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2. NIH Extramural Loan Repayment Programs Robert D. Hammond, Ph.D. Chair, NIH Extramural LRP Oversight Panel Director, DEA, NIDDK May 16, 2005

3. Purpose The Loan Repayment Programs are vital components of our nation’s efforts to attract health professionals to careers in the research areas specified by the individual programs.

4. NIH Loan Repayment Programs Clinical Research Loan Repayment Program Pediatric Research Loan Repayment Program Pediatric Research Loan Repayment Program Clinical Research LRP for Individuals from Disadvantaged Backgrounds Clinical Research LRP for Individuals from Disadvantaged Backgrounds Contraception and Infertility Research Loan Repayment Program Contraception and Infertility Research Loan Repayment Program Health Disparities Loan Repayment Program

6. Features In exchange for a two-year commitment to a research career responsive to an announced LRP, NIH will: Repay up to $35,000 per year of the qualified educational debt, Pay an additional 39% of the repayment to cover Federal taxes, and May reimburse state taxes that result from these payments.

7. Features – cont’d Repayment level is dependent on the total educational loan debt and applies to each year of obligated service.

8. Eligibility United States citizens or permanent residents M.D., Ph.D., Pharm.D., D.O., D.D.S., D.M.D., D.P.M., D.C., N.D., or equivalent degree

9. Eligibility – cont’d Qualifying educational debt equal to or in excess of 20 percent of their annual income or compensation, as applicable, at their expected date of program eligibility.

10. Eligibility – cont’d Must engage in qualified research responsive to the specific LRP for at least two years at 50% effort or above. Research must be supported by a domestic nonprofit institution and/or by a U.S. Government (Federal, state, or local) entity. Individuals apply for a single LRP, not to multiple LRPs.

11. Clinical Research LRP: Fiscal Year 2004 Nearly 1,200 new and more than 200 renewal applications were submitted to the Clinical Research LRP. Slightly more than 50% of the new applications and nearly 90% of the renewal applications were funded. More than 50% of awards went to applicants with M.D. or M.D./Ph.D. degrees. Majority of awardees were within 5 years of receipt of their doctoral degree.

12. FY 2004: Applications, Awards, and Success Rates by LRP Clinical Research ApplicationsAwardsSuccess Rate 137183461% Pediatric Research ApplicationsAwardsSuccess Rate 58931353% Health Disparities Research ApplicationsAwardsSuccess Rate 34420058% Clinical Research for Individuals from Disadvantaged Backgrounds ApplicationsAwardsSuccess Rate 654366% Contraception and Infertility Research ApplicationsAwardsSuccess Rate 421740% Total Applications: 2,411 Total Awards: 1,407 Overall Success Rate: 58% Distribution of Awards by LRP

13. NIH Loan Repayment Programs FY 2005 Timeline 2004 September 1 FY 05 application cycle opens September 1-December 31 Applications to CSR for referral to ICs December 15 Application receipt deadline 2005 February 1-May 31 ICs review LRP applications June 1 IC deadline for providing selections to LRP of applications to financially vet June 1-July 22 LRP collects and vets financial information from selected applicants and calculates contract costs September 1-September 15 Finalize all FY 05 obligations

14. Application Receipt and Referral Staff in the NIH Loan Repayment Program screen the applications for completeness and eligibility. Applications are sent to CSR, where they are referred to the NIH Institute or Center (IC) to which the application will be assigned for review.

15. Review Peer review – Internet Assisted Review, standardized across all LRPs and ICs Focus is on applicant’s potential to pursue a career in research Review criteria are posted on the web for applicants and reviewers

16. Review Criteria – Clinical Research LRP Appropriateness of the applicant's previous training and experience as preparation for a career in clinical research. Suitability of the applicant's proposed clinical research activities in the two-year period to foster a career in clinical research. Assessment of the applicant's commitment to a clinical research career as reflected by the personal statement of long-term career goals and the plan outlined to achieve those goals.

17. Review Criteria – cont’d Strength of recommendations attesting to the applicant's potential for a clinical research career. Availability of appropriate scientific colleagues to achieve and/or enhance the applicant's research independence. Quality and appropriateness of institutional resources and facilities.

18. IC Funding Considerations Funding considerations: priority score, critiques, program balance, stage of career. Applications can be transferred across IC lines before funding. ICs make awards to meet a pre- announced set-aside budget. The NIH intends to commit approximately $59 million in Fiscal Year 2005 to the Clinical and Pediatric Research LRPs.

19. Awards Awards are made by the end of the fiscal year, after NIH Loan Repayment Program Office conducts final vetting for eligibility.

20. Review Challenges Expertise range: large numbers of applications with a reasonable sized review panel Clear instructions to reviewers: these are not research project grant applications Feedback to unsuccessful applicants