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NIH’s career development K awards intend to help early career scientists become independent. These awards afford the recipient protected time for research, publishing, and generating new ideas. As part of ongoing efforts to take a data driven approach to managing NIH programs, my colleagues within the NIH Division of Biomedical Research Workforce (DBRW) in the Office of Extramural Research sought to determine whether K awards might be achieving this goal, and published their findings in Academic Medicine last December .
Dr. Silda Nikaj and Dr. P. Kay Lund focused their attention on a particular subset of K awards called individual mentored career development awards . Their study used a “regression discontinuity design” to assess the possible causal effects of mentored career development K awards.
Drs. Nikaj and Lund assessed how likely early-career scientists who received a K01 , K08 , or K23 award (referred to as “K award participants”) were to subsequently receive an R01-equivalent or other RPG award. Their funding success was compared to those who did not receive an independent mentored career development award, but who had scores close to the ‘funding cutoff’ (referred to as “unfunded K applicants”). To further assess the K award’s effect, individuals in these two groups were matched on variables including sex, race, ethnicity, type of grant activity code, degree type, and the NIH Institute or Center that funded the award.
Figure 1 shows the likelihood of receiving a K award as a function of a “normalized priority score,” that is a peer review score recalibrated for the payline of the Institute or Center (the vertical line at zero on the graph).  Since NIH Institutes or Centers primarily base award decisions on peer review scores, we see a clear “step function” whereby those applicants with scores just above i.e. higher than the payline are exceedingly unlikely to be funded, whereas those below the payline are highly likely to be funded.  No surprises here. Figure 1: Probability of K award being funded as a function of normalized peer review priority score
For simplicity in this post, we refer to these K award participants and unfunded applicants as those who later receive an R01-equivalent or RPG award, but please note that NIH officially recognizes the institution as the recipient of a research grant .
Table 1 shows characteristics of K Award Participants and Unfunded K Applicants.  Data demonstrate that the matching procedures were effective, with equivalent proportions of participants and unfunded applicants by demographics, baseline degree and prior NRSA support.  A majority of the Award Participants and Unfunded Applicants were physician-scientists.
Table 1 Variable “K Award Participants” (below cutoff) (N=3309) “Unfunded K Applicants” (above cutoff) (N=2069) Women 38% 38% Racial minority 1.4% 1.4% Hispanic 1.3% 1.3% Post-doc NRSA 21% 21% Pre-doc NRSA 6.7% 6.7% MD 56% 56% MD-PhD 11% 11% PhD 33% 33%
Table 2 shows the likelihood of receiving first and second R01 Equivalent Grants (R01s) or first and second Research Project Grants (RPGs).  K Award Participants were much more likely to receive first R01 and first RPG awards.
Table 2 Variable “K Award Participants” (below cutoff) (N=3309) “Unfunded K Applicants” (above cutoff) (N=2069) First R01 (%) 37% 23% First RPG (%) 47% 32% Second R01 (%) 17% 10% Second RPG (%) 27% 16%
Figure 2 shows the probability of receiving a first RPG according to the normalized priority score on the index K application. Each dot refers to an individual included in the study.  Note that there is a “step function” – the probability of receiving a first RPG jumps when going from just above to just below the payline.  This kind of “discontinuity” is consistent with a causal association between receipt of a K award and an increased probability of receiving a first RPG. Figure 2: Probability of award and normalized priority score
After accounting for confounders in multivariable regression discontinuity models, K awards predicted a 24% increased likelihood of subsequent first R01 or RPG.  K awards were not independently predictive of second awards.  The effects were strongest for K23 awards  both during and after the NIH doubling. For K01 awards the positive effects were strongest post-doubling and for K08 awards the effects were strongest pre-doubling, However, it is important to note that the post-doubling effects may seem diminished for K08 awards because of less available time for follow-up.
For those researchers who did receive a first R01 or RPG, the time from K application to R01/RPG receipt was about 1 year longer among K award recipients.  This may not be all that surprising – it takes time to complete the K award work.  However, the time delay largely disappeared for those who went on to receipt of a second R01/RPG.
Previous work has shown some beneficial effects for K award recipients (see here , here , here , and here ) though with important differences among women and men and for K99 awards compared to others. The current analysis is based on a sophisticated regression discontinuity design and compares outcomes across time and different K award types: K01 (primarily awarded to Ph.D. researchers), as well as K08 and K23 (primarily awarded to physician scientists).
In summary, these data suggest that researchers who receive an individual mentored career development award, when compared to those who did not, are more successful in receiving a first major NIH award.
There are, however, other metrics for success beyond receipt of subsequent NIH funding. As discussed in the paper, future studies could look at achieving first faculty positions, publication output, ability to receive funding from other federal agencies or non-federal sponsors, and achieving tenure. Careful consideration of findings, such as those from this paper, can help us better achieve the NIH goal of enhancing and sustaining the careers of early-career biomedical researchers.
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