April 2004 Bulletin

Obtaining academic research funding

By David L. Skaggs, MD

Obtaining research funding is always an issue for orthopaedists working in academic institutions. As Claude Nichols' article in the February Bulletin noted, dollars for research funding are a major element of academic physician's compensation. This article will review the primary grant sources available: external peer review grants, industry grants, and departmental, institutional and endowment funds.

NIH grants
Grants from the National Institutes of Health (NIH) are generally the largest, most prestigious and most difficult to obtain. As external, peer-reviewed grants, funds from NIH grants are viewed quite favorably by academic institutions. Up to 40 percent of an NIH grant is earmarked as institutional overhead, which in most universities goes directly to the institution and is not shared directly with the researcher or department obtaining the grant.

Many researchers believe that NIH funding is essential for a sustainable, high-quality academic research program. R-01 grants are often considered the most desirable grants because of their flexibility and size. However, these grants are generally secured by very established and productive investigators. Other NIH grants are aimed at junior faculty, including RH03 and RH21 grants for pilot or exploratory studies, as well as K-series training grants. More information on NIH grants may be obtained at www.nih.gov/grants/

Other peer-reviewed grants
Many orthopaedic groups such as the Orthopaedic Research and Education Fund, as well as sub-specialty societies, also sponsor peer-reviewed grants. In general these grants are smaller than NIH R-01 grants; moreover, they usually require less extensive paperwork and, depending on the grant, may be easier to obtain. Disease-specific foundations, such as those for arthritis, cerebral palsy and muscular dystrophy, are also excellent sources of grants.

There has been a shift in the orthopaedic community, as well as in medicine as a whole, toward industry as a source of research funding. Industry funding is often easier to obtain than peer-reviewed grants. In addition, the application process is usually far less onerous. An industry grant may be obtained from a short letter and phone call, compared to the telephone-book-sized NIH application. These reasons make industry funding well suited for researchers early in their career, or for researchers with limited resources for grant applications.

A potential downside of industry funded research is the real or perceived ability of the industry to bias the research being done. Contracts are generally written by agents of the industry and may contain language limiting the researcher's ability to use or publish data.

Another downside of industry funding is that the researcher may be prohibited from using or disclosing (publishing) the data in any way without the written approval of the company. The first draft of a recent industry contract for which I am the primary investigator contained this language.

Obviously such “gag orders” cannot be tolerated in academics. It has been my experience that industry will compromise on this point, but only if asked.

Private philanthropy is an excellent source of research funding, though this requires that the physician/researcher step out of the ivory tower and his/her traditional role. (See the April 2003 Bulletin for an article on this subject.) Some doctors may find the role of a salesman uncomfortable, but packaging and selling your research to non-scientists can secure significant funding.
Local organizations are often happy to know exactly where their money is going, and to deal with a familiar face who may attend a dinner, report on the year's progress and explain how their money has improved the lives of sick patients. As the business community knows, establishing a personal relationship is a key factor in success.

Most hospitals and academic centers have foundations or development offices that can facilitate the introduction of and relationships with potential donors. Grateful patients and families are often an underrecognized source of research funding.

Institutional funds
Most academic institutions have several grants particularly for junior faculty. A good department chair or dean should be able to advise and assist junior faculty on obtaining this institutional funding. Institutional funding generally aims to help develop a program to the point where extramural funding can be obtained for long-term viability. Many institutions regularly notify faculty of both intramural and extramural funding sources.

Other options
It may be helpful to think about developing a research program for a junior faculty member or a new research direction, instead of simply looking for research money.

These programs can be funded with department or institutional money, or possibly via industry support through introductions by established faculty. After preliminary studies are performed and a research plan is solidified, peer-reviewed funding sources may be sought from organizations and the NIH.

Due to the competitive nature of grants, there may be periods of drastically reduced funding that can threaten the existence of a research program. Ideally, departments or institutions may have “bridge” money from endowments or reserves to help weather such periods.

The AAOS Washington Office has a Research and Academic Affairs e-mail Update to inform AAOS members about news on research funding opportunities at the NIH and other federal agencies, as well as the AAOS. A list of requests for applications for orthopedic related projects is included.

David L. Skaggs, MD, is Associate Director of Orthopaedic Surgery at the Childrens Hospital Los Angeles, Associate Professor of Orthopaedic Surgery at the University of Southern California and a member of the Academic Business and Practice Management Committee.

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