The Unfunded Grant, Now What? Advice, Approach, and Strategy

Abstract

Background:

Grant writing takes a significant amount of time and effort and often may be elusive, especially on a first attempt. Following rejection of a grant, many investigators face a dilemma regarding the best next steps. In this article, we discuss the options of revision versus resubmission and how to navigate these decisions.

Methods:

The literature was surveyed including review articles, personal perspectives, and editorial pieces regarding the grant writing process and funding process. The National Institute of Health (NIH) database was reviewed and data were extrapolated from the past 10 years of funding percentages and rates of both R01 initial applications and resubmissions. Recommendations were then generated based on pertinent literature and experience from the authors.

Results:

The grant writing process involves many checkpoints between conception and funding. Only approximately 15% of R01 and R01-equivalent grants are accepted for funding on the initial submission. However, this statistic increases to over 30% if the appropriate steps are taken to revise and resubmit the grant. These steps include consulting co-investigators, modifying hypotheses, drafting of a succinct “introduction” document, and many more. Knowing the options that exists after rejection of an original submission plays a huge role in the ultimate success of the grant.

Conclusions:

While receiving funding for an original grant can be a difficult process, with appropriate guidance, it may seem more feasible than initially expected. Adequately responding to the critiques of the grant and revising the grant appropriately can make or break the outcome of the grant.

Article Summary

Grant writing is a necessity for the surgeon scientist. However, a successful grant application is rarely achieved on a first attempt. This article highlights the process of grant revision and resubmission after a failed initial attempt and how to navigate these difficult decisions.

Introduction

Academic success as a surgeon has frequently been measured on the metrics of papers published and the acquisition of external grants. It is widely recognized that obtaining grant funding has become increasingly difficult for new faculty members. Furthermore, the age at which surgeons obtain their first major grant is becoming increasingly older [1]. Grants are not only important for the academic advancement of a surgeon, but they are also imperative to fund innovations and drive new ideas and technology. Writing a competitive grant takes a large investment of time and effort by the individual investigator, as well as resources from the supporting institution. Once the grant is submitted it typically takes months until it is reviewed and potentially scored. Although, the percentage of surgeons being funded by the National Institutes of Health (NIH) significantly increased from 2010 (0.5%) to 2020 (0.7%) (p<0.05), rejection of a grant is a relatively common event [2]. After an unsuccessful grant application, it is important take the right steps and invest the time to determine why it was unsuccessful. This article will discuss how to obtain and interpret grant feedback and explore the pros and cons of different strategies to move forward when a submitted grant is unfunded.

Types of Grant

Similar to the preparation of a manuscript for publication, the author must be familiar with the target audience. A crucial strategy when applying for a grant is to make sure that the proposed project meets the mission and interests of the society or institute to which it is being submitted to. There are many different opportunities available for grants. These include institutional, society, private and federal awards. Assuming that the grant has been targeted to the appropriate award mechanism and the topic presented is of interest to the entity, it is always helpful to obtain feedback before and after a submission. Although the focus of our discussion will be regarding federal grants, a discussion of strategies for other grant types are briefly included.

Getting Feedback

Regardless of the type of grant that was applied for, it is routinely recommended to seek feedback. Following an application to the NIH, a score will be released followed several days later by a summary statement. The NIH notification indicates that the summary statement will be available within 30 days, however, in our experience this timeline is often closer to 10 days. In the case of institutional or society awards, this type of detailed feedback may not be available, and instead written confirmation of acceptance or rejection may be the only communication. If a generic rejection letter is received from a society or institution regarding an award, it is always worth contacting them, thanking them for the review and asking if any granular critiques are available. Obtaining these narratives may help explain why the grant was unsuccessful and, at best, provide helpful suggestions for improvement (experiments, controls, published resources etc.). It may also provide information regarding the perceived strengths of the application, thereby facilitating development of a successful revision or helping to redirect a new project. Unfortunately, written feedback is not available for all grants, especially non-federal opportunities such as those from societies or foundations. Another helpful strategy when working towards a larger grant such as an R01 award, is to seek smaller funding opportunities by expanding aspects (i.e. an aim) of the larger project into a smaller grant application. Even an award that did not achieve funding with the NIH may be of genuine interest and successful in obtaining funding from a different source. The benefit of smaller awards from societies or foundations are that they allow the author to continue to build upon their hypothesis, generating data, while still having obtained external funding. This will allow an attempt at a reapplication in the future, but from a more seasoned vantage point. Any type of external funding also helps provide validation as to the merit of an investigator’s ideas, which may be helpful in continuing to obtain support from one’s home institution. When feedback is received it is important to carefully read and accept these critiques. This is especially important if there is a reapplication or resubmission option available. Many of the society awards will have some of the same reviewers for subsequent applications and the NIH does it’s best to provide at least one of the same reviewers to a revised application. By being open minded and responsive, it is possible to dramatically improve a score and move towards, or into the fundable range.

How Does a Review Process Work?

Following the submission of a grant application, the grants are reviewed to identify core topics or themes. For most review panels, the committee chair tries to assign the reviews to members with expertise in similar areas. In the case of the NIH, the scientific review officer seeks to assign the application in a similar fashion; typically to three independent reviewers. For NIH applications such as a K08, K23, R03 or R01, one revision of the original application is permitted. After that, a “new” application will need to be submitted. The NIH typically has three application dates per year for rolling awards. Following submission, it is typical to wait approximately three months until the grant has been reviewed. The program officer will sit in on the discussion and take notes, but will not enter into the review process. In some ways, they are a “fly on the wall” and often an important source of feedback at a later date. Each of the reviewers will receive the grant before the meeting and provide a score and comments beforehand. On the basis of this group score, it will be decided whether to discuss the grant in detail at the meeting. Should it be discussed, there will be room for scores to change. All eligible members of the study section will vote (typically in a range approved by the chair) and a richer array of comments will be available for the investigators review after the meeting. The program officer is responsible for assembling these into the summary statements. Once the meeting has concluded, the scores are typically available after a few days and thereafter by the summary statement. Prior to the study section meeting, reviewers will also discuss proposals that are either lack significant preliminary information or are deemed “non-competitive” for the specific funding agency. If there is agreement amongst the reviewers, these applications are “triaged” and do not receive a preliminary score [3]. This typically occurs to the bottom 50% of R01’s submitted. Even in cases where a grant is triaged, the comments will be available. However, in those cases, comments are only from the written review of the original assigned reviewers.

Interpreting the Score

A score provides important numerical data regarding the strengths and weaknesses of the grant. A low score is favorable, and a high score is not (Table 1)[4]. Depending on the grant mechanism the scorable elements may differ. Traditionally scores are assigned to standard aspects of the application, i.e. investigator, significance and innovation, research approach and the environment. However, certain grants such as K-series (or other mentored awards) will also weight the candidate and the career development plan as an important scorable element. The funding opportunity announcement should be carefully read prior to applying to determine the crucial score-driving factors. Other aspects of the grant, such as the budget, may be reviewed, but these do not impact the score. The individual scores are collected, weighted and combined into an overall score with ultimately determines the final percentile and impacts the grants likelihood of receiving funding. Once the scores and summary statement are received it is helpful to compare the perceived areas of strength and weakness of the application between reviewers. It is highly recommended to compare comments between reviewers and identify common issues or themes. This approach is very useful when identifying the revisions necessary to best improve one’s chance of a successful revision. Sometimes, it may be that the reviewers are “missing the point”, or are incorrect in their assessment. At times, this may be accurate, but if the theme of critique holds across reviewers, it is more than likely that there is some truth in the comments, or the grant is not clearly communicating what was intended by the authors. Once the written summary statement is available, it is very important to contact the program officer. They will be able to set up a time to speak and discuss the comments. They will often provide insights, some of which are not written down, as to how the application was received. The importance of this follow up must be clearly emphasized. The grant writer is responsible for initiating contact. This is typically done via email and should include the grant number, mechanism, and any other meaningful information. Before contacting the program officer, it is important that the author has familiarized themselves with the summary statement and identified specific areas or items that they would like more detailed feedback on. The program officer cannot make edits to the proposal or provide specific advice regarding an experimental approach, but he/ she can give general advice and suggestions. Moreover, although payline percentile ranks are often utilized by each institute to delineate those scores that will generally be funded and those that will not, there may be borderline applications (scores just outside the range). If an application covers an area of research that is deemed a high priority, it may receive funding. The program officer can serve as both a resource and an advocate for applicants, which may be of importance for borderline applications. For specific scientific feedback, it is recommended that the investigator also reach out to mentors and collaborators, providing them both with the application (or relevant portions) and the summary statement. During a conversation with the program officer it may be helpful to have written questions. The conversation is best conducted soon after receipt of the feedback; waiting until a new deadline is fast approaching is not a successful strategy.

Table 1:

National Institutes of Health (NIH) scoring system for grant applications

Impact Score	Strengths/ Weaknesses	Degree of Impact
1	Exceptionally strong with essentially no weaknesses
2	Extremely strong with negligible weakness	High
3	Very strong with only some minor weaknesses
4	Strong but with numerous minor weaknesses
5	Strong but with at least one moderate weakness	Moderate
6	Some strengths but also some moderate weaknesses
7	Some strengths but with at least one major weakness
8	A few strengths and a few major weaknesses	Low
9	Very few strengths and numerous major weaknesses

Deciding when to Revise and Resubmit vs. Recycle

This can be a difficult decision, especially in the case of grants that are triaged, streamlined, or received a very unfavorable score (far outside of the published funding range). However, just because a grant was scored poorly or even triaged, may not mean that there was a fatal flaw and in some cases a proposal may be revised and resubmitted with a good outcome. It should be noted that applications that are not discussed as an initial (A0) application have a much lower rate of being funded (<10%), than those A0 applications with an overall impact score of 10-30 (80-90% chance of eventual funding) [5]. It is crucial to review the comments and critiqued themes to determine whether one can readily enact the necessary changes. If the answer is “no”, then a revision may not be advisable. If the answer is “yes”, then it is certainly worth taking the time to do the needed work and required changes. This may result in a pause greater than one application cycle. Because only one revision is permitted, it is crucial to put in the best and most comprehensive version of the grant. It may be helpful to share your summary statement with trusted advisors, as they may identify whether your application has a fatal flaw or if the reviewers had very low enthusiasm, which even with revision may not be received positively. A truly fatal flaw may mean that the application idea is not able to be revised and that it is not appropriate to be modified for another funding opportunity. Although rare, it is important to concede and retire an idea if it is deemed to be fatally flawed. This will allow new projects to be entertained and prevent valuable time and energy being wasted. When reviewing the critiques, it is useful to consider whether the reviewers’ expertise fit your topic and whether they appeared knowledgeable regarding your rationale and approach. There are times when a proposal finds itself in a non-ideal study section. In these cases, it may be worth targeting another study section with a new application. It is possible to influence the study section by carefully wording the application title and abstract to include key words that are associated with the particular study section. It is also advisable to contact the program officer prior to any new application to determine the project fit. In summary, a revision is possible even in the case of a non-discussed application, as long as the issues are able to be addressed. Non-correctible issues include a topic that is consider of low interest, a deeply flawed hypothesis, work that has already been published/completed, or an approach that is unable to truly test the hypothesis. In rare cases, when the review appears highly unjust, an appeal process is possible. It should be noted that these are uncommon and it is extremely rare for an appeal to succeed. In general, this approach is not widely recommended. It is far better to reflect on the feedback given and work to improve or redirect the application. However, once the decision to resubmit is made, rates of funding for resubmitted (A1) grants are often higher than initial applications (A0) (Figure 2). This trend has held constant over at least the past 10 years per the NIH statistics on success rates (Figure 3) [6].

Figure 2:

R01-Equivalent success rate between original submission and first resubmission from 2013 to 2022 based on National Institutes of Health (NIH) data.

Figure 3:

My Grant was Rejected. Where do I go from here?

Writing “The Introduction”

While almost all grant agencies (Federal, State, and Society/ Foundation grant agencies) provide written feedback, not all agencies allow resubmission of a modified grant. For instance, while NIH and Veterans Association Office of Research and Development (VA-ORD) allow resubmission of grants (NIH allows one resubmission while VA-ORD allows up to two resubmissions), Congressionally Directed Medical Research Program (CDMRP, Department of Defense) does not allow resubmission of the same grant. Resubmission refers to the submission of a modified grant along with a point-by-point response to the comments and questions raised in the first review. If a funding agency does not allow resubmission (along with response to critique), it is still possible to resubmit the same grant in a future grant cycle to the same funding agency, and this grant will be considered a new grant and not a modification of the previously submitted grant. Whenever a grant is resubmitted, it is accompanied with a point-by-point response to the questions and comments raised by the reviewers. This document, which contains the detailed response is called, “The Introduction”. While there are many ways to organize an introduction document, a few general guidelines are provided with suggestions for formatting the introduction (Table 2). The length allowed for this document varies and is dependent upon the award agency. Typically, the NIH allows for a single page introduction, while the VA, in comparison, provides three pages of space. Careful attention to the grant application instructions are necessary in order to provide a clear and concise response.

Table 2:

“The Introduction”

Points to consider when writing “The Introduction”

There may be a combination of reviewers who have and have not read the initial grant submission Address all the comments/critiques in a point-by-point fashion The PI must not be critical of the reviewers and respond to the critiques in a respectful way If the PI chooses not to modify the approach or use additional experiments, provide a clear reason why Starting ‘The Introduction’ by mentioning the strengths gives an overall positive vibe to the document Be aware of and adhere to the page limit provided Discuss the contents of the summary statement with other team members for feedback and approval Consider the format and organization of responses: Grouping responses based on reviewer comments Grouping responses based on specific sections of the grant

While the resubmitted grant may be reviewed by the same group of reviewers (for instance primary, secondary, or tertiary reviewer in the NIH system), frequently, one or more reviewers will be new and would not have reviewed the grant in the first cycle. Even if the reviewers are new, this document serves as an important means of communication with the review panel and requires meticulous planning. It is important to address all the comments and critiques made by the review panel in the first submission in an explicit, and preferably, point-by-point fashion. The principal investigator (PI) may not agree with some (or most) comments made by the review panel. Even in such a situation, the PI must not be critical of the reviewers and draft the introduction document to respond to the critique(s) in a respectful way, making most, if not all, changes to the grant as per the reviewer suggestions within reason. If the PI makes a strategic decision to not perform any additional preliminary studies and/ or modify the approach as suggested by the reviewer, a clear and plausible reason for the same should be mentioned in the introduction.

The challenge with writing an introduction is the limited amount of space available to legibly answer the questions raised by the review panel. Because of the length limitations for this response, it requires that all the questions and critiques are answered in a succinct and organized fashion. While the introduction is intended to provide a reply to the critique and questions raised by the reviewers, PI’s should also highlight the strengths of the project noted by the reviewers. In fact, starting the introduction by succinctly pointing out the strengths of the proposal provides an overall positive vibe to the introduction. Drafting of the introduction should not be left for the last minute. This is a very important document and deserves a lot of attention. One helpful strategy is to initially not focus on the length of the document, respond to all the critiques, and group them and the responses as described below. Once the authors are satisfied with the response to all of the comments, the next step is to generate succinct and clear sentences, so that the total response can meet the page limitations.

It is important to share and discuss the summary statement with other members of the team (i.e. co-investigators, collaborators, and other experts), and get their feedback on the proposed responses. Different members of the team bring different perspectives and an introduction document developed collectively is likely to be more robust. For the sake of clarity, the responses should be grouped and organized. Generally, two different grouping strategies are available. The author may choose to group the responses according the reviewers (Reviewer 1, Reviewer 2, etc.) who have raised various issues and concerns. In this approach, the early part of the introduction is focused on addressing the common issues raised by the reviewers and/ or those mentioned in the summary of discussion section of the summary statement. Alternatively, another formatting method is to group the responses under multiple headings, each addressing the comments made in the summary statement with respect to; 1) Significance of the study; 2) Innovation of the study; 3) Study team; 4) Approach (Research Strategy); 5) Environment; 6) Vertebrate/Human section of the grant.

Approach to the Revised Grant that does not Receive a Fundable Score

It is not uncommon that despite responding to all the critiques and questions, the grant still does not receive a fundable score. Since the NIH only allows one resubmission, a grant which has been reviewed twice and still has not received a fundable score, cannot be resubmitted. The author then has to decide what to do next, however, there are many possible paths forward (Figure 3). While it is important that the PI does not brood on the failure, it is paramount to reflect on comments/ critiques made by the review panel. Obtaining unbiased opinion from trusted mentors and colleagues can help guide the next steps for the grant. Asking questions such as, “Does the hypothesis and/ or approach need to be modified? Is there inadequate preliminary data? Does the study team need to be modified/ expanded?”, will help provide a path forward for the project/ grant.

The authors may revise the grant based on the previous review and then resubmit as a new grant to the same funding agency. In this case, the PI has to make a strategic decision whether to try to steer away a grant from a previous study section, or not. Even if the grant is not funded in the previous two reviews, it does not mean that the grant cannot (and will not) get funded in the study section where it was reviewed previously. Thus, one does not necessarily have to try to steer it away from previous study section. If the PI feels that the questions and concerns raised by the reviewers were reasonable and can be allayed by additional experiments, then one may spend six months to a year addressing the concerns experimentally. Such additional experiments may, in fact, provide new ideas and suggest novel approaches so that the grant can be strengthened. Once revised based on the additional data and new ideas generated, the grant can be sent back to the same or a different funding agency. One may also decide to send the same, original grant to a different funding agency. For instance, a grant which has been rejected from NIH, can be sent to VA-ORD (if such an opportunity exists for the surgeon-scientist) and/or CDMRP/ DOD. Indeed, the same grant can be simultaneously submitted to multiple funding agencies. This is not prohibited and the only requirement is that the PI cannot accept funding for the same work from multiple sources.

Conclusion

Receiving funding for a grant is a difficult task and often requires multiple attempts. If a grant is not funded on the initial attempt, it is paramount to have a plan as to whether to continue with revision and resubmission of the same proposal. The PI should be proactive in obtaining feedback on the initial submission and involve co-authors and collaborators in decisions moving forward. Funding opportunities are abundant and a thorough analysis of the hypothesis and goals may reveal better opportunities for funding elsewhere. If the authors choose to revise and resubmit the grant, knowing how to construct an effective introduction to respond to reviewer critiques can make or break the decision for grant acceptance.

Figure 1:

Overall R01-equivalent success rate between original submission and first resubmission. Based on National Institutes of Health (NIH) data.