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Final Thoughts and Summary of Recommendations by Actor

The U.S. biomedical¹ research enterprise has been one of the most productive segments of the U.S. economy since the second half of the 20th century. It has been responsible for generating a wealth of knowledge about the very workings of life, producing groundbreaking medical advances, and creating thousands of new companies and tens of thousands of well-paying jobs. It has also served as a model of how multiple stakeholders, working both independently and collaboratively, can make and turn fundamental discoveries into products and economic activity that benefit many areas of modern society. Yet, as with any successful complex enterprise, sustained success—and the benefits accrued to society—requires a constant infusion of talented individuals who receive support from the enterprise as they generate the next wave of discoveries and innovations.

However, as this report and others preceding it have stated, there is substantial room for improvement when it comes to nurturing, supporting, and, in some cases, valuing that next generation of young scientists. Indeed, the U.S. biomedical enterprise is in danger of at best underutilizing and at worst losing a significant number of its brightest young scientific minds because of significant structural and cultural problems. However, stakeholders in the U.S. biomedical research enterprise, working independently and collaboratively, could implement solutions to these problems in relatively short order. Through its recommendations in this report, the committee has enumerated what it believes to be the most important of those solutions.

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¹ In this report, “biomedical” refers to the full range of biological, biomedical, behavioral, and health sciences supported by the National Institutes of Health.

Although most of the committee’s recommendations are directed at the National Institutes of Health (NIH), given its outsized role in funding biomedical research and training, they are not intended for NIH to implement by itself. In fact, of all stakeholders, NIH has been the most attentive and responsive to the issues facing emerging investigators as they strive for independent research careers. Now, it is time for the remaining stakeholders—universities and other research institutions, principal investigators, professional societies, philanthropic organizations, Congress and the nation’s biomedical research funding agencies, and industry—to be equally involved in creating an environment that enables the nation’s young investigators to thrive and push the frontiers of knowledge, generate enumerable benefits to our society, and provide the intellect and energy needed to keep the biomedical research enterprise strong and vibrant.

To clarify the obligations of many, though certainly not all, stakeholders to address the challenges facing young biomedical researchers, the following sections parse by stakeholder the committee’s recommendations. While recommendations are assigned to a stakeholder, their implementation will often require collaborative efforts by several or all stakeholders.

THE RECOMMENDATIONS—BY STAKEHOLDER

Congress should

• Establish a Biomedical Research Enterprise Council (BREC) to address ongoing challenges confronting the Next Generation of Biomedical Researchers. The BREC would exercise ongoing collective guardianship of the biomedical enterprise function as a forum for sustained coordination, consultation, problem-solving, and assessment of progress toward implementation of the recommendations put forth in this report.
• Consider increasing the NIH budget, specifically to implement the recommendations in this report and to sustain NIH’s recently announced Next Generation Researchers Initiative.
• Revise the Small Business Innovation Research (SBIR)/Small Business Technology Transfer (STTR) program to create a novel ecosystem that fosters entrepreneurship for next generation biomedical scientists, facilitates women and minority-owned entrepreneurship, and supports fulfillment of NIH’s mission across the private sector.
• Extend or establish an employment tax credit to research and development (R&D) firms for hiring recently minted Ph.D.’s, M.D.’s, and M.D.-Ph.D.’s and make the credit higher for small- to medium-sized R&D firms and firms that recruit into R&D activity for the first time.
• Promote innovative pilot projects on the part of research institutions and other stakeholders that seek to improve and accelerate transitions into

• independent careers. A Next Generation Researcher Innovation Fund should be created to support these experimental projects.

The National Science Foundation should

• Develop and implement a plan to improve sector-wide data collection and analysis in a manner that is easily accessible by policymakers and that integrates data from numerous other sources.
• Work expeditiously to link the Survey of Doctorate Recipients and the Survey of Earned Doctorates to U.S. Census data, and then make those linked data, under strict confidentiality protocols, available to qualified researchers at Federal Statistical Research Data Centers to understand better the biomedical workforce.

The National Institutes of Health should

• Phase-in policies that require the collection and publication of data on outcomes and demographics of biomedical pre- and postdoctoral researchers, using common standards and definitions, as a prerequisite for further funding to incentivize compliance.
• Require the inclusion of an institutional training and mentoring plan as a component of the “Resources and Environment” section of grant applications.
• Require principal investigators (PIs) to provide a postdoctoral training and mentoring plan in all grant proposals that will support postdoctoral researchers and to update those plans in progress reports.
• Increase the Ruth L. Kirschstein National Research Service Award (NRSA) starting salary for new postdoctoral researchers to $52,700 (in 2018 dollars), with annual increases for inflation and for cost-of-living tied to the Personal Consumption Expenditure Index.
• Expand awards or create new competitive awards to support postdoctoral researchers’ advancement toward an independent research career. By July 2023, there should be a 5-fold increase in the number of individual research fellowship awards (F-type) and career development (K-type) awards for postdoctoral researchers granted. This goal should be achieved incrementally and steadily during this period. The indirect recovery cost rate earned by K-type and training awards should be increased to 16 percent.
• Phase in a cap (3 years suggested) on salary support for all postdoctoral researchers funded by NIH research grants and multi-project grants. This phase in should occur only after a robust pilot study (or studies) of sufficient size and duration to assess the feasibility of this policy and the opportunities it provides has been undertaken.

• Work with Congress to revise the SBIR/STTR program to create a novel ecosystem that fosters entrepreneurship for next generation biomedical scientists, supports women and minority-owned entrepreneurship, and facilitates fulfillment of NIH’s mission across the private sector.
• Increase the number of NIH Director’s New Innovator Awards (DP2), and similar programs funded by individual NIH Institutes and Centers, to promote innovative research with high potential for groundbreaking discoveries.
• Ensure that the duration of all R01 research grants supporting early-stage investigators (ESIs) is no less than 5 years to enable the establishment of resilient and independent research programs. NIH Institutes and Centers should experiment with further extending the duration of R01 awards for ESIs.
• Retain the ESI status for individuals who participate in multi-PI submissions prior to receiving their own R01 grants, unless serving as a co-PI on a funded multi-PI award provides them with R01-equivalent funds for their own research, to avoid dis-incentivizing research collaboration.
• Expand the Pathways to Independence (K99/R00) award but prioritize fostering independence through career development. The award should require development of an innovative and independent research project that is conceived of and executed by the applicant. The award should not represent additional or new training.
• Continue to improve the peer-review process to optimize the evaluation of applications submitted by early-stage and early experienced investigators in the Next Generation Researchers Initiative. This is of special importance for investigators from underrepresented groups.
• Revise the biosketch requirement to focus peer review on recent contributions and accomplishments and continue to test effective practices for reducing the effects of implicit bias and for increasing the diversity of reviewers.
• Develop mechanisms to increase the number of individuals in staff scientist positions to provide more stable, non-faculty research opportunities for the next generation of researchers.
• Require an institutional diversity and inclusion plan as a part of the Institutional Resources component of research grants to promote diversity and inclusion at the junior faculty level.
• Allocate funds from the Next Generation Researchers Initiative to expand the number of Research Supplements to Promote Diversity in Health-Related Research (PA-16-288). Award these supplements to underrepresented minority ESIs and investigators who have not received a prior research project grant and seek to collaborate with funded investigators on new but related research projects.

• Offer the Loan Repayment Programs to all individuals pursuing biomedical physician-scientist researcher careers, regardless of their research area or clinical specialty, and increase the amount of loan forgiveness to reflect the debt burden of current medical trainees.
• Continue implementation of the recommendations set forth in the 2014 NIH Physician-Scientist Workforce Working Group Report, and test new strategies and expand effective approaches to increase the pool of early-stage physician-scientists.
• Promote innovative pilot projects of research institutions and other stakeholders that seek to improve and accelerate transitions into independent careers. Create a Next Generation Researcher Innovation Fund to support these experimental projects.
• Enhance the use of Institutes and Centers as vehicles to pilot new mechanisms designed to support the independence of early-career researchers and thereby strengthen NIH capacity for innovation more broadly. Monitor and evaluate these pilots through the Biomedical Research Enterprise Council proposed above.

Biomedical research institutions should

• Promote, document, and disseminate existing and planned efforts, both independent and collaborative, to reduce the barriers to recruiting and retaining diverse researchers for pre- and postdoctoral positions and the initial stages of research independence.
• Collect, analyze, and disseminate comprehensive data on outcomes, demographics, and career aspirations of biomedical pre- and postdoctoral researchers using common standards and definitions as developed in concert with NIH.
• Provide evidence to NIH of formal training of faculty mentors of postdoctoral trainees.
• Adjust the base postdoctoral salary annually to match the corresponding NRSA rate, with increases based on local cost-of-living, and harmonize benefits for all postdoctoral scholars regardless of their support mechanism.
• Levy a fee of at least $1,000 per year for each postdoctoral fellow supported on all biomedical research grants. These fees should be used to support effective training and professional development programs for postdoctoral researchers, as well as effective training of mentors. The use of the fees should be reported publicly.
• Identify or provide an institutional ombudsperson to resolve fairly and expeditiously conflicts and concerns between principal investigators and postdoctoral researchers related to the training experience.
• Limit postdoctoral training to 5 years, after which postdoctoral researchers continuing in the same laboratory should be shifted to employment as a staff

• scientist with an increase in salary and benefits appropriate for a permanent staff member.
• Develop mechanisms to increase the number of individuals in staff scientist positions to provide more stable, non-faculty research opportunities for the next generation of researchers.
• Experiment with creating career tracks for staff scientists with clearly defined review and promotion processes, as well as opportunities for professional development.
• Provide individuals in the staff scientist track with salaries and benefits commensurate with their experiences and responsibilities.

Principal investigators should

• Provide every postdoctoral researcher with a high-quality training experience that prepares them for a successful research career.
• Receive formal training from their research institutions on mentoring postdoctoral trainees.
• Provide a postdoctoral training and mentoring plan in all grant proposals and updates of those plans in all progress reports to NIH if funded.
• Provide a diversity and inclusion plan in all grant proposals and updates of those plans in all progress reports to NIH if funded.