but a knowledge of subjective influence of illness and its impact upon a given personality. The teacher, administrator, researcher and the technologist specialist require training beyond the baccalaureate level and it is in this area our greatest shortage will exist. In common with medicine and nursing, allied health professionals course of their preparation must be exposed to patient contact in actual work situations under supervision of competent faculty. Faculty supervision must be on a personal basis, both in the laboratory and in the care of patients; conseque the ratio of faculty to students requires maintenance of a large teaching staff with attendant expense. This desirable educational experience can best be offered in a university medical center complex whose resources include a medical school, hospitals and a school of nursing and allied health professions with access to a full range of related disciplines, i.e., education, basic sciences, administration, etc., but where the administrative structure with its coordinating processes are in existen Government Assistance The allied health programs at Saint Louis University and in other schools with similar programs would be severely handicapped or perhaps discontinued if assistance in the form of basic improvement grants were not made available over the past five years. I would encourage this committee to strongly support legislation continuing this form of assistance in an increased amount and with less rigid requirements for annual increase in enrollment. As with all programs designed to meet a growing need, there exists the danger of over proliferation. New and innovative programs should be encouraged but it is conceivable that we will so fragment our delivery of health care with specialists that manpower in terms of efficiency and effectiveness will be dissipated. needs of the public might best be served by exploring the feasibility of preparing The health personnel with capabilities in more than one area, rather than encouraging the continued development of technicians and/or technologists with expertise in but one specialty. The majority of our hospitals are small; the majority of consumers live in areas that cannot support, in terms of demand, the many specialties that exist. Research on the contribution of each specialty, evaluated in terms of developing technology and feasibility of application, should be conducted by a selected number of institutions with the resources to conduct such a study. To meet the needs of various sections of the country, perhaps more than one such program could be subsidized to work with curriculum development, evolution of new programs and experimentation with existing programs. Perhaps one example of the need for such research is the emergence of the Physician's Assistant. The concept is valid; the terminology may be unfortunate. Several programs designed to prepare personnel qualified to assume routine responsibilities of the physician have been initiated, but objectives and standards seem to lack uniformity. For the protection of consumers and the medical profession, the role of the Physician's Assistant must be clearly defined. As a consumer, I would expect a person with the title of Physician's Assistant to have a basic orientation to health care. Thank you. This orientation can best be provided in a medical center complex. Senator EAGLETON. We now have Dr. Oliver Duggins, Ph. D. It is refreshing to have a Ph. D. with us, after all of the M.D.'s. He is chairman of the Life Sciences Division, Forest Park Community College. STATEMENT OF OLIVER H. DUGGINS, PH. D., CHAIRMAN, LIFE SCIENCES DIVISION, FOREST PARK COMMUNITY COLLEGE Dr. DUGGINS. Dr. Cosand apologizes for having to leave. Senator EAGLETON. Yes, I would like the record to show he was with us for 2 or 3 hours waiting very patiently, and I know what his schedule problems are. Dr. DUGGINS. He has asked that I represent him, and we appreciate this opportunity. I'd like to make four or five very rapid comments on things that have been said so far. I think probably the community colleges are in better position, or as good a position, as any other institution or type of institution to supply allied health personnel, and there are three or four reasons for this. First of all, 42 percent of all the students who are in colleges today are in community colleges. The Junior College District of St. Louis in its very short existence is already the second largest college in the State of Missouri, and we anticipate or estimate that 60 percent of all students in college by 1975 will be in community colleges. Secondly, community colleges are open-door colleges. We feel committed to meeting the needs of each individual student, as well as meeting the needs of the community. Senator EAGLETON. Your open-door colleges are subject to the limits financially, aren't they? Dr. DUGGINS. Well, we haven't been limited yet. Senator EAGLETON. Federal City College, for instance, in Washington, D.C., yesterday turned down 2,500 students. Dr. DUGGINS. We may have to do this; we haven't yet. Dr. DUGGINS. Thirdly, technical or career training is one of the major emphases of the community college. Fourthly, there are over 200 allied health programs, and most of these can be offered in 1 or 2 years which, of course, is the specialty of the community college. The Junior College District of St. Louis at the present time has more than 600 students enrolled in allied health programs. There are eight allied health programs we are presently offering. Senator EAGLETON. Would you supply for the record at a later date, Doctor, the titles of the programs, a brief description as to the type of training that provides, and the number of students enrolled in each? Dr. DUGGINS. All right. I might just say that these are in eight programs and we have them listed here [indicating]. Senator EAGLETON. Oh. Dr. DUGGINS. There are 34 in clinical lab technology, 74 in dental hygiene Senator EAGLETON. That's all right. That will be in the record. I'm sorry. Could these programs, if you had greater demand, could you handle-I see you have 74 in dental hygiene, but could you handle 84? Dr. DUGGINS. Only with additional faculty, and we don't have the funds for it. Senator EAGLETON. Are you at the breaking point, the point of no return, on all of these programs, that is, you just can't take any more into any of these programs? Dr. DUGGINS. Not quite, no; we are approaching it. I think the figure that you brought out this morning might be clarified a little bit. You said, I think, that there were 28,000 vacancies or openings in a certain number of programs, but only 10,000 graduates. Senator EAGLETON. Yes, here [indicating] it is. This is from the AMA. Dr. DUGGINS. The reason for this, I think, is that probably most of those programs are running at capacity, but you don't graduate the number of students that you have in the program because of your attrition rate. So, even though Senator EAGLETON. I will clarify it, then. This is from the AMA, September 15, 1969, the total student capacity, and I read the job titles earlier-28,308 student capacity, enrollment 20,495, graduates 10,079, still it leaves 8,000 vacancies according to these statistics. But you are pretty much at the top level. Dr. DUGGINS. Four of our programs are oversaturated, we are beyond capacity. Nursing is over capacity. We have a waiting list of 275. Senator EAGLETON. In operating a junior college, your vocationaltechnical programs, per student, are more expensive than straight liberal arts, usually speaking; isn't that the case? Dr. DUGGINS. Right. I pointed out here to train a nurse it takes $51.58 in our institution per credit hour, plus the expensive equipment and professional personnel. We can train four liberal arts students for the same amount. Therefore, we are in competition with the liberal arts programs for the limited budget dollar. I personally feel that it is well worth the expense and that we probably can train this person as economically or more economically than anyone else, but still it is expensive and, of course, we have problems meeting our budget, too. Senator EAGLETON. Of these 600 students enrolled in these programs, do you have an estimate as to how many of them are black? Dr. DUGGINS. I can tell you on the Forest Park campus, this is a very difficult figure to come by, because we keep no records of this type. I went back and spent a lot of time just looking it up in preparation for this, however. We have taken in 100 freshmen in our nursing class for the Fall, and 57 are black. More than this would be of minority groups, Philippino, Indian, and so on, but 57 we can identify as being black. We have taken in 27 at Forest Park in X-ray, 14 of whom are black. We have taken in 17 in clinical lab in our freshmen class, seven of these being black, and so on. The percentage is going up. We had the same difficulty that you mentioned before. In the first year or two we had difficulty in attracting black students into our program, but it is catching on now and we are getting more and more applicants from this group. We feel very much obligated to meet this 52-314 0-71-15 minority demand. We have several programs in order to try to prepare students for this. We have a general curriculum program which has more than 700 students in it. These are students who have graduated from high school, but who are deficient in math or reading. Some of them have sixth, seventh grade reading level and can't read college level material, so we have a general curriculum program by which these students are given 6 months, maybe a year, of additional training. This is not college credit, but additional program material, learning lab, individual tutoring, and so on. Hopefully they move either into a college transfer program or into the technical programs. Many of our students in these numbers I am giving you have come up through the general curriculum, through a year of special remedial training. We have another program called Project Ahead where we go out into the high schools and identify students who have ability but for some reason have not gone to college. Then our counselors go from door to door and knock and say, "Why aren't you in college?" If they find that they can encourage them to come, we have financial aid, and so on, they bring those in. We have 350 of those, 55 of whom were moved last June into 4-year universities after just a year with us because they showed the type of ability that was needed. Washington, St. Louis, other schools have already given them scholarship funds from the Ford Foundation. In addition to our 324 nurses, we are training over 100 from Barnes and 100 from Jewish, that is, they take their academic training with us. Senator EAGLETON. Is that a shared time deal, taking their firstyear academic training with you and then part-time technical or scientific with the hospitals? Dr. DUGGINS. Yes. We have this same relationship in other programs, with Deaconess Hospital and others, Missouri Baptist, and some others, where they come from X-ray tech or clinical laboratory technology with us. Senator EAGLETON. Do you see the possibility of future interrelationship in this paramedical field with the medical schools? Dr. DUGGINS. Yes, very definitely. We already have, as was mentioned this morning in the dental area, where we are going to begin to train our dental hygienists and dental assistants with the dentists. This is a part of this inter-institutional committee, an outgrowth of that, and we are hoping to begin the team approach to dentistry and, of course, with our students at Barnes Hospital for clinical experience. Many of them are working pretty well along with the team there, anyway. There are just one or two other things. The problem of accreditation has come up several times here, and this becomes a real obstacle for some of these programs, because some of the programs are unrealistic and archaic. We find, for example, maybe three or four accrediting agencies, each one competing to accredit your program. We find that many of the accrediting agencies insist on so many hours of transfer work. Why is it, for example, that we must give a student college algebra instead of maybe technical math which would be more applicable, let's say, for X-ray tech. Why must we give him psychology instead of human relations. Why must we give him English composi tion instead of communications, subjects that we feel are better. But |