Pausing the NIH

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Gentle reminder: please share this cathartic safe space. We want/need to document this.
 

White House to propose massive NIH budget cut​

The Washington Post is reporting that Trump’s near-final 2026 budget proposal will seek a roughly 40% cut to the current $47.4 billion budget of the National Institutes of Health. The proposal would also merge NIH’s 27 institutes and centers into eight and eliminate the nursing and minority health institutes, according to the newspaper. (The Centers for Disease Control and Prevention would be slashed 44% to $5.2 billion as part of an overall $40 billion, or one-third, cut to the budget of the Department of Health and Human Services.) Congress, which will have the final say, rejected requests Trump made during his first term to slash NIH’s budget.

I feel like these "proposed cuts" were in line with what Trump proposed last time. However, this time, he's got more sycophants around him and appears more unstable than prior (which is a feat!), so who knows.
 
I don't know if anyone pays attention to the NIH weekly Opportunities and Notices. It for notices of interest, program announcements and new funding opportunities. Historically, I found it very informative.

Most recently, its just been announcing canceled grant opportunities or expiring them early. There have not been any new funding announcements for months.

Until TODAY!

We must get to the bottom of why we are poisoning poor children with school lunches!

This was the best part of the "Review Criteria"
How well does the applicant demonstrate administrative and operational readiness to implement the proposed food service intervention during the 2025 – 2026 school year?
Ah yes, find all the poisons in the entire US food system and have them out and operationalized in 2 months. It's an RFA so they are throwing tens of millions of dollars at this ($20 million according to the FOA).

MAHA!
 
I don't know if anyone pays attention to the NIH weekly Opportunities and Notices. It for notices of interest, program announcements and new funding opportunities. Historically, I found it very informative.

Most recently, its just been announcing canceled grant opportunities or expiring them early. There have not been any new funding announcements for months.

Oh but did you miss this one?

"Innovative new approaches that reflect an exposomics framework and that apply new analytic and statistical methods to data derived from human epidemiology and clinical settings are needed to advance the study of GxE interactions in autism"

IT'S THE MERCURIEZ IN THE VAXES
Move aside slowpokes, wE aRE gOIng to sOLVE aUtisM noW!!@!#!

Until TODAY!

We must get to the bottom of why we are poisoning poor children with school lunches!

This was the best part of the "Review Criteria"

Ah yes, find all the poisons in the entire US food system and have them out and operationalized in 2 months. It's an RFA so they are throwing tens of millions of dollars at this ($20 million according to the FOA).

MAHA!

Hold me back, boys:

"The goals of this funding opportunity are to:
  1. Identify contaminants (e.g., heavy metals) present in school meals.
  2. Promote whole food offerings and minimize the use of foods commonly considered ultra-processed,
  3. Measure potential changes in contaminant levels and nutritional content pre- and post-intervention."

Better get after the Tater Tot pipeline in Flint, MI! That'll solve 'em!
 
Oh but did you miss this one?

"Innovative new approaches that reflect an exposomics framework and that apply new analytic and statistical methods to data derived from human epidemiology and clinical settings are needed to advance the study of GxE interactions in autism"

IT'S THE MERCURIEZ IN THE VAXES
Move aside slowpokes, wE aRE gOIng to sOLVE aUtisM noW!!@!#!



Hold me back, boys:

"The goals of this funding opportunity are to:
  1. Identify contaminants (e.g., heavy metals) present in school meals.
  2. Promote whole food offerings and minimize the use of foods commonly considered ultra-processed,
  3. Measure potential changes in contaminant levels and nutritional content pre- and post-intervention."

Better get after the Tater Tot pipeline in Flint, MI! That'll solve 'em!
I need to write a grant on how school lunches cause autism and hit pay dirt.
 
Curious about what was going on with MSTP grants, I searched the NIH Reporter to see what the 2025 awards were. First of all, only about 75% of those institutions who had an award in FY24 have an award listed for FY25. The Department of Government Efficiency obviously has some work to do to get these grant awards posted. Much more concerning, however, was my discovery that they NIH has taken a machete to programs whose 5-year grants were renewed in FY25. By my reckoning, there are 15 schools that were renewing their grants this year. Four of these schools do not show an award for FY25, but this is probably because the NIH is way behind in updating its website. Two programs show an increase over FY24 funding; this is due to significant increases in program size over the past 5 years. Of the remaning 9 programs, all had significant cuts in funding: 33%, 29%, 28%, 24% (3), 21%, 16%, and 11%. Of the programs that did not renew in FY25 (i.e., they are in the midst of a 5 year award), nearly all had a negligible cut of >3%. My assumption is that the programs "spared" this year will be cut when their grants are renewed in future years. I do not know what MD-PhD program leadership is thinking, but my guess is thatMST programs that suffered significant cuts in NIH funding this year will reduce the size of their entering class beginning in 2026. Furthermore, programs whose grants are due to be renewed in FY26, FY27, etc., will likely also be thinking about cutting the size of their entering classs, let they find themselves in the same situation of having to scramble for money to make up for decreased NIH funding. (Those programs may be able to ameliorate some of the NIH antipathy by being able to scrub any sign of DEI from their programs before they have to submit their grant applications.) Bottom line: my guess is that the number of MSTP slots in the 2026 entering class will decline by 15% or more. Applicants should probably take that into consideration when deciding which and how many programs to apply to.
 
Dear Maebea, I am glad that you are doing well and still checking up on us. We hope that you are enjoying retirement.

There has been a delay on issuing T32 funds, not truly a cut as of yet. Several programs are still waiting for their NOAs (even Y3, Y4 or Y5). I received mine late for Y3 about 5-6 weeks after than usually expected date (i.e.: Y2 NOA in 2024, Y1 in 2023). I do not think it is as bleak as you suggest. However, the overall environment is not optimistic and nationally, we have about 8% less MD/PhD applications at this point this year as compared to 2024 cycle. Most training programs continue offering the same number of positions. NIH websites (Reporter and eCommons) are actually ahead of PDs or institutions receiving emails with NOAs. There is also a delay in NIH Grants Management in moving the funds. I do see your reasoning for T32 cuts, which undoubtedly will happen, but I still hope that the budget cuts will end up in the 15-20% range rather than 43% as requested by the current administration.

We have our national meeting in a few weeks, and we will learn from frank discussions if that is the case or how severe the training environment is. Overall, PhD admissions took a harder crash with many programs decreasing their class sizes between 25-50% their first year entry positions in 2024. This is partly because Graduate Schools got hit with losing many of the diversity training program and also having their international training appeal (and harder to get visas) taking a big hit. In contrast, MD/PhD training programs only contracted about 3% in 2024 vs 2023 cycle. In a few weeks, the PDs will be having 3 meetings in a hard-working week: 1) the Institute of Medicine finally is paying attention to training issues of Physicians Scientists, 2) the AAMC GREAT annual meeting, and 3) the annual meeting of the National Association of Clinical Scientists Training Programs (formerly National Association of MD/PhD Programs). I have been in leadership of the last 2 groups and have been EAB member for over 15 other programs, so I will be able to report my perspective soon.
 
Dear Maebea, I am glad that you are doing well and still checking up on us. We hope that you are enjoying retirement.

There has been a delay on issuing T32 funds, not truly a cut as of yet. Several programs are still waiting for their NOAs (even Y3, Y4 or Y5). I received mine late for Y3 about 5-6 weeks after than usually expected date (i.e.: Y2 NOA in 2024, Y1 in 2023). I do not think it is as bleak as you suggest. However, the overall environment is not optimistic and nationally, we have about 8% less MD/PhD applications at this point this year as compared to 2024 cycle. Most training programs continue offering the same number of positions. NIH websites (Reporter and eCommons) are actually ahead of PDs or institutions receiving emails with NOAs. There is also a delay in NIH Grants Management in moving the funds. I do see your reasoning for T32 cuts, which undoubtedly will happen, but I still hope that the budget cuts will end up in the 15-20% range rather than 43% as requested by the current administration.

We have our national meeting in a few weeks, and we will learn from frank discussions if that is the case or how severe the training environment is. Overall, PhD admissions took a harder crash with many programs decreasing their class sizes between 25-50% their first year entry positions in 2024. This is partly because Graduate Schools got hit with losing many of the diversity training program and also having their international training appeal (and harder to get visas) taking a big hit. In contrast, MD/PhD training programs only contracted about 3% in 2024 vs 2023 cycle. In a few weeks, the PDs will be having 3 meetings in a hard-working week: 1) the Institute of Medicine finally is paying attention to training issues of Physicians Scientists, 2) the AAMC GREAT annual meeting, and 3) the annual meeting of the National Association of Clinical Scientists Training Programs (formerly National Association of MD/PhD Programs). I have been in leadership of the last 2 groups and have been EAB member for over 15 other programs, so I will be able to report my perspective soon.

It seems that I timed my retirement well.

I do hope that the collective efforts of the physician-scientist training community, the AAMC, NAS, etc., will bring some sanity to the funding situation. Having worked with MD-PhD program leadership for three decades to see the population of trainees more than double and the number of NIH-funded programs grow by 70%, it is disheartening to me to see the shift in priorities at the NIH. I know that MD-PhD programs will not shy away from the fight (just as in the past we took on the NIH, AAMC, NAS, NBME, state medical boards, and individual universities to promote the interests of MD-PhD students), and wish you and all my former colleagues success in this challenge.
 
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