The Report of the External Advisory Committee on the NIH Intramural Program -- How Will It Affect You?

In August 1993, Ruth Kirschstein, then Acting Director of NIH, assembled an External Advisory Committee (EAC) to ponder a congressional mandate to evaluate the "role, size, and cost" of the NIH Intramural Program. Chaired by Paul Marks of Memorial Sloan Kettering Cancer Center and Gail Cassell of the University of Alabama, this distinguished committee labored nine months to produce a report that is now the subject of much excited discussion and commentary. This issue of The Catalyst contains an executive summary of the report, and people who are interested can get copies of the entire document from their Laboratory or Branch Chief or Scientific Director. What will this report mean for the scientists in the NIH Intramural Program?

First, the report strongly endorses the concepts of stable funding and retrospective review, which are the essence of the Intramural Research Program. For those of us who are planning a future in Bethesda, this comes as a great relief. The report reinforces our belief that NIH's pluralistic approach to research support, combining the intramural approach with prospective grant review for extramural research, is most likely to optimize returns on investment. History shows that this mix has been successful, and the future should be no different. The EAC report includes suggestions for determining the optimal balance of extramural and intramural funding. The report indicates that funding of the intramural programs in aggregate should not exceed 11.3% of the total NIH budget -- the average for the past several years. This means that expenditures for intramural research would not rise faster than extramural expenditures, including any costs associated with new building. The President's FY 1995 budget calls for intramural expenditures of 10.8% of the total, and unless an unexpected crisis ensues, the suggested 11.3% cap should be achievable.

The EAC report states that as resources decline, we must jealously guard the quality of our intramural research programs and choose tenure-track and tenured scientists with great care. Currently, the Boards of Scientific Counselors (BSCs) responsible for reviewing programs quadrennially, and the Board of Scientific Directors has kept watch over the tenure system. The EAC Report recommends that there be more safeguards; the BSCs should be more clearly independent of the Scientific Directors and should review the Scientific Directors' performance regularly. I will be meeting with the chairpeople of the BSCs within two months to discuss how to make our review processes more uniform across the Institutes. Rigor and fairness are paramount issues, and I hope to establish standards for both that will protect our scientists and the independence of the review process.

The NIH leadership has actually anticipated the EAC report somewhat to expedite implementation of a new tenure system based on two of the strongest recommendations in the EAC report: the decision to create tenure-track positions should involve broad input from scientists in a Laboratory, Branch, or Institute, and national searches should be conducted for all new tenure-track positions to ensure quality and diversity. Will this mean that our own senior postdoctoral fellows will be locked out of positions at NIH? Absolutely not. You will soon be seeing many advertisements for tenure-track positions at NIH in major journals, with a synopsis biweekly in the DDIR's Bulletin Board on Gopher; NIH personnel can compete for these and may often be very well qualified for the jobs in their own or other institutes. This new openness will mean that opportunities for tenure-track positions at NIH will be increasing, not decreasing. Tenure decisions will be made within 6 years by a rigorous process involving recommendations by the Laboratory or Branch Chief, Scientific Director, Institute Director, Promotion and Tenure Committee, and a new Central NIH Tenure Committee consisting of outstanding NIH Intramural Clinical and Laboratory-based scientists. With limiting resources and the enormous investment in space, positions, and budget associated with tenure at NIH, we cannot afford to make mistakes in the tenure process, and the EAC duly noted this. The new tenure-track system (summarized on the DDIR's Bulletin Board and available through Gopher on NIH's Campus Information On-line Menu) is already in place but still awaits final approval by the Public Health Service. The new NIH Central Tenure Committee should be constituted within the next week or two. Watch for its membership in the DDIR's Bulletin Board.

The NIH intramural program is the largest biomedical postdoctoral training program in the world. We have about 2,500 postdoctoral fellows here, approximately 15% of all biomedical postdocs in the United States. The EAC report takes us to task for not paying more attention to the mentoring and education of our fellows. Look for better tracking of fellows from the time they enter NIH until 10 years or so after they have left. Expect seminars of broad general interest hosted by the Special Interest Groups. These can be easily identified given the new format of our "yellow sheet." If you are a postdoctoral fellow, you may be contacted by other fellows inviting you to join a trans-NIH Fellows Group. Dr. Varmus and I will be working with this group to improve the training environment at NIH.

Although the report touches on many other issues, including the role of CRADAs in the intramural program and administrative impediments to the conduct of research at NIH (to be addressed in our report on "Reinventing NIH"), let me conclude with some remarks about the Clinical Center. Forty percent of our on-campus laboratory space and a 450-bed research hospital are housed within Building 10. The EAC report acknowledges the poor physical condition of this facility and endorses a plan to begin building a replacement hospital with associated laboratories and renovation of the existing building phased in over the next 10 to 20 years. The EAC envisions a state-of-the-art 250-bed hospital with essential laboratories in the same building, with new space generated by the new building used to increase the average per capita space in Building 10 (much-needed breathing room!) and to begin to bring some important outlying scientific programs back to the campus.

Can we get by with a 250-bed hospital? Last year, we averaged 230 in-patients per day. Because 90% occupancy is probably not feasible in a research hospital, we may need to do some downsizing of our research activities to fit into the new facility or make increased use of additional day hospital beds. We will have several years to plan the best course for the Clinical Center and to adjust to downsizing in the clinical programs, but I expect that this will be a difficult transition.

Some readers will find the EAC report highly critical; others will see in it a thoughtful and constructive analysis of our strengths and weaknesses. As we move to implement its many ideas, I welcome your comments and suggestions. Fax them to The NIH Catalyst at 402-4303 (see page 24) or send them directly to me.

One final note. I hope you have been "tuning in" to the DDIR's Bulletin Board, posted every two weeks (usually on Monday) and available through Gopher. This will continue to be a source of up-to-date information about how the EAC reports recommendations are being implemented and about other important aspects of campus life.