The principal finding of this paper is that the Advanced Research Institute in Geriatric Mental Health (ARI) is associated with an over 2-fold increase in the likelihood of Scholars subsequently becoming a principal investigator of an NIH research grant. ARI’s focus on a transitional period in the scientific career path is consistent with the National Advisory Mental Health Council’s (NAMHC) recommendation in their 2008 report, Investing in the Future,
“The transition points between different stages of the research career continuum represent windows of vulnerability where promising trainees may be lost, or where continued research progress may be delayed…”7
ARI’s focus on the transition from new investigator to independent scientist responded to the growing loss of investigators at this stage of the career path noted by the National Academy of Science’s Bridges to Independence Report
as well as the critical need to expand the pool of scientists focused on reducing the burden of mental illness in late life. 1
Of significant note, while grant funding is the most tangible indicator of the program’s impact, ARI’s overall goal is keep people in academic research careers and to assume responsibilities of academic citizenship. To date, all but two Scholars (both from the first cohort) remain in academia and are rising through the academic ranks on schedule and are contributing nationally as contributors to the peer-reviewed scientific literature, grant reviewers, leaders of national organizations, and mentors of more junior trainees and new investigators.
Although biological scientists had a somewhat higher rate of R01 funding, this difference was diminished when R34 funding was included as an outcome. This trend is consistent with the purpose of the R34 mechanism to support intervention development making it less relevant to biological scientists. Indeed, the only type of NIH obtained by the biological Scholars was the R01. Thus we view the R34 as a meaningful outcome of ARI, especially as this type of grant has been equally difficult to obtain (e.g., NIMH R01 2004–2009 average annual success rates for R34 was 18.0% and for R01 was 19.1%). 33
ARI’s NIMH funding is consistent with the NIMH’s comprehensive model of career development programs. In the field of geriatric mental health, NIMH supports investigator-initiated career development programs for medical students (e.g., “M-STREAM: Sustained Training and Research Experience in Aging and Mental health”), postdoctoral trainees (e.g., single site geriatric psychiatry T32s and a multi-site mental health services research training program), early career transition (“SRI: Summer Research Institute of Geriatric Mental Health”, now in its 16th
year) and mentored and independent scientists K awards.34–36
This support both sustains the successful transition of developing scientists through critical stages of the career path and promotes the complex science needed to meet a significant and growing public health need. At the same time, each of these programs is funded through investigator-initiated grants and rely on participation by a national network of senior investigators, thereby demonstrating the essential commitment of the field to the next generation of geriatric mental health researchers and the goal of reducing the burden of mental illness in an aging population.
A limitation to any outcome analyses of programs, such as ARI, that target advanced trainees, is the selection bias inherent in recruiting individuals with demonstrated potential for future success. The analyses presented in this paper attempted to reduce this bias by comparing the subset of ARI Scholars who were K awardees with other K awardees of the same time period. Thus the comparison group had already been selected through a competitive process and had experienced comparable time trends in the availability of NIH funding, generally, and to new investigators specifically. A residual limitation to this strategy is that the K awardees who apply to ARI represent the larger subgroup of K awardees who remain committed to a research career midway through their K program. This potential bias is partially mitigated by including in the comparison group the small number of K awardees who achieved their R01 funding in the early years of their award and would not have been eligible for the ARI program.
Three general factors are relevant to the program’s success. First is the commitment of program faculty to work across disciplinary and institutional boundaries towards the career advancement of the next generation of investigators. ARI mentors represent a national, multidisciplinary network of researchers in geriatric mental health. These individuals, while remaining dedicated to their own research, give generously of their expertise and wisdom thereby enhancing the entire field of research (“raising the whole boat”). The faculty, therefore, serve as role models of successful researchers, mentors, and scientific citizens. Their impact is evident not only by the funding achievements of ARI Scholars, but also by the number of previous ARI Scholars who now serve as mentors locally and in ARI or other national mentoring programs.34, 35, 37
Second, ARI’s mentors and consultants focus on specific skill areas are consistent with recommendations of scientific leaders38
and other successful programs: 31
1. Grant-preparation skills
, including mastery of more than just the technical components of grant preparation but also the art --from designing innovative but methodologically sounds approaches to problems with public health significance to ensuring adequate pilot data, providing reasoned arguments, and engaging departmental and NIH program support. 2. Time management
including day-today negotiation of competing demands in ensure sufficient time to research-related activities, and timetables associated with both grant preparation (e.g., pilot data acquisition, writing, internal review) and academic promotion 8, 9, 30
and 3. Access to statistical and other expertise
is integrated into every aspect of the ARI program, from mentor matching to the Spring Retreat to individually arranged consultations.
Third, the program’s structure combines an intensive retreat with mentoring that is sustained over a sufficient period of time to complete the steps needed to accomplish the transition to independent investigator. These two structural elements are augmented, when needed, by individualized opportunities for consultation and supplemental resources for grant development. In the case of ARI, this structure, as well as the organizational infrastructure needed for recruitment, planning and implementation, are made possible by NIMH funding.
Organizing an advanced career development program around a specific subfield of mental health such as geriatrics is useful as it promotes multidisciplinary science that spans the translational spectrum, thereby potentially accelerating scientific progress and impact. However, the key elements of the program, discussed above, should generalize more broadly.