Optimizing Funding Policies and Other Strategies to Improve the Impact and Sustainability of Biomedical Research

The National Institutes of Health is requesting information from the public, specifically targeting the scientific research community. They do this by issuing RFI’s (can you get what that stands for?) as “Notices.” “Notices” have an “NOT” number, and are the official communication of the NIH with the public. Most recently, they have issued NOT-OD-15-084: RFI: Optimizing Funding Policies and Other Strategies to Improve the Impact and Sustainability of Biomedical Research. I have been encouraging my friend and colleagues on Teh Facebookz, Twitz, and other social networks to provide their feedback.

I want to put my social networking where my mouth is and share with the world my own comments that I submitted last night. There is a 500 word limit for each question. I was very surprised to see the conversational tone of actual responses to a previous RFI. I had thought that these were supposed to be well thought-out, evidence-based golden nuggets of wisdom; when really they are lists of anecdotes. They range from dripping with contempt and resentment to blissful entitlement. So I assure you, whoever reads this, that your comments will be just as valuable as they are for other RFI’s1. I was really only inspired to submit my comments after reading the contents of the last RFI which I wanted to, but didn’t because I didn’t think my opinion was worthy2. If you read the other RFI comments, they are generally less structured and more stream-of-consciousness. My comments as follows:

  1. Key issues that currently limit the impact of NIH’s funding for biomedical research and challenge the sustainability of the biomedical research enterprise. We welcome responses that explain why these issues are of high importance.
    1. The training provided to PhD students who are supported by NIH (either through T or R mechanisms) inadequately prepares the majority of them for either the real work that will be expected of them as principal investigators in research institutes, or as teaching professors at primarily undergraduate or teaching-focus institutions, or to function outside of academia/research (e.g., in business or non-profit).
      1. The training most PhD students receive does not teach them how to write excellent research proposals or papers; nor management skills for lab employees; nor budgeting or strategic long-term planning. Most trainees master the limited number of manual labor techniques which they will no longer employ as heads of labs; and do not obtain management, business, leadership, or writing skills.
    2. It is extra-ordinarily difficult for good, solid, researchers/teachers with good ideas to get started (despite the K99/R00, mechanism, which is reviewed primarily on pedigree and not applicant’s merit) with new R01s.
    3. Ideas that are funded by the 2-year mechanisms (R03, R21) are usually not continued because the funds are inadequate to support the rigorous work necessary to test the super-novel ideas required by the R21 PAR language.
    4. The large mechanisms (P30, P50) suffer from “too big to fail,” wherein non-productive, wrong hypotheses, misguided directions are renewed because “so much” was initially invested in forming the program. This is the “sunken cost” fallacy, and limits investigators’ (e.g., junior investigators who served as Key Personnel) ability to be nimble and change directions because they need to have a “continuous research arc” in the minds/eyes of reviewer study sections and so the system supports intellectual inertia.
    5. Reviewers in Study Sections do not follow instructions.
      1. One example is a reviewer explicitly critiquing (“dinging”) an applicant for providing, in the Research Support, information about recent support relevant to the research proposed (per the instructions).
      2. Other examples include critiquing the quality of writing, commenting on the investigators’ family, getting the point of PAR’s, RFA’s wrong, and lacking basic reading comprehension skills. When these errors are made, the default is for reviewers to follow their unconscious biases and the best research ideas are not always supported.
  2. Ideas about adjusting current funding policies to ensure both continued impact and sustainability of the NIH-supported research enterprise.  We welcome responses that point to specific strengths or weaknesses in current policies and suggest how we can build on or improve them.
    1.  Stop paying tuition on R-mechanisms.
    2. Institutions should be required to support a minimum effort of PI’s salaries who are PIs of R-mechanisms, unless the PI is a K01 holder or other type of “independent scientist” type of mechanism.
      1. In these exception cases, the effort of the PI should be audited to ensure that they are not performing (or being evaluated for promotion/tenure purposes) teaching, service, administrative duties that encroaches upon the effort paid for by the NIH.
    3. It should be recognized that the majority of manual labor to carry out extramural research is performed by “trainees” like graduate students.
      1. Rather than be “trainees” who learn manual labor, but not knowledge-skills — training grants should instead by like service-awards …. where students get their PhDs while carrying out this work — but they will also get demonstrable experience and accomplishments using skills that are applicable and desirable to outside businesses.
      2. This may seem outside the purview of NIH’s mission, but it’s the only way to continue getting the “cheap labor” from students; yet still make them useful to society — I think the skills necessary to get a biomedical PhD (focus on a goal, persistence in the face of hardship, statistical analysis, ability to learn new things, working with diverse people, analyzing & presenting data, finding meaning from data) should be highly desirable to a wide variety of companies and industries and would ultimately serve NIH’s mission, however the lack of _demonstrable_ transferable skills (management, leadership, budgeting, the culture and language of American “business”) makes it difficult, costly, or impossible to transition into those sectors and types of positions.
        1. “demonstrable” means must have some accomplishments using these skills to put on a resume
    4. Phase out the two-year mechanisms.
  3. Ideas for new policies, strategies, and other approaches that would increase the impact and sustainability of NIH-funded biomedical research.
    1. Training policies for NIH-supported training (and research activities performed by trainees) need to be adjusted to reflect the actual, not desired, job market landscape.
    2. Reviewers at study sections who do not follow instructions should be removed from the study section, not invited back, and not be allowed to claim the service on their CVs or biosketches.
      1. Serve coffee and yogurt parfait during study section meetings.
    3. My experience has been study-section and reviewer culture around grants dictates the content of applications more than the SF424R instructions, there should be a study (of experienced reviewers, SRO’s, etc) so that the instructions actually match what is expected (and will be rewarded with success) of applications.
  4. Any other issues that respondents feel are relevant.
    1. At many levels, there seems to be a lack of accountability for poor implementation and decision-making that has lead to the difficult situation that the biomedical research enterprise is experiencing currently in the US.

1Because the bar is so low.
2My comments are a combination of a few weeks’ of thought dedicated to this specific task curated from several years of intense interaction with the NIH grant submission and peer review systems, plus several years of intense emotion and reflection/writing/talking about training.

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