April 22, 2020
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December 9-10, 2019

Co-Chairs
Robert Carter, M.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

NIAMS held its first K Forum in 2012. Based on the positive feedback received from participants, NIAMS convened subsequent meetings in 2013, 2014, 2015, 2016, and March and December 2018. The NIAMS K Forum brings together clinician scientists who are currently in the third year of their NIAMS K08 or K23 award and established clinician scientist mentors, including some who have had an NIH K award in the past, along with 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 staff. The long-term goal of the meeting is to enhance the Institute's support of early-stage clinician 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 on December 9, with research presentations by the investigators in the 3rd year of their K award. The scientists briefly outlined their research projects and progress. Presentations were followed by a short question and answer period. This session provided attendees with the opportunity to learn about each other's research interests.

Presentation on K Award Outcomes, Policies, and Funding Opportunities

After the presentations, Dr. Amanda Boyce presented some information about the clinical K awards program and its outcomes along with information about related polices. She covered some analyses of the success of the K awards, as well as, some of the steps the NIH and NIAMS are taking to overcome common challenges faced by early-stage clinician-scientists. She then reported on policy updates over the past year that are relevant to clinician-scientists with career development awards. Finally, she briefly reiterated the goals and purpose of the K Forum.

A 2011 NIH-wide evaluation of K01, K08, and K23 awards explored who applies for and receives mentored career development awards and the effects of the K award on research productivity and independent careers. The analysis compared outcomes of individuals who received a K award to those of similar individuals who applied for but did not receive a K award. The evaluation showed that K awardees:

  • are more likely to have subsequent research publications;
  • are more likely to applyfor subsequent NIH research awards;
  • have a higher R01 award success rate;
  • have a higher percentage of years with subsequent NIH support; and
  • are more likely to apply for and receive at least one competitive renewal of an R01 grant.

A small analysis was conducted by NIAMS in 2010 in collaboration with two rheumatology-related Foundations. It suggested that individuals who received both foundation support and an NIH K award were more likely to apply for and receive R01 funding than K awardees that did not have such additional support. Furthermore, the analysis identified the transition between the K and the R01 awards as a vulnerable point in progression to independence.

Dr. Boyce discussed challenges facing early-career clinician-scientists, such as salary coverage, educational debt, transition to independence, time in training, mentoring support, protected time, and clinical demands. She also presented efforts in recent years by the NIAMS and/or NIH to address the challenges, including by:

Dr. Boyce also mentioned several policy updates from the NIH related to K career development awards and early-stage researchers, including

Concurrent Sessions

K Awardee Meetings with NIAMS Extramural Staff

On December 10, 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 administer clinical research grants. At the beginning of the session, Dr. Ricardo Cibotti provided a brief introduction to the NIH and the NIAMS, as well as information about the 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 Leadership Meeting

While the investigators with K awards spoke with extramural staff, the other participants met with the NIAMS Acting Director, Dr. Robert Carter. The group discussed challenges facing the NIH and the research community, including issues that affect the participation of women and underrepresented minority groups in research careers.

Tuesday Morning Presentations

After the morning concurrent sessions, the participants reconvened for presentations on the NIAMS intramural program and the professional and voluntary organizations. Dr. Carter welcomed the group and reiterated NIAMS’ commitment to developing clinician-scientists.  He discussed the Institute’s budget and payline. He also highlighted the recently released NIAMS FYs 2020-2024 Strategic Plan. He noted that the vision laid out in the plan is to create an environment that fosters unexpected research advances by supporting a broad base of investigators while taking advantage of emerging opportunities to also support larger team science efforts.

Resources and Opportunities in the NIAMS and NIH Intramural Research Program (IRP)

Dr. Robert Colbert, NIAMS Acting Clinical Director, provided an overview of opportunities for early-career investigators in the NIH and NIAMS intramural research programs.  He noted that the NIH IRP is about 10 percent of the agency's budget, and includes the NIH Clinical Center, the largest hospital in the world that is devoted entirely to research. It has over 6,000 physicians and scientists, including about 1,000 principal investigators and about 5,000 clinical and basic trainees at various career stages.

Over the years, the NIAMS IRP has made important contributions to research such as advancing the use of methotrexate for skin and rheumatic diseases, the discovery of several autoinflammatory diseases, and the discovery of the JAK3 enzyme and its potential as a drug target. Currently, about 280 individuals are working within the program, including clinical and  basic investigators. It comprises a clinical program with a clinical operations unit, research nurse specialists, clinical trials units in lupus and pediatrics, a dermatology branch, and a rheumatology fellowship training branch. 

The NIAMS IRP has programs in place at multiple career stages to foster clinical faculty development. This includes the NIH rheumatology fellowship and a scholars in translational research program. As individuals advance in their careers, the IRP offers other opportunities, including assistant clinical investigator, tenure-track, and tenured senior investigator positions.

Dr. Colbert also highlighted the NIH-Lasker Clinical Research Scholars Program, an intramural-extramural partnership designed to grow the pool of talented clinical and translational researchers. The program provides 8-10 years of support including 5-7 years as a tenure track investigator in the NIH IRP and up to 3 years of support at an extramural institution or as an IRP investigator.

Patient and Voluntary Organizations: Funding Opportunities and Resources

Patient and voluntary organization representatives discussed their organizations' funding programs and resources for early-stage investigators. Many of the organizations participating in the meeting, such as the Rheumatology Research Foundation (K supplement award), the American Society for Bone and Mineral Research (Rising Star Award), the Orthopaedic Research and Education Foundation (mentored clinician-scientist grant) have award programs focused specifically on researchers with NIH career development awards. Others, such as the National Psoriasis Foundation provide bridge funding to researchers with relevant competitive, but unfunded, K-type award applications to NIH or similar funders. The American Academy of Dermatology funds a Young Investigator Award that is focused more generally on clinicians who are beginning a research career. Some organizations, such as the Orthopaedic Research Society have funded research awards (Stryker Award) to promote the participation of women in science.

Concurrent Sessions

K Awardee Meetings with NIAMS Leadership and Mentors

The K awardees were split into three groups that rotated through meetings with the NIAMS Acting Director and the Acting Director of the NIAMS Division of Extramural Research and with the meeting mentors. Drs. Carter and Lester spoke with the K awardees about the importance of finding their own unique niche in research. The mentors addressed topics including independence, mentoring, and making the most of the K award. The K investigators shared their plans and any challenges they are facing and leadership and mentors offered suggestions.

Professional and Voluntary Organizations Meeting with NIAMS Staff

While the K awardees met with the NIAMS leadership and the mentors, representatives of professional and voluntary organizations gathered with NIAMS staff to share information about how the Institute and these groups work together to advance shared goals. Each organization briefly presented its mission and priorities and then provided information about its support for research and any current partnerships with the NIH. After the presentations by the organizations, participants discussed potential ways that NIAMS and the organizations could continue to work together.

Presentation: Reflections on Academic Medicine

Dr. Kenneth Saag, an established clinician-scientist who has mentored many researchers, provided some reflections on academic medicine. He presented some of the critical elements for academic researchers, such as a long-term plan, mentoring, protected time, ability to weather rejection and harness creativity, and time management. He also noted that there are many rewarding aspects of an academic career, for example, flexibility, the chance to improve public health, and the opportunity to work with smart and dedicated colleagues. He encouraged the K awardees to pursue research that they are passionate about with perseverance, collegiality, and patience.

Breakout Sessions and Group Discussion: Addressing Current Career Challenges and Planning for a Successful Transition to Independent Research

In the afternoon, the K investigators met in small breakout groups with the mentors to discuss career challenges and strategies to address them as well as planning the transition to independence. After the small group discussions, the meeting participants reassembled and the small groups shared insights from their discussions. Some major themes were time management, including work-life balance and when and how to say no to requests, working with mentors, obtaining research support, assembling a research team, and encouraging team members to write up research results.

Time Management

The group discussed various time-management strategies such as understanding one's own bandwidth and establishing deadlines for important activities, particularly where no formal deadline may exist (e.g., due dates for sending information to collaborators). When writing a grant, having a grant reviewer and providing them with a time by when you will send materials can help keep the writing process on track. Another suggestion was to block time for specific purposes, for example, setting aside a specific day for clinic or blocking time on the calendar for scientific reflection. In terms of work-life balance, the group noted that it's important to consider how much attention to detail a task requires to identify tasks that could be accomplished with less effort.

Working with Mentors

The group also discussed how to interact productively with mentors. Many emphasized the importance of having a mentoring team that could help with different issues from scientific, to clinical, to career and work-life balance. The participants noted that it can be difficult to navigate conflicting advice from different mentors. Mentors may have very different perspectives based on their individual experiences (e.g., a "bench" scientist will likely give different advice than an individual who is a clinician, but not a researcher). The group stressed that when evaluating advice, it is important to remember that there are many different paths to success.

Assembling a Research Team

The researchers also shared ideas about choosing members of the research team.  Some felt that when choosing a technician, it may be better to choose an individual with outstanding aptitude over a more experienced candidate. The group discussed the importance of clarifying and communicating one’s values to prospective team members, carefully reviewing references, and having candidates interview with other lab members. Related to assembling the team, the group also discussed ways to encourage trainees to write up their results. One suggestion was to divide writing projects into small increments that can be completed a bit at a time.

Obtaining Research Support

K awardees discussed various potential sources of research funding.  Some institutions have an internal pool of start-up funds. Many foundations support research within areas of interest to their organization. When hiring personnel, it can sometimes be beneficial to hire researchers from other disciplines that might be eligible to apply for discipline-specific funding. In some cases, technology transfer funds may be available for projects that could generate intellectual property. Pharmaceutical companies are a potential funding source for pilot studies. 

The group then focused specifically on how to obtain funding for highly innovative research ideas or areas that have not been funded in the past. Sometimes if a topic is very new, there may be a lack of expert reviewers for the topic, which can negatively impact funding prospects.  In that case, it can be helpful to take advantage of the opportunity, if available, to suggest reviewers. It may also be worthwhile to speak with journals about appropriate publication pathways for your topic. Other suggestions were to be on the lookout for specific Requests for Applications that may be related to the new area and for opportunities to introduce it to the community, for example by presenting at symposia.

Grantsmanship panel

The group ended the day with a grantsmanship panel moderated by Dr. Cibotti. Panelists included the meeting mentors and Dr. Alexey Belkin, a NIAMS program Director who previously worked at the NIH Center for Scientific Review. The panelists answered several questions related to topics such as common grantsmanship errors, aims and research strategy, preliminary data, potential issues and alternative approaches, premise, rigor and reproducibility and more. The panel observed that it is important to present material clearly and to keep in mind that reviewers may not be as familiar with an applicant's field as is the applicant. It may be helpful to ask a scientist in a different field to review the application to help identify ways to improve clarity. A common mistake for individuals writing a first grant is "overambition," proposing more than can reasonably be accomplished within the given time and budget. Another mistake is to propose interrelated aims where the success of one aim depends on accomplishing another. Overall, the panel emphasized the need to start early and to have others, particularly individuals in a different field, review the application or at minimum the aims page, before submitting it. They also highlighted the need to persevere—it may take multiple attempts before a project is funded.

Closing

Dr. Lester closed the meeting by thanking all who participated.

Participants

CLARKE, Bart, M.D., Representing the American Society for Bone and Mineral Research
CUMMINS, Deborah, Ph.D., Orthopaedic Research and Education Foundation
DOMIRE, Jacqueline, National Psoriasis Foundation
FALO, Louis, Jr., M.D., Ph.D., University of Pittsburgh
HSU, Ya-Chieh, Ph.D., Harvard University
JONES, Lynne C., Ph.D., Representing the Orthopaedic Research Society
* KOVACEVIC, David, M.D., Columbia University Medical Center
MARCHIOLO, Eryn, M.P.H., Rheumatology Research Foundation
MCMILLEN, Allen M., M.S., American Academy of Dermatology
* MINER, Jonathan, M.D., Ph.D., Washington University School of Medicine
* NAVARRO-MILLÁN, Iris, M.D., M.S.P.H., Hospital for Special Surgery
OGDIE-BEATTY, Alexis, M.D., M.S.C.E., Hospital of the University of Pennsylvania
* REESINK, Heidi, V.M.D., Ph.D., DACVS-LA, Cornell University College of Veterinary Medicine
* RHEE, Rennie, M.D., M.S.C.E., Hospital of the University of Pennsylvania
SAAG, Kenneth, M.D., M.Sc., University of Alabama at Birmingham
* SCHULERT, Grant, M.D., Ph.D., Cincinnati Children's Hospital Medical Center
* STEFANIK, Joshua, MSPT, Ph.D., Northeastern University
TOROK, Kathryn, M.D., Children's Hospital of Pittsburgh of UPMC
* URISH, Kenneth, M.D., Ph.D., Carnegie Mellon University

*Indicates current NIAMS K08 or K23 awardees.

NIAMS

BELKIN, Alexey, Ph.D.
BOYCE, Amanda, Ph.D.
BROWN, Mark
BURROWS, Stephanie Y., Ph.D.
CARTER, Robert, M.D.
CAUGHMAN, Cindy, M.P.H.
CIBOTTI, Ricardo, Ph.D.
COLBERT, Robert, M.D., Ph.D.
DUNDAS, Colleen, M.P.H.
EDGERTON, Erik
FURUMOTO, Yasuko
GARRICK, Nancy, Ph.D.
JOFFEE, Kathie
LESTER, Gayle, Ph.D.
LIN, Helen, Ph.D.
MANCINI, Marie, Ph.D.
MAO, Su-Yau, Ph.D.
NELSON, Melinda
NGUYEN, Van, Ph.D.
NICKS, Kristy, Ph.D.
PARK, Heiyoung, Ph.D.
REUSS, Reaya, M.S.
SERRATE-SZTEIN, Susana A., M.D.
TAYLOR, James M., Ph.D.
THACH, Yen
TORGAN, Carol, Ph.D.
WASHABAUGH, Chuck, Ph.D.
WITTER, James, M.D., Ph.D.
ZHENG, Ted, M.D., Ph.D.

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