the collections of the AAMC Not to be reproduced without p one 9:00 5:30 7:00 2:00 1:00 p.m. p.m. a.m. p.m. p.m. dupont Joint Joint CAS Joint Adjournment circle, Meeting Administrative COUNCIL CAS/COD Administrative Reception association (see medical ADMINISTRATIVE January January MEETING n.w./washington, OF Administrative pg. and ACADEMIC 9) Board Dinner SCHEDULE Boards 20, 19, 1983 1983 Meeting SOCIETIES BOARD colleges Luncheon Boards of american d.c. Thoroughbred Edison Hemisphere Map Room 20036 Room Room Room Document from the collections of the AAMC Not to be reproduced without permission • S I. Report ACTION B. A. C. DISCUSSION B. A. C. Appointment Approval CAS Executive AAMC A CAS Research Proposed of ITEMS D. C. H. J. F. I. Administrative Interim Awards the The Prospective Provided Assessment Undergraduate Report Programs Improved ACCME as ACCME ITEMS of

Chairman Council Accreditors Future Sliding the of Meeting COUNCIL Essentials Protocol

of 1983 Minutes Geriatric to the

ADMINISTRATIVE Action of

Board Payment Medicare Scale CAS Plans OF Medical AAMC the for of ACADEMIC AGENDA of Nominating and Items AAMC's of Local Officers' Care Recognizing September Proposals

Beneficiaries Guidelines Grant Education --A with CME Management SOCIETIES BOARD Guideline Awards Committee

Particular Retreat 8-9 for State Preparation

Hospital for

Education for Medical Biomedical

Emphasis Curriculum Services for Societies On:

110 68 91 25 93 35 14 15 6 1 9 Document from the collections of the AAMC Not to be reproduced without permission • S * the change for The session PRESENT: was Board ABSENT: present CAS adjourned a usual joint reconvened in Administrative with for custom, graduate David Board Bernadine Daniel T.R. Lowell William Robert Joseph Frank Douglas David Virginia luncheon the for part Johns OSR at Members M. C. H. a the X. M. L. E. of medical F. E. 9:00 social Brown Wilson Cohen V. and meeting H. Greenbaum Freedman Johnson, Hill GUESTS: COUNCIL the CAS Ganong Kelly Board Weldon Bulkley Washington COTH am ADMINISTRATIVE meeting Administrative September education hour, on convened at Washington, OF Administrative III Donald Thomas September 12:30 ACADEMIC MINUTES followed Hilton 8-9, opportunities. Langsley K. on pm. Oliver* 9 BOARD September DC Board 1982 SOCIETIES by for Hotel dinner Boards AAMC Janet James James Joan John Thomas Lynn John August Anne Xenia joined a business 8 Staff A.D. Bloom Scanley* Sherman Morrison at regarding Bentley* Bickel Erdmann* Tonesk At at Swanson Kennedy* the 8:00 7:00 5:00 Cooper* other meeting. pm. pm, pm portents for AAMC the The Following a session Boards joint CAS of Document from the collections of the AAMC Not to be reproduced without permission ACTION: I. II. III. The A. ACTION Approval for The proved in pharmacology A. ACTION CAS. 1. 2. minutes Membership 3. the technical CAS In Therefore, would services Medicare American last less lish community However, Administrative interest Dr. hospitals, hospital proposal. payment as ITEMS discussing ITEMS tion. of American American a that the American regarding hold had be percengage Board had reason's James of The for several than submitted. primary be this approved of organization's Minutes reviewed reviewed system - academic the application and - costs each Hospital Prospective adjusted revenues, in purchased approved recommendations Bentley, the had the Applications CAS In Essentially, in Executive provided organization's the College organization College stated the Institute years orientation the addition, the fixed the been hospital June Board of Board for greater for concept this this American fact appointments. the proposal, each spring Association's the locally associate and thereby advocating Medicare 23-24, CAS above. payment background of of of Payment Council had organization's organization's AIUM that of application applications year a that than it Legal membership. Neuropsychopharmacolo the the as fixed endorsed of toward Ultrasound be Institute may journal 1982 appeared membership, incurring by a ultrasound Board American to would 1982, the proposal Federal patients. approved System director possible have such hospitals. -2- reflect price information CAS Proposed payments practice For members the the be for as ramifications an that Administrative of of policymakers these application in application. College for allowed a is for well strategy of AHA approach principles - membership technicians Drs. the Ultrasound loss. increases Dr. Medicine a Dr. none each would the issues CAS expressed four-year Hospitals developed as reasons, American on Bentley Johns - Brown gy of to AAMC of its membership. At Medicare the for have to - Legal retain - and the rather which of its in were meeting in and Drs. in Medicare AHA's department reported Board represent Drs. While containing stated the College concern the to able a the plan organization's CAS recommended Medicine June Ganong Medicine showing prospective Freedman are discharge. the be than Board Johns cost AHA proposed should Meeting they which to programs meeting, that underwritten not resulting payment that of that proposal. provide 'of medical recommended a of agreed for and had Medicare increasing significant was Neuropsycho- immediately would the and be goods teaching a were that some prospective concerns Ganong membership payment denied. revealed review denied the for Payments hospital Johns members care educa- that estab- savings ap- it of and the costs COTH by for the • apparent or necessarily predictable. However, Dr. Bentley pointed out that the COTH Board action only recommended that the AAMC support the principles of the document.

ACTION: The CAS Administrative Board voted to recommend that the AAMC support the AHA prospective payment proposal in principle.

B. Medicare Reimbursement for Provider-Based Physicians

As mandated by the Congress, the Health Care Financing Administration had recently published Medicare reform regulations which attempted to distinguish between 1) services performed by "the physician in person" covered under Part B and 2) services provided on a reasonable cost basis by the hospital covered under Part A. Pathologists in particular had objected to the pro- posed regulations as they required that a pathologist be personally involved in the performance of a laboratory test in order to receive fee-for-service permission permission payment. Otherwise, payment would be made to the hospital under Part A.

Dr. Bentley outlined the concerns of the pathology community with respect without without to the regulations and their potential impact on the development of the discipline. In response to these concerns, the AAMC Executive Council and Administrative Boards were asked to review a 1980 AAMC policy statement

regarding Medicare reimbursement for pathology services: reproduced reproduced be be "While the AAMC does not have a compensation alternative which to to would recognize the concerns of pathologists and of the government,

Not Not it is concerned about payment mechanisms which could possibly dis- courage the contributions pathologists make to patient diagnosis and treatment and inhibit the development of the discipline. The

AAMC AAMC Association notes, however, that Senate Report 96-471 would permit physicians to be compensated on a percentage arrangement if the

the the amount of reimbursement is based on an approved relative value of of scale '..which takes into consideration such physicians' time and effort consistent with the inherent complexity of procedures and

services.' The Association supports such a proposal." collections collections ACTION: The CAS Administrative Board reaffirmed its support for the 1980 position state-

the the ment regarding Medicare reimbursement for pathology services. from from C. Minority Students in Medical Education

Given the political and economic climate, the Minority Affairs Section of the reaffirm Document Document AAMC Group on Student Affairs had recommended that the Association its support for efforts to provide minority and disadvantaged students with the opportunity to pursue careers in medicine. A statement had been developed for consideration by the Executive Council which pointed out that the nation's commitment to affirmative action seemed to be waning and that progress made in recent years with respect to minority enrollment in medical school had been threatened by rising tuitions, enrollment reductions, and the reduced availability of student financial aid. The statement reaffirmed the Associ- ation's commitment to improving efforts to recruit minority students into medical school.

The CAS Administrative Board endorsed the statement on the status of minority students in medical education.

-3 Document from the collections of the AAMC Not to be reproduced without permission IV. V. B. DISCUSSION A. DISCUSSION C. A. formance. The The She ficulty findings. evaluation essential The session session of to CAS Clinical small However, overwhelming activities. it to Dr. Dr. the the staff small Medical Administrative and and and 1983 Dr. report Possible Federal Legislative mat Dr. ing activity. the present address very "who, Swanson Swanson Board stated Fall methodology Board chairmen Thomas should technology CAS attitudes. Xenia was -group Interim group and AAMC ITEMS recommended ITEMS with informative. in representatives Education." discussed regarding policies such Meeting speakers Evaluation where, Tonesk, reviewed Executive discussed knowledge; of As that the identifying the He be Kennedy General sessions. discussions reviewed also Update - - of the success Meeting was students might stated used. findings Board CAS CAS in Executive of the the Following Organization Plans when on not reported for and medicine the principal evaluation a that Board of regarding Project study Professional Branch three be academic medical plans fundamental summary the This of members the that and It topics a it the expected, and in A again with the will in variety was case CAS/OSR was Council plans PEP for why" clinical also AAMC involved the involved that these AAMC officials appropriately addition at investigator 1982 "The agreed CAS will report agreed informally discuss informally to (clerkship of at the regarding the for found of Dr. staff staff working of be presentations, Student skills; studies Education meeting, the cocktail - representatives. serve the Enigmatic 1983 University Stanley clerkships, considered the 4 relevant which that that to fall that in centers - provided had evaluation CAS groups CAS psychometrics, participation as a below for forms, evaluating it indicated worked Representatives and, it meeting Dr. there it reception plenary joint fall of J. Interim should would topics Future of the was and Tonesk will average the an Reiser, by personal summarized small examinations, Texas meeting is these closely of two-year their agreed discussion the update session of Physician be excessive focus The that were address Meeting. and clinical above will groups conduct the of useful had faculty or topics. at professor Tumultuous qualities, theme respective faculty identified. that of including with key failing for on conclude CAS. Houston, prepared average AAMC and the a recent (GPEP) for Congressional of leaders the for emphasis of clerkship staff a a CAS/OSR In etc.). should informal project's similar students study discussion CAS effects of Dr. research. had view students. the groups: students. Past and legislativelill the a had values from and project. humanities Tonesk joint of no examine of of meet- plenary found The on agreed day's for- dif- OSR of the per- of the the the • House Science and Technology Committee in the amendment of legislation to limit the use of animals in research. The most recent draft was signifi- • cantly less onerous than the original version. However, the bill was still a source of concern and was viewed as a "foot-in-the-door" to more stringent legislation.

With regard to appropriations, Dr. Kennedy stated that the Association and many other organizations (including most CAS member societies) had cosigned and sent to key Members of Congress a position statement regarding NIH and ADAMHA funding. The document proposed an additional $287 million above the Administration's FY 1983 request to allow for the FY 1982 level of effort in terms of the number of new grants and research trainees supported. With regard to student financial aid, the Association had strongly opposed an $80 million appropriation for the Health Education Assistance Loan program and advocated funding at the full authorization level of $225 million. The AAMC had emphasized that the HEAL program is a revolving fund and that the permission government would save no money by capping the appropriation at a mere one- third of the authorized level. without B. AAMC Response to Small Business Innovation Development Act

In response to numerous inquiries, AAMC staff had explored the implications of faculty participation in the development of for-profit entities eligible reproduced for funding under the NIH Small Business Innovation Research program, to be be established pursuant to Congressional passage of the small business set-aside to legislAtion. Anne Scanley of the AAMC staff reviewed a discussion paper

Not which outlined the pros and cons of such activity. The document pointed out that extra-institutional research could 1) provide greater opportunity for scientists to commercially apply basic science discoveries, 2) foster greater

AAMC university/industry cooperation, and 3) provide supplemental income for faculty. The paper also identified some potential adverse effects including the orientation toward the institution of the realignment of faculty loyalty and and conflicts of interest which might serve to distort traditional academic values. The paper highlighted the political implications of faculty parti- cipation in the SBIR program, emphasizing that the establishment of profit-

collections making research ventures by academic scientists might compromise the academic community on Capitol Hill, particularly with those Congressmen who had so the vigorously opposed the legislation. The paper also pointed out that academic participation might provide the illusion of success for the SBIR program and from thereby enhance the possibility of its renewal in 1988.

The Board agreed that the document would be extremely useful to faculties

Document considering the possibility of competing for SBIR funds. It was agreed that it should be distributed to the AAMC Assembly.

5 Document from the collections of the AAMC Not to be reproduced without permission Section The slate On mittee mittee must Thomas CAS 1979 individual Philip William David Daniel Carmine 1980 Frank Carmine Thomas George Milton Solomon Mary Daniel "The the man Committee The basic Administrative mare Net a tions American present Nominating 1978-1982 Nominating choose Ellen slate of H. C. following will will D. C. K. T. N. X. K. of V. more Nominating Nominating D. F. D. Snyder, than nominees Cohen, Wilson, for science Oliver, Anderson, Federman, Edgerton, Aagaard, Oliver, Freedman, #1 the from Clemente, Ganong, Clemente, Jones, of at meet three also than Medical of and two these CAS Administrative Committee nominees the Committee. the Ph.D. M.D. the by pages nominate Jr., shall APPOINTMENT one and members to basic Jr., Nominating Ph.D. M.D. Board Committee Committee meeting. M.D. M.D. conference positions Council M.D. M.D. M.D. M.D. CAS Colleges." fill Ph.D. Ph.D., three representative M.D. is M.D., for scientists vote Bylaws from candidates may a a three Several clinical Administrative list clinical of Chairman shall in The shall Committees Chairman ,OF Board among be may call Deans the reads basic 1983 current Committee of be be report and alternates sometime case shall for representatives all science) may made scientist to CAS as comprised science 6 three CAS Chairman serve are follows: of members be NOMINATING be to by Board will a appointed listed Representatives the the any clinical 1.981 in David David Daniel Robert Warren T. F. 1982 David Joseph John Frank Franklyn Robert Frank tie. shall should as positions as of -Elect also May Marian R. Chairman of Council representative vacancies. Chairman Chairman T. seven below. M. H. C. Johns, M. C. Six of the be or Stamp, M. X. D. R. COMMITTEE recommend also Sessions, from scientists Solomon, Brown, Brown, Wilson, G. Wilson, appointed the of early Berne, Bishop, Freedman, Bianchine, Yates, individuals Administrative on members. at -Elect Knox, of the -Elect be M.D. member a the M.D. its from the society Additional selected. June M.D. M.D., Association M.D. M.D. Ph.D. M.D. to Board. Ph.D. M.D. Jr., M.D., to Annual of Nominating by which of to M.D., societies. the to Ph.D. The the the Chairman (three the serve CAS M.D. and develop Ph.D. AAMC Chair- Board. Meeting The Council the AAMC. Chairman CAS The nomina- and not of on Board Com- Com- an a the CAS REPRESENTATIVES AND PUBLIC AFFAIRS REPRESENTATIVES

BASIC SCIENCES CLINICAL RESEARCH ANATOMY American Assoc. for the Study of Liver Diseases Dr. Marcus A. Rothschild American Association of Anatomists Dr. Harold J. Fallon (PAR & Rep) Dr. John E. Pauly Amer. Federation for Clinical Research Dr. Sanford L. Palay Dr. Randy Zusman Dr. William P. Jollie (PAR) Dr. Jerry Olefsky Association of Anatomy Chairmen Dr. Bernadine Bulkley (PAR) Dr. George D. Pappas Amer. Society for Clinical Investigation Dr. Douglas E. Kelly (PAR & Rep)• Dr. Michael M. Frank (PAR & Rep) Central Society for Clinical Research BEHAVIORAL SCIENCE Dr. Norton Greenberger (PAR & Rep) Association for the Behavioral Sci. & Med. Education Plastic Surgery Research Council Dr. Shirley Nickols Fahey Dr. R. Barrett Noone Dr. Eman G.- Pattishall,. Jr. (PAR & Rep) Dr. Robert L. Ruberg Dr. Donald Serafin (PAR) BTOCHEMISTRY Society for Gynecologic Investigation Dr. W. Ann Reynolds American Society of Biological Chemists, Inc. Dr. Ronald A. Chez Dr. Robert E. Olson Dr. Robert B. Jaffe (PAR) Dr. Robert M. Bock (PAR) Society for Pediatric Research Assoc. of Med. School Depts. of Dr. Lynn M. Taussig permission permission Dr. Lowell P. Hager Dr. Richard E. Hillman Dr. Robert L. Hill Dr. Virginia V. Weldon (PAR) Dr. Eugene Davidson (PAR) DERMATOLOGY without without Association of Professors of Dermatology, Inc. American Society of Human Genetics Dr. Phillip C. Anderson Dr. David Rimoin Dr. J. Graham Smith, Jr. Dr. Robert L. Summitt (PAR) Dr. Peyton E. Weary (PAR) reproduced reproduced MICROBIOLOGY EMERGENCY MEDICINE AND CRITICAL CARE be be Assoc. of Med. School Microbiology Chairmen Society of Critical Care Medicine to to Dr. Harold S. Ginsberg Dr. Solomon G. Hershey (PAR & Rep) Dr. Kenneth I. Berns (PAR) Society of Teachers of Emergency Medicine Not Not Dr. Richard M. Nowak NEUROSCIENCE Dr. John Lumpkin • (PAR) Society for Neurosctence Dr. Daniel T. Schelble

Dr. David H. Cohen (PAR & Rep) AAMC AAMC

the the PHARMACOLOGY Endocrine Society of of American Soc. for Clinical Pharm. & Therapeutics Dr. Jo Anne Brasel Dr. Arthur Hull Hayes, Jr. Dr. Virginia V. Weldon Dr. George N. Aagaard (PAR & Rep) Dr. Claude J. Migeon (PAR) Amer. Soc. for Pharm. & Experimental Therapeutics Dr. Lewis Aronow FAMILY MEDICINE

collections collections Dr. William L. West (PAR & Rep) Association of Departments of Family Medicine Assoc. for Medical School Pharmacology Dr. Thornton Bryan the the Dr. Joseph R. Bianchine Dr. Edward Kowalewski Dr. Lowell M. Greenbaum (PAR & Rep) Dr. Thomas A. Nicholas (PAR)

Society of Teachers of Family Medicine from from Dr. Frank C. Snope American Physiological Society Dr. Lewis Barnett, Jr. Dr. Franklyn G. Knox Dr. Jack M. Colwill (PAR) Kostyo Dr. Jack L. GENERAL SURGERY

Document Document Dr. John T. Shepherd (PAR) Assoc. of Chairmen of Depts. of Physiology American Association for the Surgery of Trauma Dr. Stephen H. White Dr. William R. Drucker Dr. William F. Ganong Dr. Donald S. Gann (PAR) Dr. Norman R. Alpert (PAR) American Surgical Association Dr. Arthur J. Donovan CLINICAL SCIENCES Dr. Jerome J. DeCosse (PAR & Rep) Association for Academic Surgery ALLERGY Dr. Richard P. Saik American Academy of Allergy Dr. Joyce Rocko Dr. Paul Vanarsdel Dr. Charles M. Balch (PAR) Dr. Thomas E. Van Metre (PAR) Soc. for Surgery of the Alimentary Tract, Inc. Dr. John R. Brooks ANESTHESIOLOGY Dr. John Cameron Association of University Anesthetists Dr. Bernard M. Jaffe (PAR) Dr. C. Philip Larson, Jr. Society of Surgical Chairmen Dr. Nicholas M. Greene (PAR & Rep) Dr. David B. Skinner Soc. of Academic Anesthesia Chairmen, Inc. Dr. Frank G. Moody Dr. S. Craighead Alexander (PAR & Rep) Dr. Norman M. Rich (PAR) Society of University Surgeons Dr. John W. Harmon Dr. Morris D. Kerstein Dr. Alden Harken (PAR) 7 Document from the collections of the AAMC Not to be reproduced without permission INTERNAL Association American Association Association American American American NEUROLOGY American Child Association Amer. NEUROSURGERY OBSTETRICS Assoc. Amer. American OPHTHALMOLOGY Association ORTHOPAEDICS Association OTOLARYNGOLOGY Society Association Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Catherine Dr. Dr. Robert Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. John John Leighton Oscar Gene Alfred Jay Joseph Pervis Susan James Irwin Paul Paul John Ernest T. Jerry John John Frank Erland Hartwell Elliott Paul Neurology Thomas Lawrence Mary John Association Douglas College Harry Warren Ervin Joseph Allan Bruce David Joel Randall John Charles Warren Frank John Frank Warren Jerome Robert John of MEDICINE College Gastroenterological Society of Academy Neurological R. Academy H. Professors T. R. H. T. McCurdy A. F. Conomy R. Anne Shillito AND Sacks of D. of A. of F. P. C. H. Johns University Chutkow M. of Yatsu Grealy S. E. B. J. of E. Spivey Jay C. Stein of E. C. Milnor, Jaffe of Nelson W. H. C. D. Ball Stollerman Sessions Stamp Sessions Y. Marks I. Goldstein Aita L. Dyken of R. American J. E. Professors Gartland Program Ratnoff V. Stewart Curtin Rosenberg Adams Thompson Fredrickson University A. GYNECOLOGY Jonas Nicholas Weingold Noonan University Johnson, Wilson Wilson Orthopaedic Academic Society Guggenheim Langfitt Pearse Scott, of Bollet Reinecke of of Adkins Kohut Mancall Obstetricians of Knab Olson Cluff Heck (PAR) of Lockman (PAR) Cohen (PAR) Physicians (PAR) Hematology Neurology (PAR Ophthalmology (PAR) Jr. Neurological of (PAR Association (PAR) (PAR) (PAR Directors Otolaryngologists (PAR Jr. (PAR) Physicians (PAR (PAR) (PAR) (PAR) Gynecology III Depts. & of (PAR) Professors Professors & (PAR Rep) Chairmen & (PAR &,ReP) Medicine Rep) Association & Rep) Rep) and of & in & Rep) Surgeons Otolaryngology Gynecologists and Rep) Internal of of Obstetrics Neurology Ophthalmology Med. 8 PEDIATRICS Thoracic Plastic PLASTIC PREVENTIVE PATHOLOGY PSYCHIATRY PHYSICIAL Society Society Soc. THORACIC Assoc. Assoc. American American Association UROLOGY RADIOLOGY Amer. Academy Association American Association Association American Association Acad. Amer. HEALTH Dr. Dr. Dr. Dr. Dr. Mr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Mr. Dr. Dr. Dr. Dr. of dames Theodore Thomas John David Paul Paul Benson Daniel Clarence Creston Robert Thomas Judson William Hal Larry Layton Leonard David Paul Cornelis Clarence Christine Norman Robert Ronald Rolla Richard Murray Marshall Assoc. A. Andrew Alicia Ali A. Jerry Harry Harry William Robert Ralph of of AND for Surgery SURGERY of of Chairmen Pediatric Surgery SURGERY Association Association Everett Urological Everette MEDICINE Med. G. Directors AND A. B. Clin. J. J. J. HUMAN University MEDICINE J. of of of of of P. for L. B. C. C. M. M. Alfidi Health of Bingham M. E. E. D. L. McCurdy M. K. A. G. G. R. K. Kawi X. Jarett E. L. Lynch CLINICAL C. Fink E. Friedman Fink School Murphy Physical S. Swartzberg Teachers Pathology Brown S. M. Academic Heijn, Hill Wiener Elliott University Miller, Miller Rabin Blizzard Oliver Harding Chairmen Hastings Hugo Educational Freed Carson Randolph Academic Hunt Webster Wilcox Freedman Rhamy K. Stass, James, Herold of Lab. Parry Directors Verville VALUES (PAR) Cole James, Weldon Weldon (PAR) Society AND and Cassel (PAR (PAR of Association, Academic (PAR) (PAR (PAR of for (PAR (PAR (PAR) Pediatric Jr. Physicians Urologists (PAR Jr. LABORATORIES REHABILITATION Med. Human (PAR) (PAR) Plastic Physiatrists Medicine Jr. of Jr. (PAR (PAR & Chairmen, Thoracic & Jr. of Psychiatry (PAR) (PAR) & & Radiologists & & Preventive Rep) Association Rep) (PAR & Student Foundation kep) Depts. Rep) (PAR) Rep) Radiology Values Rep) & & Rep) Dept. Surgeons Rep) Rep) & and and Inc. Surgery of Rep) Inc. Educ. Scientists Rehabilitation Chairmen, Psychiatry Medicine Departments in • • Psychiatry Inc. Document from the collections of the AAMC Not to be reproduced without permission • S Associate CONJOINT School Chairman, GRANT Director CAS/COD National George A of AWARDS PROPOSED William H. Reception Medicine Thoroughbred January for George Department Hemisphere ADMINISTRATIVE Washington FOR Institutes 5:30 Extramural 7:00 F. SLIDING Mandel, and BIOMEDICAL and 19, and Raub, p.m. p.m. of Room Dinner 1983 Health Room University for Ph.D. Pharmacology SCALE Ph.D. Research BOARDS RESEARCH Health Sciences OF MEETING and Training A PROPOSED SLIDING SCALE OF GRANT AWARDS FOR BIOMEDICAL RESEARCH

In a letter to Science published in February 1982, Elliot S. Vesell and H. George Mandel proposed that National Institutes of Health research grants be awarded on what is termed a "sliding scale" (p. ). The purpose is to fund a larger number of research proposals by providing partial funding based on a formula related to the priority scores assigned by study-sections.

Mandel and Vesell aver that the competition for NIH grants is so intense that investigators spend. an inordinate amount of time writing and rewriting proposals and reviewing proposals which, although they are considered meritorious, are not funded.- The sliding scale would provide 100 percent funding to proposals with "top priority scores;." other proposals with "respectable priority scores" would receive partialfundfng. The authors envision that about half of study-section- approved applications would be eligible for this formula-based partial funding.

permission Vesell and Mandell argue that study-sections discriminate insufficiently to identify research proposals that may have an unexpectedly fruitful outcome, even without though the ideas upon which they are based are not currently popular. They infer that by partially supporting ,a greater number and variety of investigators, the opportunity to bring to fruition new ideas will be enhanced and that this will help to maintain the preeminence of the United States in biomedical research.

reproduced This proposal must be considered in depth and from be every possible angle. While funding more grant requests to is attractive, the administrative and political consequences of spreading limited resources more widely through partial funding Not on a formula basis are formidable both at the national and institutional levels.

The fundamental tenet of the Na review and granting procedures has been to AAMC fdenttfy and support the best scientific proposals that will advance its mission the to tmprove human health. Peer review by study-sections composed of individuals of who can judge both the ideas and concepts and the technical feasibility of accomplishing proposed projects is the foundation of the review system. Study- sections already are carefully reviewing budgets and recommending reductions when it is believed that a project can be accomplished with fewer resources. collections If, after this review, the project were to be funded at an even lower level, the would not the study-section have to once again review the project because it was now altered by modifications required by reduced funding? If the answer is no, from then it could be inferred that many projects are over-funded and that arbitrary cuts can be made in N1H funding without reducing the quality or quantity of biomedical research. With both the Congress and the Administration looking for every opportunity to cut budgets, this proposal may invite even greater reductions Document in funding for the Institutes. Furthermore, serious doubts could be raised as to the widely touted essentiality of the study-section role.

At the institutional level the investigator who receives only partial funding would be likely to seek local support to make up the difference. It is doubtful that in most institutions sufficient resources are available to achieve this. However, were $uch institutional support made available, the message to the federal government would be that the institutions are capable of even more cost sharing than supposed--again, an impetus to reduce federal research support.

- Document from the collections of the AAMC Not to be reproduced without permission S funding comment Dr. enterprise. the what significant impacted is Vesell high a Mandel NIH. crisis is quality and from termed as must will Mandel a alteration and the They result and be a present the fully crisis measured perspective insist have of degree inflation in approved brought the in that grant against to NIH proposed of even which funding forth the awarding by is the study projects dismantling NIH. the sliding this potential and -sections. biomedical concepts, proposal imply only scale the long that partially in research as policies, The nation's range detail the a extent means reduction funded consequences enterprise and and biomedical of to Dr. operations weathering would which in Raub is research of there research be will being of this of Document from the collections of the AAMC Not to be reproduced without permission standing to The academic also lished member time these which The This blished In Thomas John George Flexner Award Paul Sherman Thomas Julius Franz Research J. Andrew William Ivan Roger Hugh Bert Donald Raymond Edwin Kimishige medical recent Abraham recipients award of presents Michael awards. is 0. during, societies. L. L. B. W. the J. by C. D. clinical community's a T. C. Hale H. F. V. •Caughey, years, Bennett,. G. M. Beeson O'Malley McDevitt L. member consists schools the Award Ingelfinger L. Guillemin Kilbourne Flexner Annual Comroe, Harrell, Steiner Schally Merigan, Ishizaka Anlyan Mellinkoff Bishop Erikson the an Ham The of AAMC annual the of or the preceding and CAS Meeting. Jr. Jr. Award of in Jr . laboratory the awareness AAMC Jr Jr and awards $2,000 1958 to Administrative award AAMC. Teruko for the has five to for for cash Distinguished medical received of recognize The research Ishizaka the calendar distinguished the AAMC and award last education awards Board only a AWARDS - extraordinary medal by years. is ten 14- Service a should a and made faculty years limited presented community research to for Both consider to stimulate are member research number individual Medical awards shown in in as ways the recognition of of a are nominations below. whole. which Education a to nominations biomedical contributions medical presented increase has The of was been from school out- sciences. AAMC for at the esta- pub- the • Document from the collections of the AAMC Not to be reproduced without permission • • tive On so as an guests, discussion A School, tation, geriatrics Representatives recommendations. On names ings presentation Following meeting January afternoon last that the (see Assistant Senate Branch Office Other All Senate Senate Senate Senate Congressional Congressional House HCFA FDA House House House Health Executive VA of morning year Medical and dinner invitations will Dr. Commissioner these NIH schedule Administrator these page Sclence 10, administrative Subcommittee Energy Ways group and Officials of and and and Finance Labor a Resources John institute with discuss regarding plenary reception Secretary letters Branch Management individuals of 35 gerontology and of House House Director's House presentations leaders Rowe, and and a of February 15, He and Staff Budget the appears Means briefing session will geriatric Executive and Appropriations Arthur Commerce and Budget Labor/HHS/Education Human Technology of directors CAS the Director Carolyne on in (to for From staff Congressional invitation Services Office and raise Office on the will can Health attendees both RIGME CAS Resources Health session Hayes and be Budget the the and evening. the be Council research from INTERIM of appointed the in be staff Davis discussion document staff following extended and Following discussion, and sent Administration Council the the Edward issue to staff will in NIH Environment staff and institution Agenda). Division Staff. the MEETING the to and The of Appropriations and at be Brandt staff the will in Committees: Interim morning groups education. pages. invited the increased health advance.) Dr. plans respective PLANS The on reconvene January Following and staff John for and Aging invitation for Meeting for The aides to staff at faculty Sherman the format implementation the CAS 20 Subcommittees at for of professorial CAS CAS Dr. were representatives, reception. Harvard CAS the representatives reports list will and will Sherman's discussion Board sent Senators the includes: make be Medical to from meeting). society invited the of (The key a presen- of and its same the brief Execu- meet- Document from the collections of the AAMC Not to be reproduced without permission 11:00 FEBRUARY 12:30 5:30 3:30 1:30 p.m. p.m. a.m. p.m. p.m. 14 (CAS (CAS Plenary Presentation Plenary Lunch Small Cocktail The Entertainment A Sponsorship Political on Research Program other Invited Chairman, Julius Executive Specific Director, Chancellor, University witty Gerald group Theodore James themselves AcaAemtc Collective Representatives, Representatives Group important Session Session of B. political and ,Reception Guests) S. R. Control Cooper, Congressional Example: Wyngaarden, Levey, Department Discussion Krevans, National of Medical Policy Vice of of as University by Biomedical Impact Legislative Pittsburgh "purveyors background "The President,

satire and M.D. M.D. Directions MEETING Centers and M.D. Institutes Animal AAMC Capitol of Its of Sessions M.D. AAMC since staffers of Federal Medicine and Effects Staff, of SCHEDULE information Update California, Upjohn Research - Staff) Steps"-- intelligent Behavioral of 16-

1981" of Policy the and who on and Company Health Legislation Federal NIH describe a San Changes small and Francisco (Rooms Ballroom Jefferson Jefferson to West be West West assigned • • • Room Room Document from the collections of the AAMC Not to be reproduced without permission • el 12:30 FEBRUARY 9:00 a.m. p.m. 15 (CAS CAS Presentation Adjournment Reports Meeting Representatives from Dr. Discussion John and Rowe Group - AAMC 17- Staff Leaders Only) - Jefferson West Room