NIH F30 NRSA awards and Size of MD/PhD Programs

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The NIH F30 NRSA (or the F31) is probably the most prestigious award that MD/PhD students can earn by themselves. This funding mechanism provides funding for MD/PhD students to pursue their research as well as pay for 2 years of medical school. MSTPs have on average 10-25% of their positions paid by their T32 training grant, therefore, they encourage trainees to apply. National success rate is about 40% but varies across NIH institutes. Some institutes (such as NINDS) only give F31s, which also are given to regular PhD students but only cover graduate training. This might change in the future as the recommendations by workforce and diversity task forces to the NIH director strongly suggested that all institutes should offer F30s. I was a NIH reviewer for 5 years of F30s and F31s, and as program director, I have advised my students on how to write these applications.

This week, I got into NIH reporter and downloaded all active F30 applications. There are 400 of them. I categorize them by institution. Some of them, for example, UCLA and Cal Tech belong to the same MD/PhD program. I tried to lump them in the best manner possible. One caveat, F30s include also DDS/PhD. Nevertheless their number are small.

I then got into the Table 36 of AAMC, which indicates the size of MD/PhD programs in 2012. There are a total of 5,097 MD/PhD students in the AAMC database. I then made a simple ratio of institutional F30s / MD/PhD program size, and ranked all programs by that metric. The national average is 7.8% (400 / 5,097). Below are the institutions with ratios better than the national average:

Rank Organization Name --------------------------------------------------- F30's ---- Prog Size -- Ratio: F30/Prog size
1 NEW YORK MEDICAL COLLEGE ------------------------------------- 3 ------------ 6 ---------- 50.0% ---------- non-MSTP
2 UNIVERSITY OF NORTH CAROLINA CHAPEL HILL ---------- 24 ---------- 72 ---------- 33.3% ---------- MSTP/CTSA
3 MEDICAL UNIVERSITY OF SOUTH CAROLINA ---------------- 15 ---------- 46 ---------- 32.6% ---------- MSTP/CTSA
4 UNIVERSITY OF ARKANSAS MED SCIS LTL ROCK ---------- 6 ---------- 20 ---------- 30.0% ---------- non-MSTP/CTSA
5 BROWN UNIVERSITY ------------------------------------------------------ 3 ---------- 10 ---------- 30.0% ---------- non-MSTP
6 OREGON HEALTH AND SCIENCE UNIVERSITY ---------------- 9 ---------- 35 ---------- 25.7% ---------- non-MSTP/CTSA
7 WAYNE STATE UNIVERSITY ------------------------------------------- 6 ---------- 26 ---------- 23.1% ---------- non-MSTP
8 LOUISIANA STATE UNIV HSC NEW ORLEANS ----------------- 7 ---------- 41 ---------- 17.1% ---------- non-MSTP
9 UNIVERSITY OF PITTSBURGH AT PITTSBURGH ------------- 14 ---------- 84 ---------- 16.7% ---------- MSTP/CTSA
10 UNIV OF TX HSC SAN ANTONIO ------------------------------------- 5 ---------- 30 ---------- 16.7% ---------- non-MSTP/CTSA
11 LOYOLA UNIVERSITY CHICAGO ------------------------------------ 3 ---------- 19 ---------- 15.8% ---------- non-MSTP
12 UMDNJ-NJ MEDICAL SCHOOL / Princeton ----------------------- 5 ---------- 33 ---------- 15.2% ---------- non-MSTP
13 UNIVERSITY OF MINNESOTA TWIN CITIES --------------------- 8 ---------- 54 ---------- 14.8% ---------- MSTP/CTSA
14 UNIVERSITY OF ROCHESTER ---------------------------------------- 9 ---------- 61 ---------- 14.8% ---------- MSTP/CTSA
15 WAKE FOREST UNIVERSITY HEALTH SCIENCES ---------- 2 ---------- 14 ---------- 14.3% ---------- non-MSTP
16 UNIVERSITY OF CALIFORNIA IRVINE ----------------------------- 6 ---------- 46 ---------- 13.0% ---------- MSTP/CTSA
17 UNIV OF TEXAS MEDICAL BR GALVESTON /UT Austin --- 4 ---------- 32 ---------- 12.5% ---------- non-MSTP/CTSA
18 GEORGETOWN UNIVERSITY ----------------------------------------- 1 ------------ 8 ---------- 12.5% ---------- non-MSTP/CTSA
19 UNIVERSITY OF WASHINGTON ------------------------------------ 10 ---------- 82 ---------- 12.2% ---------- MSTP/CTSA
20 WASHINGTON UNIVERSITY ------------------------------------------ 22 -------- 194 ---------- 11.3% ---------- MSTP/CTSA
21 UNIV OF CALIFORNIA AT LOS ANGELES / Cal Tech ------ 11 ---------- 98 ---------- 11.2% ---------- MSTP/CTSA
22 UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR --------- 1 ------------ 9 ---------- 11.1% ---------- non-MSTP/CTSA
23 UNIVERSITY OF WISCONSIN MADISON ------------------------- 9 ---------- 82 ---------- 11.0% ---------- MSTP/CTSA
24 NEW YORK UNIVERSITY SCHOOL OF MEDICINE ---------- 8 ---------- 73 ---------- 11.0% ---------- MSTP/CTSA
25 VIRGINIA COMMONWEALTH UNIVERSITY --------------------- 6 ---------- 55 ---------- 10.9% ---------- non-MSTP/CTSA
26 UNIV OF CINCINNATI / Children's Hosp Cincinnati ------------ 5 ---------- 46 ---------- 10.9% ---------- MSTP/CTSA
27 TUFTS UNIVERSITY BOSTON ---------------------------------------- 4 ---------- 37 ---------- 10.8% ---------- non-MSTP/CTSA
28 DARTMOUTH COLLEGE ------------------------------------------------ 3 ---------- 28 ---------- 10.7% ---------- non-MSTP
29 UNIV OF CONNECTICUT SCH OF MED/DNT ------------------- 3 ---------- 30 ---------- 10.0% ---------- non-MSTP
30 UNIV OF CALIFORNIA AT SAN FRANCISCO ------------------- 9 ---------- 91 ---------- 9.9% ---------- MSTP/CTSA
31 UNIVERSITY OF MIAMI SCHOOL OF MEDICINE ------------- 4 ---------- 41 ---------- 9.8% ---------- non-MSTP/CTSA
32 UNIVERSITY OF MICHIGAN AT ANN ARBOR ------------------ 9 ---------- 93 ---------- 9.7% ---------- MSTP/CTSA
33 UNIV OF IL URBANA-CHAMPAIGN / IL - CHICAGO -------- 17 -------- 183 ---------- 9.3% ---------- MSTP/CTSA
34 UNIV OF COLORADO DEN/ Ntl Jewish & UC Boulder ------- 6 ---------- 65 ---------- 9.2% ---------- MSTP/CTSA
35 VANDERBILT UNIVERSITY MED CTR ----------------------------- 8 ---------- 89 ---------- 9.0% ---------- MSTP/CTSA
36 DREXEL UNIVERSITY ---------------------------------------------------- 3 ---------- 34 ---------- 8.8% ---------- non-MSTP
37 MOUNT SINAI SCHOOL OF MEDICINE --------------------------- 9 ---------- 104 ---------- 8.7% ---------- MSTP/CTSA
38 NORTHWESTERN UNIVERSITY AT CHICAGO ---------------- 9 ---------- 111 ---------- 8.1% ---------- MSTP/CTSA
---- NATIONAL AVERAGE ------------------------------------------------- 400 ------- 5097 ---------- 7.8% ----------

There are 60 Clinical Translational Science Awards (CTSAs) which reflect research intensive institutions. There are 44 MSTPs and 40 of them have CTSAs. If you are looking into non-MSTP programs that are growing and are primed to become MSTP, the number of F30s and the ratio of F30s/Program size are very good indicators of a quality environment. My program just got notice of award of an additional F30 and one F31. Our numbers are just going to improve for 2013!

Sources:
CTSA: https://www.ctsacentral.org/institutions?order=title&sort=asc
Program Size: https://www.aamc.org/download/321554/data/2012factstable36-2.pdf
NIH Reporter: http://projectreporter.nih.gov/reporter.cfm

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MSTPs have on average 10-25% of their positions paid by their T32 training grant, therefore, they encourage trainees to apply.

My program did not strongly encourage us to apply. It was highly dependent on the applicant to do so. You had support if you wanted to, but otherwise it was not really mentioned. I do hear that some non-MSTPs and some MSTPs that allow students to join labs that are not as well funded will push for students to get F30s due to financial concerns. Also, some institutions do give students kickbacks to their stipend if they get a F30/F31, though my program did not do this.

National success rate is about 40% but varies across NIH institutes. Some institutes (such as NINDS) only give F31s, which also are given to regular PhD students but only cover graduate training.

Only 8 institutes give F30s these days, and they tend to be the smaller ones. See: http://grants.nih.gov/grants/guide/contacts/parent_F30.html

The problem with F31s is that you almost need a year in the lab to get a good handle on what your project will be and get some preliminary data to write a grant. The grant will likely take on the order of a year to get approved and funded. So that leaves you with a year or two of funding. That's better than a sharp stick in the eye, but it's not terribly helpful if your lab is well funded and isn't concerned for external funding to help pay for you.

This week, I got into NIH reporter and downloaded all active F30 applications. There are 400 of them. I categorize them by institution. Some of them, for example, UCLA and Cal Tech belong to the same MD/PhD program. I tried to lump them in the best manner possible. One caveat, F30s include also DDS/PhD. Nevertheless their number are small.

I appreciate the data, but I just don't think it's too meaningful. Some programs that most strongly encourage students to apply for F30s are really hurting for financial resources. Thus, a F30 rate doesn't necessarily mean program quality.
 
.... I appreciate the data, but I just don't think it's too meaningful. Some programs that most strongly encourage students to apply for F30s are really hurting for financial resources. Thus, a F30 rate doesn't necessarily mean program quality.

I disagree. You made a cogent argument for the negative proposition, which is "LOW F30 rate doesn't necessarily mean LOW program quality". I can agree with that statement...

High F30 number and ratio indicate that a MD/PhD program provides the environment for career development for MD/PhD students.
Other indicators include Institutional overall research funding, NIH funding, CTSA, T32 training awards (such as MSTP), etc.
 
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I would agree that high F30 number and ratio may indicate that a MD/PhD program provides the environment for career development for MD/PhD students. It could be one indicator of a strong program.

But it may mean that more of the students at that program do research in areas supported by institutes that sponsor F30s. We had a strong neuroscience contingent in our program. When the NINDS stopped supporting F30s, they all became ineligible. There would often be a sense of "Well submit the grant to a *related* institute", but we found that F30s that could not be very strongly tied to a F30 supporting institute would be rejected despite excellent priority scores.

It may also mean that the program is poor, so they are really pushing their MD/PhDs to find external funding. It could mean all sorts of things...
 
I appreciate the data, but I just don't think it's too meaningful. Some programs that most strongly encourage students to apply for F30s are really hurting for financial resources. Thus, a F30 rate doesn't necessarily mean program quality.

Do you think it's a better indicator of program quality for non-MSTPs? It seems like those schools are more likely to be less prestigious, have less cash etc, and thus be more likely to encourage/require students to apply for F30s.
 
Neuronix's points are well taken; some MD-PhD programs might be over-represented by students in disciplines like neuro that are not eligible for F-30, but are for F-31. In addition, some programs (and/or PI's)actively discourage students from applying, others provide monetary incentives to applicants, and still others require that students apply for fellowships. No quarrel with UNC being a great program and a quality environment; Gene Orringer does a great job there and his students are top-notch. But is UNC really that much better than UCSF or Vanderbilt in terms of the quality of the environment?

I think that data is interesting, and I commend you for putting it together. To be sure, at my program we do tell applicants about the success of our students in getting F30, F31, F32, AHA, DOD, etc, fellowships. However, I agree with Neuronix that it is a stretch to say that the ratio of awards to program size is an indicator of program quality without mentioning other significant factors that influence that number.
 
.... It seems like those schools (non-MSTP) are more likely to be less prestigious, have less cash etc, and thus be more likely to encourage/require students to apply for F30s.

I see the issues that Neuronix raised and Uniqenam articulated. Most MD/PhD programs including MSTPs are using the research grants of the supervising professors to pay for the stipend, tuition and fees of the MD/PhD students. Most MSTP slots are used during the MD years because tuition is generally more expensive than during PhD years, but plainly because the program otherwise picks the tab. Perhaps, a 50% relies too heavily in this funding mechanism, but ranges in the 15-25% might be the optimal mix.

My view, however, is that clinican scientists live and die from grants, and what is the best training but to write a real NIH grant. My program requires it. In our case, it cost the program more to get an F30 or F31. We have to pay the shorfall supplement between the NIH salary and our institutional salary AND the F30/31 only pays for 60% of tuition, which means that the program pays for 40%. Despite that the supervising professor (SP) is now able to have more funds (as the student's labor is now for free), the SP can't use federal grants to pay for that 40% or for the difference in salary. Now, the institution clearly gains but the program incurs in a higher cost.

Perhaps another column in the quality indicators is the amount of dedicated MD/PhD program endowment.

Lastly, Neuronix raised the issue of some research areas not funding F31s. I am keenly aware of that, as a recent NINDS reviewer. However, there are two responses. The first is that you could do the same list with F31s, then sort by Program Announcement (MD/PhD F31s are reviewed separately and compete against themselves not mixing up with PhD F31s), and calculate the F31 and the F30+31 ratios. The second response is simply that F30s will be offered by every institute within a year or two. Dr. Collins announced it in a public meeting of the NIH Advisory Council.
 
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However, I agree with Neuronix that it is a stretch to say that the ratio of awards to program size is an indicator of program quality without mentioning other significant factors that influence that number...

Please notice my initial quote ... the number of F30s and the ratio of F30s/Program size are very good indicators of a quality environment... I didn't say it was "the best" indicator.

..."LOW F30 rate doesn't necessarily mean LOW program quality". I can agree with that statement...
High F30 number and ratio indicate that a MD/PhD program provides the environment for career development for MD/PhD students.
Other indicators include Institutional overall research funding, NIH funding, CTSA, T32 training awards (such as MSTP), etc.

I think that we are all more in agreement than disagreement.

F32s are not for pre-doctoral students. There are other training grants from foundations such as AHA that are also valuable.
 
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