Participation in the NIH Loan Repayment Programs has had a major impact on the careers of thousands of research scientists. Initial evaluation findings show that participants in the NIH extramural LRPs stay in research careers longer, apply for and receive more research grants, and become independent investigators more frequently than their colleagues who do not receive LRP funding.
The following success stories highlight current and former LRP participants who are making significant contributions to their respective fields.
Rachel C. Vreeman, M.D., M.S.: Storyteller, Myth-buster and Advocate for the World’s Children
Dr. Rachel C. Vreeman is an assistant professor in the Department of Pediatrics at the Indiana University School of Medicine. Dr. Vreeman’s research focuses on pediatric adherence to antiretroviral therapy in resource-limited settings, and she spends almost half of the year in Kenya as part of the Academic Model Providing Access to Healthcare (AMPATH), an Indiana University-Moi University School of Medicine partnership. In addition, Dr. Vreeman, who has a K23 from the National Institutes of Mental Health, is an expert myth-buster who has co-authored two books – Don’t Swallow Your Gum: Myths, Half-Truths and Outright Lies About Your Body and Health and Don’t Cross Your Eyes…They’ll Get Stuck That Way! And 75 Other Health Myths Debunked. You may follow her adventures at Doctor V Goes Over the Sea.
I’ve always wanted to do research to improve healthcare for children in the world’s poorest places, and having an LRP award helped me eliminate my tremendous loan burdens and allowed me to stay on this career path. Through the partnership that Indiana University School of Medicine has in Kenya, I am able to work in a large HIV care system with 25 clinics across western Kenya. We have cared for nearly 25,000 children since the partnership began — and 130,000 patients altogether. My work focuses on the challenges to maintaining children’s HIV care over the long-term, particularly how we can improve adherence to medication and guide families through HIV disclosure. When in Kenya, I do clinical work about two days per week and spend the rest of my time implementing clinical research projects. About seven percent of the Kenyan population has HIV, but most are not open about having HIV. Even for adults, there’s a fear of stigma, discrimination and isolation, so my pediatric patients are often unaware of their HIV status. Caretakers may tell them that they are being treated for chest problems, for another disease such as tuberculosis, or sometimes, they simply say, “If you don’t take your meds, you will get sick and die.” As a result, only 11 percent of six to 14-year-olds in Kenya with HIV know their status. We especially worry about disclosure once children are 13 or 14. At 14, our pediatric patients have to move into the adult HIV care programs and take responsibility for their own treatment. This is a big challenge when no one has ever prepared you for the fact that you have HIV. This is also an age when many adolescents are questioning why they have to take medicines at all and may have more trouble sticking to a treatment routine. Like most teens, they just want to be normal.
My research helps me figure out how we can best address these issues for the world’s 2.3 million HIV-infected patients, most of whom live in places like Kenya. My blog includes snippets of the issues we combat. Nearly every day, I see children who are wrestling with HIV and other diseases of poverty and their caretakers who carry the weight of a tremendous secret on top of all their other struggles. I love how research helps us figure out the answers to questions. Research helps us figure out everything from what we can do to help these families in Kenya to how the body really works. My myth-busting started out as a lighthearted way to address all of those things you just “know” about your body and health. As someone who teaches in the medical school, I help students learn to carry out evidence-based medicine. Our myth-busting books are a fun way to teach people how we look at scientific evidence and determine what is true. Here a few of my favorite myths that have been studied and proven false:
Common Medical Myths
- Sugar makes kids hyper.
- Children who are in daycare tend to be sicker than others.
- You need to drink 8 glasses of water per day.
- Reading in dim light ruins your eyesight.
- You need to stretch before running.
Brendesha M. Tynes, Ph.D.: Tracing Adolescents’ Online Experiences
Dr. Brendesha M. Tynes is an associate professor of educational psychology at the University of Southern California’s Rossier School of Education. Her research focuses on adolescent experiences in online settings. In addition to receiving an LRP, Dr. Tynes has also received an R01 to study racial discrimination from the Eunice Kennedy Shriver National Institute of Child Health & Human Development.
After college, I got a job as a history teacher and taught for one semester before I realized I needed more training in classroom management and youth psychosocial development. In graduate school, I became more interested in the internet and decided to focus on education and children’s interaction with technology. My primary goal is to paint a holistic picture of adolescent experiences in online settings – both positive and negative aspects. The LRP along with a grant from the Ford Foundation has been key to my success, and while receiving LRP support, I developed the Online Victimization Scale for adolescents. This scale, which has become the basis of all of my work, is a 21-item measure that contains four domains – general, sexual, individual racial discrimination and vicarious online racial discrimination. With this measure, researchers may categorize online experiences and assess why the experience occurred. Also, the scale is significant because it is the first to focus on racial discrimination. I have just recently joined the USC faculty and am now in the third year of my R01. I am particularly interested in how individual resources and coping mechanisms may protect youth from online victimization. This exciting field is advancing quickly, and as my career progresses, I want to use my work to empower youth and help them avoid discrimination and cope with the messages they receive.
Advice for Researchers Who Transfer NIH Grants to New Institutions
For additional advice on successfully changing institutions, listen to the All About Grants podcast “Taking Your Grant With You When You Move.”
- Start paperwork as early as possible.
- Talk with new institution about the items that will need to transfer.
- Ask whether you can receive advance funding for all aspects of the grant.
- Be clear about the details and ensure you can hit the ground running.
- Really get to know your NIH program officer and grants management specialist and keep them posted every step of the way.
Naomi Hamburg, M.D.: Moving from career development to independent research funding
Dr. Naomi Hamburg is Assistant Professor of Medicine at the Boston University School of Medicine and an attending cardiovascular physician at Boston Medical Center. In addition to receiving the NIH LRP, Dr. Hamburg was supported through the NHLBI Research Career Development Program in Vascular Medicine K12 program at BU. She received an R01 from the National Heart, Lung and Blood Institute that funds her research on translational studies of vascular function in diabetes and peripheral artery disease.
I am fascinated by the promise of bringing novel scientific discoveries into clinical practice in cardiology. Recent estimates suggest that more than 170 million people worldwide have diabetes. There is a critical need to create innovative strategies to prevent heart attacks, strokes, and amputations in this high risk group. In my laboratory, we concentrate on advancing our knowledge of how blood vessel function becomes abnormal in patients with diabetes. The NIH commitment to career development through funding and trainee support has been critical to my successful transition to an independent research career in clinical investigation.
My advice for early career investigators applying for research project grants:
- Get to know your NIH program officers. I met program officers and NIH scientists at K12 trainee meetings and their advice has been extremely valuable. The NHLBI program officers are knowledgeable about my area of science, are always available, and have guided my grant applications.
- Establish a mentoring group. Pick a few key trusted colleagues to review your specific aims and refine your research approach.
- Demonstrate innovation and feasibility. Use your time during the career development award period to show productivity and generate preliminary data to support your experimental objectives.
- Understand NIH support of Early Stage Investigators. The NIH is committed to increase funding success for individuals transitioning to independence. Talk to your program officer about how policies for ESIs can benefit you.
- Communicate clearly. Make sure your fabulous ideas are understandable to diverse audiences. Give yourself enough time to revise your proposal for clarity.
Carrie Breton, Ph.D.: Five Tips for Applying for Career Development Awards
Dr. Carrie Breton, an assistant professor in the Department of Preventive Medicine at the University of Southern California’s Keck School of Medicine, is an environmental epidemiologist who investigates how environmental factors affect children’s health. Her recent accomplishments include receiving a career development award from the National Institute of Environmental Health Sciences, publishing a paper in Epigenetics and presenting at the annual meeting of the American Thoracic Society. Dr. Breton received an LRP in 2008.
Applying for the LRP was my first initial jump into the federal funding game. It was like writing a mini grant proposal, and at first, I must admit the process was kind of daunting. My success in receiving the funding let me know that I was on the right career track, and since then, I have received a grant from the American Heart Association and the K01. My current research focuses on the effects of air pollution and tobacco smoke on children’s cardiopulmonary health. While most genetic marks are inherited, others may be affected by environmental factors while children are still in the womb. I am specifically interested in knowing what happens within this window of opportunity. For the research associated with my K01 award, I will use data from the Children’s Health Study to analyze the prenatal effects of air pollution.
What advice can you offer for other people applying for K awards?
- Give yourself at least three months to prepare and know all of the associated deadlines. This includes deadlines set by your institution.
- Understand the award you are applying for and ensure it fits your career stage. I thought about applying for a K99/R00, but since I was close to getting a faculty position, I opted for the K01.
- Enlist the help of colleagues. USC senior faculty members are great mentors. I’m a part of a junior investigator seminar that meets weekly to discuss grant ideas, do mock reviews and practice presentations. The group also helps critique and edit documents.
- Do your research and talk to the program officer. I spent time looking on the Web sites of the NIH Institutes and Centers and talked to program officers to ensure I knew where my research fit.
- Be persistent. I did not receive a K award with my first application, but followed up on my score and summary statement to improve my second application.
Tracy Riggins, Ph.D.: R03 Recipient Highlights Keys to Research Success
Dr. Tracy Riggins is an LRP recipient whose research focuses on memory development in early childhood. She leads the Neurocognitive Development Laboratory at the University of Maryland, College Park, and since joining the Maryland faculty, Dr. Riggins has received R03s from both the National Institute of Child Health and Human Development and the National Institute on Drug Abuse.
Receiving support from the Loan Repayment Programs gave me the option of completing two postdocs – one that introduced me to advanced brain imagery techniques and another that helped me master these techniques. This training proved essential for me and refined the imaging skills that led directly to my NIDA grant. The number of children’s memories double between ages three and six, and I am interested in looking at the brain to discover what’s behind this increased capacity. After all, these are the cognitive and behavioral memories that make our autobiographical memories rich and meaningful. My lab is growing rather rapidly. When we started in 2008, I had one study, but I now have 10 as well as three graduate, 15 undergraduate and 1 high student working alongside me. Also, the university has invested in imaging technology, and I will now be able to do more advanced work onsite and hopefully, develop paradigms for working with young children.
What are your keys to success?
In research, it’s sometime hard to balance teaching, mentoring and research loads. It’s even more difficult when you’re like me and have a new baby at home. One key to success is finding good mentors in your field and department. You need people who will give you candid feedback and help you navigate issues. Also, the overall environment has to be supportive. My department supports junior faculty, and I’m lucky to have excellent female role models.
How do you prep for a grant application?
When I apply for grants, I like to start early and enlist assistance. For both R awards I sought feedback from at least two senior investigators. When developing my timeline, I ensured that I accommodated their schedules, as well as my own and my university’s. Also, I reached out the Institutes that were likely to fund my projects. I spoke with the NIDA program officer because the grant that I applied for and later received differed from similar mechanisms. The program officer was able to confirm that my research met qualifications.
Nirav R. Shah, M.D., M.P.H.: Former NIH Loan Repayment Program Participant Tackles Major Public Health Care Issues in New York
New York State Health Commissioner Dr. Nirav R. Shah is helping to transform the nation’s largest Medicaid system with a coordinated effort to redesign its components and reduce the state’s Medicaid spending by $2.3 billion. Prior to this appointment, Dr. Shah was an attending physician at Bellevue Hospital Center in Manhattan, associate investigator at the Geisinger Center for Health Research in central Pennsylvania and an assistant professor of medicine at the New York University School of Medicine. Dr. Shah received a clinical LRP in 2006 and successfully renewed in 2008 and 2010. He is regarded as an expert in the use of systems-based methods to improve patient outcomes and is a leading researcher in the use of large scale clinical laboratories and electronic health records.
Research is definitely the best training ground for anyone who may have an interest in public policy. It opens a lot of doors, and it’s easier to transition to a policy role because you know the language and are aware of the issues. Having the NIH LRP definitely allowed me to do work that interested me. Also, because I didn’t have to worry about a large debt load, I could comfortably purchase a home and start a family. With my new position, I now have the opportunity to change the lives of millions of people.
I started January 3, but had only begun to consider the position in December. I had to leave grants, papers, consulting jobs as well as a variety of speaking engagements. I also had to invest in a completely new wardrobe – suits instead of khakis. Thankfully, I have a phenomenal and extensive staff that is helping me through this transition, and we’ve hit the ground running. I am focused on reducing costs, maintaining access and improving the quality of the health care New Yorkers receive. To this end, we have already assembled a redesign task force and have 4,000 reform suggestions worth well over $4 billion.
With both rural and urban areas, New York is a virtual microcosm of the U.S., and health care delivery is quite different in the Bronx than in Buffalo. There are no one-size-fits all solutions. The health care industry has been reluctant to embrace the paradigm shifts of information technology. In 20 years, everyone will have electronic health records, and this will impact how and where health care is delivered. We will no longer see the doctor just three times per year for 20 minutes each. Instead, the paradigm of healthcare will expand so that the care continuum will extend to almost anytime and anywhere.
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Date Last Updated: June 13, 2012