SCIENCE : Global Prestige at Stake as Medical Agency Faces ‘Brain Drain’ : Though still viewed at the cutting edge of research, the National Institutes of Health suffers morale problems. Uncompetitive salaries are a main cause.
The National Institutes of Health, long a key to U.S. leadership in biomedical research worldwide, is facing a potentially damaging “brain drain” as a result of uncompetitive salaries, budget constraints, government red tape and what many see as political meddling in basic science.
And the flight of talent is keenest where it can hurt the most: among the middle-level and senior scientists who provide all-important creative leadership.
NIH continues to attract highly talented students and young researchers. But with more senior scientists--those with mortgages to pay and children to educate--leaving to go elsewhere, many who come to NIH to train are beginning to view it as a stepping stone. It is in danger of becoming a place to gather experience and credentials instead of a place to build a career.
“It’s a tragedy on many fronts,” says one NIH scientist who is thinking about leaving after 10 years with the institution. “You have to ask: Do you want the best people in the nation guiding the work that’s being done--or just second-string researchers?”
Any such decline would have serious implications for the United States as a whole because NIH has traditionally been the global leader in basic scientific and medical research--the place that all other institutions look upon as the cutting edge. “It’s the only thing of its kind anywhere,” says one congressional source who deals with NIH issues. “There is no other place like it--with its record of breakthroughs and Nobel prizes--in any country in the world.”
And salaries are not the only problem. A number of other factors have been eating away at NIH’s allure:
* The post of NIH director has been vacant since July, 1989, the longest stretch in NIH’s 100-year history. Dr. Bernadine Healy, director of the Cleveland Clinic Foundation’s Research Institute, recently was named to the post and is expected to take over soon. But the long absence of a leader at NIH has taken a toll on morale.
* The perceived intrusion of politics and ideology into NIH. Several potential candidates for the director’s job were turned off by questions about their stances on abortion. And it is widely believed that Healy, once an outspoken critic of the present ban on the use of fetal tissue in federally supported research, softened her position at her Senate confirmation hearing in deference to the White House.
Other researchers complain that the continuing ban has cut off promising avenues of study for the treatment of diabetes, spinal cord injuries, Alzheimer’s disease, Parkinson’s disease and a host of other major problems. They object to similar restrictions on in vitro fertilization work.
* Politically tinged scrutiny of scientific ethics. While they accept criticism where legitimate problems exist, NIH scientists say that when controversies are fought in the political arena, it can have a chilling impact on researchers.
In particular, NIH has been the focus of inquiries by Rep. John D. Dingell (D-Mich.), chairman of the House Energy and Commerce Committee and of its oversight and investigations subcommittee. Dingell, and now NIH itself under pressure from Dingell, has been probing activities in the laboratory of Dr. Robert C. Gallo, the National Cancer Institute researcher who is credited with co-discovering the human immunodeficiency virus that causes AIDS.
“We are under siege,” says one close associate of Gallo. “I want to do my science. But it’s impossible to concentrate. I simply can’t function anymore.”
* Bureaucratic rigidity, which researchers say discourages pursuing knowledge across institutional lines. Dr. John Mulvihill, who left after 20 years and now chairs the department of human genetics at the University of Pittsburgh, recalls one example. Several years ago, while at NIH in the National Cancer Institute, he was asked to participate in a study sponsored by NIH’s Heart, Lung and Blood Institute.
“They were looking at a specific heart defect, and had no one to study the genetics of it,” he says. But his involvement “meant crossing institute lines,” he says. “The attitude was that NCI paid my salary, therefore I should be working on cancer.” He completed his part of the study anyway, but remembers the experience as “very discouraging.”
Mulvihill says he also became frustrated trying to mobilize his NIH colleagues to collaborate in a grant proposal for the Human Genome Project, a government-funded drive to map all human genes.
“We couldn’t get it together,” he says. “There’s no one institute that deals with genetics, so the specific challenge of mounting a large effort for the genome project failed at NIH.” At Pittsburgh, he says, “One of our people put together a $15-million proposal and synergized this group into a multidisciplinary approach.”
* Like other government agencies, NIH has been forced to accept the budget constraints worked out during last year’s congressional budget agreement. Its spending has not declined; it has even recorded a modest increase. But many NIH researchers believe funding now lags behind the pace of research in the biomedical sciences--with implications not only for patients but for the nation’s competitiveness in an increasingly important field of economic growth.
“Progress in basic biomedical science has been breathtaking, and there are many more areas that could be productively pursued than several years ago,” says one outside researcher who reviews grant proposals for the NIH and is frustrated that only a fraction of them can be approved. “But the ability to do that is being limited by the fact that funds have not flowed into the system as rapidly as ideas have.”
Probably the most significant reason for the erosion of morale at NIH is a huge salary differential that exists between senior NIH positions and comparable jobs on the outside in academia and industry.
“It’s awfully selfish to stay here,” says one researcher in the National Institute of Neurological Disorders and Stroke, one of NIH’s 13 institutes. “After a while it becomes hard to justify. A lot of people who train here owe a lot of money. The cost of living in Washington is high. People go deeper in debt just to work here. Your family pays the price.”
A middle-level researcher at NIH--one who has spent about 10 years there--earns about $55,000 to $60,000. High-ranking scientists--those who head branches or institutes--earn about $106,000. And the recently established Senior Biomedical Research Service will provide about 200 top-level NIH researchers with salaries up to $138,900.
Those are substantial salaries, but most of the scientists who earn them could reap up to two or three times that amount in the private sector.
“The government increase is a tiny percent a year,” says one researcher. “The salaries haven’t kept pace for 30 years. The people who work here now work at considerably less salary proportionate to their peers on the outside than they did 20 years ago.”
As more good scientists exit NIH, they leave gaps that have become almost impossible to fill.
“It is more and more difficult to recruit senior level people to give up a university position to come to a government-sponsored research lab,” says Dr. Sam Broder, director of the National Cancer Institute, who admits he often worries about “what’s going on in the minds” of some of his very best people who he fears will depart.
Those who stay do so because “the NIH is still the best place in the world to do basic research--the atmosphere is electric,” says Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, the lead institute on AIDS research.
“Certainly there are gripes, but to say that morale is reaching a new low here is completely incorrect,” Fauci says. “Do I think I should be making more money? Yes. Is my morale low? No. Morale is how you feel about the place and about your work and your colleagues. Most of us believe that the benefits of working here are worth the differential in salary.”
Fauci’s work on AIDS puts him and his staff at the center of one of the hottest research topics in medical science today, however. His view of NIH is far from universal.
“NIH is a very nice place,” agrees one NCI researcher who is unhappy but perseveres. “It is intellectually delightful. There is more here in basic intellectual resources than anywhere in the world. That is unique.”
On the other hand, he still lives in a rented, two-bedroom apartment with his wife and two children. He wants to buy a house, but cannot afford one. “It would be nice to have adequate living conditions and join the human race,” he says.
To work at NIH, says NCI chief Broder, “takes people who have a real calling, people who are affirmed by generating knowledge--so much so that they are willing to come and put up with all the other things.”
