December 4, 2018

December 3-4, 2018

Co-Chairs
Stephen I. Katz, M.D., Ph.D.
Gayle Lester, Ph.D.
Ricardo Cibotti, Ph.D.
Amanda Boyce, Ph.D.

Introduction

The NIH K08 and K23 Mentored Research Career Development Awards provide support for a sustained period of “protected time” (3-5 years) 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 clinician scientists’ independent research careers.

Purpose

The first NIAMS K forum was held in 2012. Based on the positive feedback received from participants, NIAMS convened subsequent meetings in 2013, 2014, 2015, and 2016. The NIAMS K forum brings together clinician scientists who are currently in the third year of their NIAMS K08 or K23 award, mid-career physician scientists with R01 awards who have had an NIH K award in the past, established clinician researchers, early-stage clinician scientists in the NIAMS intramural research program, and representatives of professional and voluntary organizations. The purpose of the meeting is to foster a shared, open discourse on the challenges K investigators face in pursuing research independence. The forum also provides an opportunity for the K awardees to network with one another, and to interact with NIAMS leadership and extramural staff. The long-term goal of the forum is to enhance the Institute’s support of early-stage physician scientists by encouraging and enabling them to continue performing basic, translational, and/or patient-oriented research in their chosen fields.

Research Presentations

The forum started in the afternoon on December 3, with an overview of the research being conducted by the investigators who currently hold K awards. The scientists briefly outlined their research projects and progress. Each presentation was followed by a short question and answer period. This session provided attendees with the opportunity to hear about each other’s research projects and to receive feedback and suggestions from the group.

Concurrent Sessions

K Awardee Meetings with NIAMS Extramural Staff

On December 4, scientists with K awards participated in a morning “Round Robin” session with NIAMS program, grants management, and scientific review staff, as well as with NIAMS staff who coordinate clinical research. At the beginning of the session, Dr. Ricardo Cibotti provided a brief introduction to the NIH and the NIAMS, as well as information about NIAMS organization and leadership and the various functions of the NIAMS extramural program. The K researchers then met in small groups with NIAMS staff to ask questions and learn about the Institute’s policies, procedures, and programs.

NIAMS Strategic Plan Listening Session on Training, Career Development, and Health Disparities

While the investigators with K awards spoke with extramural staff, the other participants met with the NIAMS Director, Dr. Stephen Katz, and Deputy Director, Dr. Robert Carter, for a NIAMS strategic plan listening session on training, career development, and health disparities. The session was the fifth of seven listening sessions the Institute held in 2018 to solicit broad input on topics that should be included in the forthcoming NIAMS Strategic Plan for fiscal years 2020 through 2024. The goal of the session was to discuss changes that the NIAMS should consider making to update the training and career development and health disparities sections of the FY 2015-2019 plan. Specifically, the group discussed research training needs to enhance the pipeline of trainees in NIAMS mission areas. The participants also talked about how best to attract individuals with critical skills in areas such as data science, artificial intelligence, and engineering into biomedical research careers. Additionally, they discussed opportunities to promote health disparities research in NIAMS mission areas and additional steps that NIAMS could take to encourage individuals from underrepresented minority backgrounds to pursue biomedical research careers.

Setting the Stage

After the morning concurrent sessions, the two groups of participants reconvened for the welcome by Dr. Katz. Dr. Katz noted NIAMS commitment to developing clinician scientists. He mentioned that recent budget increases for the NIH and NIAMS have allowed the Institute to increase its investments in the K08 and K23 programs. He thanked the patient and voluntary organizations that, through their sponsorship of various funding programs and other resources, are partners with the NIH in supporting early-stage investigators.

K Award Outcomes and Funding Opportunities

After Dr. Katz’s remarks, Dr. Amanda Boyce presented historical outcomes data on the NIH/NIAMS K08 and K23 awards. She noted that the NIH and NIAMS have performed various analyses of the individual mentored career development awards programs. Some key findings were that K awards appeared to have the greatest beneficial effect on subsequent involvement in research by M.D. recipients, followed by individuals with both an M.D. and a Ph.D., and then Ph.D. recipients. K awardees are more likely than comparable researchers without a K award to publish, apply for subsequent NIH awards, be awarded an R01, and apply for and receive at least one competitive renewal of an R01 grant. Among K awardees, individuals who received both an NIH K award and foundation support were more likely to apply for and receive R01 funding than those who did not. Dr. Boyce also discussed some of the challenges facing K08 and K23 awardees, such as salary coverage, educational debt, time in training, mentoring support, protected time for research, and clinical demands. She then highlighted several ways in which the NIH is attempting to help K08 and K23 researchers overcome these challenges, including:

Finally, Dr. Boyce provided several updates from the NIAMS and NIH. These included:

Concurrent Sessions

After hearing about the K award outcomes and recent policy and programmatic updates, the K investigators met in small groups with Drs. Katz and Carter and with the established and mid-career mentors. Concurrently, representatives of professional and voluntary organizations gathered with NIAMS program staff to share information about how the Institute and these groups work together to advance shared goals.

K Awardee Meetings with NIAMS Leadership and Mid-Career and Established Investigators

Drs. Katz and Carter spoke with the K awardees about the importance of finding their own unique niche in research. Dr. Katz noted that having a niche is the key to growing a lasting career. The K investigators shared with the small group their plans and current challenges they were facing. The K awardees also had the opportunity to meet with the mid-career and established researchers to discuss mentoring, both in terms of how to make the most of their interactions with their own mentors and how to effectively mentor junior researchers.

Professional and Voluntary Organization Representatives Meeting with NIAMS Extramural Staff

This meeting provided a forum for NIAMS staff and professional and voluntary organization representatives within the same field and across NIAMS mission areas to discuss how best to share information (e.g., about funding opportunities). They also talked about the role of the NIAMS Coalition in disseminating information from NIAMS and professional and voluntary organizations to researchers.

Research Resources and Opportunities Outside of the Extramural Program

Patient and Voluntary Organizations: Funding Opportunities and Resources

Patient and voluntary organization representatives discussed their organizations’ funding programs and resources for early stage investigators. The Society for Investigative Dermatology offers bridge awards and fellowships. In some cases, the organizations augmented the NIH career development awards with targeted programs such as the Rheumatology Research Foundation’s K supplement and K bridge awards. The Orthopaedic Research Society (ORS) has developed a webinar titled “Competing for NIH Career Development Awards” and offers a course on grantsmanship. The Arthritis Foundation sponsors a rheumatology fellowship program along with small and large grants.

Resources and Opportunities in the NIAMS and NIH Intramural Research Program

Dr. Robert Colbert, NIAMS Acting Clinical Director, provided an overview of the NIH and NIAMS intramural research programs. The NIH intramural program comprises approximately 10 percent of the NIH budget. The program, housed primarily on the NIH campus in Bethesda, Maryland, includes the NIH Clinical Center, the largest biomedical research hospital in the world. The intramural research program supports both clinical and basic investigators. Over the years, researchers within the program have made important contributions to improving human health, such as the discovery of the protein kinase JAK3 and its potential as a drug target. The NIAMS intramural clinical program works to develop faculty by offering opportunities for researchers at various career stages, including an NIH-wide Rheumatology Fellowship program; a scholars in translational research program; and assistant clinical investigator, tenure-track investigator, and tenured senior investigator positions. The NIH also sponsors the Lasker Clinical Research Scholars program, an intramural-extramural partnership designed to grow the pool of talented clinical/translational researchers.

Discussion: Addressing Current Career Challenges

In the afternoon, the K and IRP investigators met in small groups with the established and mid-career investigators to discuss career challenges and strategies to address them. The participants then reassembled to share insights from their meetings with the larger group.

Time for Research

A major challenge for K investigators is finding time for research while also fulfilling other commitments, including clinical duties, administrative tasks, and family and other responsibilities outside of work. Some suggestions for managing time were cutting down on meetings and outsourcing tasks where possible. A good deal of discussion focused on time spent on administrative tasks. Some institutions help K scientists with securing administrative support and research coordinators, which can free up investigator time for research. K scientists also noted that part of their administrative responsibilities includes complying with the NIH’s policies. The K researchers noted that finding information about requirements related to applying for and reporting and reporting on grants can be challenging. The K researchers thought that succinct checklists of what is required, particularly for less well-known types of awards, would be helpful.

Resources for Research

The group also discussed the challenges of obtaining the resources needed to conduct research, from securing funding, to attracting students, to accessing resources for data storage and management. The researchers also noted the need for more training in the administrative skills required for running a lab, such as hiring and managing personnel, operating a small business, managing time, and negotiating. The group also mentioned the importance of access to research resources such as disease registries and repositories. Additionally, K investigators must determine the best time to bring students into the lab, and the right number of students to mentor. While having the help of excellent junior scientists can be extremely valuable, it takes time and effort to train them and many students must move on after a short period of time. It can be beneficial to have others on staff who can participate in training students. Having a small well-defined project for a student can also benefit both the laboratory and the trainee.

Discussion: Planning a Successful Transition to the R01

Planning for the Future

The group discussed the need to develop a plan early on for the transition to research independence. Mentors can and should play an important role in helping K awardees with this planning. Some institutions require a written plan mapping out a path to independence for early-stage researchers. Some participants recommended that K investigators discuss the future with their mentor(s) several times per year. Many K scientists have more than one mentor, and different mentors may be able to advise on different aspects of building a research career from scientific, to administrative, to work-life balance. Some K awardees had mentors both within and outside of their institution, and benefit from this broader network. K scientists can potentially get help from professional organizations with finding mentors outside of their institution as some groups have programs to match early-stage researchers with more senior investigators. K scientists can also see if there are faculty promotion and tenure groups that can help them to understand the expectations and milestones associated with career advancement. Peer-to-peer mentoring can also help K researchers as they progress in their careers, and some of the K investigators expressed interest in additional K webinars to share information. NIH program officers also have insights regarding the research milestones, and K investigators expressed interest in receiving more guidance and feedback on progress reports.

Applying for the R01 Award

The group also discussed applying for an individual’s first R01 award. Some of the K awardees had already applied for or received the R01 award. Others were planning applications. The participants discussed when to submit the first R01 application. Researchers often do this when they have preliminary data that will be published around the time of the application. This seems a natural time to apply for additional funding since a pending publication means that the investigator has data to present and has considered possible next steps for the research. The group also noted the importance of having as many people as possible read the specific aims of the grant application, including individuals in different fields. It is important to get as much feedback as possible on whether the specific aims are feasible, focused, and worthwhile.

The participants also discussed considerations related to including their mentor in their first grant application. Some expressed concern that including their mentor would suggest that they had not achieved independence. Opinions varied, and participants acknowledged that this decision would vary from case to case depending on many factors. Participants noted the need for candid discussion, early on, with mentors and collaborators of issues such as authorship and ownership of resources. Others wondered whether the trend towards team science was at odds with the model of a single independent PI leading a grant. While more team science is happening, at present, most felt that it is still necessary for early-stage investigators to demonstrate independence before focusing on more collaborative requests for funding.

Grantsmanship Tips for Physician-Scientists

After the breakout sessions, Dr. Ricardo Cibotti presented some tips on grantsmanship from his perspective as a program officer. A number of issues can raise concerns regarding the research approach proposed in an application (e.g., proposal is overly ambitious, the experimental design is not clearly explained). The proposed specific aims of a grant should be independent such that failure to achieve one aim would not jeopardize other aspects of the project. He stressed the importance of correctly preparing statistical power analyses both in research proposals for clinical research as well as for animal studies. In this regard, working with a statistician can be helpful and, if a statistician is involved in the research project, that person should be mentioned in the application. Focus on issues such as biological variables, rigor and reproducibility have increased and should be addressed in grant applications. Investigators need to understand the difference between significance and innovation. Significance is about the research question, while innovation is about how the question could be answered, for example by using cutting edge approaches, applying inventive concepts, and engaging new resources.

Dr. Cibotti echoed earlier discussion from the breakout sessions by reiterating the importance of having others review, at a minimum, the specific aims of the application. Such reviews can quickly identify issues with the application, and most people are happy to review 1-2 pages of text. Some ideas for finding researchers who might be willing to critique a grant proposal are to ask colleagues at society meetings, use the NIH RePORTER database to find scientists conducting research in related areas, and ask mentors for suggestions for reviewers. Various NIH Institutes and Centers provide grant writing resources. For example, NIAID has a good website, including examples of applications. Many institutions also offer grant writing courses for researchers. These sessions are often competitive to get into, but they provide the sort of candid critique that can help to identify and address issues before the grant is submitted to funding organizations.

Closing Thoughts

Before adjourning, the group shared their reflections on the meeting. Drs. Katz and Carter thanked the participants for taking the time to attend and participate. They expressed special appreciation to the mentors and organization representatives. Many of the K awardees noted that they were particularly appreciative of the opportunity to meet with the Institute’s senior leadership. They also appreciated that the meeting offered lots of opportunity for interactions with NIAMS program staff, particularly those in review and grants management who they interact with less frequently than with program officers. They noted that the small group discussions provided a good opportunity for frank discussion with the mentors. The Ks also appreciated the opportunity to hear from their peers and to share and discuss their common experiences. They expressed interest in ongoing interactions with other scientists with K awards. The mentors conveyed that they were impressed by the excellent science being conducted by the K investigators. They encouraged the K scientists to be persistent and to be self-advocates.

Dr. Katz closed the meeting by thanking all of the attendees for their participation, and reaffirming the NIAMS commitment to fostering the next generation of scientists. Without that next generation, he noted that we would not have a biomedical research enterprise in 20 years. He reiterated the advice that the K awardees be direct and candid in advocating for their work and discussing ownership and authorship. He expressed his hope that they were leaving the meeting with more confidence to address tough issues, and his enthusiasm for the excellent research the K investigators are conducting.

Participants

ANANDASABAPATHY, Niroshana, M.D., Ph.D., Weill Cornell Medicine
*BERNTHAL, Nicholas, M.D., University of California, Los Angeles
*BUNICK, Christopher, M.D., Ph.D., Yale University
CALLAHAN, Leigh, Ph.D., Representing the Rheumatology Research Foundation
*CAPELL, Brian, M.D., Ph.D., University of Pennsylvania
CAULEY, Jane, Dr.P.H., University of Pittsburgh
*CUNNINGHAM, Melissa, M.D., Ph.D., Medical University of South Carolina
*DELCO, Michelle, D.V.M., Ph.D., Cornell University
*DUBREUIL, Maureen, M.D., Boston University School of Medicine
EAKIN, Guy, Ph.D., Arthritis Foundation
ECONS, Michael, M.D., Representing the American Society for Bone and Mineral Research
*ELMARIAH, Sarina, M.D., Ph.D., Harvard Medical School
EZHKOVA, Elena, Ph.D., Icahn School of Medicine at Mount Sinai
*FRECH, Tracy, M.D., M.S., University of Utah
*GLASS, Donald, M.D., Ph.D., University of Texas Southwestern Medical Center
*HANAOKA, Beatriz, M.D., University of Alabama, Birmingham
*HORTON, Daniel, M.D., Robert Wood Johnson Medical School
*HSIEH DONROE, Evelyn, M.D., Ph.D., Yale Medicine
*JABBARI, Ali, M.D., Ph.D., University of Iowa
JAN DE BEUR, Suzanne, M.D., The Johns Hopkins University
JONES, Lynne C., Ph.D., Representing the Orthopaedic Research Society
*KORMAN, Benjamin, M.D., University of Rochester Medical Center
*LEUCHT, Philipp, M.D., Ph.D., New York University School of Medicine
LIAO, Katherine, M.D., M.P.H., Harvard Medical School
MINNILLO, Rebecca, D.M., M.P.A., Society for Investigative Dermatology
* RAHIMI, Homaira, M.D., M.T.R., University of Rochester Medical Center
SIBILLE, Kimberly, Ph.D., M.A., University of Florida, Gainesville
*SPARKS, Jeffrey, M.D., M.M.Sc., Harvard Medical School
*SUN, Bryan, M.D., Ph.D., University of California, San Diego

*Indicates current NIAMS K08 or K23 awardees.

NIAMS

ALEKEL, Lee, Ph.D.
BOYCE, Amanda, Ph.D.
BROWN, Nakia, Ph.D.
BURROWS, Stephanie Y., Ph.D.
CARTER, Robert, M.D.
CAUGHMAN, Cindy, M.P.H.
CHU, Emily, D.D.S., Ph.D.
CIBOTTI, Ricardo, Ph.D.
COLBERT, Robert, M.D., Ph.D.
DRUGAN, Jonelle K., Ph.D., M.P.H.
DUNDAS, Colleen, M.P.H.
EDGERTON, Erik
GOURH, Pravitt, M.D.
JONES, Andrew
KATZ, Stephen I., M.D., Ph.D.
LESTER, Gayle, Ph.D.
LIN, Helen, Ph.D.
MANCINI, Marie, Ph.D.
MAO, Su-Yau, Ph.D.
NELSON, Melinda
NGUYEN, Van, Ph.D.
PARK, Heiyoung, Ph.D.
REUSS, Reaya, M.S.
SALAITA, Kathy, Sc.D.
SERRATE-SZTEIN, Susana A., M.D.
THACH, Yen
WALKER, Robert, Ph.D.
WITTER, James, M.D., Ph.D.
ZHENG, Ted, M.D., Ph.D.