Presentation at the Career Development Institute for Psychiatry, Pittsburgh, PA, April 8 - 11, 2006

David Kupfer: Let me introduce Mark Chavez who is a colleague of ours, somebody who has been very, very helpful in continuing to shape both the curriculum and the direction of these career development institutes. Mark?

Mark Chavez: I have a tendency to talk really quickly and so if I start doing that, say slow down. I don’t mind at all. One of the things that I prefer during the session is really to be able to answer some questions that you have. I do have a number of slides, some of this I do think is important to talk about. But again anytime during the presentation feel free to interrupt, ask questions and I’d rather have this be a dialogue where you’re asking me questions and most likely some of the things that you have to ask are really going to be relevant to a lot of the other people in the room. Even just during lunch and in the hall a lot of the questions I get are really very similar to what other people are asking. So we should feel perfectly free just to have this going back and forth as a dialogue. Okay?

Mark Chavez: Okay. So this first slide is a timetable. Some of the different funding opportunities that are available to junior investigators during the different stages of a research career. And there’s actually one that’s missing. There’s a relatively new K-award that should be right here. And I’ll talk about that this actually was an issue probably three months ago. And it’s for it’s a postdoctoral mechanism that transitions into an R mechanism. And I’ll get into more detail about that in a minute.

But again you can see there’s a number of different mechanisms that really are available to you at the various stages of your research career. One of the things is to become familiar enough with these different mechanisms because you can use them to build one on top of the other. You can’t just specifically depending on your situation. I mean there’s not a formula to apply to if I do this, all this steps is going to work exactly. I mean we’ve been talking about the K-awards, there may be certain situations that some of you may be in for coming in with a small grant like an RO3 may really be the first thing that you want to do simply to give you the type of preliminary data that you are going to need to be able to get the K-award. Again that’s going to depend specifically on what your situation is.

Mark Chavez: Okay, so what I’m going to do now is just a few rules of thumb that you should always keep in the back of your mind when you’re getting ready to submit applications to NIH. And the first thing is is you really need to plan ahead. I think you heard that through the number of discussions early this morning in terms of even navigating your academic trajectories but clearly at NIMH it’s a very large bureaucracy. It’s very cumbersome and it’s very slow. And so you really do need to be planning ahead and there’s approximately a 10 month time span between the time that you submit the application and the time that you be able to start receiving money assuming you successfully compete the first time that you apply. Okay?

And I can also tell you with what’s going on with the budget now if you have any budget questions, what’s going on with some of that, how we’re paying K-awards. Feel free to ask me any of those questions. We can discuss that. Most people aren’t getting the first time, getting funded the first time they apply for the K-award or for any other grant for that matter. So you should really plan on probably having to resubmit. It’s not that it’s impossible to get funded the first time, but it’s becoming less and less common. And so when you’re really thinking about submitting an application to NIH or NIMH, you really do want to be thinking well in advance it may take me up to a year and a half, two years to actually get the application funded. And then fortunately that’s not that unrealistic, it probably could. In many cases, that’s really become more of a common scenario than it used to be in the past. Okay.

So when you submit an application, it’ll go to CSR, that’s the Center for Scientific Review, most of the times. It goes to CSR: their referral officer is going to assign the application to a specific study session and those are the people who review the application and it’s going to be assigned to that study section based on the content of the research focus of that application. And it will also be assigned to an institute like NIMH. It takes about two, two and a half months before it gets reviewed. After it gets reviewed, we probably find out about I’d say five months, maybe four to five months after it’s been submitted the application’s generally been reviewed. Most of the time what we try to do is we try to attend the reviews where your applications are being reviewed at. So if I’m the project officer on somebody’s K award and I know it’s being reviewed by a specific study
section at this time either myself or one of my staff tries to attend the reviews.

So we have a pretty… So we know right after the review we have a pretty good idea of how the application did. We don’t know what the exact score’s going to be, but we have a pretty good idea. You could always call us fairly shortly after that and we can tell you the application did – it did fantastic; you have every reason to be optimistic. We’re never going to tell you it’s going to be funded because we can’t do that. But we’ll say you have every reason to be optimistic. Or we can say given the priority score, you really ought to be planning out a revise and resubmit. Or you could be in the situation where you’re in the gray zone. We don’t quite know what the payline is going to be, what we’re going to be pay up to. So you’re just going to have to be patient and wait. But it’s probably I would say within six months we should have a definite, we should be able to tell you, be able to give you a pretty good idea of whether or not your application is going to be something that we’re going to be able to pay. Okay?

Audience: This is something I didn’t quite understand from earlier today when Dr. Kupfer showed the statistics. I’ve never quite understood this. If it’s getting harder and harder to recruit people into research, why is it getting so much harder to get a K? I know that there’s reallocation of resources and budget cuts, but you would think that that trend that Dr. Kupfer showed this morning would actually make them, would be in our favor.

Mark Chavez: I completely agree with you. And so there’s been a couple of things that have been going on. One is just a budget reality. Money is just getting tighter, so everybody is having a much more difficult time getting funded. Another thing, NIMH has always had a fairly large proportion probably larger than most institutes a proportion of their budget devoted to research training and career development. And I think under the new leadership we decided it needed to come down and try to be more comparable with other institutes. And so that’s also part of the reason it’s been cut. I think things like the K program where we’ve done long-term assessments. We went back, we looked 10 years, looked into people who have successfully competed for K’s and we look at the outcomes. Because one argument for cutting is say these outcomes aren’t that good. We’re putting a lot of money in here but the outcomes, people really are not transitioning to get research grants like R01s and things like that. That’s not the case with the K.

People who have been submitting the K’s, it’s an incredibly successful mechanism. They do very well in terms of taking that next step and getting the R01 within say a four, five, six-year period of time. And so I think part of… So really what I’m… I wish the cuts weren’t there, especially for the career development mechanisms, but I can tell you it’s been getting cut back over say the last year and a half, two years; we reached a steady state. It’s not going to be cut any further than it is now. And again but it is more competitive now than it was two years ago to get funded. Okay, so I also, I want to talk about is the terms of the budget. I think this could be very confusing as well.

In the past we would have so many K’s that we were able to pay per cycle and so what we would do is for the most part we would pay up to what we’re able to pay up to. And again there are times when we may skip something, pick something else for a number of different reasons. That’s something that we can talk about in a little while. But for the most part we follow the payline. We follow what IRG or the reviewers recommended. It is a peer review process, what happens at the review really that is 90% of the variances whether or not the person gets funded is really what happens in the review. Not what happens with us, not with the program officer sitting behind a desk; it really is what happens in the review.

What’s happened is I say with these cuts in the budgets, now fewer… People were able to successfully compete with say a priority score of 160; that’s probably not going to be the case anymore. But one thing that we’re doing, we’re paying the same number of K awards now that we paid last cycle and the cycle before that. And that’s going to be held constant. And that’s going to be approximately 13, 14 per cycle. There is three cycles per year, so on the average, they pay 39 to 40 K awards in NIMH per year. That should be held constant.

We’ve been told it’s not going to change and so I actually don’t think it will. But what’s happening is I think people are submitting applications and are getting very good scores – 160, 165. The applications aren’t… We’re not able to reach up that high. So what the reviewers are seeing is applications, they don’t expect to see coming back to review are actually coming back. So what’s happening is they say we want to see this application paid so now they’re giving incredibly good scores. Scores we didn’t used to see in the past 101’s, I thought only God could get 101. We’re seeing 101’s, 106, 120’s and so actually what we’re able to pay up to in terms of priority scores is really much lower even though we’re paying the same number of applications. Okay?

And so I think that’s when people say well the payline’s this low, you guys are paying less; at this point we’re not going to be paying less. We’re going to be paying the same amount of applications but again it may be a lower priority score. Does that make sense? Okay?

Mark Chavez: Having said that, here’s something that I think is very important is I’ve spoken to people on the phone before, and they say I’m getting ready to submit a K application, one of the things my advisor, my mentor, they suggest just get that first application in there. Put in a respectful application, but just get it in there, get the summary statements back. That’s really going to serve as a template that you need to follow to really get that score down in the fundable range. The reviewers are going to tell you what you need to do. And I think even when budgets were better, that was very, very bad advice for a number of different reasons.

One thing is you send in an application that the quality is compromised simply because you didn’t spend the amount of time that you could have or should have, you annoy the reviewers. You’re wasting their time, they’re very busy so you lose any kind of halo effect you may have had. So I just don’t think that’s a good idea. But in this funding climate what you can’t afford to do is you can’t waste a submission. You don’t want an application coming in with a really high priority score because the chances are the higher it is it’s even more unlikely now to be able to bring that down into the fundable range. You may need three chances; you don’t want to waste any of those. The lower you come in with the first one; hopefully it will continue to crawl down when you resubmit. So don’t send something in premature, make sure all the I’s are dotted, T’s are crossed. If you don’t really have the preliminary data you need, take a little extra time if you have that option and get that preliminary data. And I say I think that’s probably more critical now then that’s been in the past.

And I agree – why we’re cutting back on training – I don’t like it either, but guess what? I can argue with the director, and guess who wins?

Mark Chavez: So okay, so there’s a number of reasons you want to contact NIH or NIMH. One of the reasons is is you want to make sure that the research that you’re proposing – and that I think for this, for all of you this is probably not really an issue – but to make sure that the research that you’re going to be proposing really meets the referral guidelines of NIMH, that it’s really relevant to the admission of NIMH. And our referral guidelines have changed fairly abruptly over the last couple of years. Things that we accepted three years ago, we’re no longer accepting. So you want to make sure, and again I think with most of you that’s going to be, that really isn’t going to be an issue, but you want to make sure. The last thing you want to do is submit an application, you get a good score and we say, ‘Guess what? We can’t pay it. It doesn’t really fit our mission.” We can try to find a new home for you; sometimes we can do that successfully, sometimes we can’t.

And again it’s simple; you just make a phone call. We can discuss what you’re planning on doing; send in a brief concept paper. And at that point we can give you the thumbs up and say yeah, this is very appropriate for the institute. It may be marginal; one of the things that we can then do is we can work with you saying listen, this is right on the cusp of whether or not we can accept it. If you would include these additional outcome measures or this outcome measure, maybe incorporate this assessment, this would really be something that really would fall clearly within our referral guidelines. That’s something that we could discuss; it could be resolved prior to your submitting the application. So it’s easy enough to make a phone call, set up an appointment, and we can discuss that, okay?

Another thing you can do is talking about the variety of funding opportunities or mechanisms that are available to you. In some situations, people say they want to come in as a K and is in the position to do that but when you talk to them, you see the publications they have, you see the preliminary data, you realize it may not be all that competitive for the mentored K at that point. Maybe they need to get a little more preliminary data. That may be a situation where coming in with a R03 first would be a better idea. Those are the types of things that we can discuss, find out what’s the most appropriate mechanism for you to be coming in with. Are they talking about the referral guidelines? One of the other things that we can do is we can talk about the specific application process. The application’s going to come here; this is how long it’s going to take for that. But we can also talk about the review criteria. For the K awards we have fairly unique review criteria. It’s not like a research grant, and we can go over all that in detail. What are the five things they’re really going to be focusing on? What do you really need to have? What are the things you want to make sure you don’t do? What are the things you want to make sure that you do do? Sometimes people come into situations where they may not have say the ideal mentor at their home institution. This is relatively common. Are you going to be competitive without having an ideal mentor at your institution?

Well that’s going to be a hurdle to get over. It’s not going to work to your advantage. But there’s ways to compensate for that. You may want to get an offsite mentor who really does have that expertise. If you have an offsite mentor though, how do you have to establish that relationship so the reviewers are going to be convinced that this is something that’s actually going to work? And people have done that. They’ve done it really well; people have also done it poorly. That’s some of the experience that we can share with you. This is how some people have worked this in the past. This seemed to work very well for them, and this did well at review. But these are the type of things that we can discuss. Okay?

And probably one of the… If you remember anything is before you’re going to submit the application, you should always feel free to contact the program officer. I mean I can serve as a contact point for all of you. I can give you my card; I can give you some other contact information. I may not be the person serving as your program officer, but I’ll know the person who will. And depending on the type of science you are involved with. But you should feel free to call; we’re not doing you a favor. That’s what our job is. And in the long run we can be more helpful if you contact us early and you can save yourself a lot of grief in the long run. So it’s better to do that. You should feel comfortable.

In the past when I had a K award, I was always afraid to call. I was afraid I might say something stupid. They would remember me; they wouldn’t want to pay my grant. That’s not the case. And again you can try to wade through all the web pages, all the information’s on the web and most of it is, but I can’t find half the stuff. So I don’t really expect you guys to be able to do it. It’s much easier to make contact, have a brief conversation as you’re putting the application together if there’s a certain budget issue to come up. If there’s certain issues you want to discuss about mentorship. What should I be putting in my career development plan? Those are the types of things we can help with. Most of the program officers, like I say, that run the K programs, we probably sat through three, four hundred K reviews. And so we have a pretty good idea of the type of things the reviewers are looking for. Things that people have had problems with in the past. And things where people are in unique situation. Maybe somewhat difficult, but here’s how people addressed some of the things in the past. And that’s something that we are always more than happy to share.

Mark Chavez: Okay, so here’s a new mechanism, a new funding opportunity that was just issued a few months ago. And this is the NIH Pathway to Independence Award, K99/R00. This was issued for a number of different reasons, but one of it is for the normal mentored research core development awards, one of the formal review criteria is institutional commitment. And if you try to apply for a K as a post doc, there’s less institutional commitment than if you’re applying as say as research staff or research faculty. Because if you’re a research associate or instructor, different universities call their research staff different names. Or assistant professor, you’re an employee of the university there’s clearly some commitment. You come in as a post doc; there really isn’t any institutional commitment in terms of well not formal institution commitments. You can still get very strong letters. People at NIMH we do allow senior post docs to apply for the K award. I had a K in the past. The institute I wanted to go to – I was a post doc and I was applying – they told me, “Absolutely not. You’re not eligible. You can’t apply.

So I talked to the people, they promoted me to research associate, which for the most part was a glorified post doc, but that at least allowed me to apply for the award. So at NIMH we’ll allow you to come in as a post doc, but again knowing that’s going to be an additional hurdle to get over because again you’re not going to be that strong on that specific review criteria. Okay? So what this award is intended to is… This new award is specifically intended for people during their postdoctoral period of training. Okay? And so what it does is you, like I say, so what it does it provides two years of K support. I’ll talk about the type of things, the provisions that it gives you in those two years. And at the end of that two-year period, you’re expected to have obtained a faculty position which will then and getting that faculty position making sure that you’re going to be able to accomplish what it is that you stated in the initial application, you’re able to transfer that award and have an additional three years of funding. And it has a very different payline. It’s more equivalent; it’s more of an R grant and again the same thing. Hopefully within two, three years of that award after you’ve done the transition, you’re going to be ready to submit a competitive RO1.

So these are for people who have less than five years of postdoctoral training. This may be a mechanism that you want to think about applying for if you’re still a post doc. And -

Audience: Mark, do you know how many of these are going to get paid?

Mark Chavez: It looks like it’s probably going to be maybe 10 for the year. We don’t know how many applications. Yeah, so it will probably be 10 across the year, so probably three per cycle. I don’t know how many applications are actually going to be coming in, this is the first. None of them have come in yet. The application deadline date was in April. So again so the odds of getting this may be incredibly, incredibly high. That doesn’t mean you don’t want to necessarily apply, but it is good and have an idea of what it’s going to be like. And it’s probably going to be extremely competitive simply based on the number of phone calls we’ve received about this mechanism. We’ve received so many phone calls. I think there’s going to be a lot of interest. One of the other unique things about this application is for the mentored K’s you need to be a citizen, non-citizen national, or permanent resident. For this you don’t have to be. That citizenship requirement is waived and so we’re probably going to be getting a lot of those applications in. So it is a mechanism. It is something to think about. But again, it’s probably going to be very, very, very competitive.

Mark Chavez: Let me go onto a couple slides here because I think some of this will explain it. Really what you’re going to be describing in those first two years is really the postdoctoral experience that you’re going to be having. Who are you going to be working with? What’s the projects you’re going to be working on and what are the resources available? All those type of things. And then the real question becomes what happens after that two years?

Are you really going to be in the position to transfer over to that R phase? That’s what you need to really convince the reviewers of. Because obviously the research you are going to be doing in those two years it has to be directly linked to what you say you’re going to be doing the following three years. And but no as an MD you’re absolutely eligible to apply. Okay?

Let me do this first. So this is the provisions for this, for the K99/R00. So during the first two-year phase, you get total cost, they can’t exceed $90,000.00. the salary is limited to $50,000.00 plus fringe, which is what most post docs would be, approximate what you would be getting for the individual post doctoral fellowship or if you were appointed on the T32 grant and also provides up to $20,000.00 in research support cost which is more than you’d be getting if you were on the T32 or independent fellowship. Again at the end of that two-year period of time that you have to have already obtained an academic position somewhere. And that’s going to be, we haven’t really defined what we mean by that. Obviously if you get an assistant professorship position, that’s going to be fine, but there’s probably going to be other institutes that try to keep the people, don’t give them the equivalent of a real faculty position, but just give them the new titles so they can take them for the next three years. That’s something we’re going to have to deal with in terms of how that actually takes place.

For that transition phase, you don’t need to resubmit that application. What will happen you’ll say I’m in the two-year phase; I have this academic position. Here’s what I’m planning on doing; here’s my transfer package. There willl be very specific instructions in terms of what you need to do to transfer. And then it will be people like me in a committee who review it to see if the transfer, to see if we can approve the transfer. This happens with mentored research core development awards like the K23’s. Quite often people are in a K23; they’re at someplace for two years, they get this really great offer somewhere. They want to transfer the award. The last thing that we want to do is get in anybody’s way. I’ve been involved in a lot of transfers; there’s only been one situation when we haven’t allowed a person to transfer. And that’s because they were working with a very unique population on the east coast. What the project was based on they were going far away and they couldn’t actually have access in that population. So everything, the last three years they weren’t going to be able to do the research.

But every other situation we’ve allowed the person to transfer so it’s not going to be a big hurdle to go from the K22 phase on to the R00 phase. The bigger hurdle is going to be getting that academic position, the appropriate type of academic position. But anyway, after that two years and then what you’ll do is you’ll step to the R00 phase and that’s where the total costs are going to be. They can’t be over $249,000.00. It sounds like a lot, but when you really break it down, it isn’t as much as it sounds like. That’s going to include your salary, your fringe benefits, the research support allowance, and the indirect costs of the university. Okay? So like for a mentored K-award, all the provisions that you get have nothing to do with the indirect cost; you get a certain salary, you get certain research support. Indirect cost, the universities get like eight percent, very small amount. But for this one, most universities, say, have approximately 50, 55% indirect costs. And that’s the money, and normally what happens like see we’ll pay a grant for $200,000.00, and then we’ll add an additional $100,000.00 for the indirect costs. In this one… Is this making sense? Is it?

The indirect costs actually come out of this $249,000.00. So that could be half of the -

David Kupfer: Just to translate it, some of us who have to deal with budgeting all the time – if I have a faculty member, a junior faculty member, an MD, and we have $90,000.00 a year salary, and then we have about $50,000.00 worth of research costs that we’re getting. The only thing that’s really getting screwed is the indirect, but the faculty member in question, in a sense is going to go and we can get $140,000.00 a year. So this independent investigator phase if I sort of back track say that’s that would still exist and there would be indirect paid at 50%, I’m already up to $210,000.00 a year. So what this is is about another $25,000.00 a year in this mechanism in the year three, four and five for an investigator. No I mean there is a benefit but as you correctly point out it isn’t like it’s a huge multi hundred thousand dollar benefit each year. It does represent a substantial increase and makes it much more attractive for the department or university in terms of giving somebody a faculty appointment.

Alan Schatzberg: So one thing that we didn’t talk about before. Some departments will not encourage their people to get K-awards. The reason why is that they have – there is usually two reasons. One reason is that the K-award will only pay 8% indirect and they want to get the indirects, so somebody else can get the R01 and pay 55% indirects and depending on the school and depending on how they finance so that becomes one reason they discourage. There’s another place they’re discouraged and that has been – one of my young post docs went off to a place but he was being paid on the state line. Okay? And at that institution they said why bother, in fact, getting a K-award; just get an R01. The project was very ambitious. The project wasn’t going to fly; He could never get the project funded. And he would have, I’m convinced, gotten the project funded as a training mechanism, as a K-award. So you may have to push back at your institution to allow the K. Another place, people work in the VA setting. There are VA K’s, but you can also get a regular K. A lot of times they’ll say why bother? I’ve got you on a line to do some clinical work or whatever. If the K is going to be important for your career, push back and go for it.

Mark Chavez: And I think especially with the conditions, I think the K-award really is critical. I think for the people doing basic science, who’ve had five years of training as a graduate student in basic sciences, do a two, three-year post doc, most of them are not, should not need five years to be in that position to be able to submit for an R01. But I think with the clinicians, just given the responsibilities you have, given that your background isn’t coming out of, focusing on research during medical school, during residency I think it kind of really is a critical mechanism. So I think, any questions about this?

Mark Chavez: Okay, so really quickly here is what the eligibility requirements are. The citizenship requirements for the normal K’s don’t hold for this so you don’t have to be an US citizen, non-citizen national, or permanent resident. You must have earned a terminal doctoral degree; you can’t have had more than five years of postdoctoral research training. And the one thing to be aware of with this mechanism is, say that you’re getting ready to apply; you’ve had four years of postdoctoral training. You’re eligible to apply, you apply and you don’t get it the first time so you have to come back in.

If by the time you’re ready to come back in, you’ve now exceeded that five-year limit, you can’t come back in. Okay, so then that means if you’re applying as somebody who has four or four and a half years of postdoctoral training, you really have one shot for this mechanism. So just keeping that in mind. You can still come in with the K01, K08, K23, but to get, so you have to within that five years have no more than five years of postdoctoral training. I know some institutes they’re not called formal postdoctoral fellowships, but they have other positions that have different titles. But they’re really equivalent to a post doc so sometimes people say I’m not a post doc, but what I’m really doing is a post doc, and it’s been less than five years. So in that situation we ask then OK, let us know exactly what he is doing, get some statement from the university about what this position really is and we determine if it is really equivalent to a post doc you can still come in. And reviewers are told don’t penalize them for that, they’re eligible to come in.

So even though you may not have a formal post doc title, if in reality your position really does reflect a post doctoral position and you haven’t had it for more than five years, you still may be eligible to apply. Again that’s when you want to contact your program officer to get prior approval, make sure that you will be eligible and then just to get that approval. Okay? And you must be able to devote a minimum of 75% effort toward the award during both phases. So you can have up to 100% effort but it can’t be any lower than 75% effort that you’re going to be devoting specifically to the research training and career development activities that you’re proposing in that application. Okay?

Alan Schatzberg: Mark, let me just ask you a question. If somebody has a couple years of post doc working as kind of a research scientist, only done a couple, now may be a candidate to go on faculty, are they eligible?

Mark Chavez: As long as they don’t have that faculty position and depending on how you’re going to define that two-year research associate position. You can’t---

Audience: If it’s a research, truly a research associate –

Mark Chavez: On staff at the University?

Audience: Will that count?

Mark Chavez: Probably not. But again there are a lot of places people have different titles, and you talk to them and you see what they are actually doing, it really is an approvable post doc. So again waivers are being made, so that’s really just something you have to be able to negotiate especially if you applied so it doesn’t hold you up but once you have the faculty position, then that’s it.

Okay. You can’t have previously had a research faculty position or a professorship. You can’t have been a principal investigator in an R01. I mean, the purpose of all these mentored career development awards are really to put you in that position to get the R01. If you’ve already had it, most likely then you don’t really fit the spirit of what that initiative was intended to do.

Mark Chavez: Say that you were to call me up and you’d say this is what my position is, what I’m going to ask you is… In a situation like that, we probably would provide a waiver for that. So here’s what’s going to be important. You have to describe what you’ve been doing, how it really hasn’t been involved in research and so what you want to really do is get involved in research. That two years of postdoctoral training that you’d get on this K00 award would be really valuable to do this and this and this. So probably in that situation it would be possible.

One of the things though once you can get approval from us you have to make sure on the application that you’re really very, very clear about that when it comes in so the reviewers even though they’re told not to look at that, it still may influence them, so you just want to be very, very clear about what you’ve been doing, why you’re eligible, that you’ve received NIMH approval to do that. But again it’s really going to be done on a case-by-case basis. And so if this would be something that would be of interest to you, you ought to call and that’s how we’re letting it be worked out is just dealing with your program officer or your potential program officer. Again I’d be more than happy to talk to you about what it is you’re planning on doing.

Okay? So let’s… And this mechanism, this was something that Dr. Zerhouni was actually very interested in. So most of the time when we want to issue some new mechanism in NIH or NIMH it’s a long slow process. You have to write this thing; it has to go through 15 different offices’ approval and has to sit in the computer for this long. Because this thing came out so, so quick so it usually takes us about a year to get an initiative out. Because he was interested in this, he thought it was very, a way of trying to protect the more junior investigators, this thing got issued so quickly that there’re a lot of things about this mechanism that the details haven’t been worked out.

So again if you’re thinking about applying for this you really need to call because in terms of how do you write a budget for the last three years when you don’t even know where you’re going to be. You don’t know what indirect costs are going to be. You don’t know what the salary structure is going to be. And so what we will tell you to do is assume 50% and just get an idea, make an estimate of what your salary’s going to be. When you come back into that last review phase, we have to negotiate with you. But again there’s a lot of nuances of this that are currently being worked out. And so if you really think about this award, make sure you call because again we’re still trying to figure out what we’re doing with it internally so make sure you call ahead.

Audience: If someone were to get this award successfully and complete the first two years but fail to meet the criteria for the last three, would they then be eligible to apply for a K03 or K08 or whatever?

Mark Chavez: See you remember I told you we haven’t worked out all the details. So that’s actually a very important question. And I think a person should still be eligible for a K01, it’s not that you had so much mentored research training at that point that you’re really beyond what a K is supposed to be providing. But again there is not a policy that says no you can’t come in, there’s not one that says you can come in, so again these are one of the nuances that really do need to be worked out. Hopefully they’re going to be flexible. They may say if you come in for a K01, or K23, you can only come in for three years. That’ll probably be the case because you can only have a total of five years on the K-award either this or on the K01, K08, K23. But again that’s one of the nuances that I don’t think has been completely worked out.

Like I say, what we‘re hoping though is we’ll say yeah you would still be eligible but it’ll be for three years. Now so that’s one issue and then the other issue’s going to be at review. When you come back in, you tell your reviewers I had this for two years but I couldn’t get a faculty position. That’s probably not going to work in your favor at review. Why weren’t you able to get a faculty position, and other type of things? And it doesn’t mean that it would be impossible for you to get another three years on a K01, that you’d never be able to get through review. But again it’s another thing that you’re going to want to take into consideration. Something that you want, again, to be able to explain in the application if you come in with a K01 or K08 or K23.

Mark Chavez: Okay, and so we’ve been talking about K’s all morning. Really what the purpose of the K-award was provide people with an additional three to five years of mentored research training beyond say post doctoral experience that really will put them in a position to be competitive for an R01. One of the things that you would clearly want to do is you submit a K, you successfully compete for it, you really want to be in a position, hopefully within three to four years into the K, you’re going to be ready to submit an R01. Part of the reason is most likely the R01 you’re not going to get funded the first time. You may have to resubmit and you may have to resubmit again. And so there could be a year and a half, two year, two and a half year lag. If you still have the K, you still have that protected time. You’re still able to devote at least 75% of your time to research. If your K ends you don’t have another grant or research grant. There’s a chance that you’re going to be dragged off into more clinical activity, making it more difficult for you to then be competitive for the R01.

So you want to plan on being able, if possible, to have an R01 ready to go say by the end of the third year on the K or by the end of the fourth year. One thing is in the past you couldn’t have any kind of salary support from any federal grant if you were being supported on the mentored K. That was the only thing you could have. Even if you’re only asking for 75% effort, you couldn’t get 25% effort off of, say your mentor’s R01. That wasn’t allowed. You’d have to get that from the university; you could make up that time in clinical activities or teaching or however else the university could pay for that. And one of the policies that have changed is that’s still true. But after the three years into the K if you’re able to successfully compete for your R01, then you are going to be able to draw salary from both.

And again but it’s only after the third year. If you get say one year into a K and you get an R01, you wouldn’t be able to draw salary off off the R01. So again you really do want to be thinking about submitting a K application three, four years – I mean a R01 – three four years into the K and you’re not going to get penalized by doing so if you successfully compete.

Audience: Excuse me. Is that something that you’d want to write into the K? Such that by the end of the third year. Because I mean ---

Mark Chavez: You’re absolutely right that you do want to talk about that because part of the reviewers looking at the K-award is they want to see… They’re not expecting you to answer some major questions with a K-award. It’s a relatively small budget; you’re a junior investigator, and so the scope of what you’re actually going to be able to do is going to be relatively limited. What they really want to see happen is that good science gets done, really good training, you know career development activities and training takes place in the K, but you really need that mechanism to put yourself in a position to get the R01.

They want to know that you’re thinking about it that way. They want to know that this is the way that I envision it working for me and so yeah you clearly want to talk about doing it. But you don’t want to tell the reviewers, yeah, by the end of year three I’m going to have that R01 ready to go if it’s completely unrealistic. Reviewers, they’ll look at that and they’ll just say “You’re putting it out there because you think we want to hear it but there’s no way to do that type of study. You won’t have recruitment finished for a year and a half. You won’t even begin to be able to start testing your hypothesis, collecting data, probably won’t have any publications in that period of time. So you don’t want to say you have an R01 ready to go in three years if it’s completely unrealistic. So you have to be very clear about if you’re asking for something that will come in 3 or 4 years that’s why I kept saying if you’re in that position to do that, you do want to do that, but you clearly want to talk about it in the application. This is the way I’ve reasoning this, the way I’ve structured my K application I expect to be able to start collecting this data, analyzing and hopefully getting something out of it. Publications and at this point I’ll have enough preliminary data that could go into a R01. Those are the types of things they want to see with the K-awards are put together, that you’ve really structured it in that way that’s going to put you in that position.

But you always want to be honest because reviewers aren’t dumb They’ll get through all that stuff; if you put something out there completely unrealistic because you think it sounds like what they want to hear, that won’t go over.

Audience: Because I guess I was worried about the other concern where you say that you‘re going to submit it at the end of your third year and then they say well if you can get all the data to submit it by the end of your third year then you don’t really need five years worth of K funding..

Mark Chavez: Don’t worry about it. Once you have it, we’re not going to take two years away from you. No, don’t worry about it. And you’re probably not going to get it the first time you submit it. Hopefully you’ll get it by the end of the fifth year. But really planning ahead is what you really want to do. But if you get an R01 say in your fourth year, we’re not going to say well I got the R01, so we’re going to take it away. That doesn’t happen. Sometimes people will get an R01 literally within a year after the K and in some ways they probably should come in with the R01 first. We don’t take it away, so you don’t have to worry about that.

But again the thing with the reviewers, don’t tell them what you think they want to hear. Make sure that it really does have to project reality. These are very savvy people and they’re not, they know what it’s really going to take to put yourself in that position, so you want to be very realistic in terms of what you’re proposing.

Mark Chavez: Okay. There’s a, we have a myriad of K’s as you can see. They all provide and I’ll talk about how much money they provide, type of research support, how they’re reviewed. They’re all for the most part in terms of the provisions; they’re pretty much the same in terms of eligibility criteria. They are very, very, very comparable. One question that we get quite often is should I come in with a K01 and what the K01 is designed for is it’s a relative; it’s a very broad mentored K mechanism. But it’s generally utilized by basic scientists who are doing basic science.

The K08 is really designed for clinically trained investigators, say a psychiatrist who’s doing basic research, maybe doing mouse genetics, something like that. The K23 is for clinically trained investigators which could include clinical psychologists, psychiatrists who are doing patient-oriented research. And sometimes people say well which one will have a better chance of getting funded? It they all go on the same payline. We don’t have separate pots of money at NIMH for K01’s versus K08’s versus K03’s. In terms of where they get assigned and when they get, where they get reviewed, there’s not a K08 study section, there’s not a K23 study section, or K01 study section.

What happens is when the application comes in, the referral officer looks at it, they look at the content of your application, the scientific focus. That determines what study secton it goes to. So if it comes in as a K01, or a K23, and the science is identical, it should be going in the same study section. Okay? And in terms of how we pay them at NIMH when the applications when the scores all come in, they’re all put on the same payline. So we’re not paying you to, we don’t have separate paylines for different mechanisms. So you should be coming in with a more appropriate mechanism. But that’s not something that you should be losing any sleep over – should this be a K01 or K23.

If you’re eligible for K23, you’re automatically eligible for K01. That’s not necessarily true vice versa. But don’t worry about that. That’s another thing, if you call your program officer, I mean that’s something we can tell you yeah that sounds like the best mechanism to come in with but that’s not something to worry about. There’s not an advantage to one versus the other. I can tell you at at NIMH the K23’s… We’re talking to the basic scientist. Do they have an advantage at review; do they get paid more? The number of applications that are being paid that are K08’s and K23’s are probably I’d say – I know for sure this cycle because I was just looking at it – 80% of them are K08’s and K23’s. Okay?

So the clinically, the patient oriented and the clinically trained investigators are coming in for these are clearly doing as well or in this situation much better than the basic scientists who are coming in with K01’s. Part of it may be a lot of K01 people may be going straight to an R01 because I think given their backgrounds it may be easier for them to go straight into an R01 after three, four years of post doc. And anyway I’ll talk more about this in terms of when we make funding decisions what are the factors and influences beyond the priority score; I’ll talk about that in a minute. But anyway, did you? Yep.

Audience: What if you don’t like the review committee it’s going to?

Mark Chavez: Okay, so here’s a couple things before you submit an application is here’s one area where you have a little bit of control. So you’re getting ready to submit an application. You know what the scientific focus of that application is. You can go to CSR’s webpage and you can look at different study sections and you can see who’s on it. You can see the panel of people, the type of grants, the type of applications that they review, the type of expertise on the panel. You find one that you think is a really good fit, one of the things that you could do with these when you submit the application, you can ask that your application be assigned to that study section.

If your request is a reasonable request and it does make sense, I would say 90% of the time it would be assigned to that study section. So that’s something that you actually do have some control over. Say that you don’t do that or you do do it and it gets sent to a different study section anyway, one of the things you could do is you can call. Again, it wouldn’t be a person like me because I don’t have anything to do with review, but if you do have some of those concerns, I’d be more than happy to talk to you about it. Tell you about this is the type of things you want to talk to the SRA about when you tell them that you’re concerned about the study section. What you would have to do is you would have to call and so you submit the application, you get this little card back and it will say your application has been received. It’s been assigned to this study section; it’s been assigned to this institute. They’ll have contact information for the scientific review administrators, the CSR who’s or it could be potentially being reviewed in house at NIMH by we also have standing committees. This is what’s being reviewed. You go in the website, you look at the roster, you probably should do this. Look at the roster, look at the study section; make sure that it’s somewhere where you feel comfortable that your application’s been reviewed. If it isn’t, then it’s clearly within your rights to contact a scientific review administrator and say I have the following concerns. I really don’t see the appropriate expertise, and you explain why and they’ll listen to you. Whether or not they’ll go along with it, that’s a different question. But at least I think it’s really worth trying to do.

And this is a situation where your program officer could be potentially helpful, if you call me up and you tell me what your concerns are and I actually agree with you, it doesn’t necessarily mean that I will, sometimes I do, sometimes I don’t. But if I agree with you, I can also lobby on your behalf with the SRA. Okay? But that’s something that you should probably do. Soon as you find out where your application’s been assigned or it could be assigned to an institute that you don’t want it assigned to. There’s a lot of overlap between our institutes and so let’s say you’re coming in with something, you’re looking to some aspect of geriatrics, it gets assigned to NIMH, but really you think given what the NIA is doing, this really seems to be more of a fit with NIA, that’s one of the things that you can also, you can always ask for the transfer type of thing.

Most likely what happens in situations like that though – this is something else, talk about say in the cover letter, requesting a study section – one of the other things that you can do is if you have an application that’s coming in, and the research focus of your application really is relevant to say NIMH and to NIDA, one of the things that you can do is you can request to have your application dually assigned a primary assignment at NIDA or at NIMH and a secondary assignment at the other institute. Where that may benefit you is when you come in, say that it comes to the NIMH your application comes in, very meritorious, very good score, we’re not able to reach it. Our budget isn’t going to allow us to pick that up. It makes it very easy for us then to call our colleagues at NIDA and say listen here’s a great application, it was dually assigned also to NIDA, would your payline allow you to pick this up? They say yeah, this cycle, we’re actually able to reach it. We’ll never hold onto an application another institute will pay. And so that’s one of the things; you can also request what institute your application gets assigned to. If you actually think it’s relevant to more than one institute, you can ask for dual assignment.

Alan Schatzberg: One thing you have to keep in mind is that a K-award does not pay the same by each institute. And so K through aging won’t pay as much. And okay I always get confused, but I don’t think aging pays as much on the ancillary. It doesn’t go to 50K. So it can cost you and sometimes it’s a very appropriate to go to aging, more appropriate, likely to get funded but you’re going to get less money.

Mark Chavez: I think of the things that’s going on at NIH now is they’re trying to make everything the same. And so I think -

Audience: They should. Because it’s really creates a problem for the young folks.

Mark Chavez: Well I see that when people come with K01’s. A lot of institutes don’t even support a K01 and again I think that’s because the perceptions are if you’re a basic scientist, went to graduate school, you got three, four years of post doc, you should be ready for an R01. Not like that for the clinicians, so a lot of the institutes only support K08’s and K23’s. Even at our institute, we do have a preference for the K08’s and K23’s. And when we do, and so there’s a number of applications coming in, say there’s I can say even now with this budget it’s going to be hard to say this, but what happens is there’s enough money. There’s three applications that are all very comparable in priority score; there’s really no difference between them in terms of the reviews and scores, if we have to so we only have enough money to pay one of them. One of the things that we’re going to be looking at is we’ll be looking at the individual backgrounds. We’re going to be looking at the area of science he’s working in, is this an area where we see very little research or is this an area where we see a lot of research and we’re already supporting a number of things.

So again that or if you’re an MD, I mean we do take that factor into consideration, given these budgets and the way things are compressed, that doesn’t make as much of a difference anymore but again, and there’s even talk within our own institute of maybe not having the K01, the general K01, or if we do have it, only allow people to have it for three years. Not the case with K08’s, not the case for K23’s. The K01 that I had, it was a three year K, they just didn’t give, which I think was very legitimate.

Mark Chavez: Okay, so what they provide or the requirements are you can ask for a minimum of three, maximum of five years. They require minimum of 75% research effort, obviously up to 100%. These are non-renewable, you get one mentored K per career. And the salary support they provide is up to $90,000.00 of salary support and up to $50,000.00 in research support per year. Okay? So say that you’re making $120,000.00 a year and you ask for 75% effort. NIMH will pay the full $90,000.00. Say that you make $120,000.00 and you and you ask for 100% effort, you’re going to have to make up that $30,000.00 difference. Okay? So that’s the way that that works.

There was something else I wanted to say about, okay one of the things. Another question we commonly get is people call and say if I ask for three years will I have a better chance of getting funded, compared to if I ask for five years. And the bottom line is you should always ask for what you need. The reviewers, the only time you’re going to get penalized for this is say you come in, you have an incredibly strong background, you’re looking like your bringing in a lot of publications, a lot of preliminary data, you’re pretty close to that position of getting a R01. If you ask for five years the reviewers may say this guy doesn’t need five years, cut it back to three. Or sometimes you’ll be talking to the program officer, you’ll send in, you’ll talk about your background, what you’re doing. And then we’d advise you given your background, given how strong you are at this point, you should probably be asking for three years. So sometimes we’ll tell you to ask for three years, sometimes we’ll say this probably won’t work in your favor. If you come in to review asking for five and it really looks like you should be able to have an R01 ready to go after two years.

Most of the time, I think 90% of the people who we talk to, I shouldn’t say that high. Probably the five years is a very legitimate thing to ask for. If I was in your position, I would be coming in for five years. It just gives you that much more protected time. But again you want to make sure that’s a legitimate request, but I think the majority of people asking for the full five-year duration, it’s clearly what you should be doing. Okay? And always ask for the 50,000. I mean with the K awards, in the budget, they don’t ask you to give them a real detailed specific budget in terms of how much every little thing is going to be costing you. You just put the $50,000.00 down. If it looks like your application’s going to be paid, then what we do is we ask to send in a detailed budget. I don’t even look at it. I know you’re asking for $50,000.00, I know you’re going to need the $50,000.00, that’s just automatically approved, so always ask for the full $50,000.00 because it’s just not that much.

Mark Chavez: Okay. What this is saying again it’s talking about the K01’s for basic scientists, you have K01, K23 is for clinically trained investigators. You can come in with any of those different mechanisms, now if you’ve had a K in the past or an R01, you’re not eligible to apply for K because again the purpose of that is to put you in that position to get it. But if you have say an R21 which is a smaller grant I could talk about in a minute or an R03, you’re still eligible to apply for the K. And it’s not that uncommon that people actually come in with an R03 simply to get the preliminary data that’s going to allow them to be competitive for a K.

Mark Chavez: Okay. So these are the review criteria for the K’s. There’s a lot of different criteria, but these are the five main things the reviewers going to be focusing on. Okay, the first thing they’re going to be looking at is they’re going to be looking at you as a candidate. They’re going to be looking at your background, your previous training. They’re going to look at your publications, they’re going to look at your letter of recommendation and so again you want to have publications. Again they’re not going to hold you to an R01 standard. They’re not going to expect to see 15 first authorship publications in that content area. But they do want to see some kind of history of productivity.

Now again and this is why it’s important to talk to a program officer even with your mentors. They’re good people to call and say listen this is what I’m going to do, this is the ideal mechanism for me, this is the time for me to apply. I don’t really have that many publications. That doesn’t mean that you automatically don’t have a chance of getting funded. One of the things that I say, so if you’re in a situation like this when you don’t have as many publications as you want, the best thing to do in review is to be very upfront about this. Identify this as I know in order for me to really become an independent investigator, I’m going to have to have a stronger track record, a stronger publication record. Part of what I’m going to be using this K for is my mentors and I developed a plan that we’re going to make sure during this period of time that I’ll be supported by the K, we’re going to be generating publications that really will allow me to be competitive for the R01.

One thing that is you identify a problem that is an obvious problem and reviewers aren’t saying “this person doesn’t even realize that this is – that if they don’t really pick up on the publications they’re never going to get an R01.” So you’ve identified it as a problem. And then you have a plan in place, a well-articulated, detailed plan in place, in terms of how you plan on improving that publication record during this period of time that you’re going to on the K. Now clearly it’s going to be a disadvantage. Somebody with a stronger publication record, they’re always going to have that as an advantage. But it doesn’t mean that if you don’t have 4 first authorship peer-reviewed articles in a high impact journal that you’re not going to be eligible, you’re not going to be competitive. That’s not going to be the case, but again they’re going to want to see publications. First authorship publications are better than co-authorships, but again you’re junior investigators; they’re not expecting to see a huge array of these. Book chapters don’t mean much at review. They’re really going to be looking at data-based publications.

Audience: Is there a difference in terms of secondary data analysis versus data that’s [been collected by the researcher.]

Mark Chavez: A lot of that is going to be depending upon the question that you’re going to be asking. You can get funded doing secondary data analysis on a K, and people have done that. And that’s perfectly appropriate. But again part of what the reviewers are going to want to see is what comes next? What is the trajectory you’re developing yourself for the R01 for this, for that? It’s not enough that you have this discrete project; it’s done and who knows what’s going to happen afterwards. You need to tell the reviewers at least what your plans of what’s going to be happening afterwards. And sometimes I think that may be easier when you’re generating your own hypothesis-driven questions.

So but you are eligible to apply if you’re doing secondary data analysis, okay? Does that answer the question? Because again how the reviewers are going to perceive it. And even within NIMH, I mean it depends on the data sets that you’re going to be looking at, the questions you’re going to be asking within the content of that data set, really what’s it going to tell us that’s new that we don’t know now. And again these are issues that are really primarily important for review, but also something that we look at within the institute. So again and what are you going to be doing with that? You do the secondary data analysis; now you get all this data. You’ve done all this analysis; you’ve answered something; you’ve identified the problem. What are you going to do with that after that? What’s the next step? And that’s what you clearly want to be able to articulate about. For any K application, but clearly, really indicates with the secondary data analysis.

If your post doc is doing nothing more than being somebody else’s technician, you’re not going to get paid just for doing somebody else’s work. And so hopefully what you can build into that… Obviously, like you were saying this morning, it has to be a compromise. Both people have to gain from it. But you want to make sure that you’re going to be able to at least have a possibility of leaving with the first authorship publications. It’s not a problem having co-authorships, but first authorship publications are going to carry more weight at review. But you’re going to at least have the possibility of generating that first authorship publication. And what do you need to do to do that? Are the things in place for you to be able to do that? Have you work out? Have you negotiated this stuff? And also the preliminary data. Are you going to have the preliminary data you need for the K’s. That’s another question we quite often get: do you need preliminary data for K’s? And yes you do need some, okay; they’re not going to hold you to an R01 standard. They’re not going to expect to see that you’re going to have strong preliminary data on every specific aim that you’re proposing.

That’s pretty much the case for an R01. But they want you to at least have enough preliminary data so that it at least demonstrates the feasibility of what you’re proposing. If you’re going to be proposing I’m going to do this technique and this technique, but you’ve never done it, and you don’t even, haven’t even run one or two subjects through it, it’s not going to work in your favor. So you want to have, like I say, some preliminary data to a large extent. The more it supports the hypothesis you’re putting forward, that’s good. Even if you get some kind of effect size estimates, whatever that’s going to be, but also just to show that you can recruit the subjects you say you’re going to be able to recruit, you’re going to be able to appropriately screen them. People doing imaging work, if you can run one or two people through the magnet, showing that you can recruit them; you can get them in there; you can collect the data; you can actually analyze it appropriately. You’re not sending in as part of the scans you’re looking at an artifact rather than signal, saying here look, I’ve done this. That’s the reviewers want to see that you’re actually able to going to be able to do what you’re proposing.

Again it doesn’t mean that when you first submit a K, you have to be an expert at imaging. That’s probably part of the skills that you’re going to be learning with the K. But at least enough they’re going to know that this is on a feasibility level that you’re going to probably be able to do what you’re proposing to do. Okay?

Paul Pilkonis: That’s probably the most effective way to get people published quickly. So rely on those archival databases for that purpose in order to enhance your vita in terms of peer-reviewed publications.

Mark Chavez: And there are a lot of databases out there. I think Ron Kessler’s is now going to become available. He’s going to be offering courses in terms of explaining to people how to actually access and mine this information. I think there’s also James Jackson‘s for the African American and Afro-Caribbean populations, Margarita Alegria for the Latina populations and David Takeuchi. All these are going to be coming publicly available very, very soon. Of course the NIMH has some of the results from the trials, the CATIE trials, the depression trials. Again that’s access, that’s data that you have access to and I do agree with you this is one way. You’re doing a post doc with somebody; you work on this project; you get the publications. That’s something that you may be able to partially do on your own if you have the statistical skills and everything else you’re going to need. This may be – mining some of these data sources to get publications could be very important. It could be very helpful for the K or whatever application you’re planning on submitting.

David Kupfer: The other thing about the mining and also the publications is that they that may allow you to facilitate the importance of your question that you’re trying to answer if you can then show look how important this is in terms of the number of people or how much functional impairment there is and the fact that they’re not getting better, etc., etc., etc.,. So it may enhance the goals and objectives of what your particular question is that you’re going to ask. But you need a certain skillset be it statistical and epidemiological to be able to access those datasets. They are very good for that.

Mark Chavez: So one of the things also obviously the reviewers are going to be looking at is they’re going to be looking at the research proposal that you’re putting together. And again they’re not expecting to see an R01, it’s going to be much smaller in scope, but they, so but it has to be incredibly rigorous, very well designed. You can’t have… And again, it clearly has to be feasible. You have to be able to say is this sufficiently powered? Do you have the appropriate controls? All of those things like with any of the research projects really do have to be in place. It’s just going to be on a smaller scale. And one of the things they want to see is this research plan that you’re putting together really going to give you is it going to take you down a road, down a path that’s going to put you in a position to be able to submit a K award – I mean an R01. That’s what they’re going to want to see with this.

If you’re proposing something that sounds incredibly interesting, very innovative but it’s really high risk, there’s a good chance that you’re going to end up leaving with nothing, that’s not going to work in your favor at review. Because again if it doesn’t pan out, you’re not going to be in a position to put together an R01. It’s going to be hard now without having the protected time and everything else to really put yourself in a position you’re going to be able to submit an R01. So you want to ask something that does have significance. The innovativeness issue is a double edge sword; it’s a hard thing to answer with the K’s, but really just focusing on making sure the proposal’s going to give you the requisite skillset you need, you’re going to be learning some additional techniques by doing this, that it’s actually going to put you in that position to get the R01. Okay?

And it’s kind of hard to reduce – I know how much work goes into putting together the research proposal and I kind of reduce it to 45 seconds, but again it really does have to be very strong in terms of being very appropriately designed, all the appropriate controls, specific power analysis. The question that you’re asking is a question that’s worth asking. That type of thing.

Mark Chavez: There’s a career development plan and again this is where the mentored K is different from a research grant. One of the things by applying for mentored K’s in some ways you’re telling the reviewers “I’m really beyond post doctoral training, or I’m a very senior post doc, but I’m not quite ready to compete as an independent investigator in the R01 arena.” So what you’re asking for is the three to five year period of time to get that additional training that will put you in that position. And part of it is doing the research, getting the publications, getting the preliminary data, but there may be skillsets that you need to acquire. Again I think for somebody doing imaging who doesn’t have a lot of imaging experience obviously just taking the basic physics courses, learning how to analyze data, the appropriate statistical techniques, just learning the nuts and bolts so you can become a hands-on imager. Obviously those would be things that you’d be proposing in your career development plan. It may be you’re developing a specific manual for some type of assessment or for CBT applied to a unique population.

What are the type of skills that you’re going to need to get behind you in order to be able to really do that? Maybe you’re working in an area with some aspect of comorbidities. There’s a lot of comorbidity discussions. Maybe you have a lot of background in one area, but in one of the other areas you don’t know that much about. It could be some aspect of pathophysiology, psychopathology. So that’s the type of thing that you want to be proposing in the career development plan. Here’s where I’m at now, here’s where I want to be in five years. In order for you to really be in that position and be strong in that position, these are the skillsets that I need to get behind me. Here’s how I’m going about getting them. It may be… For a lot of faculty positions there’s a lot of emphasis on quantitative skills that you’re going to acquire during this period of time, taking additional coursework in experimental design and statistics and statistical modeling. Those are the types of things the reviewers are going to be looking to see.

And again the bottom line is ask for what you need. I mean you’re in a good position working with your mentor to know what all you really need. Because sometimes people will say well should I ask for career development activities the full five-year period of time? Or should I just do during the first couple of years? I mean the bottom line is there’s not a formula that you should apply, that if you ask for four years of career development activities, you’re going to get a better score than if you ask for two. It really depends on the individual background. When you put these didactics together, you put these career development activities, you want to be able to make sure that those activities are really well integrated with the research plans, so they say this makes sense, this is what this person is doing research-wise, this is what they say they want to be doing in the long-term. These are the types of skills that they are going to need to have to be able to do that. They don’t have them now; they are doing the appropriate type of didactics to get that skillset behind them.

Mark Chavez: The other thing is going to be the mentors. I think that’s fairly obvious. So there’s two ways of talking about the mentors. One is the reality of what goes on in the setting that you’re at with the mentor. And then there’s also getting it through review it’s going to be very different. When I had my K01, I literally wrote my mentor’s statement because that’s how absent he was. I sounded great, but that’s not the situation you want. But again for the grant purposes, I could do that, I got funded. That’s obviously not the reality you want to be dealing with. So you want to pick mentors that are really committed to seeing you move along. And again the same thing that they were all talking about this morning: how you choose your mentors, the milestones that you develop with the mentors, what their expectations are for you, what your expectations of them are. You clearly want to have… Not only is that going to be good for you professionally, that’s the type of thing the reviewer’s going to be looking at in the application.

Being able – As somebody else was talking, make sure that the relationship between you and your mentor is structured. Don’t just assume you’re going to run into each other in the halls, spend 30 minutes discussing things, or he’ll come by your office. You want to have a structure. Clearly the application of that is the only thing the reviewer’s going to be able to understand is a structured mentored research plan. Not that we know that this guy is really gregarious, they’re going to talk a lot, there’s going to be a lot of interactions. What are those interactions going to consist of? How often are you going to be meeting? Are there things in place or if you start going off course for whatever reason, having trouble recruiting, getting something through IRB, whatever it would be, that the mentor is actually going to be aware of it, is going to be able to help you identify, recognize this problem and help you rectify that problem.

You want to make sure that so the mentors you choose that they have the appropriate expertise and that it really is a structured mentorship that the reviewers can see and say we understand how this is going to be working. Quite often the type of interdisciplinary work that’s going on now, people quite often ask for more than one mentor. And that’s another thing. Another question you get quite often: how many mentors should I have? The bottom line is ask for what you need. Say you’re working with comorbidities and you need somebody with expertise in two different areas. It’s not better to have one mentor because you think that’s what the reviewers want. You should make sure that all the areas that you’re going to need mentorship in are being covered by an appropriate mentor, so you can have up to three mentors say depending on the nature of your research project.

Just like the career development plan, you need to be able to justify why have you chosen this person as a mentor? Again, you want to be able to justify everybody that you’re choosing. I saw an application come in about a year and a half ago and they literally had probably six mentors and five consultants. And it literally looked like part of the roster from the Institute of Medicine. Incredibly impressive names were on it; reviewers looked at it, and said “Who’s going to really provide the mentorship here? This person’s going to be spread between so many people that there’s really probably going to be no real mentorship going on.” So the bottom line, go ahead –

Audience: So there’s a difference between mentorship and consultants? So you have limits to the number of mentors –

Mark Chavez: No limits to any of it.

Audience: Oh I’m sorry I thought you said you can only three mentors.

Mark Chavez: No, no, no, but I tell you if you start getting more than three mentors, they’re really going to be asking do you really need more than two mentors and so again you start getting too many mentors and again that issue comes up. Who’s really going to be providing your mentorship if you have all of these people? You want to be able to say the reason I chose this person or this person is because they had the type of expertise that I’m going to need so they can guide me over the next three to five year period of time. Just having people on there because again they have impressive names, are well-known, some reputation, but they’re not really going to be serving any real function. You don’t want somebody like that on your grant as a mentor. Because –

Audience: But as a consultant possibly.

Mark Chavez: If there’s a reason to have them as consultant, by all means. But you want to have, say that you need four mentors given your research, you’re better off having four if you really need all four of them, than not, so there’s not a magic number, but you want them to be able to legitimately say here’s why I have the mentors I have. Say that you do have a handful of mentors, say that you come in with four mentors. One of the things that I would strongly recommend that you put in the application is that during some period, this may be happen once every four months, we’re going to, say one of the mentors is offsite, they’re at another university, they’re the experts in this specific assessment; it’s going to be critical for you to be able to accomplish what you’re proposing. You’re going to spend four months there; you’re going to make sure you learn this, they’re going to make sure the fidelity is all in place, these types of things. One of the things that you’re going to want to do is you’re going to probably want to say once every four months or every six months, we’re going to have a conference call where we’re all going to be on the phone together so that each one of the mentors knows what’s going on, the full spectrum of my project. So that it comes together as an integrated mentorship team that you’re working with, not I’ll talk to this one when I go to this conference. When I go to this one, I’ll talk to this one. You want to have it come across – again, the structure’s very important just because I think it’s probably going to be better for you on the K, but it’s also going to be important because that’s going to be clear to the reviewers. They can understand something that’s structured in that way. Something that’s relatively diffuse, they’re not going to assume it’s all going to come together and it’s all going to work because these are all good people; they won’t give you benefit of the doubt..

That’s why you want to have those type of things structured. The more people you have, the more you want to make sure that structure is there. That’s why I say you periodically want to say we’re going to be meeting as a group so everybody sees the progress I’ve made, problems I may have had because there may be different components you’re having problems with so we all know what’s going on with – what’s going on with your award, what’s going on with you. Does that make sense?

Audience: Yeah it does.

Mark Chavez: And the last thing I’ll talk about is institutional commitment. And again I spoke about that earlier. One of, so again what the reviewers are going to be looking for in the most black and white way, if you’re an associate professor, if you’re research staff in a formal sense that’s sufficient institutional commitment, okay that’s the type of thing they’re saying; some institutes, without that you can’t even apply. We’re not that way at NIMH; you could apply as a senior post doc. But what you clearly want though is you want a letter from the chair of your department, somebody with the appropriate authority who says we’re going to make sure that the person has the necessary protected time to be able to accomplish what they propose. We’re going to ensure that they’re going to have access to the space and the equipment that they’re going to need to be able to compensate what they propose.

So they have to make sure that you’re not just getting this award – you’re in this department and hopefully it will work out if the resources are available for you to use. If the equipment’s available that’s great. But so you want to make sure that you have a clear strong letter of institutional commitment. And again even as a post doc, it’s the same type of thing. See here’s a problem when you’re on the T32. Say you’re on the T32 and you want to apply for a K-award, again it’s – really to be competitive for the K, it’s almost, it’s going to be really important for you to be able to tell the reviewers “I’m a post doc now; I’m in this T32, but in say eight months, I’m going to be applying for this award and in eight months I want to be able to”. For the institutional commitment, you want to be able to say “I’m going to be moving off of post doctoral status into some type of research staff position, some type of faculty position.” And so you almost need to have that agreement by the University where you’re at, where that T32 is at and where you’re getting training.

And sometimes that can be very difficult to do. Sometimes they’re not going to want to make that commitment for a lot of reasons that are very, very legitimate. So that’s something that you want to be negotiating with somebody very clearly. You’re on T32, you’d like to have a K-award come in in a year-and-a-half, two years. Are they going to be able – will they give the appropriate position that’s really going to allow you to be as competitive as possible to come in with that? That’s something that you probably you do want to talk about. What you never want to do is get a letter from the department that says “Yes, we’ll promote this person from a post doc to a research associate if they get their K funded.” If getting the K funded, I mean if your promotion is contingent upon you getting the award, they’re pretty much saying we have absolutely no institutional commitment. As long as we don’t have to pay them, sure, we’ll let them stay around. So you want to make sure if that’s reality, you don’t want – to make sure that does not say that where you have something lined up that’s going to be. The bottom line is you got to get the money. You want to, so if you could say in eight months we plan on promoting this person, or they’re going to be coming up and they’re going to be – to see if we’re going to move them on to this position. Even if they’re not guaranteeing that you’re going to have this new position in eight months, at least if they could say you’re coming to review, you’re being very seriously considered for this position, that will probably work in you favor at review. Okay?

Mark Chavez: Okay, so here’s some of the other, the other mechanisms that you might want to think about as junior investigator. All these slides I don’t think I sent them to them earlier to put in the book, they may be in there. Are they? So again you can see, you can get this information, just go ahead and look it over. If you have any questions about it, feel free to call. You can always look at the program announcements on the web page. But these are all the things just to keep in mind. Here’s the situation that they may actually be very useful. Say that you submitted a K, you didn’t get it, very good priority score, but you’re not, for whatever, given the budget constraints and everything else, it’s a very meritorious application and believe me there’s a lot of incredibly meritorious applications that don’t always get paid.

Say you have one of those applications; you can’t come back in again for a K. One of the things you’ve done a lot of work on this mentored career development award; it’s been to review sometimes, so you’ve got a lot of feedback. At this point it’s going to be very, very strong. You may want to say can I take this component out of it and can I really turn this into an R21, potentially into an R34. So that all that work that’s went into this, all the things you have because you already have some of that preliminary data, probably already have relevant publications, you have the experiments very well designed. So it may be something that you’re going to be able to turn into another mechanism if that’s the scenario that turns out, if that ends up happening in your situation.

These are the types of mechanisms you want to look at as well as the R01. You don’t have to be asking for a five year R01, you could be asking for a three-year R01. And during that two-year period of time when you’re trying to apply for the K, maybe you got more preliminary data, more publications that do make it feasible for you to be competitive for the R01. But again, these are just other potential options if the K doesn’t come through.

Again, this will be something – talking about the different mechanisms, the strengths, the weaknesses, how they’re being reviewed. This should be something if you were to decide if you would decide to take that path, you’re thinking about one of these, give us a call because they have different review criteria. The reviewers are going to be… There’s going to be the same review criteria for every grant, but there’s also going to be some unique things to each of these. Again, this is going to be worth talking to somebody at NIMH saying these are the types of things that you want to make sure you have in place. Maybe you don’t want to do the R34; come with the R21 first because you’re not going to need as much preliminary data. So those are the types of things that you can discuss prior to doing – putting the application together and submitting it, okay?

Mark Chavez: And I assume… I know a lot of you are familiar with the loan repayment programs. I know that a few of you in here are actually on it so what this is is… Do most of you know about the loan repayment program? Do I need to say much about it? Does anybody not know about it? I’m sorry but you’re from Canada; it’s not going to help you. But anyway so what it is is if you’re able to commit at least a year, in at least a postdoctoral status and you’re able to commit at least 50% effort to research, one of the things that you could do is you could apply for loan forgiveness. So if you’re a psychiatrist doing mental health research, your application – well first it goes to the loan repayment program office; then it comes to NIMH. We get a lot of applications and again the applications, we can talk in detail what the applications actually consist of. They’re very different than a research grant that you’re putting together. It’s not as if they don’t have to be excellent, but they have to be excellent in a different way. But again this is something that I’d be more than happy to talk to anybody about if they’re actually thinking of applying for a loan repayment program, for loan repayment program support.

But if you successfully compete what happens is it will pay up to, and there’s a lot of different ones. Okay? So there’s the clinical research LRP and pediatric, contraception and fertility that’s being supported by the National Institute of Child Health and Development. There’s a health disparities and a LRP for individuals with disadvantaged backgrounds. These two are only supported by the Center for Minority Health and Health Disparities in NIH. Actually, these are the two that NIMH supports. We have about five million dollars and maybe a little less now simply because it’s been slightly reduced with the budget. But it’s close to five million dollars that we have every year to pay loan repayment program applications.

Mark Chavez: And so if you successfully compete, what it will do is it will pay up… Depending on the size of your debt, it can pay up to $35,000.00 per year in loan repayments, and again it’s dependent on your debt. It’ll also cover the taxes, so it can pay up to an additional $13,650.00 for the taxes. And say that you have loan repayment program – I think a couple of people I spoke to in here that was their situation – they get it and they transfer, so can you take it with you? Yes they are transferable assuming certain things are in place like you still can come in with 50% effort and –

David Kupfer: Yeah, so the question I know Alan Schatzberg wanted me to ask is that some people are now having difficulty in this not getting the initial contract length, but going back in in terms of the competitive piece of the extension. And how that best be positioned in terms of the reality I assume that not everybody going back for an extension is going to get it in terms of the amount of money that is available for the whole program. And where that goes and what does one have to accomplish from a research point of view during that two-year period to say look I’m still a good investment for the next two years.

Mark Chavez: Okay. So there’s a lot of answers to the question. Now one thing is if we look last cycle we received 388 loan repayment program applications. And I think historically this is happening across all of NIH is the type two, the people coming back in and recompeting, when you receive an award from the NIMH we automatically give it to you for two years. We can go for one or two; we automatically give it for two years. So we’ve come back in across all of NIH, there was about an 85% success rate for people who were coming in on type two applications. And so NIH is saying this is ridiculous, we’re not giving the new people coming in a fair shot since 85% of the people getting paid are type two applicants, and that’s what was happening. We weren’t quite that high at NIMH, but we were still paying a disproportional number of the type twos and so what we’re trying to do is make it more of a 50/50 balance, and that’s about what we have.

Why people don’t get funded when they come back in. I mean there’s a number of reasons I think. You’ve been productive; you’ve been publishing. That’s the best that you can do. If you still don’t get it just because the amount of money or maybe the people who reviewed your application. These reviews are not like the reviews that happen at CSR. When you send in the applications at CSR, it’s not that CSR’s perfect, they don’t make mistakes, there are mistakes made. It’s a good system, but again it can be mistakes that are made. Loan repayment program in many ways is a little more arbitrary the way the review process takes place. And so again you don’t have the same type of rigor, and so it’s not a crapshoot, but it’s not a CSR review either. So why people with type twos don’t get paid. Sometimes part of it could be because we have applications come in – I was talking to someone earlier, we had somebody come in who had an R01, an R21, was in a tenure track and they were an associate professor and they owed something like $30,000.00. The purpose of this program is for recruitment and retention. You have an R01, an R21, and you’re an associate professor and you’re not recruited and retained yet, you’re never going to be. If $30,000.00 going to make that much difference, then you probably shouldn’t be in the field. That person can have a 100 priority score, we won’t pay it. So there may be a lot of differences. If you owe $7000, you may still be eligible, but again is it worth taking the $7000 away from somebody else who may owe $80,000.00.

And so there’s a lot of different reasons people may not get paid. All you can really do is put in the best application possible. We for the most part follow the payline, so that’s going to account for most of the variance. One thing that we do is the spirit of this initiative is really for physicians who you know have incurred a lot more debt than say most PhDs do. We also reach for the physicians. We make sure that we pick up as many of the physicians as possible. We’ll reach for a grant with a higher score to get a physician because again that really is the spirit of that initiative, and it’s not that we don’t – We still pay a lot of PhDs; they’re eligible to apply if they also have the debt. But again, we really do use this to capture as many physician-scientists, and I don’t really know how to answer the question why somebody comes in with a type two – they could have gotten burnt at review, maybe they weren’t as productive as they thought they were. And you’re not going to get the same reviewers obviously. You never get the same reviewers for that.

The thing is look at the criteria. It’s a loan repayment program, and I’d be more than happy to talk to anybody about it. Put in the best application, but I don’t think there’s anything mysterious or going on with type twos versus type ones, so that’s…

Mark Chavez: And one other thing. This is really quick; I’m only going to mention it for one second. And this is the new electronic submission. And so there’s going to be… We’re going to be using a different format, and I’ll talk about it in a minute; it’s electronic submission. What they’re trying to do is make all of the government follow the Department of Defense’s model and we know what a resounding success the Department of Defense has been over the last couple of years, but that’s what we’re all modeling after now. And so there’s all these places that you can go to find out what you need to do, and it’s a pain. I’m learning it, so I know it’s very complicated; it’s very difficult. Again when you’re doing it, you can contact me. I can put you in contact with people who can really walk you through it. The only thing that I really have to say about this though is there’s specific deadlines for different grants.

One of the things is if you have to submit an application, it’s electronic submission, don’t wait for the day before to submit. Because most likely there’ll be a problem. Because it’s very, very common and you don’t want to miss an application receipt deadline date because there’s some glitch in the system, something’s down, something didn’t work right. You have to coordinate with your budget office because now they submit the budgets; you don’t submit the budgets. And so you want to be doing this early on at least the first time you get through it, just to kind work though all the different bugs and really understand it. So don’t wait to the last thing to submit that.

Another thing you submit after… You know, putting together an application is time consuming, it’s stressful. The first thing you want to do is I’m take a few days off and enjoy it. Don’t do that because what you have to do is the next day you have to go in verify that it’s been received, verify that everything has been entered right.