Rheumatology Training and Career Development Roundtable Discussion Summary

Tuesday, May 15, 2012
(This summary became available on the website September 13, 2012.)

Co-Chairs:
Susana A. Serrate-Sztein, MD, NIAMS
Leslie Crofford, MD, AF
David Daikh, MD, PhD, ACR REF
Helen Emery, MD, AF

Introduction:

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the American College of Rheumatology/Research and Education Foundation (ACR REF), and the Arthritis Foundation (AF) are committed to ensuring that a diverse and highly skilled workforce is available to assume leadership roles related to biomedical and behavioral research in rheumatic diseases. In 2008, the NIAMS hosted a meeting to discuss needs and opportunities for developing future generations of physician-scientists who will play a critical role in rheumatic diseases research¹. This activity was informed by a 2007 report summarizing an NIAMS evaluation to assess the success of postdoctoral research trainees who received NIAMS support through specific extramural research training and career development award programs ². Similarly, in 2008-2009, a Blue Ribbon Panel was convened by the ACR REF to review and reorganize its funding portfolio with a focus on the career development pathway. The NIAMS, ACR REF, and AF have a shared interest in evaluating programs to date, in order to continue to assist rheumatology trainees in their career development.

Purpose of the Session:

The goal of the meeting was to evaluate whether the funding mechanisms that the NIH, ACR REF, and AF are using to support junior investigators are successful in fostering the development of productive independent rheumatology researchers.

Key Questions and Discussion:

How successful have the training and career development mechanisms been in fostering the trainees’ career development towards independence?

Participants agreed that the existing programs have shown good overall success, including the ACR REF/AF Career Development Bridge Funding Award. This program, commonly referred to as a “K Bridge Award,” provides up to one year of funding to support early stage investigators as they resubmit their applications for Research Career Awards (K awards). However, analysis indicated that some of the K awardees were leaving rheumatology research for reasons that were not entirely clear. Another area of concern was the fact that many of the programs are not available to non-citizens.

Do the available mechanisms span the progression of a scientific research career appropriately, so that there is an adequate pipeline from which to develop independent investigators?

While looking at the continuum of support for rheumatology trainees, significant challenges are encountered following a K award. During this critical stage, awardees find it difficult to dedicate themselves to research, due to a lack of protected time and limited resources to support continued progress of their research after the K award has ended. It was reported that trainees spend most of their effort in the clinic when they do not have protected time in research. In part because their status as K awardees restricts their eligibility for some additional sources of funding, trainees cannot afford to hire technicians that could help their research progress at a faster rate, and awardees end up doing the work of lab technicians. It was unclear if these challenges lead emerging investigators to leave the field, but efforts are needed to encourage them to stay in the pipeline.

Do the available awards need to be modified or re-structured (and if so, how) to better support the goals of the awards?

Since K awards have very low indirect cost rates, participants recognized that they can cost institutions money. In times of fiscal hardship, institutional support systems are often strained and this can lead to significant variability in the training environment and in supplemental resources available from the mentor and/or institution. Discussants suggested that expanded flexibility, like allowing concurrent funding, would help trainees adjust to their particular situations. Additional oversight and monitoring by NIH program staff, as well as increased support from professional societies, were proposed. Increased outreach and information dissemination are also critical so that awardees are aware of the resources that are available to them.

Do these analyses help to identify any barriers or gaps in the career development of rheumatology researchers, and if so, what are potential solutions?

Participants volunteered several ideas that might help grow the rheumatology training pipeline. However, there was no clear consensus on what priorities might be cut to accommodate expanded training efforts.

To address the challenge faced by trainees following a K award, the group weighed the pros and cons of a supplement to the K award versus a post-K bridge award. A supplement would provide additional resources to awardees during the course of their K award, while a bridge award would support investigators who did not receive funding after their first R01 submission, as they prepare to resubmit their R01 applications.

In addition, the possibility of non-governmental funding organizations requiring matching funds from academic institutions was considered. Finally, there may be opportunities to enhance mentoring efforts.

In closing, participants reaffirmed their commitment to supporting rheumatology research and the pipeline of new investigators, and agreed to meet again at future scientific meetings.

References and Background Materials:

  1. NIAMS Summary of the Roundtable Discussion on Research Career Paths in Rheumatic Diseases, March 25, 2008: http://www.niams.nih.gov/News_and_Events/Meetings_and_Events/Roundtables/2008/career_paths.asp
  2. NIAMS Training Grant and Career Development Award Program Evaluation Final Report, September 2007: http://www.niams.nih.gov/News_And_Events/Meetings_and_Events/Reports/2007/training_grant_eval_final_report.asp

Participants:

Anne Bass, MD, ACR REF
Susan A. Boackle, MD, ACR REF
Branden Brough, PhD, NIAMS
Robert H. Carter, MD, NIAMS
Flavia Castelino, MD, ACR REF
Robert Colbert, MD, PhD, NIAMS, ACR REF
Leslie Crofford, MD, AF
David Daikh, MD, PhD, ACR REF
Steven C. Echard, ACR REF
Helen Emery, MD, AF
John Hardin, MD, AF
David R. Karp, MD, PhD, ACR REF
Stephen I. Katz, MD, PhD, NIAMS
Alfred Kim, MD, ACR REF
John Klippel, MD, AF
Debra R. Lappin, Esq, AF
Anita Linde, NIAMS
Marie Mancini, PhD, NIAMS
Su-Yau Mao, PhD, NIAMS
Kathryn Marron, PhD, NIAMS
Louise Rosenbaum, PhD, NIAMS
Susana A. Serrate-Sztein, MD, NIAMS
Mary J. Wheatley, ACR REF