No Progress Without Research
Dr. Nigrovic
“Rheumatologic advances evolve through research … and that research cannot be performed without adequate funding,” says Dr. Nigrovic, associate professor of medicine at Harvard Medical School. “But the process of obtaining grants is not necessarily familiar to many rheumatologists. Writing a good grant [application] is difficult. Often, the most substantial obstacle is roping someone into reviewing it in a thoughtful manner.”
While working in his lab, Dr. Nigrovic noted that his basic science colleagues tended to work on grants in isolation, even as trainees, and that even talented investigators with good ideas often had difficulty securing funding. “As basic scientists we are all in our little niches, and we don’t necessarily have overlapping subject interests. This creates an environment [in which] we don’t readily obtain external input. I puzzled over the question of how to get people to go over one another’s grants. This is typically a big ‘ask,’ because the process isn’t especially gratifying—especially if the grant proposal is in poor shape.”
Working from his own experience in grant writing, it occurred to Dr. Nigrovic that there could be a simple solution. The science section of every grant begins with a single page that serves as an outline of the proposal. Called the specific aims page, it introduces reviewers to the topic of the grant and how the investigator will proceed if funded.
In most cases, Dr. Nigrovic thought, fundamental problems with a grant proposal are evident in the aims page. By contrast, if the aims page is clear and compelling, then the rest of the grant proposal is likely to be so as well. Could group discussion of the aims page substitute for a review of the whole grant, providing the feedback that young investigators need to craft a good grant? The Aims Review Committee (ARC) was born.1
“This is a sensible, high-quality shortcut that is collaborative in nature,” says Dr. Nigrovic.
Beginning in 2011, Dr. Nigrovic and his colleagues began to meet approximately once every six weeks for an hour to go over two, or sometimes three, specific aims pages submitted by investigators the day before. They bring lunch along and discuss the written presentation, including the science, as well as how the ideas and plans are presented, typically in the presence of the researcher who wrote the proposal.
Says Dr. Nigrovic, “This process involves just 10 minutes of reading time per aims page before the meeting, and then a one-hour meeting. Compare that to someone dropping a 20-page proposal on your desk and asking for detailed comments.”
In the Review Room
“The ARC members are reading these pages cold, which is exactly what the real reviewers will be doing. In the few minutes it takes a reviewer to read an aims page, he or she will have a solid idea of whether it will be a decent grant proposal.”
You don’t need seasoned experts on the ARC, states Dr. Nigrovic. “It was surprising to find that you don’t need someone who knows about the topic at hand. You actually need smart people who don’t know about the topic. It turns out that a good grant is easy to recognize, even if the reader is working in a different field. After all, reviewers are also unlikely to have specific expertise. In particular, clinical and basic researchers can provide helpful feedback on each others’ grants.”
Dr. Nigrovic and his colleagues found the collective aspect of ARC was important. “We often find that it’s not the individual reviewer who squelches the project. It is a consensus that builds around a certain point. One reviewer will say, ‘I am a bit concerned about XYZ,’ and someone else chimes in, ‘Oh, me too.’ You then have the snowball effect. This effect mimics that seen in real grant review committees and is helpful for young investigators who have never participated in such a committee to see first hand.”
Asked what most young rheumatology researchers don’t understand about compiling a winning aims page, Dr. Nigrovic notes, “The most important lesson is that this part of the proposal has to sell the entire project—not just the science. Why is this the right investigator? What makes the timing appropriate? It’s not just a summary of the science. Young investigators learn a lesson when one of our reviewers asks, ‘What about such and such?’ and the researcher says, ‘Oh, that is addressed in the grant.’ That won’t work.”
Results?
The ARC has received support from the NIH as part of Dr. Nigrovic’s P30-funded Joint Biology Consortium. “We did this without external funding until 2016, when the National Institute of Arthritis and Musculoskeletal and Skin Diseases stepped in and began to support us.”
Five years after the ARC was established, is it really making a difference? “Absolutely,” says Dr. Nigrovic. “To date, we have reviewed over 60 aims pages. Of those, more than half of the proposals submitted to granting agencies have been funded. Along the way, investigators are learning from each other how to write grants better. Thus, the ARC is serving an important educational function, especially for scientists at the beginning of their careers.
“I would love to see the ARC become a model for the future of preparing investigators for grant funding. My advice to anyone interested in replicating it is this: Just try it. It is incredibly easy to implement, and it is a high-impact intervention. Keep things simple, be neutral, and always be supportive.”
Dr. Rao
One ARC success story is Deepak A. Rao, MD, PhD, co-director of the Human Immunology Center at Brigham and Women’s Hospital. Dr. Rao has sent three aims pages for review—two for fellowship awards and one for an NIH career development award. The first two were funded, and the third is pending review.
“I was a rheumatology fellow when I first sent an aims page for review,” says Dr. Rao. “It was invaluable to someone like me, who was new to the grant application process. It was an opportunity to get focused, valuable feedback on all aspects of the proposal via this distilled portion—the aims page. There was nothing left out. Reviewers commented on the scientific questions being asked, details about the experimental approach. Even the wordsmithing and page layout are addressed. Reviewers tell you what they find appealing and not appealing, and offer tips to incorporate and pitfalls to avoid. And the reviewers benefit as well, because this process can help raise the level of their own grant writing.”
So what kind of shape would Dr. Rao’s proposals be in without the ARC? “The phrasing of my aims section would not have been as clear and easy to understand. My summary paragraph at the end of the aims would have been missing or would not have conveyed the importance of the entire grant. The quality of the aims page improves because people who are not invested in the project are looking deeply into the text. They are reading from a different perspective, and this helps investigators specify why their work is important to a broader audience.”
Asked how he might improve things if he were charged with such a task, Dr. Rao says, “It’s honestly hard to say, because the process is very smooth. The one thing I might add is that we would love to have more of the most senior members of the division participate—those individuals who have written the most grants and had the most funded. The group really benefits from a diverse set of voices with different experiences and approaches.”
Dr. Rao is adamant about the importance of what Dr. Nigrovic has created. “Without the ARC there would be little review of grants other than from those you can badger into looking at them. The Aims Review Committee is a rare and valuable opportunity to learn from those who have walked the same path.”
Elizabeth Hofheinz, MPH, MEd, is a freelance medical editor and writer based in the Greater New Orleans area.
Reference
- Nigrovic PA. Building an ARC to grant success: The Aims Review Committee. Arthritis Care Res (Hoboken). 2017 Apr;69(4):459–461.
