In today’s economic climate, grant writing has become a dog-eat-dog world (read: researcher eat researcher).
Dr. Javad Parvizi, an orthopedic surgeon and researcher at The Rothman Institute at Thomas Jefferson University Hospital in Philadelphia, has been awarded twelve grants during his career. He says,
Knowing how to properly approach a grant application is much more of a necessity now. High caliber scientists are losing their jobs and exciting projects that would have enabled us to better care for patients have been discontinued. While the new administration in Washington is looking to reverse these trends with an infusion of $7.9 billion to the National Institutes of Health (NIH), the grant arena remains extraordinarily competitive.
Dr. Parvizi elaborates, “Balancing the demands of being a clinician scientist is a major challenge. The person who has a serious interest in research should dedicate a significant portion of his or her time to clinical or basic science research—ideally 50%. Also, to be successful in a scientific field one needs to have a primary area of interest, generate sufficient data, and be peer reviewed.”
Getting inside bone can be hard…getting inside the NIH funding stream is harder. Dr. Parvizi: “The major source of funding for clinical research is still the NIH. To obtain their funding you must have a topic of research that appeals to the study section related to your area of interest. There is typically a primary reviewer, two or three secondary reviewers and then a tertiary reviewer. Aside from the benefit of having lots of experienced eyes ‘on the case, ’ employing so many reviewers avoids even the hint of bias…no one can say, ‘I didn’t get the grant because such-and-such reviewer didn’t like me.’”
“After these individuals have completed their tasks, ” says Dr. Parvizi, “another meeting takes place in which the applications are scored by a large number of people. Who obtains funding also depends on the availability of funds in that particular year. There is an annual funding line, meaning, for example, that in a certain year the top 10% of projects get funded…anyone in the 11% category is not funded.”
Those on the right side of that line, however, will now have a better chance than ever of having a clinical impact. “The NIH has made it an objective to move more towards translational research, ” says Dr. Parvizi, “something that will obviously benefit patients. As for researchers, we can focus on the clinical problem and design around it.”
NIH’s job could be described as risk management. Dr. Parvizi: “In essence, the study section is charged with funding proposals that have the least amount of risk with the greatest chance of success. One of the most significant challenges is to have enough preclinical or clinical data or supporting material to convince the study section that the project is doable. They are also going to ensure that your background includes experience in the appropriate areas…they want to know that you are the one who can get the project done right.”
“Then there are the R01 grants, ” explains Dr. Parvizi, “which last from four to five years, have one principal investigator, and are milestone-based. Using my R01 grant as an example, we have looked at the issue of infection. If bone has eroded, you have the option of using cadaveric bone, which, although it works fine most of the time, can get infected. This is particularly true in cancer surgery where the immune system is depleted and the risk of infection is high. Working with allograft provided by the Musculoskeletal Transplant Foundation, my team and I are doing chemical modification of bone allograft and implants, something the NIH study section found sufficiently promising to fund.”
If you’re not ready to climb “Mount NIH” just yet, there are other sources of funding that can help propel your hypotheses testing and data. Dr. Parvizi explains, “Other options are the Small Business Innovation Research Program and the Small Business Technology Transfer Program, both administered by the U.S. Small Business Administration Office of Technology. These programs are structured such that researchers partner with small business to develop a proposal for producing products.”
“In the event that your project may aid those in the military, ” says Dr. Parvizi, “you may also consider approaching the Department of Defense (DOD). For example, there are studies involving various aspects of trauma care, including treating soldiers in the field, that the DOD may find promising. In addition, you might approach the specialty societies for funding. To do so you need to be a member of the society or be eligible to apply. Begin with inquiring as to how much funding is available for the year and how many grants are being awarded that year. Look at their website to determine what type of studies they have funded in the past. If, for example, the American Society for Surgery of the Hand only gives two grants a year, both of which are $15, 000 for tendon repair projects, for you to write an application asking for $17, 000 to study hand prosthetics is a waste of time.”
Funding may be sexy, but you only need your preliminary data to be suggestive. “You must have enough pilot data to approach these funding sources, ” explains Dr. Parvizi. “And it should be strong enough to point in the right direction. You could also take such data to the Orthopaedic Research and Education Foundation (OREF). While they have a variety of grants, like many others, they have cut back in this economic downturn. If your work is on arthritis or a related condition, you might approach the Arthritis Foundation. And despite the Department of Justice investigations, you shouldn’t give up on industry funding. The companies are becoming a little more active now, but are still primarily interested in projects with more immediate commercialization. Regardless of the entity you approach, I recommend that you contact the previous grantees to discuss their experiences and ask questions.”
And how to acquire good pilot data? First and foremost, advises Dr. Parvizi, adopt a good mentor. “Find someone who has a long track record of being awarded grants in your area of interest. The second thing is that you must have a clear idea that you know you will be able to address. For example, a researcher may think that by injecting stem cells into the knee he can regenerate cartilage. In the beginning this is just an idea swirling around in his head. To prove it he must undertake an in vitro study and show that chondrocytes like stem cells and will proliferate. The next step would be to design an animal model for osteoarthritis and inject the stem cells into the animals and show a reverse of osteoarthritis. You want to hone it down and be very clear that you are the one who can get the project done.”
Dr. Parvizi continues, “Let’s say there is a collagen polymer that delivers antibiotics and anticancer drugs and can be utilized in tumor surgery (leaving a stent behind to deliver the drugs). The researchers have preliminary data showing that they can make the collagen polymer. They are tumor surgeons with a busy practice and all they need is an animal model to prove the concept works. The researchers approach the funders saying, ‘The collagen polymer can be engineered in our lab; we can put antibiotic and anticancer drugs on it; we have preliminary data indicating that when a collagen polymer is used in an animal model the outcome is better than when a collagen polymer is not used; we have the infrastructure in place to execute a pilot study.’ This kind of strategy and organization is what funders are looking for.”
But you had better know how to write all of this up. “Grantsmanship is a different animal than writing a scientific paper or review article, ” says Dr. Parvizi. “It is very difficult as you must anticipate problems and offer strategies to troubleshoot if and when those problems arise. Grants tend to be scored on scientific flow, ease of reading, and organization. I recommend sending your grant proposal to individuals who have obtained grants in your research area in order to get their input and critique. Then there is your mentor and his or her contribution. Although, to begin with, one should probably take a course on grantwriting.”
Yet despite your best efforts, you may end up staring at a ‘We regret to inform you letter.’ Dr. Parvizi: “Don’t be disappointed if your first grant proposal does not get funded. It’s actually quite rare that someone’s first application receives an award of funding. The process is to go back, rewrite, and incorporate the critiques into a revised application.”
“And remember that the pilot data must be solid, ” says Dr. Parvizi, “not just a single observation that won’t withstand the test of time. If I say that allograft bone is capable of eradicating infection, but I have only seen that in one of two cases (n=2), then I’m way off base. Verify that your writing is clear and simple with no ‘razzle dazzle.’ Do not contact the NIH study section members—this is seen as highly unprofessional and is in fact illegal. Also, ensure that you have declared any conflicts of interests…or potential conflicts. You don’t want to leave anything out, and then later something comes to light. It may affect not only the grant, but your career.”
So approach the grant process like you would approach the research process. Be focused, strategic, thorough…and patient.
