rivka

Last week and this I've been settling into my new life in the Psychiatry Department. Biggest change: people are glad to see me. In Infectious Disease I drifted through the day doing my own thing, sometimes not speaking to anyone else all day. In Psychiatry, people say "Hey, Rebecca! You should come to this meeting and possibly get involved in Thing X. And maybe we can help you with Y and Z."

Infectious Disease was probably like this for the docs and virologists, but I don't think it would ever have been that way for me. Even if there hadn't been complications related to my former supervisor, there just weren't enough points of convergence.

The other big difference is that Psychiatry has systems and resources and personnel to do all of the things I am used to doing myself or having ad hoc arrangements for. So, for example, instead of writing a position description and hiring a research assistant, I'll be meeting with the person who coordinates RA assignments and contracting with her for parts of various existing RAs who have the skill sets I need. And when I start enrolling participants, there's someone who is in charge of ensuring IRB compliance, making sure that all my consent forms are properly filled out and storing them for me in a HIPAA-compliant way. "Because the investigators really need time to write and think."

I used to do all of that stuff for my former boss, Lydia: all the day-to-day arrangements and regulatory details and organization, so that she could write and think. Then when I was promoted to faculty level and became a PI, I still did those things for myself. It'll require a huge mental shift to be able to delegate those things to other people - especially, without forgetting about them. But I can see how it gives faculty a much fairer chance to succeed.

Last month I was contacted by an NIH official asking me if I would do him a big favor by serving on a special review panel for a single grant application. I am not a fool, so I said that I would be delighted.

(In the first place, why on earth would any scientist working in an area funded by NIH not want to do a reasonable and ethical favor for NIH program staff? But in the second place, my external mentor has strongly encouraged that I try to get on NIH review panels because it will help me understand what grant reviewers are looking for and how they treat applications.)

So I said yes. I read and reviewed the grant proposal. I was assigned as the fourth reviewer, and when I uploaded my critique I was considerably relieved to find that my scores were in line with the other three reviewers; I hasn't missed anything. I enjoyed the phone meeting at which we all discussed the application and settled our final scores. All in all, it was an extremely educational experience, which I think will help me next time I have a grant to submit.

So I was blown away to open my e-mail this morning and find an e-mail from NIH which begins: "Thank you very much for serving as a reviewer for CSR peer review meeting for [information deleted]. According to our records, you should receive ($200.00) for honorarium..."

Holy shit! They pay me for that?! They pay me for that, at what works out to a rate of $100 an hour? That thing I thought I was doing for free, and enjoyed, and found beneficial?

The best part is that it's an "honorarium," not salary reimbursement. That means that it goes directly into my pocket, instead of to the university to help cover my salary. Awesome.

I just got my "pink sheets," the summary statement of my grant review. Wow, it's really good.

This resubmission retains all the numerous strengths of the previous submission including: addressing a highly significant public health problem (failure to initiate or delayed initiation of ART); a clearly thought through iterative model of intervention development; well established involvement of the community; and a strong and clearly articulated research design. The revised application has been highly responsive to the previous reviewers comments and has been substantially strengthened. The team is outstanding and the choice of sites and inclusion criteria to increase generalizability have now been well justified. A few negligible issues for clarification are described in the individual critiques. In review considerable enthusiasm was expressed for this timely, highly innovative and clearly outstanding study that addresses a very serious and real public health concern.

I would like to express my particular affection for Reviewer 3, who used the phrases "superb investigative team" and "PI a very promising Early Career Investigator with demonstrated publication productivity."

Edited to add: guys, we're in clear text here. I've screened some comments.

I have spent a pleasant afternoon writing cheerful e-mails about my grant score to my division head, the COO of the Institute, all of my collaborators, someone I've worked with in the Career Development office, the head of the APA CyberMentors program (my actual CyberMentor got a phone call), and my NIH Program Official. The PO called me just now.

PO: Hi, Rebecca, how are you doing today?
Me: I am very, very happy!
PO: (laughs) I bet!

He said that at this point in the process he likes to be able to give people a summary of how their proposal was discussed at the meeting. In my case, "I didn't hear anything negative... only positives." He said that the perception was that I was really responsive to the critiques of my prior proposal, and that the resubmission strengthened my application. "Everyone thinks this project has really high significance" and addresses an important issue. They like that I am using both an HIV clinic site and an AIDS Service Organization site. "They bought the argument about a Motivational Interviewing approach" (in the initial submission, one of the reviewers had doubts) and thought I did a better job of justifying my choice of an attention-only control group.

"And then there are two more general points I wanted to bring out. The comment was made that this is a very well-written application. And one of the reviewers said that you are 'a promising early-career investigator who has good productivity to date.' So they don't just like your application. They like you."

I ♥ my NIH PO so very much. He is so unbelievably sweet and helpful.

He walked me through what comes next. I'll get my Summary Statement (the formal critique from my primary reviewers) in a couple of weeks, after which he'll want me to write a memorandum responding to any residual critiques. Then, in September, the NIMH Advisory Council will review the reviews and factor in their particular funding priorities. In October they make their "pay plan," and somewhere around December they'll start sending out money.

He cautioned me that you can never be absolutely sure of funding until you receive your Notice of Award. But my chances are obviously pretty damn good.

I feel queasy every time I log in to eRA Commons, the NIH electronic research administration website.

I am waiting to find out when the study section will meet to peer-review my grant application. I was expecting them to meet in July; for AIDS proposals, which are on an expedited review cycle, the study section usually meets two months after the applications are due. But here it is June 30th, and the date of the study section meeting hasn't even been posted yet. (That's what I keep logging in to check.) So we might be talking about August instead.

I've written before about how peer review works for NIH grants. It's hard to exaggerate the stakes this time. My proposal is a resubmission of the proposal I submitted in January. This is my last chance to get this proposal funded. If it doesn't make the cut, I'll need to start over with a whole new idea.

I am not sure how long my institution would continue to keep me around if that happened. I am in a "soft money" position - required to bring in grants to cover my salary. If my grant gets passed over, which is what happens to most grants, I'll be in a very precarious position.

I am waiting for them to post the date of the study section meeting. Then I'll wait until the meeting happens. A few days after that, my score will be posted and I will probably know what I need to know. There will still be exciting waiting after that; the NIMH Council meets to discuss the reviewed grants and pick those to be funded according to their own priorities. Those priorities can sometimes be mysterious. But my score itself will say a lot, and after I get my score and summary statement I can call my NIMH Project Officer.

So every time I log in to eRA Commons I feel queasy. I keep expecting to log on, hit "status," select my proposal title, and see the word UNSCORED. Total washout. Even though I know that my reviewers haven't even met yet, that's the image in my head every single time I log in.

Current length of the research plan:14 pages. Maximum allowable length: 12 pages. Only two pages to go. Sadly, I only have two pages left to edit, and since they include my entire data analysis plan I don't think I'll be able to cut them out entirely. So I will still need to cut, cut, cut. But damn, 25 pages to 14 is a pretty good start.

Once I work through these two pages, I will have a complete draft![1] Yay me! I can send it off to my mentor and to my very kind NIMH Program Official. Maybe they'll know what else I can cut.


[1] Except for the project narrative, the Facilities and Resources section, the revised biosketches, and the appendices. Mercifully the human subjects section stays the same. And the budget. The budget is done.

Updated to add: 13! 13 pages! I am the awesomest person who has ever been awesome! I got it down to 13 pages 10 lines, and then realized that I would totally gain more space once I formatted my references as numbers rather than in-text Endnote tags. And it saved a TON! Go me!

I just got off the phone with my Program Officer at NIMH. He doesn't think my grant is going to be funded this time around. He says that I got a great score for the first submission... but I should prepare to resubmit. I more or less expected that to happen, so I'm not crushed.

The part of the discussion I didn't expect had to do with when I should resubmit. There are three deadlines per year for AIDS-related applications: January 7, May 7, September 7. The review cycle is such that the earliest possible start date is about six months in the future; for my January submission, I proposed a start date of July 1.

My PO said that, given the level of the critiques I need to respond to, he would normally encourage me to reapply at the next deadline: May 7. That is totally what I had expected to do. However, as I've mentioned before, NIH has completely revamped their application structure. I'll need to substantially modify my application - including cutting the length in half. And, my PO suggested, that might take me more than a month.

We talked about the pros and cons for a while. He does say that May is "not out of reach." Advantages of trying for May: (1) I know myself to be a fast and good writer. (2) It might be politically difficult for me here at work to let a deadline go by without a submission. (3) The sooner I resubmit, the more likely it is that I'll get the same primary reviewers - who basically liked my idea, and who saw my longer more-detailed initial application and will know that any areas that I have to skim over to meet the new page limits did at one point exist in more fleshed-out form.

Advantages of waiting: (1) These days you only get two chances to submit a grant. (It used to be three.) If I don't get funded this time around, I can never resubmit this application or anything "substantively identical" to it. So it might make sense to take more time to get this submission perfect. (2) The new application format is going to shake things up, and it would probably be safer to not be one of the first people reviewed under the new system, by peer reviewers who are suddenly getting half as much detail as they expected. (3) My work pace preparing the resubmission would be substantially more humane.

I have written to my external mentor, and am drafting a letter to my collaborators on the grant to get their input.

They posted my grant score this afternoon.

I got a priority score of 27. Under the new system, a priority of 20 is "Outstanding. Extremely strong with negligible weaknesses." 30 is "Excellent. Very strong with only some minor weaknesses." I'm somewhere in the middle there. (The lower middle.) That's pretty good for a first submission.

My percentile score is 20. (NIH does this weird thing where lower percentile = better.) The percentile score is the best indicator of whether a grant is likely to be funded. And mine tells me... not much.

Some NIH institutes have a "payline," a percentile above which virtually everything is funded and below which virtually nothing is funded. NIMH doesn't. That would be too easy. Here's what they say about their payline:

In general, NIMH assumes that research applications that fall below the 20th percentile are scientifically meritorious and that sufficient funds are available to support up to 80 percent of these new and competing research applications. Council and program staff may selectively recommend payment of grants that fall in this range, as well as beyond, based on: 1) Institute and division priorities; 2) balance in the existing research portfolio; 3) early stage new investigator status (see below); and 4) availability of funds. [...]

Early Stage Investigators: NIMH is committed to supporting new investigators and facilitating the independence of emerging scientists. The Institute considers early stage new investigator status--new Investigators who are within 10 years of completing their terminal research degree or within 10 years of completing their medical residency at the time they apply for R01 grants—as a priority in funding decisions. This means that a research grant from a newand/or early stage investigator may be funded out of order and at percentile scores the same or higher than grants not selected for payment from established investigators.

So I'm juuuust on the edge of the potentially fundable range. I do have Early Stage Investigator status, which should help, but my guess is: probably not quite enough. It could be funded this time around, but I am not in the hold-your-breath range.

A score this high does bode well for my chances of a successful resubmission. But here's the sad thing: NIH radically changed their applications just after I submitted my grant. So I won't be able to just polish what was already a very good application, working in carefully-crafted responses to the reviewers' criticisms. I'll have to rewrite the whole damn thing. AND SHORTEN IT FROM 25 PAGES TO 12. *cries*

I actually feel pretty good about my score. It's a frustrating score, almost more so than something in the definitely-not-gonna-get-in range would have been. But it's a good score for a first submission. Most grants don't get funded the first time around. It would've been nice to defy the odds and get a fantabulous, immediately-fundable score. But the score I got says "really good grant, just needs a tiny bit of work." I'll take that.

The peer review committee meets to review my grant application in 22 days.

*hyperventilates*

I had the opportunity to take part in a mock review through my Cyber Mentors program. It was a harrowing yet fantastic experience. I am assured that the process was very much like a real grant review - certainly, the people conducting it regularly serve on peer review committees for NIMH - except that my mentor and I got to listen in by conference call.

So I have a much better idea of what is happening to my grant right now than I did the last time through.

Peer review happens like this: Your grant is assigned to a "study section," a group of scientists drafted by NIH to review applications of a certain broad type, topic, or speciality. I am lucky in this regard, because NIMH has a speciality subsection for grants of my exact type (R34s proposing AIDS-related interventions), which means that my grant is not going up against projects with bigger scopes and/or more completed preliminary work. Within the study section, two or three people are assigned to review your grant.

The primary reviewers decide whether your grant falls within the upper half of applications. If it doesn't, that's the end of the road. They write up some comments for you and your grant is "unscored" - it never makes it to a full study section meeting.

If the primary reviewers agree that your grant is in the top half of the pile, it gets presented at the study section meeting. All the peer reviewers meet at NIMH, and the primary reviewers take turns presenting the grants they've read. There is some general discussion and a time for questions, and then everyone assigns your grant a score.[1] The primary reviewers write up comments, plus the NIH staff member assigned to the study section summarizes the group discussion.

This is the part I didn't really grasp before I participated in the mock review. It is absolutely harrowing to listen to someone with only a vague understanding of your grant application pitch it to a group and answer questions about it, potentially mangling it in a way you have no control over. The other study section members have the opportunity to read all the grants, but realistically speaking they are only likely to read the abstract and perhaps the Specific Aims section, which outlines the purpose and goals of the study. So what the review committee thinks of your grant is pretty much entirely dependent on what is conveyed by the primary reviewer.

Many of the grantsmanship strategies I learned from my mentor during this process had to do with spelling things out for the reviewers, making it easy for them to fill out their review forms, and making sure they don't miss any of the important stuff. At first I kind of rolled my eyes about some of her suggestions, but after the mock review it became clear why she wanted me to do things like briefly recap the entire grant application in the Aims section, use bolded topic sentences in the Background & Significance section so that someone who is quickly scanning will get the gist of my argument, and include homework-helper sections like the paragraph that begins "This proposal is innovative because..."

I "know," in the professional way that you know people in your field, two of the thirteen people assigned to the study section. They're both very good. I don't know anything about the other eleven. I will never know who the primary reviewers of my grant are.

Sometime after March 23rd, I'll log on to the NIH eRA Commons and click on my grant application, and there will be a score and a percentile. A few days after that, there will also be a written review available.

*nailbiting commences*



[1] They've changed the scoring system since the last time I had a grant reviewed. Now grants are ranked on a scale from 1-9 (1=exceptional, 9=poor), and the mean score is multiplied by 10 to produce an "impact score" from 10-90. You can see the criteria I'll be reviewed on here.

This morning I was scheduled to present my research at the hourlong general staff seminar, in front of the eminent and notable (and scary) Dr. Institute Director, my division director, and about forty other people.

I had strong work to present. I put together a great presentation. I practiced it in front of wcg and curiousangel, which was especially helpful because my general staff audience was not going to be composed of psychologists.

Two hours before I was due to go on, I had (a) no childcare, and (b) the beginning stages of a raging cold.

Our nanny was sick. Our backup childcare person wasn't answering her phone. Michael had already taken unscheduled time away from work to take care of the kids just last Friday, and we were both a little unsure where his boss would want to draw the line. Oh: and I had a headache and cough and a swimming head.

I finally got through to a friend on the phone, and she was so awesome that before I could get my groveling request out of my mouth she offered to come over with her two-year-old to care for Colin. Michael came home just in case I had to leave before she got there, and then stayed to drive me to work. I actually got there with enough time to spare that I could look over my presentaton a few times before the seminar. I still felt dangerously light-headed as I loaded my presentation, and I had to have a water bottle on the podium to deal with coughing fits.

And then? Then I utterly rocked my prsentation. I hit it out of the park.

It was very well received. People made a lot of comments and asked cogent questions. There was only a little whispering among the senior staff (usually a chronic problem). People seemed to be genuinely interested, which is so not a given when a behavioral scientist gets up in front of a bunch of virologists and immunologists.

Dr. Institute Director was stuck in traffic and didn't arrive until about 45 minutes in, which was unfortunate. Or maybe fortunate. I would've liked him to hear about my research, but I confess that I did feel safer with him absent.

Afterwards, the adrenaline that got me through the presentation ebbed away and I started to feel very ill indeed. Lydia had no trouble believing that it would be better for all concerned if I just went home. Phew. I felt wrecked.

But man did I ever do a good job at general staff. I am proud. And grateful to my community, without whom it wouldn't have happened.