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Meghan B. Lane-Fall, MD, MSHP; Anthony T. Gerlach, PharmD, BCPS, FCCM, FCCP; Marilyn Hravnak, PhD, RN, ACNP-BC, FCCM, FAAN; Ashish K. Khanna MD, FCCP, FCCM
A lot of us complete critical care training with the hopes of establishing a name and a reputation in the world of research. As romantic as this thought seems, it is certainly not the easiest goal to achieve. Early career is never an easy time—there are multiple ongoing challenges, a new work environment, new colleagues, and probably a new electronic medical record (among many other changes)—not the best combination of situational events to encourage the expenditure of time or energy on scientific thinking. While some of us may be fortunate to start with some protected time for academic benefit during our first years, these rapidly disappear or diminish to the point that no real research advancement can happen. The end result is either a rapid extinguishing of the research fire or a realization that quality clinical research can happen only with time and dedicated resources (funding) to support it.
Research funding is pivotal for early career investigators for two reasons. First, funding supports the nonclinical time necessary to design, conduct, oversee, and disseminate the investigator’s work. Second, funding pays for research staff, core laboratory services, supplies, and other expenses. Fortunately, multiple funding options are available to early career investigators. Irrespective of funding source, some common strategies improve the likelihood of funding.
First, grant applications must align with the priorities of the funding agency. It is imperative to read grant announcements and requirements closely. In the proposal, be explicit about how the goals of the proposed project support those of the funding agency. Second, the project should convince the funding agency that the applicant and the research team are equipped to undertake the proposed work and that the applicant’s institution is able to support it. The application should speak to the future, helping the agency understand how the proposed work, if successful, will further the agency’s goals (usually, the advancement of health and progression of science in the area of research). Third, agencies and organizations need to have faith that any funded applicant will be able to disseminate the findings, since no research, not matter how good it is, can be useful to the scientific and clinical communities unless it is shared. Fourth, a key strategy for an early career investigator is to connect with a strong mentor. A senior mentor, especially someone whose career goals align clinically with those of the junior investigator, can provide an excellent symbiotic research relationship.1 Serving as a co-investigator on existing funded studies in the research focus area can also be helpful to gain knowledge of research team function and grantsmanship. Finally, establishing and articulating a research trajectory that is clear and focused is essential.2
Early in an investigator’s career, it is helpful to seek out any potential funding opportunities, no matter how small the award might be. Establishing the ability to develop small but compelling research applications that compete successfully for small funding gives reviewers of larger awards confidence in the applicant’s ability to apply for, implement, and administer an award and to adhere to the principles of research conduct. Demonstrating the ability to successfully obtain and administer “little money” leads the way to “big money.” It is also important to establish early a strong record of research dissemination in the form of peer-reviewed published manuscripts, abstracts, posters, and presentations.
While any single funding opportunity may be extremely competitive, it is possible to fund a research program by accumulating funding from different sources. The funding sources can be divided into four categories: 1) intramural funding, 2) foundation/association funding, 3) industry support, and 4) federal funding. Funding from the investigator’s own institution is often the first research support obtained for an early career researcher. These intramural funds may come from departments in the form of start-up funds or discretionary research pools; pilot funding from departments, schools, or universities; funds earmarked for recruitment and retention of scholars whose work is of particular interest to the institution (e.g., translational research) or scholars from historically underrepresented demographic backgrounds (e.g., women, people with disabilities, or underrepresented minority researchers).
Numerous foundations fund early career researchers, usually for one to two years. The objective of this funding is often to facilitate pilot work that may form the basis of applications for federal career development funding (e.g., K awards) or independent investigator awards (e.g., R awards). These funding agencies tend to recruit from particular constituencies with specific areas of focus (e.g., the SCCM-Weil Research Trust funds grants on basic, translational, or clinical research relating to critical care), professional background (e.g., the American Association of Critical-Care Nurses [AACN] funds nursing researchers), or identification with a particular demographic background (e.g., the Robert Wood Johnson Foundation funds underrepresented minority physician researchers). The Foundation for Anesthesia Education and Research, Anesthesia Patient Safety Foundation, and International Anesthesia Research Society all offer excellent early career training grants for clinical and bench research, to help kick-start early career investigators in anesthesia and perioperative medicine.
Industry partners are also important funders of critical care research, both for studies relating to particular innovations (e.g., drugs or devices) and unrestricted grants to support researchers (e.g., PhRMA Foundation’s research starter grants). Numerous U.S. government agencies are interested in funding research related to critical care. Some of these agencies include the National Institutes of Health (NIH), Agency for Healthcare Research and Quality, Veterans Health Administration (VHA) (open only to VHA-affiliated investigators), and Department of Defense. Funding opportunities spanning multiple federal agencies are listed at www.grants.gov.
Critical care medicine is best when practiced in multiprofessional and multidisciplinary teams, and so is clinical research. In the same spirit, physicians and nonphysicians may collaborate within their critical teams to achieve investigative support. Many pharmacists have transitioned into clinical researchers either as the primary focus, or at least a significant focus, of their careers.3 Funding for early career pharmacists is paramount to help provide a basis for future scholarly activities. Research support funding for early career pharmacists usually takes the form of grants. In addition to industry, many associations also offer grants to early career pharmacists.
The American Association of Colleges of Pharmacy offers a start-up $10,000 grant for full-time faculty at the assistant professor level at accredited American colleges or schools of pharmacy. The PhRMA Foundation offers research starter grants of $100,000 each for one year to offer financial support to those at the beginning of their independent research careers at the faculty level. The American College of Clinical Pharmacy offers members who are in a fellowship training program or within six years after completion of training a Junior Investigator Research Award of up to $30,000. The American Society of Health-System Pharmacists awards two $20,000 grants to young investigators who are less than five years from their terminal degree or postgraduate training. The Clinical Pharmacy and Pharmacology (CPP) Section of the Society of Critical Care Medicine (SCCM) also awards a Young Investigator Travel Grant to those within up to 10 years out of training. The grant pays the cost of SCCM’s annual Congress registration. In addition, the CPP Section’s Research Committee maintains a detailed list of research funding for pharmacist investigators, including early career pharmacists. A link can be found in the CPP Section of SCCM Connect.
Early career research funding opportunities are also available for nurses. For nurses enrolled in a doctorate degree program, a variety of NIH-funded Ruth L. Kirschstein National Research Service Awards are available (F31 for either Predoctoral Individual National Research Service Award or National Research Service Award Individual Predoctoral Fellowship to Promote Diversity in Health-Related Research, F31 for Dual Degree Awards). There are also F99/K00 Individual Predoctoral to Postdoctoral Fellow Transition Awards, which provide for training and transition to an R award mechanism. It is important for nurses to know that they are eligible for predoctoral, postdoctoral, and career development awards funded by institutions other than the National Institute of Nursing Research and for fellowships not associated with nursing schools, as long as their research focus fulfills the mission of the other institutions or the fellowship intent. The NIH also has a New Investigators designation, which encourages investigators who are within 10 years of receiving their doctorate degree and have not yet received substantial independent NIH funding to be eligible for higher pay lines (i.e., they may receive funding with a higher [worse] score than those not so designated and in competition for the same award). For more information, visit grants.nih.gov/policy/early-investigators/faqs.htm.
There are also opportunities via other avenues of government-funded research. The Agency for Healthcare Research and Quality (www.ahrq.gov) has a large portfolio of funding mechanisms, including Career Development Awards (K01 and K08). It is important to remember that nurses can and do function as principle investigators of intra- and transdisciplinary research teams.4 There are also many avenues for research funding outside of federal agencies. Some professional organizations offer early career development awards. For example, the American Heart Association’s (AHA) Council on Cardiovascular and Stroke Nursing offers Early Career Development awards (professional.heart. org), as do other AHA councils. Nurses with doctorate degrees are also eligible for research awards from professional organizations including SCCM, AACN, Oncology Nursing Society, American Nurses Foundation, and Sigma Theta Tau International Honor Society of Nursing, to name only a few.
Most academic institutions hiring new doctors of nursing have some mechanism for the provision of start-up monies and protected research time for an initial period. It is important when interviewing for such positions to ask questions about the availability of such initial support. It is also important to ask about university-awarded funding available on a competitive basis. Such internal funding is helpful to establish pilot work and proof of principle. There are two pathways to doctorate degrees in nursing—the Doctor of Nursing Practice (DNP) and the research-focused PhD. It is best to contact funding agencies to determine whether they have any eligibility requirements that are specific to the doctorate pathway. One particular opportunity of interest may be the NIH K08 Mentored Clinical Scientist Research Career Development Award, which provides support and protected time for an intensive, supervised research career development experience for clinically trained individuals.
Critical care research has several inherent challenges, which come to the fore when executing and successfully running clinical trials in this field. Our patients are always inherently unstable, clinical courses are unpredictable, and any intervention is associated with risks and challenges, both obvious and unforeseen. Before embarking on a clinical or bench research path, any early career investigator should identify a mentor, clearly define a vision, chart a clear trajectory, identify resources, and align research requests with easily available opportunities to start out. Planning the climb on this research ladder is as important as the final goal of achieving name and acclaim in an area of scientific interest. Fortunately, available resources are increasing significantly. The hope is that, with appropriate guidance and direction, most will achieve desired goals and research ambitions will be fulfilled.