The program of intramural research at the National Institutes of Health (NIH) could be seriously damaged by 1982 unless the sprawling Bethesda, Md, facility can curtail its expenditures. Dr Robert Goldberger, NIH Deputy Director for Science, estimates that with President Carter's 1981 budget increase of less than 4% for the Bethesda-based institutes (which will result in an approximate 10% drop in overall buying power), such obligated costs as salaries will commit a dangerously high proportion of the intramural budget and lead to severe financial pressures on the NIH mission. It appears that extramural funding for 1981 will stress support for investigator-initiated research grants, allowing approximately an 11% increase in this area, with the boost for intramural research lagging far behind.
What consequences will the contraction of intramural NIH's scientific mission have on US medical practice and medical education? Consider the large number of well-trained researchers and clinicians who served their