Medical Researchers 7

To the Editor:

During the past year there have
been numerous statements by govern-
ment officials and others to the effect
that too many young physicians are
going into research, thereby depriving
the country of badly needed medical
practitioners, and that the medical
schools are stimulating this trend. In
part based on such opinions, reduc-
tions in biomedical training programs
have been justified.

_A survey of hospital house officers
and fellows in training published in
the journal “Hospital Physician”
(April-May 1970) shows that among
1,900 internes and residents polled, a
maximum of 4 per cent plan a career
in research or medical administration,
only a 1 per cent increment over the
present distribution. Even more sig-
nificant is the 3 per cent figure for
those planning to go in research
career among 418 M. D® gstdoctoral
fellows surveyed. Only 8Sger cent of
the internes and residents plan aca-
demic careers; 73 per cent will stay in
the practice of medicine. Among the
much smaller number of postdoctoral
fellows, 50 per cent plan to practice

medicine, essentially full time, and only
26 per cent plan academic careers.

The Harvard Medical School is
widely considered to be more oriented
toward research and academic careers
than are most schools of medicine, yet
even here, examining plans of medical
students in the class of '73, only 4 per
cent are choosing the basic sciences;
6 per cent biomedical engineering, and
16 per cent full-time clinical faculty.
The others will go into clinical medi-
cine, public health or part-time clin-
ical-academic work plus private prac-
tice.

It is also worth looking at some
figures with respect to the proportion
of medical care in this country pro-
vided by teaching hospitals, i. e. those
affiliated directly with medical
schools, as compared with the total
number of hospitals, Teaching hospi-
tals account for 6 per cent of the total
7,000-plus hospitals, yet they account
for 23 per cent of the bed patients
and 23 per cent of all out-patient
visits. The research and training pro-
grams of the Federal Government
have made it possible for these insti-
tutions to provide the teachers and
biomedical investigators so important
in improving the quality and effective-
ness of health service.

Roughly, 3 per cent of a total of
$62 billion spent on health in 1970,
was used to advance knowledge. This
is in contrast to 10 per cent of the
total of $70 billion spent on research
and development in the Department of
Defense. A comparatively small in-
crement to the present health budget
will have a far greater beneficial im-
pact on the welfare of the American
people. The training of more and bet-
ter biomedical scientists is a public
responsibility and should be amply
supported by public funds.

JEROME GROSS, M.D,

Professor of Medicine

Harvard University Medical School
Boston, Feb. 26, 1971