are U.S. citizens or permanent residents to enhance their research skills in the NIH intramural environment. Trainees pursue both basic and clinical research. A parallel program, Visiting Fellowships, serves foreign national doctoral-level scientists. For clinicians, there are opportunities for residency and subspecialty training, including graduate medical education accredited programs. (For program completion data, see Appendix E.) These graduate medical education programs enable research-oriented clinicians to weave research experience and training into their post-medical school training.
In recent years, NIH’s intramural program increasingly has focused on helping graduate students and postdoctoral fellows develop their career skills. To ensure that intramural trainees and fellows can successfully advance in their careers, NIH offers courses in scientific writing and grant writing, as well as presentation and teaching skills. In addition, intramural trainees and fellows—indeed, all members of the NIH community—benefit from access to a wealth of NIH courses, seminars, and science career resources.
In late 2011, NIH unveiled plans for a new "intramural-extramural" partnership to nurture the next generation of clinical researchers, funded in part by the Lasker Foundation. Individuals selected as Lasker Clinical Research Scholars38 have the opportunity to serve as an investigator in the NIH intramural program. If they choose to work in an extramural setting after their time as a Lasker Scholar, they can qualify for additional years of support at an extramural research institution.
The NIH Loan Repayment Program39 is a vital component of our nation’s efforts to attract eligible doctoral-level professionals to research careers in fields of special importance, including clinical, pediatric, health disparities, contraception and infertility, and AIDS research. To encourage qualified scientists to pursue research in these critical areas, the Loan Repayment Program provides financial assistance for educational debt in exchange for a two- or three-year research commitment. Over 1,600 program participants each year receive up to $35,000 annually in loan repayment and fulfill their commitments by conducting research in nonprofit, university, or government settings, or as an NIH employee.
35For more information, see https://www.training.nih.gov/programs/gpp.
36For more information, see https://www.cc.nih.gov/training/crtp/crtp.html.
37 For more information, see https://www.training.nih.gov/programs/postdoc_irp.
38 For more information, see https://www.nih.gov/science/laskerscholar/ or https://grants.nih.gov/grants/guide/rfa-files/RFA-OD-12-001.html.
39 For more information, see https://www.nih.gov/science/laskerscholar/ or https://www.lrp.nih.gov/index.aspx.