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Write a Winning Grant

Tony Peregrin

June 7, 2023

Write a Winning Grant

Let鈥檚 face it鈥攕urgical innovation is expensive.

At least nine Nobel Prizes have been awarded to surgeon-scientists鈥攊ncluding Sir Frederick Banting鈥檚 for the discovery of insulin in 1921.1 Of course, today, these types of revolutionary medical advances rely on significant financial support, often in the form of grants provided by the US government, specialty societies, or private foundations.

The early career surgeon may find grant writing to be an intimidating process, especially as these skills are rarely included within the formal curriculum during training. Fortunately, adhering to good grantsmanship protocols and seeking the advice of experienced mentors can help surgeon-scientists at all stages of their careers pursue funding opportunities, and myriad sources of financial support are available for investigators willing to put in the work.

An article published in the Journal of the 麻豆传媒 in 2021 revealed an overall increase in National Institutes of Health (NIH) funding for surgeon-scientists from 2010 to 2020.1

Specifically, in June 2020, surgeons held $872.5 million in NIH funding compared to $614.7 million in June 2010. General surgery-based subspecialties topped the funding list, comprising one-quarter of the funded specialties and nearly 40% of the total funding.1,2

Although the NIH is the largest public funder of biomedical research in the world, investing more than $32 billion per year to 鈥渆nhance life and reduce illness and disability,鈥 some experts suggest starting with society-based awards to establish a history of recognized research projects.3,4

鈥淚 started with non-NIH grants, with smaller society grants, that were a little bit less arduous in terms of the time and energy that it takes to put these together,鈥 said Timothy L. Frankel, MD, FACS, the Maude T. Lane Professor of Surgical Oncology and director of the Center for Basic and Translational Science at the University of Michigan in Ann Arbor. 鈥淭hen I started to build the initial blocks of how to write a successful grant. With the help of both my primary mentor and co-mentors, I started to establish what I wanted my research career to look like and what I wanted to study, and then I put together my first major grant, which was an NIH K08 career development award.鈥

Figure 1. Three Phases of Grant Writing
Figure 1. Three Phases of Grant Writing

Where Do I Start? The Art of Grantsmanship

There are several approaches to good grantsmanship, but generally this term refers to the skills necessary to procure peer-reviewed research funding. One US university research development office defines grantsmanship as the ability to 鈥渕atch your agenda to the mission, culture, and procedures of funders, and doing so in a way that maximizes quality, is innovative, and is a positive representation of the requesting organization.鈥5

According to Luz Maria Rodriguez, MD, FACS, a dual fellowship-trained surgical oncologist and colorectal surgeon with the NIH鈥檚 National Cancer Institute, good grantsmanship begins with developing a question that is extraordinary.

鈥淭hink about the clinical significance of your proposal: How is it going to benefit the patient, the community, and the world? You need to be able to demonstrate how your idea will move the scientific听needle forward,鈥 said Dr. Rodriguez. In other words, the grant proposal should address a question that is unknown in the field and that warrants further study.

鈥淐onsider whether or not your idea will result in lasting and permanent change,鈥 added Tammy Leonard, president of a grant writing consulting firm based in Orland Park, Illinois. 鈥淲hatever you are proposing, it has to be unique and not duplicative of previous work.鈥

If you鈥檙e looking for a source to fuel scientific discovery, attend a conference鈥nd listen.

鈥淲hat I often tell junior faculty members is, if you鈥檙e at a lab meeting or conference and you hear, particularly a senior person, say 鈥楾hat鈥檚 a great question鈥攚e just don鈥檛 know why,鈥 that typically means the collective community does not know why either鈥攁nd that鈥檚 something that funding bodies are going to be interested in investing in,鈥 said Dr. Frankel.

Beyond developing an innovative idea, good grantsmanship involves the skills necessary to communicate your proposal in a clear and intentional manner, the ability to engage in strong time management, and a collaborative approach involving mentor feedback and guidance.

In an article presented at the Academic Surgical Congress in 2020, titled 鈥淭op Ten Strategies to Enhance Grant-Writing Success,鈥 the authors asserted that 鈥渁 grant that reads poorly is likely to be set aside long before the final page,鈥 and they suggest writing in a style that is accessible to a general scientific audience.6

鈥淩eviewer panels include individuals with different levels and types of expertise within your field,鈥 explained Dr. Rodriguez. 鈥淵ou want to make sure that everyone in the room, especially the primary and secondary reviewers, understand precisely what you are talking about.鈥

鈥淲hen you鈥檙e writing for a government scientific foundation, there are no fluff, there鈥檚 no adjectives, there鈥檚 no emotion鈥攖hey don鈥檛 want any of that,鈥 added Leonard. 鈥淵our writing should feature the fundamentals of good grammar and be clear and engaging, but also remember that the reviewers will be educated in your field, so they will generally know what you are talking about.鈥

Experienced grant writers also invest the time and resources to ensure there are no overt typos, unusual font changes, or figures and tables that are cumbersome and difficult to comprehend. 鈥淎ll of these can be problematic for institutions that are thinking about giving you millions of dollars to study something,鈥 explained Dr. Frankel.

Ultimately, when it comes to successful grant writing, good science is not enough. A focused, well-written proposal that underscores the novelty of your ideas in an edited and organized manner is essential to winning financial support.

鈥淗elp the reviewers, help you,鈥 advised Dr. Rodriguez.

Another facet of good grantsmanship鈥攁void so-called domino aims, which are goals that are dependent on each other in order to achieve success.6

鈥淲hen I write my grants, I make sure that if any individual aim were to fail, it would have minimal effect on the next aim,鈥 said Dr. Frankel. 鈥淎 classic mistake is to propose finding an agent in aim one, and then testing that agent in aim two, because if aim one fails, you have nothing to test in aim two.鈥

Reviewers are more likely to penalize an application if the aims are interdependent. Certainly, the aims should have a common thread, such as studying a disease or process, but they also should be self-contained so that the success of one does not rely on the other.

鈥淭hese are potential pitfalls of a junior person writing a grant,鈥 said Dr. Frankel, referring to all of the best practices that embody good grantsmanship. Overall, perhaps the most important piece of advice for novice grant writers is to avoid being overly ambitious; in other words, don鈥檛 overshoot.

鈥淚f you propose things that are outside of your skillset and training, then this will be one of the first things that reviewers are going to comment on,鈥 explained Dr. Frankel. 鈥淭his is a non-starter that will kill the grant no matter how interesting the question or proposal. Also, 鈥漣f a grant reviewer comments that you are overly ambitious, this is not a positive comment in this context,鈥 added Dr. Rodriguez.

Grant-writing experts suggest submitting a more focused proposal rather than an overly elaborate one that could be difficult to complete within the timeframe of the award. The authors of the 鈥淭op Ten Strategies to Enhance Grant-Writing Success,鈥 article recommend avoiding 鈥渟creens, descriptive studies, or 鈥榝ishing expedition鈥 projects that are open-ended and not hypothesis driven.鈥6 These projects typically involve substantial amounts of work that may not result in significant findings.

jun23bullgrant-writingtimothyfrankel.jpg

Dr. Timothy Frankel

Planning Ahead: Time Management

The process involved in assembling a grant proposal varies widely and is predicated on the type of grant that is being pursued and the mission of its funding agency.

The NIH, the world鈥檚 largest source of funding for medical research, has one of the most comprehensive application pathways and, therefore, provides a template for successful grant applications, generally speaking, no matter the source.

Right from the start鈥攊n the opening paragraph of NIH鈥檚 鈥淧lan Your Application鈥 website鈥攖he agency suggests that a research grant can be 鈥渟ubverted by poor planning, preparation, disorganization, and lackluster presentation.鈥7

鈥淵ou have to have an early start. You may need as few as 2鈥3 weeks for a small project and as long as a year or more for larger projects,鈥 said Dr. Rodriguez, who suggests approaching proposals in three stages:

  • Planning Phase (8 months to 1 year before submission phase): Conduct an assessment of yourself, the field, and resources; brainstorm, research your idea, and contact NIH or granting agency program staff; set up your own review committee, collaborators, partners, and mentors.
  • Writing Phase (6 to 2 months before submission phase): Plan/outline the application鈥檚 structure; write your application; get feedback and proofread.
  • Submission Phase (1 month prior to submission date): Ensure all registrations are in place; meet institutional deadlines, also known as receipt date, due date, or application deadline.

A key component of the Planning Phase should involve researching the agency鈥檚 approach to funding, eligibility restrictions, and the types of grants offered by the program. For example, the NIH has 27 institutes and centers, and each has its own mission, priorities, budget, and funding strategy.

The NIH uses 鈥渁ctivity codes鈥 to differentiate the various research-related work supported by the organization: R series (research grants); K series (career development awards); T and F series (research training and fellowships); and P series (program project /center grants).8听

jun23bullgrant-writingluzrodriguez.jpg

Dr. Luz Maria Rodriguez

Submitting a Successful Grant Is a Team Effort

鈥淔ind experienced staff at your institution who can assist you,鈥 advised Dr. Rodriguez in a blog post for the Association of Women Surgeons.9 鈥淭his person may be in a central grants support office, or it may be another investigator or department administrator.鈥

The grants office, sometimes called the Office of Sponsored Research depending on the organization, can provide guidance on registering with the Electronic Research Administration (eRA Commons); inform you of any institutional deadlines or criteria that must be met prior to submission; and offer advice on developing the application, especially regarding its budget.7

Seeking out mentors, specifically colleagues who are funded investigators, also is a key component of the team approach to successful grant writing.

鈥淢entorship is 100% recommended. After you鈥檝e spent weeks or months working on your proposal, you鈥檙e probably not going to see errors, but a colleague reading it in a peer-to-peer review will help flag what you may have missed,鈥 said Leonard.

鈥淚 met with my mentor every week in my first 6 months on faculty, just to pitch new ideas of what I wanted to study,鈥 added Dr. Frankel. 鈥淭he harsh reality was that I didn鈥檛 know nearly as much as he did. He would tell me 鈥榯hat鈥檚 been studied already鈥 or 鈥榯hat鈥檚 a dead end.鈥 That feedback was critical to making sure that I didn鈥檛 spin my wheels and waste valuable time.鈥

An example of an error that a mentor might detect could be something simple, such as a failure to follow directions. 鈥淥ne of the biggest mistakes people make in a grant occurs when there are several questions embedded within one main question,鈥 explained Leonard. 鈥淧eople sometimes answer the first question, when there are actually several more that need to be addressed.鈥

jun23bullgrant-writingtammyleonard.jpg

Tammy Leonard

You Received a Low Score: Now What?

The NIH uses a scoring system based on a 9-point rating scale, with a score of 1 representing the highest score possible, 9 the lowest, and a score of 5 representing a good medium-impact score. The NIH defines 鈥渋mpact鈥 as 鈥渢he likelihood that your project will exert a powerful influence on its field.鈥10

As noted earlier, Dr. Frankel鈥檚 first major grant application was for an NIH K08 career development award. 鈥淚 received a good score, but I didn鈥檛 get funded, which I think was an important step in terms of learning how to address criticisms from reviewers and then resubmitting the grant. I was lucky enough to get the grant on the next round,鈥 he said. The award funded a 5-year study totaling $875,000 that examined why patients with chronic inflammatory conditions are prone to developing pancreatic cancer.

In fact, rejection on a first submission is so common, grant-writing experts suggest planning for it by building into the overall timeline the days necessary to revise and resubmit a proposal.11

Before embarking on the resubmission process, review the original funding opportunity announcement to learn about any potential new deadlines and eligibility requirements.

When resubmitting a proposal or application, consider the reviewers鈥 suggestions for change (e.g., the need for more preliminary data). Collaborate with your mentor to determine what is fixable and what may be irreparably flawed, such as a question that wasn鈥檛 deemed significant or innovative.

鈥淏eing awarded grants takes grit and persistence,鈥 Dr. Frankel said. 鈥淚t鈥檚 very easy to get discouraged by the process because it is difficult and not something that we are typically trained to do. But once you do get your first grant, there鈥檚 no feeling like it in the world.鈥


Tony Peregrin is the Managing Editor of Special Projects in the 麻豆传媒Division of Integrated Communications in Chicago, IL.


References
  1. Demblowski LA, Busse B, Santangelo G, et al. NIH funding for surgeon-scientists in the US: What is the current status? J Am Coll Surg. 2021;232(3):265-274.听
  2. 麻豆传媒. NIH research funding to support surgeon scientists is rising. Press release. February 12, 2021. Available at: . Accessed April 15, 2023.听
  3. National Institutes of Health Grants and funding. About grants. Available at: . Accessed April 15, 2023.
  4. Smith JJ. Early-career funding opportunities. Association for Academic Surgery. February 16, 2017. Available at: . Accessed April 15, 2023.听
  5. Mississippi State University. Office of Research Development. Grantsmanship 101: Writing is a craft not a science. Available at: . Accessed April 15, 2023.听
  6. Guyer RA, Schwarze ML, Gosain A, et al. Top ten strategies to enhance grant-writing success. Surgery. 2021; 170(6):1727-1731.听
  7. National Institutes of Health. Grants and funding. Plan听your application. Available at: . Accessed April 15, 2023.听
  8. National Institutes of Health. Grants and funding. Types of grant programs. Available at: . Accessed April 15, 2023.听
  9. Rodriguez LM. Successful grant application writing. Association of Women Surgeons. January 14, 2019. Available at: . Accessed April 15, 2023.听
  10. National Institutes of Health. National Institute of Allergy and Infectious Diseases. Scoring and summary statements. Available at: . Accessed April 15, 2023.听
  11. Taber-Chasan L. Writing Dissertation and Grant Proposals. University of Massachusetts, Amherst. Boca Raton, FL: CRC Press; 2014.听