The selection of professional or technical personnel for training is left to the discretion of the State agency receiving the grants. Types of persons trained include: physicians, dentists, nurses, laboratory workers, sanitation personnel, and other persons who are, or are to be, employed in official State, county, or local health programs. This group includes some who are not employed by an official health agency but who will, as the result of the training, render services to public health programs. At the present time the personnel receiving sponsored training must fall into one of the three following pay and allowance criteria: (1) Those who receive stipends instead of regularly established salaries, (2) those who receive salaries but have been relieved of their regular duties for the training period, and (3) those for whom only tuition and travel expenses are paid. Sponsored training may be either accredited or nonaccredited.

Accredited training.-Courses include academic classroom instruction or approved hospital, clinic, or field training for which a university gives credit toward a degree. Short university workshop classes which are credited toward a degree are also classified as accredited training.

Nonaccredited training. This training includes supervised experience in health departments, hospitals, or clinics, but it is not recognized by a university as contributing toward a degree. Refresher courses, short specialized hospital and clinic courses, such as those conducted in the fields of venereal disease, tuberculosis, obstetrics, and general public health field practice, are also classified as nonaccredited training.

Federal, State, and local public health workers receive field training in the various health programs through the utilization of local health departments and other selected installations as centers for further training. These health centers have the necessary facilities for conducting planned field training for one or more occupational groups of public health workers.

Public Health Service grants used by the States and Territories for educational activities for 1957-58 and 1958-59 and the amounts budgeted for 1959-60 are listed in table 50. Details for the 1958-59 school year are also listed in column 18 of summary table 3. These data are given as reported to the Public Health Service by State health departments and by other State agencies participating in grants administered by the Public Health Service. They include the portions of the grants used for educational purposes. The amounts do not represent the total expenditures for education since it is known that funds spent for training are sometimes reported as regular charges to the specialized program rather than identified separately as amounts

for educational projects. In addition to the funds reported, it is understood that State funds are also used for these educational activities.

Table 50.-PUBLIC HEALTH SERVICE GRANTS USED BY STATES AND TERRITORIES FOR EDUCATIONAL ACTIVITIES: 1957-58 TO 1959-60

Responsibility for administering the health program for Indian and Alaska native citizens was transferred from the Bureau of Indian Affairs in the Department of Interior to the U.S. Public Health Service (USPHS) in the Department of Health, Education, and Welfare on July 1, 1955.

Training activities with particular emphasis on the training of Indian and Alaska natives in the health-related fields are an integral part of the Indian health program. Although there are other technical training programs of a less formal nature carried on by the USPHS staff at Indian health facilities, the following two training programs are adapted to the particular health problems of the Indian people.

DENTAL ASSISTANT TRAINING

The Division of Indian Health offers training for the preparation of dental assistants at Bureau of Indian Affairs Vocational Training Schools at Mt. Edgecumbe, Alaska, and Brigham City (Intermountain), Utah. Students receive instruction in clinical and academic courses conducted by the staffs of the USPHS and the Bureau of Indian Affairs. At Owyhee, Nev., training is also offered by the USPHS staff through a course approved for credit by the local board of education. Students who complete training at these centers are assigned to work with dental officers in Indian health hospitals or outpatient clinics. These students are also eligible for work with dental preventive units operating outside of the clinical environment. Table 51 shows the number of students in training for dental assistants at the three schools. Federal funds obligated for the operation of this training activity, included in the Division of Indian Health operating funds allotted for dental services, amounted to an estimated $5,800 in 1958-59.

Table 51.-NUMBER OF STUDENTS IN TRAINING FOR DENTAL ASSISTANTS: 1955-56 TO 1959-60

The Division of Indian Health operates two special schools for training young Indian men and women to become practical nurses. Upon completion of the 1-year training program, the graduates are assigned to work in Indian health facilities. One of these schools is located at Albuquerque, N. Mex., and the other at Mt. Edgecumbe, Alaska. Table 52 shows the number of students admitted and graduated and the Federal funds obligated for this program from 1955-56 to 1959-60. The total of Federal funds for both the Practical Nurse and Dental Assistant programs is $282,857. This amount is reported in column 4 of summary table 2.

Table 52.-FEDERAL FUNDS OBLIGATED AND NUMBER OF INDIAN STUDENTS IN PRACTICAL NURSE TRAINING: 1955-56 TO 1959-60

PUBLIC HEALTH SERVICE RESEARCH FELLOWSHIPS

Research fellowships are awarded to scholars to stimulate interest in research and academic careers in medical and allied health sciences and to increase the number of scientists competent to follow such careers. Two plans, the regular and the new, are used in making these awards.

Under the regular or traditional plan, three types of research fellowships are offered. These include predoctoral, postdoctoral, and special. "Special" refers to those awarded to qualified persons who have demonstrated unusual competence for research or who require specialized training for a specific problem.

In the new approach, student part-time, postsophomore, and senior fellowships are awarded through acceptable participating schools. Funds for student part-time fellowships are for medical, osteopathic, dental, nursing, and public health schools to provide for part-time research during the school term or for full-time research for 2 months at any period when curriculum work is not scheduled for the student. Postsophomore fellowships are awarded to students who wish a full year of research training in schools of medicine, osteopathy, and denistry before the students secure their professional degrees. The senior fellowships are awarded to medical, dental, and public health schools in behalf of individuals to foster research in the preclinical sciences and to support those preclinical science investigators between completion of postdoctoral research training and eligibility for permanent academic appointment.

Also, foreign fellowships, which had been awarded on a small scale. from 1945-46 to 1950-51 as a part of the regular fellowship program, were reactivated in 1957-58. Under this fellowship award plan,

postdoctoral fellowships are provided to foreign nationals initially selected by appropriate national research organizations in their respective countries to study in the United States. Column 4 of table 53 indicates for a 9-year period the Federal funds that have been awarded for research fellowships.

Table 53.-FEDERAL FUNDS FOR RESEARCH FELLOWSHIPS, DIRECT TRAINEESHIPS, AND TRAINING GRANTS AWARDED BY THE PUBLIC HEALTH SERVICE: 1951-52 TO 1959-60

PUBLIC HEALTH SERVICE TRAINEESHIPS AND TRAINING GRANTS

The U.S. Public Health Service has recognized the critical need for personnel well qualified in matters pertaining to health and has thereby established the two following types of training awards in order to stimulate such training: (1) Direct traineeships recommended on a competitive basis by review boards of the Public Health Service and paid directly by a monthly Federal check to the trainee, and (2) training grants made to institutions for teaching and other purposes including indirect traineeships. Both types of training awards are discussed below.

Direct traineeships.-The preponderant majority of direct traineeships awarded by the National Institutes of Health (NIH) are for training M.D.'s and Ph. D.'s in clinical and basic research. Their purpose is to increase the competence and number of people qualified in fields important to the attack on diseases with which the Institutes are concerned. In 1959-60 traineeships were awarded directly to individuals by the following Institutes: Cancer, Arthritis and Metabolic Diseases, and Neurological Diseases and Blindness. Also, under this plan, funds are awarded by the Bureau of State Services in the fields of air pollution and for training of professional public health personnel.

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