The New NIH Loan Repayment Program for Pediatric Research and for Clinical Research

Abstract

In 2000, the United States Congress enacted an eagerly anticipated program to encourage physicians to pursue careers in research by providing educational loan repayments. This program was designed to help alleviate the financial burden associated with pursuing an academic career. Physicians pursuing pediatric research and clinical research who compete successfully in this program may receive up to $35,000 each year toward repayment of their educational loan indebtedness, plus 39% of that amount to cover the tax consequences of this additional income. An aggressive lobbying effort by the pediatric academic community in the last few years culminated in success on October 17, 2000, when Congress passed the Children's Health Act, which contains a provision authorizing the Secretary of the Department of Health and Human Services, acting through the Director of the National Institutes of Health (NIH), to establish a loan repayment program for health professionals conducting pediatric research. In this program, the NIH enters into a contract with a qualified health professional who agrees to conduct pediatric research for at least 2 years in return for the educational loan repayment. If performance is satisfactory, the contract may be extended until most of the educational loans are repaid. After passage of this groundbreaking pediatric research loan repayment program, Congress moved quickly to pass, on November 13, similar legislation authorizing such a program for clinical research in general, not limited to pediatrics. The NIH moved quickly to plan and implement this new authority, building on experience gained in similar loan repayment programs that have existed for several years in the NIH intramural research program. A planning committee produced a proposal for joint implementation of the two programs that was reviewed and cleared to proceed by the Office of Management and Budget (OMB). The program was formally published and announced in the Federal Register (2001;66(173):46643–7) on September 16, 2001, and the acting director of the NIH announced that funds would be provided in fiscal year 2002 to make contractual arrangements with approximately 250 individuals to begin the program. The NIH will select the recipients of these contracts on a competitive peer-reviewed basis, to assure that loan repayments serve the intended purpose of recruiting and retaining high-quality health professionals (mostly physicians) in careers in biomedical research, especially clinical investigation. Applicants must be U.S. citizens, nationals, or permanent residents with doctorate degrees. They must be currently supported by an NIH grant (F32 or T32 training grant; a K series career development award; a first-time RO1, RO3, or R21 research grant; a UO1 cooperative agreement grant; or a first-time director of a subproject of a PO1 or U series grant). Their total educational debt must exceed 20 percent of their annual income. Finally, they must be engaged in pediatric research or clinical research. The NIH expects application forms approved by the OMB to be available around December 1. Forms may be obtained from the Office of Loan Repayment and Scholarship, NIH, 2 Center Drive, Room 2E30, Bethesda, MD 20892-0230, U.S.A., or by e-mail request ([email protected]). Applications will include a personal statement about research career goals, a description of the current research that qualifies the applicant, a research training plan (if applicable), recommendations from three individuals, and a supporting statement from the sponsoring institution. Information on loan indebtedness must also be provided. In the first year of the program, applications will be assigned to the Institute funding the grant that qualifies the applicant for the program. Institute Initial Review Groups (IRG) will provide peer review. The Institute will make funding decisions based on the evaluation of the IRG and on program need and balance. Successful applicants will be offered 2-year contracts, indicating the amount of the loan that will be repaid quarterly by the NIH to the lending institution, in return for a commitment by the applicant to continue to engage in pediatric or clinical research during that time. Performance will be closely monitored, and if research activity ends, the loan repayment will terminate. This program represents a commitment by the U.S. government to increase the number and quality of health professionals engaged in pediatric or clinical research by reducing the often-cited barrier of educational loan debt as a factor that forces young clinicians into clinical practice. The NIH is eager to launch and extend this program, and encourages applications from highly qualified individuals for whom this program can become the means to a career in research.