1. How can an Eastern European medical resident obtain grants to work in France?

2. I wasn't even scored on my NIH grant application! What should I do?

Dear GrantDoctor,

I'm a Romanian resident in internal medicine who is looking for medical grants in France or in the French part of Switzerland. What options do I have?


Dear Claudiu,

Check out L'Association Le Pont Neuf (ALPN). Founded in 1990 on the initiative of the wife of French President Jacques Chirac, the foundation aims to "increase exchanges between young people from Central and Eastern European countries, Russia and France." According to their official Web site, the ALPN has awarded more than 200 medical grants during the last decade to young doctors, medical students, and "specialized practitioners." Says the ALPN Web site, "The main countries which are presently concerned are Russia, Poland, Hungary, the Czech Republic, Slovakia, Romania and the Baltic States." Just what the doctor ordered, I hope.

--The GrantDoctor

I was funded on a grant for my Ph.D. work. Since then I have moved on to another appointment and have recently submitted my first NIH grant, to the National Institute of Neurological Disorders and Stroke, building on the work I did as a Ph.D. student. Much to my chagrin, I just received a letter that says that I wasn't even scored. Is this a sign that I need to toss the work from my Ph.D.?

--Young Investigator

Dear Young Investigator,

Not necessarily.

In the old days the National Institutes of Health (NIH) did use a category--"disallowed"--that WAS a signal from the reviewing panel that your project was without hope. That designation doesn't exist anymore, and even if it did, you have no reason to believe that your grant would have been slapped with that label.

Assuming you were near the top of the bottom half, your grant may need to rank just a little higher to be funded. The fact that your grant was not scored indicates only that the panel of reviewers placed it in the lower half. In 2000, the National Institute of Neurological Disorders and Stroke (NINDS) (your division) funded 32% of RO1 Type 1 (new single-investigator) grants. The estimated 2001 NINDS research budget is more than 10% larger, and there's every indication that it will continue to grow at a similar rate in the coming years.

Take a look at your reviews. If, say, three of four reviewers expressed a favorable opinion of your proposal, it is reasonable to assume that your proposal was not among the very poorest. The fact that similar work was funded when you were a graduate student is another indication that the work has merit and that an NIH grant for doing that work is not a pipe dream.

Indeed, far from being the kiss of death, your rejection has put you in a better position than you were in before. First "amendments" to NIH grants--first resubmissions--succeed 10% more frequently than do new submissions, across all NIH programs. Second amendments succeed 15% more frequently than new submissions. This means that even if your grant wasn't in the top half, your chances are still good if you play your cards right, either in the next round or the round after that. Dr. Paul Nichols of NINDS notes: "A lot of times unscored applications have come back in and been successful."

You now have a clear objective. "In a revised application," says Nichols, "the first thing reviewers look at is how well the scientist tried to deal with criticisms." If you ignore the reviewer's comments, argue with them, or try to gloss over them, you aren't likely to succeed with your resubmission. So whatever the main criticisms, find ways to address them, substantively and convincingly. If the reviewers are concerned that your approach won't work, include an alternative approach; better still, include two alternatives. If the reviewers questioned the relevance of the work, refocus the proposal to emphasize key NIH priorities. If your ability to do the work is in question, remind them that you've already proved yourself in your Ph.D. project, then find another way to demonstrate your competence--perhaps by collecting better preliminary data. If you can't adequately address the reviewers' criticisms, you might want to start from scratch. But you probably can.

And don't hesitate to contact the program director. It is possible that they will have specific, helpful advice. But even if they don't, a well managed, respectful interaction with the program director can be helpful. The GrantDoctor is not cynical, but he likes to think he is politically aware. You want the program director to think well of you, to know that you are sincere, eager to learn, and determined to do your science. In dealing with program directors, grant reviewers, and all the other people who will be evaluating you in the coming years, you need to do your best work, but you also need to mind your image.

By the way, there are some grant programs--although none that I know of in your area--which fund only scientists that have been turned down for a major grant. Check out GrantsNet's August news for more details.

--The GrantDoctor

Due to the high volume of questions received, The GrantDoctor cannot answer all queries on an individual basis. Look for an answer to your question published in this column soon! Thank you!