NIAMS Forum for Clinical Mentored K Awardees
December 7-8, 2015
Stephen I. Katz, M.D., Ph.D.
Susana A. Serrate-Sztein, M.D.
Marie Mancini, Ph.D.
Amanda Boyce, Ph.D.
The NIH K08 and K23 Career Development Awards provide clinician-scientists support for a sustained period (3-5 years) of “protected time” for intensive research career development under the guidance of an experienced mentor, or sponsor, in the biomedical, behavioral or clinical sciences leading to research independence. Previous discussions have identified the K-to-R01 transition as a critical point in the development of an investigator’s independent research career.
This Forum was first held in 2012. Based on the positive feedback received from participants, NIAMS has held the meeting every year since then. The purpose of this Forum was to bring together current NIAMS K08 and K23 awardees who are in their third year of award, as well as clinicians-scientists who have recently received an R01 (or equivalent independent research award), established clinician-researchers, and representatives of professional and voluntary organizations for a shared, open discourse on the challenges junior investigators face in pursuing research independence. The Forum also provided an opportunity for the awardees to network with one another, as well as to interact with NIAMS leadership and extramural staff. The long-term goal of this Forum is to enhance the Institute’s support of early-stage physician-scientists by encouraging and enabling K08 and K23 awardees to continue performing basic, translational, or patient-oriented research in their chosen fields.
In preparation for the meeting, participants were asked to identify obstacles facing clinician-scientists and what NIAMS, as well as the broader medical/scientific community, might do to help support clinician-scientists to achieve research independence. They were also asked what NIAMS, as well as the broader scientific community, could do to encourage leveraging opportunities with industry and other Federal partners. Current K awardees and invited early-career stage investigators were specifically asked about the challenges they may have encountered when seeking access to NIH or university research shared resources (e.g., core facilities, biological materials, data, biostatistical support). Answers provided to these questions set the stage for the discussion.
The Forum started in the afternoon of December 7, with the current K awardees presenting a brief overview of their research projects and progress. Each presentation was followed by a short period for questions and discussion. This session provided attendees with the opportunity to hear about each other’s research projects and to exchange information about ways in which they might overcome challenges.
On December 8, the K awardees participated in a morning "Round Robin" session with NIAMS program, grants management, and review staff, as well as with NIAMS staff who coordinate clinical research. At the beginning of this session, Dr. Marie Mancini provided a brief overview of the structure and budget of the NIH and NIAMS. While the K awardees spoke with extramural staff, the other participants met with the NIAMS Director, Dr. Stephen Katz, and Deputy Director, Dr. Robert Carter, to discuss programs that may help facilitate the K-to-R transition, as well as trans-NIH programs and policy changes that may aid in retaining clinician-investigators in biomedical research careers.
Setting the Stage
After the morning sessions, the entire group reconvened to discuss how K awardees can make the most of their awards and plan for a successful transition to research independence. Dr. Katz reminded the participants that while NIH’s budget prospects in recent years have been particularly tight and the current funding climate is a strain on all researchers, the situation may particularly affect new investigators, especially early-career clinician-scientists. For this reason, NIH has developed a number of programs to help support new investigators. However, NIAMS does have more than half-a-billion dollars to invest in promising research and will continue to devote the majority of its extramural budget toward funding the best investigator-initiated research ideas within its mission. Dr. Katz reiterated his hope that the discussion at the Forum would help shape the Institute’s thinking about how to sustain the outstanding research the NIAMS is currently supporting, while ensuring that a diverse and highly skilled workforce is available to lead future generations of scientists.
Dr. Mancini presented historical outcomes data on the NIH/NIAMS K08 and K23 awards. Key messages included that K awardees are more likely than comparable non-K awardees to apply for and receive subsequent NIH funding. Researchers who had held K08 or K23 awards had a significantly higher R01 award success rate than individuals with no prior career development support. Likewise, individuals who received both foundation support and an NIH K award were more likely to apply for and receive R01 funding than those who had only the K award. Nevertheless, the transition period between the K and the R01 award remains a vulnerable period in scientists’ careers.
Focusing on the Present – How to Make the Most of Your K Career Development Award
Obtaining Additional Research Support
The NIH mentored K award provides salary and benefits, plus funding for research supplies. K awardees emphasized the importance of obtaining financial and intellectual support beyond what is provided through the NIH K award.
A number of societies and foundations offer programs for emerging clinician-scientists. K awardees also suggested requesting a startup package from the university that might enable one to hire a technician or buy supplies. Some K awardees have also received unrestricted private donations, which can be used to support a diverse set of needs. Some individuals reported that leadership and management courses were helpful as they began work on their K award. Furthermore, numerous participants stressed the importance of the NIH Loan Repayment Program in enabling them to continue pursuing research careers.
Balancing Patient Care and Research
The K08 and K23 awards support clinically trained professionals, most of whom see patients in addition to conducting research, teaching, and fulfilling administrative responsibilities. It is the sense of the awardees that each university has a different definition for what 75 percent of their time constitutes; the base number of hours varies from 24 to 60. It is sometimes difficult to balance the desire to follow-up with patients and answer their questions with the need to have dedicated research time. There may also be pressure from the institution to spend more time on clinical responsibilities.
Conducting Clinical Research
Several K awardees who were conducting clinical studies mentioned challenges in creating a patient cohort within the confines of their mentor’s research. It takes a long time to develop a cohort that is sufficiently large to enable the publication of clinical data. There can be issues with cohort "ownership" and the associated data when one is pursuing research independence.
Intellectual support is also very important as K awardees work to develop an independent research career. Most of the K awardees report having a mentoring team in place. Often, it is helpful to find mentors from a variety of scientific areas. Additional mentors can provide guidance for non-scientific concerns (e.g., general advice, such as tenure, promotions, work/life balance). Another suggestion to increase and diversify scientific involvement was to have combined laboratory meetings with others in the organization to garner a broader cross-section of input. Some universities have encouraged networking of K awardees, regardless of which NIH IC provides their funding, to provide support for grant writing and other career development advice.
Early on in the K award, it is crucial to meet with the mentor often, possibly weekly, transitioning to fewer regular meetings as one progresses and approaches independence. The mentor/mentee relationship should ideally transition to more of a collaborative one as the K award progresses. Several individuals have created peer mentoring relationships to provide another layer of review of grant applications before submission. It can also be helpful to get feedback from those outside your area of research to broaden one’s perspective.
Looking to the Future: Planning a Successful Transition to Your R01
Becoming a principal investigator (PI) on an NIH R01 grant is a widely accepted measure of independence and a primary goal for most K awardees. Researchers who recently received their first R01s shared their experiences and challenges with establishing independent projects.
The current K awardees shared their own stories about moving forward to becoming successful independent investigators. Some spoke about the difficulty of getting sufficient preliminary data for an R01 application, while working under a K award, and also balancing the need to have publications in peer-reviewed journals. It is helpful to communicate with one’s mentor as early as possible about what the expectations are for one to reach independence. The K awardee should view themselves as a collaborator of the mentor if there are shared resource interests. It is also important to reach out to colleagues at scientific meetings.
Many of the participants pointed out that they had strong institutional support to help ensure their successful transition to an R01. By holding meetings such as this one, K awardees experience firsthand how NIH and NIAMS can help them to become independent researchers. For example, they realize that NIAMS program officers and other staff are a valuable resource for information.
Participants (* indicates current K awardee)
*CANNA, Scott, M.D., NIAMS, NIH (K equivalent)
CAULEY, Jane, Dr.P.H., Representing the American Society for Bone and Mineral Research, University of Pittsburgh
CHANG, Gregory, M.D., NYU Langone Medical Center
*CHUNG, Cecilia P., M.D., M.P.H., Vanderbilt University Medical Center
*CHUNG, Sharon A., M.D., University of California at San Francisco
*CUDRICI, Cornelia, M.D., NIAMS, NIH (K equivalent)
DEYLE, David, M.D., Mayo Clinic
GARZA, Luis, M.D., Ph.D., Johns Hopkins University School of Medicine
*GUMA, Monica, M.D., Ph.D., University of California at San Diego
* HANSON, Eric, M.D., NIAMS, NIH (K equivalent)
*HINCHLIFF, Monique E., M.D., Northwestern University Feinberg School of Medicine
*JACOBSEN, Christina M., M.D., Ph.D., Boston Children’s Hospital/Harvard Medical School
JONES, Lynne C., Ph.D., Representing the Orthopaedic Research Society, Johns Hopkins University School of Medicine
*KAHLENBERG, Michelle, M.D., Ph.D., University of Michigan
KHORMAEE, Sariah, M.D., Ph.D., Representing the American Academy of Orthopaedic Surgeons, Hospital for Special Surgery
*LEWIS, Cara, P.T., Ph.D., Boston University
*MACLEOD, Amanda (Büchau), M.D., Duke University School of Medicine
MARCHIOLO, Eryn, Rheumatology Research Foundation
MCMAHON, Maureen, M.D., M.S., UCLA David Geffen School of Medicine
NILSON, Susanne, Arthritis Foundation
*NOEHREN, Brian, P.T., Ph.D., University of Kentucky
*NOSS, Erika H., M.D., Ph.D., University of Washington
*OGDIE, Alexis R., M.D., M.S.C.E., Perelman School of Medicine, University of Pennsylvania
RAMSEY-GOLDMAN, Rosalind, M.D., Northwestern University Feinberg School of Medicine
RIDKY, Todd, M.D., Ph.D., University of Pennsylvania
*SCHER, Jose U., M.D., NYU-Hospital for Joint Diseases
*SIBILLE, Kimberly, M.A., Ph.D., University of Florida
* SIKORA, Keith, M.D., NIAMS, NIH (K equivalent)
*XIA, Guangbin, M.D., Ph.D., University of Florida
BOYCE, Amanda, Ph.D.
BURROWS, Stephanie Y., Ph.D.
BUSCHMAN, Justine, M.S.
CARTER, Robert, M.D.
CHEN, Faye, Ph.D.
CIBOTTI, Ricardo, Ph.D.
DRUGAN, Jonelle K., Ph.D., M.P.H.
KATZ, Stephen I., M.D., Ph.D.
KESTER, Mary Beth, M.S.
KHAN, Shahnaz, M.P.H.
LIN, Helen, Ph.D.
LINDE, Anita M., M.P.P.
LIU, Yin, Ph.D.
MANCINI, Marie, Ph.D.
MARRON, Kathryn, Ph.D.
MCGOWAN, Joan A., Ph.D.
NICHOLSON, Anna, M.S.H.S.
REUSS, Reaya, M.S.
SALAITA, Kathy, Sc.D.
SERRATE-SZTEIN, Susana A., M.D.
WASHABAUGH, Charles H., Ph.D.
WITTER, James, M.D. Ph.D.