Evaluation of the Markey Scholars Program (2006)

Early in its existence, the Markey Trustees recognized the importance of providing funding to promising young biomedical scientists at the point of launching their careers. In April 1984, the Trust convened a one-day meeting of distinguished experts in the biomedical sciences to consider the ways in which the Trust could contribute to the biomedical research community. Many important ideas emerged from this meeting in Palo Alto, California, some of which subsequently evolved into Markey funded programs. One theme that was emphasized throughout the meeting was the need to support promising young investigators, especially as biomedical research fellowship funding had not kept pace with the needs of researchers seeking to transition from postdoctoral positions to independent research careers. The Trust conducted a second meeting of experts in the biomedical sciences in New York City in May, 1984. Many of the ideas for funding targets that surfaced during the meeting in Palo Alto were echoed in the New York meeting. From these two meetings, the framework of a mechanism to fund promising young biomedical scientists began to take shape.

The experts were concerned that the number of NIH-supported postdoctoral trainees and new awards to young scientists had been decreasing (National Institutes of Health, 2001, 2003), as was postdoctoral support from other funders such as the American Cancer Society. In addition, the group recognized that the funding level of most postdoctoral fellowships was too low to support physicians or scientists 7 or 8 years beyond their

baccalaureate. Moreover, there was a consensus that M.D.s were at a competitive disadvantage with Ph.D. scientists for postdoctoral fellowships. Finally, the experts pointed out that the move from postdoctoral fellow to junior faculty was a difficult transition. The development of a career in independent research required that junior faculty devote considerable time and effort to research with salary and research support assured. Yet NIH funding mechanisms were not designed to foster the independent research careers of new faculty. The long lead time required, the difficulty in developing independent pilot data, and the complexity of the NIH review process, combined with the limited funding available worked against the development of an independent research career for young scientists.

As a result of the deliberations that occurred at the two meetings, the Trust crafted a program to fund young scientists with the potential to contribute significantly to biomedical research. This program, the Markey Scholars Awards program, was a hybrid funding mechanism that combined postdoctoral training with the first faculty appointment. Scholars Awards provided adequate support for both the postdoctoral period as well as for the initial years of the faculty appointment, to maximize productivity, foster intellectual growth, and encourage independence. Under the conditions of the Trust, a total of 16 Markey Scholar Awards were to be made each year, half to applicants with Ph.D. degrees and half to applicants with either M.D. or M.D./Ph.D. degrees.

The Trustees recognized the special circumstances of some M.D. and M.D./Ph.D. scientists who are required to spend up to 3 years of clinical residency training. Such individuals require an additional 3 or 4 years of postdoctoral support, before obtaining a faculty position in a clinical or basic sciences department. By contrast, the Ph.D.s will have completed their postdoctoral fellowship and will be ready to assume faculty status at a much earlier point in their career. Recognizing these different career pathways, the Trustees determined that Ph.D. scientists would be eligible for nomination at the start of their second or third year postdoctoral year and would receive funding for an additional two years of the postdoctorate and that M.D.s and M.D./Ph.D.s would be eligible for nomination at the start of their last year of clinical training or after 1 year of postdoctoral training and they included funding for 3 years of postdoctoral training. All nominees were eligible for 5 years of funding at the faculty level.

In addition, the Trustees concluded that it was appropriate to fund a research allowance (varying from $15,000 to $60,000) for all Scholars. The research allowance was modest during the postdoctoral years; increased substantially during the initial faculty years; and was reduced during the final faculty years in anticipation of other extramural funding. Finally, recognizing the potential for additional education debt for Scholars with

a M.D. or M.D./Ph.D. degree, their additional years of training, and their need for more postdoctoral training the Trustees concluded that it would be appropriate to offer them higher stipends than for Scholars with a Ph.D. degree. The initial stipend and research allowance schedule is shown in Table 2-1.

In 1988, the Trustees increased the starting level of postdoctoral and faculty stipends for Markey Scholars by $5000. At the same time, the Trustees modified the policy on postdoctoral fellowships, enabling some Scholars to continue their postdoctoral fellowships for an additional year. Actual Scholar awards ranged from $570,000 to $711,000 depending on the length of the postdoctoral experience and the Scholar’s degree. The Markey Trust was unique in providing support for young scientists for up to 8 years, committing a total funding of $59,795,900 for the Markey Scholars program.

During the 7 years of the Scholars Awards program, the total number of nominations for Awards was 1,212. Individuals could be and, in some cases were, nominated more than once, so the number of individuals nominated for the Markey Scholars Awards program was 1,154. The nomination process began with a formal, written request for nominations from deans of medical schools, senior administrative officials of selected research universities without medical schools, and from research insti-

tutes with a strong interest in biomedical science. Moreover, beginning in 1987, the Trust placed notices in Science, Nature, the New England Journal of Medicine, and the Journal of Clinical Investigation describing the Markey Award and the application process. The request for nominations outlined the conditions of the award:

• Scholars were to devote no less than 90 percent of their time to research.

• Scholars could receive salary supplements from other sources without prior approval from the Trust.

• Scholars were required to submit annual budgets.

• Approval of the Selection Committee was required for equipment purchases in excess of $2000.

• Scholars were required to submit annual progress reports.

• Scholars could relocate to other institutions with the expectation that the move would enhance academic and research growth, but prior approval of the Selection Committee was required.

• Scholars were expected to conform to the host institution’s regulations on the use of humans and vertebrate animals in research.

• Scholars were expected to share research findings through recognized publications and presentations at scientific forums.

As can be seen from the data reported in Table 2-2, consistency in the nominations was remarkable over the years with respect to number of nominations, sex of nominees, and M.D. vs. Ph.D. status. Not surprisingly, the maximum number of nominations occurred in the first year of the program. One important trend in the program, however, was the decrease in the number of institutions submitting nominations: from 100 during the initial funding cycle to about 64 during the last four funding cycles. That decrease may reflect the quality of Scholars selected during the initial funding cycles, the complexity of the application package, and the rigor of the Scholar selection process. It may be that some universities whose candidates were not selected may have stopped submitting nominations. Moreover, the decline in the number of institutions submitting the maximum number of nominations also decreased substantially over the course of the program. That change may be due to the increase from 4 to 6 in the number of nominations allowed.

Nomination packages, consisting of the following eight components, were received by the Trust’s administrative office by mid-November of the year preceding the award:

1. A letter from the faculty sponsor detailing the nominee’s qualifications and research environment.

1. A letter of endorsement from the head of department or research unit.

2. A letter of endorsement from the senior academic officer.

3. A copy of the nominee’s full curriculum vitae.

4. A complete bibliography.

5. A letter of support from the dissertation advisor or chief of service.

6. Letters of recommendation from additional faculty who knew the nominee’s current research well.

7. A statement outlining a plan for research over the period of the award along with long-term career objectives. This statement was limited to 10 double-spaced typewritten pages, half of which was devoted to the research plan and half to research following completion of the fellowship.

When institutions submitted their nomination packages, the Markey administration office recorded its arrival, checked it for eligibility and

completeness, and sent copies of the nomination package to the chairman and vice-chairman of the selection committee (Box 2-1) for initial screening. The chairman and vice-chairman reviewed all nominees and, if they agreed that an application was not competitive, they classified it as unsuccessful. In cases in which there was a split decision, additional selection committee members were consulted. Competitive nominations received a second review by the selection committee (see Table 2-3). A total of 1,212 nomination packages were received over the seven-year period. Out of these, 83 were incomplete or ineligible. Of the rest, the chairman and vice-chairman of the selection committee deemed 605 unsuccessful and 524 (43 percent of all nominations) competitive and worthy to be reviewed by the entire selection committee.

In the second phase of the selection process, each member of the selection committee was sent successful nomination packages for review, usually between 12 and 15 so that two selection committee members reviewed each nominee. The chairman made sure that no selection committee member reviewed a nominee who had an institutional affiliation the same as the selection committee member. One member of the selection committee was assigned as the primary reviewer and the other as the secondary reviewer. Each selection committee member was asked to list the four highest ranking nominees and then send the ranked listing to the chairman of the selection committee.

The chairman of the Selection Committee compiled all the listings of top-ranked candidates. There were ten members of the selection committee; each submitted four candidates; so the maximum potential was 40 top-ranked candidates. These were forwarded to the Trust’s administrative office. The administrative office distributed the compiled listing to the entire selection committee for consideration at the Scholar Selection Committee meeting. The two assigned reviewers brought one-page reviews of the applicant, the proposed research, and the institutional environment, and made oral presentations to the selection committee. Following presentations on all applicants and a thorough discussion, committee members voted by written ballot, assigning priority scores from 1 to 5 as in a NIH study section. Awards were assigned on the basis of the aggregated priority scores. The differences in the priority scores between those who became Scholars and the rest of the top-ranked candidates were very small. Anecdotal evidence shows that the Selection Committee thought of the Scholars and top-ranked candidates who were not selected as “peas in a pod” (Lucille P. Markey Charitable Trust Records). However, the Scholar Selection Committee was restricted in the number of Scholars that could be appointed each year.

As shown in Table 2-3, over the seven-years of the program, there were 115 Scholar Awards, 186 top-ranked candidates who did not receive

awards, 223 others who were considered competitive but who were not top-ranked, and 688 whose applications were considered unsuccessful (did not pass the first screening). Individuals were eligible to be nominated more than once; in fact, 58 persons were nominated two times. For Scholars, top-ranked candidates, other competitive candidates, and not reviewed nominees, the number of duplicate nominations was 9, 14, 14, and 21 respectively. Consequently, the total numbers of nominees in the four categories were actually 115, 177, 209, and 653 respectively. Since 83 application packages were either ineligible or incomplete and, consequently, were never considered for an award, the total number of nominees considered for the Scholars Award in Biomedical Sciences was 1,071.

The selection committee was frequently faced with a surfeit of riches, especially of applicants with Ph.D. degrees who were highly qualified for the Scholar award. However, the annual awards were meant to be divided equally between Ph.D.s, on the one hand, and M.D. or M.D./Ph.D.s, on the other. So, the selection committee ranked all Ph.D. candidates in one column and all M.D.s and M.D./Ph.D.s in another, and then selected the top individuals, targeting half of the awards to each group. Because of the constraints imposed by the Trust, the selection committee was in the unenviable position of making Markey Scholar Awards to M.D.s or M.D./Ph.D.s with lower priority scores than some of the highly rated Ph.D. applicants. Moreover, because 60 percent of applicants were Ph.D.s, the probability of a given Ph.D. receiving an award—.08—was 50 percent lower than the probability of an individual M.D. or M.D./Ph.D. receiving an award—.12.

The selection committee’s concerns about the outcomes of physician Scholars relative to and scientist Scholars, however, were not borne out in reality. The results of the analyses of resumes, CRISP, and citation analysis show that the differences between scientist and physician Scholars were small. In fact, for scholarly productivity (journal articles) and the total number of NIH grants, physician scholars had better outcomes that did Scholars with Ph.D. degrees.

A second area of concern to the Markey Trustees was the percentage of Markey Scholar awards given to women (Markey Archival Data). At the conclusion of the initial awards (the class of 1985), the Trustees began monitoring the gender of applicants at the various stages of the award pathway (see Table 2-4). Variations in the percentage of Markey Scholars Awards made to women result from the very small number involved. The committee is aware that the data collected for the outcome measures used in this study may have been affected by both the low response rates of persons in the two comparison groups and the lower than expected number of females among Markey Scholar candidates. The latter factor,

however, would not have influenced the analytical comparisons since the percent of Markey Scholars who are women (19.5%) is similar to the percent of women in each of the two comparison groups (18.8%), as shown in Table 2-4.

A total of 115 Markey Scholar Awards were offered to worthy candidates. Two awardees declined to accept their awards as they had also been offered positions as HHMI Investigators. Unable to accept both awards, they selected the HHMI award. The distribution of Markey Scholars by gender and degree is shown in Table 2-5. Awards were made to 91 male (80 percent) and 22 female (20 percent) scientists. Half of the awardees (n = 57) had Ph.D. degrees and half (n = 56) had M.D. or M.D./Ph.D. degrees.

The Scholars Selection Committee served not only to screen and select Scholars, but also to monitor their progress while they were receiving Markey funding and to ensure that they were making progress toward the goals of productivity and independence. Scholars were required to

submit annual progress reports along with financial reports from their host institution. The selection committee reviewed these progress reports annually. The selection committee was especially concerned with Scholars’ progress at two important points in their career pathway: the transition from postdoctoral fellow to faculty status, and the midpoint of their Markey faculty funding. These annual reports and reviews by the selection committee were critical milestones for Scholars. Subsequent year funding was not authorized until a complete annual report was received and approved. Moreover, funds could also be held up at the times of selection committee reviews if scholarship and progress toward independence was not demonstrated. For two Scholars, funding was terminated before the completion of the award tenure.

As Scholars made the transition from postdoctoral fellow to assistant professor, the Scholar’s primary and secondary reviewers scrutinized the new appointment from two perspectives. First, the reviewers wanted to ensure that the new appointment would contribute to establishing an independent research agenda for the Scholar. Second, they wanted to ensure that the host institution would comply with the Markey Trust’s stipulations for Scholars—90 percent time devoted to research, adequate laboratory space and start-up package, and enhancement of academic and research growth.

Approximately two years later, as Scholars entered into the third (of five) years of funding at the faculty level, they received a second review from their primary and secondary reviewers. Here the selection committee reviewers were focusing on the Scholars’ progression toward research independence. The reviewers were particularly concerned with productivity and grant activity (Lucille P. Markey Charitable Trust Records). A sample of comments from the Scholars Selection Committee gives examples of their concern. In most cases, the comments were brief and positive, but in some showed the concern of the members of the Scholar Selection Committee.

The Selection Committee had the authority to terminate the award for Scholars who did not meet expectations of research productivity or independence. In a few cases, Scholars received tersely written warnings that funding would be ended unless and until the Selection Committee was satisfied with the Scholar’s demonstration of progress and independence

Scholars who left academia for the pharmaceutical or biotechnology industry were required to forego their Markey awards; four Scholars left for attractive opportunities in industry. Ten Scholars elected to accept HHMI investigatorships and, consequently, resigned their Markey awards. One Scholar was recruited by NIH and two Scholars accepted positions overseas—one at the European Molecular Biology Organization and one returned to his home country (Japan). Finally, two Scholars were terminated for failure to demonstrate progress in their research agendas and make satisfactory progress toward independence. All Markey Scholars were included in this study, including those who were terminated and those who were required to relinquish their Markey support to accept HHMI investigatorships or accept positions outside of academia.

One of the important features of the Markey award was the annual Scholars Conference. The conference was conducted annually from 1986 until 1996, usually during the month of September. In addition to Markey Scholars and Visiting Fellows, attendees included members of the Scholars

Selection Committee, Markey Trustees, and invited guests. Initially, all Scholars and Visiting Fellows presented posters, but as the number attending the conference increased, posters were presented by a sample of Scholars and Fellows with the rest submitting abstracts. Conferences featured keynote presentations by established biomedical researchers. Some conferences were themed: the 1995 Scholar’s Conference, for example, presented a symposium on clinical research in molecular medicine.

Scholars reported that the conference was an important opportunity to network, not only with other Scholars, but also with the members of the Scholar Selection Committee and with the invited guests. In addition, the Selection Committee members used the conference as an opportunity to meet with Scholars and mentor them. The Scholars volunteered that they welcomed and valued guidance from the Selection Committee members. Scholars, who had relinquished their Scholar award, either because they left academic research for the biotechnology industry or accepted a HHMI investigatorship, were not invited to attend the subsequent Scholars’ Conferences. When interviewed, these Scholars stated that the thing that they regretted most was not being able to attend the Scholars’ Conference.