NIH GUIDE, Volume 23, Number 1, January 7, 1994

PA NUMBER:  PA-94-025

P.T. 44


  Biomedical Research Training 

  Biomedical Research, Multidiscipl 

Office of Alternative Medicine

National Institutes of Health

Application Receipt Dates:  April 5, August 5, and December 5


The Office of Alternative Medicine (OAM) is planning to fund, through

the various Institutes at the National Institutes of Health (NIH),

individual postdoctoral training awards for FY 94 using the National

Research Service Award (NRSA) mechanism.  The purpose is to provide a

cadre of investigators capable of conducting systematic studies on

safety, efficacy, cost-effectiveness, or mechanisms of action of

unconventional methods for treating major diseases and promoting

well-being.  This training is expected to attract postdoctoral

candidates who are in the early stages of their careers.  They will

have obtained expertise in conventional research methodology and some

familiarity with/or interest in alternative medical procedures.

Prospective trainees will be expected to form an alliance with

established researchers to provide a mutual learning experience.

This program announcement (PA) on Alternative Medicine is an

abbreviation of a larger, NIH-wide PA on NRSA Individual Postdoctoral

Fellows, which should be requested from the contact person listed



Individuals must be citizens or noncitizen nationals of the United

States, or have been lawfully admitted to the U.S. for permanent

residence (i.e., in possession of a currently valid Alien

Registration Receipt Card 1-551  or in possession of other legal

verification of such status.)  Prior to beginning the award the

applicant must have received a Ph.D., M.D., D.O., D.D.S., D.V.M.,

0.D., D.P.M., Sc.D., Eng.D, Dr. P.H., D.N.S., D.Pharm., D.S.W., or

Psy. or equivalent doctoral degree from an accredited domestic or

foreign institution.

Before submitting a fellowship application, the applicant must

arrange for appointment to an appropriate, accredited university,

hospital, or other institution with facilities including staff for

postdoctoral training.  This may include institutions that train in

areas outside conventional medicine such as acupuncture or

chiropractic.  The candidate should be accepted by a sponsor who will

actively supervise the training.  The sponsor should have research

experience in clinical medicine and/or basic pre-clinical research

along with an involvement in the evaluation of alternative medicine.

Thus, the sponsor should be qualified to supervise in the application

of rigorous study design to the assessment of individual alternative

therapies.  Because of the novelty of some procedures, it is

recognized that the sponsor may not have reached the level of

"senior" investigator in a particular field of alternative medicine.

Applicants proposing training at their doctorate institution or at

the institution where they have been training for more than a year

must document thoroughly the opportunity for new training experiences

that would increase their scientific background relating to

Alternative Medicine.


The mechanism of support is the Individual National Research Service

Award.  Individuals may request up to 3 years of aggregate NRSA

support at the postdoctoral level.  The stipend level for the first

year of NRSA support is determined by the number of years of relevant

postdoctoral experience at the time the award is issued.  The range

of support is from $18,600 (less than l full year of experience) to

$32,300 (7 or more years of experience).  Relevant experience

includes research experience, teaching, internship, residency, and

clinical duties.

Supplementation, when provided, must not require obligation from the

fellow.  Under no circumstances may PHS grant funds be used for

supplementation.  NIH will provide an institutional allowance of

$3,000 per 12-month period to non-Federal nonprofit sponsoring

institutions to help defray such awardee expenses as tuition and

fees, self-only health insurance, research supplies, equipment,

travel to scientific meetings, and related items.  For individuals

sponsored by Federal laboratories, or for-profit institutions, the

NIH will provide up to $2,000 for scientific meeting travel expenses,

self-only health insurance, tuition fees, and books.  Fellows in the

first twelve months of postdoctoral NRSA support will incur a service

obligation of one month for each month of support.  Additional

information is contained in the NIH Guide, Vol 22, July 30, 1993.

It is expected that four to six awards in Alternative Medicine will

be made in FY 1994.


The OAM was established in 1992 to evaluate and determine the

efficacy of various unconventional, alternative or complementary

medical practices.  A recent survey demonstrated that as many as 34

percent of adults utilized at least one alternative, therapy for the

treatment of a serious or bothersome medical condition during the

previous year (Eisenberg, D. et al, New England J. Med. 328: 246-252,

1993).  The cost for services provided by alternative practitioners

is estimated to be more than $13 billion a year.  Many of these

interventions have not, however, been subjected to scientific

scrutiny using conventional research methods.  Existing research in

this area is limited by a paucity of well designed trials, and there

are few research data bases which allow for systematic review or

meta-analysis of treatment efficacy.  OAM feels that it is important

to better understand if any of these therapies benefit the patients

that use them.

Unconventional practices include medical interventions that are not

widely taught at medical schools or are not generally available at

hospitals within the United States.  For the most part, such

treatments are not reimbursable by third party (insurance companies)

payers.  Examples of areas of interest include, but are not limited

to: acupuncture; homeopathy; structural manipulation including

chiropractic/massage; visual imagery, relaxation techniques,

meditation, herbal therapies, or diet and life style.  The Office is

especially interested in alternative procedures in the treatment of

life threatening diseases, e.g., women's breast cancer or AIDS-HIV

and the subsequent impact on either/and:  a) course of disease; b)

wellness/quality of life/ prevention; c) statistical/population

disease trends d) basic biological systems.  However, any particular

health problem such as arthritis, depression, drug or alcohol

addiction, or heart disease is acceptable.


Applicants should submit a completed Application for Public Health

Service Individual National Research Service Award (PHS 416-1 rev.

10/91), including with the application at least three letters of


Application kits can be obtained from the following address:

Grants Information Office

Division of Research Grants

National Institutes of Health

Westwood Building, Room 449

Bethesda, MD 20892

Phone: (301) 710-0267

Applicants and sponsoring institutions must comply with policies and

procedures governing the protection of human subjects, the humane

care and use of live vertebrate animals, and the inclusion of women

and minorities in study populations.


The review criteria will focus on the following main components: a)

the applicant's academic preparation; b) the scientific merit of the

proposed research including the clarification of treatment efficacy

of a particular alternative medical procedure; c) training potential

for the student; d) the training resources and environment, including

the sponsor.  Following the initial review, the grant application

will be assigned to one of the institutes based on the major health

problem to be evaluated; e.g., alternative procedures evaluating

cancer would be assigned to the National Cancer Institute (NCI).  A

second level of review will be provided by a committee or staff from

the relevant institute and the OAM.


The following criteria will be used by the NIH in making awards:  a)

individual review group (IRG) recommendation of the overall merit of

the application; b) relevance of the application to the research

priorities of the Institute and the OAM along with program balance;

c) availability of funds.


Written and telephone inquiries concerning this PA are encouraged.

The opportunity to clarify any issue or question(s) from potential

applicants is welcome.  Direct inquiries regarding programmatic

issues to:

Dr. John Spencer

Office of Alternative Medicine

National Institutes of Health

6120 Executive Boulevard, Suite 450

Rockville, MD  20892-9904

Telephone:  (301) 402-4333

FAX:  (301) 402-4741


NRSAs are made under the authority of Section 487 of the Public

Health Service Act as amended (42 USC 288) and Title 42 of the Code

of Federal Regulations, Part 66.


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