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with their mentors to produce superior mentored letters, and how to structure a tersely written research plan. There is no single formulaic approach to a successful K Award, but there are critical concepts and important similarities that are present in almost all successful grants.

Summarizing all of the Development awards that the NIH has to offer is not the purpose of this chapter. Suffice it to say that the applicant’s choice of which award mechanism fits best with their career expectations and research idea is the first step in scripting a successful proposal. Remember to involve your mentor in the decision. I have found that after meeting with my mentor, but before putting pen to paper, reading the guidelines and instructions of a particular K Award on the NIH website, www.nih.gov, is important, as is communicating directly with a program officer at the appropriate NIH agency. For example, clinicians pursuing laboratory-based health science research careers may find that an NIH Mentored Clinical Scientist Research Career Development Award (K08) is better suited for their eventual career goals, whereas clinicians interested in a research career focused on working directly with their patients may gravitate more closely to the clinically oriented Mentored Patient-Oriented Research Career Development Award (K23).

The Career Development Plan

K Awards can be subdivided into three parts – the Candidate, the Career Development Plan, and the Research Plan. The most frequent error of many applicants is to underappreciate the impact of a well-organized, fluidly written, and impeccably designed Career Development Plan on the reviewers. Although a R01 stresses the importance of an elegantly constructed research plan, in the K Award, it is the Career Development Plan that sets the tone. It is also more than likely that the first section is closely read by a reviewer, and as in life, first impressions matter.

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Choosing the Mentor

It is commonly stated that the choice of the mentor is the most important decision facing junior surgical faculty and is probably the critical factor for success of these awards.3,4

Pollock et al. call it a “prewriting phase” decision of a successful candidate, and I have found that it is critical for applicants to decide on their mentor long before any first drafts of the proposal. It is helpful to consider both professional and personal attributes of the mentee and the mentor, and finally decide on a match much like how one chooses a date. To extend the analogy, often the complement of a mentor with a mentee is mutual. The word “mentor” originates from Greek mythology in the famous story of the Odyssey and the Trojan War.5 Odysseus asks his friend, Mentor, to watch over his son, Telemachus, while he is away at the Trojan War. Simply stated, a more experienced person guides and protects a less experienced protégé through difficult challenges based on the mentor’s judgment, ability, and willingness to communicate lessons learned from experience. The National Academy of Science describes it both as a partnership as well as the mentor playing a role as an adviser, teacher, role model, friend, and advocate.6 A point of misunderstanding of many candidate surgeons, especially, is the thought that the complete K Award should be entirely conceived by the applicant and be a solo tour de force from beginning to end. This is not what is expected, and although the grant should be independently written, there is also the expectation that the mentor is intimately involved in critical areas such as advising on important research questions,facilitating research collaborations, helping to outline experimental design, critiquing rough drafts, and so on. The following comments about mentors may help junior surgeons in choosing their mentors:

1.Select a scientifically prominent primary mentor who is known and widely respected for their scientific achievements. Someone with a substantial track record of NIH funding (preferably with a R01 grant) is also desirable.

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If your mentor’s main task is to advise you how to attain scientific independence and grant funding within the NIH system, surely your mentor also should have garnered this basic qualification. I strongly urge applicants to select primary mentors and critical co-mentors who are geographically close. Few interactions with a mentor are superior to face-to-face meetings. Critical experts that are in other institutions should best be referred to as collaborators rather than primary mentors.

2.Assemble a mentoring team which consists of a primary mentor and one or more secondary mentors each with a particular expertise that is critical for the success of the research plan. A frequent error is for candidates, who are new to the cancer field and have developed a relationship with a primary mentor in an area outside of cancer, to keep their primary mentor and not even consider a secondary mentor who is expert in the specific malignancy under study.

3.The frequency of face-to-face meetings with the primary mentor is scrutinized closely with weekly face-to-face meetings being the accepted norm. The mentoring group should also meet together as an ensemble at least every

2 months with the candidate, if possible. If geographically disparate, the mentoring group should participate in conference calls or even web-based sessions.Candidates routinely downplay the importance of these regular meetings when they should be accentuating their importance. For example, often applicants write that the primary purpose of the mentor meeting is “to monitor progress.” Be more specific and detailed, and encourage your mentors to do the same in their mentor letter. An example of a well-received mentor comment was simply a mentor who carefully explained in his mentor letter that in addition to his face-to-face meetings, he reserved each Sunday night for manuscript corrections by email from his mentees.

4.The mentor has one main opportunity to impress the reviewers and it is through the mentor letter.Although length does

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not always substitute for substance, a detailed mentor letter is often seen by the reviewers as one of the best predictors of success not only of a K Award, but also the long-term development of an applicant toward independence. Not only does a well-written mentor letter communicate directly, but indirectly it implies that the mentor set aside time to formulate a plan specific to the mentee, write the letter, and review the research plan. The most compelling mentor letters contain common elements. Specifically among many other topics, they address what considerations were given to choosing the co-mentors, how the mentor has performed in mentoring others (usually in a table), what philosophy of mentoring is employed, how in this increasingly busy environment, the mentor and mentee will craft time to commit to their relationship, how the mentee will be supervised, the plan for measuring academic success, how goals for academic promotion will be achieved etc. Occasionally, a reviewer will comment that they have read “one of the best mentor letters that I’ve ever seen.” Invariably, these letters are lengthy, sometimes as many as 10 pages single-spaced. Here is a composite of some of the best that I have reviewed. I present them not to be copied, but to be used as a guide of how much detail is expected. After a brief introduction, the letters are subdivided into the following broad sections: (1) Candidate’s Qualifications and Relationship with the Mentor; (2) Mentor’s Qualifications; (3) Philosophy/Views on Mentoring and Mentoring Experience – including a table of previous trainees showing their training period, degree earned, research project, funded award, current position; (4) Why the Mentoring Team was Chosen and their Qualifications; (5) Nature and Extent of Supervision; (6) Mentor’s Comments on Career Development Plan and Research

Plan including Limitations of the Plan; (7) Measurable Milestones and Outcomes; (8) TimeLine of Activities; (9) Institution’s Mentoring Policy and Experience with previous K Awardees; (10) Summary.

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5.Multiple letters from individuals in the mentoring team with the same language are easily recognized and discredited. Be specific with your co-mentors, especially, and instruct them not to copy and paste large sections from your primary mentor’s letter.

6.Institutional commitment from someone senior in the organization is important especially for a surgeon who is contemplating protecting over 75% of their time in profitable clinical activity. Either the primary mentor or an administrator in the institution who controls the applicant’s time and money needs to emphasize the institutional commitment to the candidate. Succinctly, how your time and money will be protected. Specifically instruct those writing your institutional commitment not to imply that your academic position or faculty appointment is contingent on receiving the K Award since this undermines the entire commitment statement.

7.When resubmitting an application, instruct your mentor to update his letter with your most recent achievements or awards. It is also good grantsmanship if the primary mentor’s letter, as well as those of the co-mentors’, are responsive to the reviewers’ criticisms of the original application, and address the solutions to the reviewers’ concerns. It is also prudent for you to instruct your administration assistant to be very careful recycling all old letters and especially to pay attention to small details such as remembering to change the date or letterhead.

8.Finally, please ensure that the primary mentor READS all of the application. Minor factual mistakes, scientific errors, and other technical flaws are all clues that the mentor did not thoroughly review the grant. Before submitting the application, have others outside your field read it and comment. For surgeons without a basic science background, for example, it would be prudent to enlist a PhD colleague to comment on relatively mundane topics such as how to evaluate the RNA quality from a surgically resected sample before it is used in a genome-wide array, or if microdissection of a sample is appropriate for a particular technique.