it upon graduation. There have never been enough fellowships to encourage these young medical graduates to continue in a life of education and research. Today this need is greater and more serious than ever before. For the past 4 years we have had our College of Medicine on a continuous program- a new class admitted every 9 monthsand the students graduating in three calendar years. Owing to this war emergency measure there has been no time for young men to devote time to research. In normal times a number of able recruits have been obtained from each graduating class in medicine for education and research. So far we have lost this normal quota from five classes to duty with our troops. Most of these have served near the front line chiefly in emergency work, out of contact with regular medicine from 1 to 3 years. If adequate fellowships are provided many of these will elect to return to research and institutional work on discharge from the Army. None of our medical schools will have sufficient fellowship funds to meet the demands of our graduates. Unless something is done quickly this 5-year void will be permanent and medical research and the health of the next generation will pay for the neglect. The Federal Government has a major responsibility to protect the health of its people. How can it justify a failure to supply fellowships and scholarships for research, needed in the interest of our Nation's welfare?

If we are to mobilize an all-out effort to defeat disease, unrestricted grants are needed for our weaker schools to assist struggling young scientists, and to make it possible for these schools to secure more able teachers by providing necessary research supplies and equipment.

The plan proposed by Senate file 1285 for a national research foundation would adequately meet the needs of all medical schools for additional funds for investigation. Such a foundation should not replace private agencies or foundations but should supplement their effort. Furthermore it should in no way conflict with the research program of other governmental health agencies. Much of the research in the Medical Corps of the Army, Navy, and United States Public Health Service must by the nature of the assignment be restricted and prescribed.

Unrestricted and unprescribed civilian basic research will complement their efforts. All three of these services must depend upon the colleges of medicine for their medical staffs and each service will profit if the recruits are better trained in research.

In more than 30 years of association with medical education I have never known a medical school adequately supplied with research and scholarship funds. Endowments that appeared adequate a generation ago are wholly inadequate today. Costs have increased and earnings from these funds have been reduced. The great foundations no longer have huge earnings from which to draw and some of them are liquidating their principals. Special funds must be begged from industry and from private sources. Our State legislators are deeply tax conscious and under constant pressure from constituents to reduce taxes and costs. Education and research often suffer first cuts.

It is beyond reason to expect the scientist, gifted though he may be and full of ardor for his task to choose as his life's work a career that promises bare sustenance as recompense. The shrinking endowments and gifts must first go to the support of these men. What is left will go to investigation.

If medical research is to be maintained on an adequate level, these sources must be supplemented. Since the health of the Nation depends upon adequate and progressive research it must be the concern of the Government to forward that research.

I therefore urge the acceptance of the Magnuson bill which provides for adequate Government subsidy for the maintenance of a comprehensive research program since it more accurately reflects the opinion of medical educators and scientists.

(Supplementary statement by Dr. Ewen M. MacEwen:)

The executive council of the Association of American Medical Colleges met in Pittsburgh October 27, to 31, where it unanimously approved the recommendations of the Bush report requesting the establishment of a National Research Foundation and unanimously approved the Magnuson bill, S. 1285, as more nearly representing the principles desired in the establishment of this foundation, and requested that these recommendations be brought to the attention of the executive session of the association. This association with 74 of the 77 schools represented, unanimously adopted the above recommendations on October 30, 1945.

(Senator Brooks assumed the chair.)

Senator BROOKS. Does that complete your statement, Doctor? Thank you. I'm sorry I was detained, gentlemen, and wasn't able to be here during the entire morning. I wonder, is Dr. Fishbein here? Would you come up, and you other men remain seated with us while we listen to Dr. Fishbein?

Good morning, Doctor. It is getting near the noon hour. Now that I am here, I want to stay with you and do whatever is advisable. I am wondering if you want to read your prepared statement, or file it and then just talk it.

TESTIMONY OF DR. MORRIS FISHBEIN, EDITOR OF THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION

Dr. MORRIS FISHBEIN. I will file it, and I can present my main points in about 5 minutes.

Senator BROOKS. Then we will have a panel discussion, which I think will be a helpful thing.

Dr. FISHBEIN. I have filed a statement with the committee. I appear as the appointed representative of the board of trustees of the American Medical Association, and I present also a statement by a joint committee on postwar planning, representing the American College of Surgeons, the American College of Physicians, and the American Medical Association, and several other organizations in the field of medicine.

The great number and diversity of the measures that have been presented have led us to believe, of course, that it is going to be difficult to find a formula, and we have no perfect formula to suggest, for the setting up of a National Scierce Foundation. We believe there are certain factors that should be avoided, including anything that would incline toward domination of research, toward any inhibition of investigations carried on by private initiative and, we are of course, anxious to avoid spending funds without a reasonable likelihood of a return.

We believe the work carried on during the war by the Office of Scientific Research and Development, and particularly the Committee on Medical Research, is of the greatest importance, and proves funds can be used satisfactorily to encourage research, and particularly to coordinate and intensify the speed with which results are secured, and that is particularly the case in what is commonly called applied research.

The customary lag between the introduction of a new discovery and its general use in medicine has been observed with insulin and penicillin.

Insulin, after many years, is still not used as widely as it might be by numbers of physicians, and the same applies to penicillin, although the lag in the introduction and widespread use of penicillin was unquestionably shortened by the coordinated effort to determine its values and toxicity, as established by the Committee of Medical Research.

Our committee is, in general, in favor of the Bush report, and recognizes the great importance of the five main points mentioned in the Bush report, namely, stability to insure long-range programs, selection of a proper administrative board, promotion of research through contracts or grants to organizations outside the Federal Government, support of basic research in colleges, universities, and research institutes, leaving internal control of policy, personnel, method, and scope to the institutions themselves, responsibility of the organization to the President and the Congress.

We are very doubtful of the desirability of setting up anything like the National Science Service, as mentioned in some of these bills. We believe that the maintenance of the national roster is of the greatest importance, so that there will be at all times a directory of men capable in the field of science, but we rather doubt the necessity for the Government to retain any hold such as would be involved in the setting up of a National Science Service. We believe that the allotment of funds proposed is satisfactory as a beginning, as an experimental basis, but experience will show perhaps that there should be other allocations, and we are rather convinced that these allocations will change from time to time, as many others have already mentioned. We doubt the desirability of entering at this time into research on the social sciences, and I will mention the chief reason for that, which is thegreat danger of the use of so-called research in the social sciences for political purposes and to influence legislation. We are aware of the various measures that have been introduced into Congress, providing large sums for research in dentistry and in neuropsychiatry, and some $10,000,000 for tuberculosis, both for research and study, and for proposals in the field of cancer, and we believe that Dr. Bush has a comprehensive program developed, so that there would not be constantly individual bills for large sums for individual studies.

The great value of such a foundation as the National Science Foundation is to maintain proper proportions in relationship to various subjects, rather than control by some temporary pressure of public opinion.

Now, medical science, is, of course, closely related to national defense. Medical science is also closely related to the basic sciences. The fellowships and scholarships that are proposed would obviously

come to the field of medicine as well as international defense, and the basic sciences, and we believe it is of the greatest importance to have the five-provision program coordinated in the setting up of a structure, and we believe that that might be developed by having the chairman of each division also a member of the regulating or dominating board of the National Science Foundation. In fact, on examining the various bills that have been proposed, we feel that the directing board should have the authority; the directing board should nominate the director to the President. They might nominate alternates, of course. The directing or administrative board might consist of the five directors of the various divisions, with five other scientists chosen because of their achievements and knowledge in the field of science, and preferably nominated to the President by some such agency as the National Academy of Science or some similar group that would be familiar with leadership in these fields.

We believe that the subsidiary advisory boards that have been mentioned are perhaps just a beginning, and that from time to time there will of course be other advisory boards set up under the main board, but the responsibility for these other boards, for the director and all of the subdirectors could very well rest with the chief administrative board.

We believe that the dissemination of information is of the utmost importance, and there must be free interchange of information between scientists if we are to make the best possible progress; we feel that there is one hazard in the creation of a National Research Foundation, namely, the tendency to monopolize personnel to the extent of depriving private industry, private education and research institutions, and to deprive other nongovernmental agencies from securing workers in a field in which there is always a shortage of competent investigators. It would be unfortunate if the Government became too great a competitor with private education, or public education, and with research institutions and with nongovernmental agencies for the men available in the field.

Now, I have mentioned the general structure of the board, and the manner in which it would be developed. In fact, the idea of coordination of the various divisions might be developed to such an extent that there would always be a representative of national defense, for instance, on the medical board, a representative of basic science on the medical board, a representative of the medical board on the basic sciences, and the national defense, because the great difficulty in these massive organizations is the failure of one division to be familiar with what is going on in the other, and the lack of coordination. The interlocking of membership between the divisions is exceedingly useful. I have seen that done in the council on pharmacy and chemistry of the American Medical Association, the general medical advisory board of the National Foundation for Infantile Paralysis, the special medical advisory board of the American Red Cross, and the Division of Medical Sciences of the National Research Council, in which organizations the various parts interlock and are coordinated through interlocking membership. It is of the greatest importance in securing coordinated and intensified action.

All of us are especially interested in that division of the bill which would increase the opportunity for young men with fellowships and

scholarships, and we are quite certain that in the appointment of fellowships and scholarships there must be clear understanding between the different divisions. Conceivably, the one division that is at the moment popular might again take young men or lead young men into that field of research, rather than into some other. Now, the place of the Federal agencies in this matter has already been mentioned and is referred to in the bills. We have the definite feeling that the directing board might well include 10 men, as has been mentioned, and that all of the Federal agencies, including the Bureau of Medicine and Surgery of the United States Navy, the Medical Corps of the United States Army, the medical research activities of the Air Forces Medical Department, the research functions of the Food and Drug Administration, the Medical Department of the Veterans' Administration, the Medical Department of the Bureau of Maternal and Infant Welfare of the Department of Labor, and indeed many other Federal agencies that are concerned with health should be ex officio members of the subdivision of medical sciences. If the director himself could not attend, obviously he could provide an alternate, because it would be important to have clearly before us the research carried on in governmental agencies as well as those carried on by the National Foundation. It does not appear to be clear whether or not the proposed National Research Foundation is also to make grants to governmental agencies concerned with health and medical research, although parts (b) and (d) of section 2 of S. 1297 do define somewhat these functions.

It is important to know whether or not the National Research Foundation is also to make grants for research to Federal agencies, or whether they would be limited to the budget they have presented to Congress.

Senator BROOKS. Would you favor them being limited to the budget provided for them?

Dr. FISHBEIN. Yes, I would feel definitely the Federal agencies should be confined to the budgets granted by Congress and the appropriations of the National Science Foundation be outside of governmental agencies, and that should be made clear. It is not clear to me in the bill as it now stands.

On the question of patents, I must admit there are so many ramifications and intricacies that I would not want to venture an opinion. I think it would be better if the relationship to patents were entirely avoided and worked out much more carefully on a larger scale in some other measure. I am convinced, from previous experience in this field, that if S. 1297 should be adopted as it now is, leaving to the director the authority to decide whether or not a patent is to be dedicated to the public or is the property of the inventor or, indeed, even to determine the proportions to which such a patent shall be the property of either the Government or the inventor, there would result so much possibility of controversy and dispute as to negative the value of the entire measure, discouraging investigators from association with the National Science Foundation or from maintenance of association with the National Science Foundation.

There are such tremendous interests involved in this field, billions of dollars involved in the ownership of patents in the field of medicine, that controversy over that alone might break down the entire purpose