So good afternoon, everyone. I want to thank Ben and everybody for inviting us to come. It's always fun to come to this meeting. It's one of my favorite meetings of the year, believe it or not. Can you think of anywhere else than sports, right? So as was said, I'm the orthopedic research program director at NIAMS. I've been doing this for more years than I want to say right now, but it's one of my It's probably the favorite job I've ever had. As it's already been said, we are an investigator initiated institute, which means we base on a budget that, as you'll see here, I'm going to give you some idea of what, it was one of the things that Ben had asked us to talk about, would say, what is our budget? How do we, what are we funding? What do we do with our money? I mean, you know, you're all sitting out there, you're taxpayers, right? So here's your look. So this year in fiscal 2023, we have a 685 and a half million dollar budget. Pretty nice, right? It's not NCI, but anyway, for fiscal, because we're in fiscal year 2023, we have to show you how we allocated fiscal year 2022 data or the monies then. So if you look at this by science area, you have the IRP, which is our intramural research program. You have the RMS, which is like salaries, anything else that is paid for the employees within NIAMS. Then you have rheumatic diseases, which were 15% muscle, 12%, bone, 11, skin, 17, and then you get to joint, which is 28%, and you say, wow, that's the lion's share, and it really is. Now the joint diseases and orthopedics group, which is what we call PCC3 in our institute, is basically, it includes clinical and basic research in orthopedics, OA, regenerative medicine, and ortho implants. So there's four or five program directors that are currently serving on this. But if you look a little bit larger at this slide, you're going to see something interesting. Think about the burden of musculoskeletal diseases. Bone and muscle fall into that, right? So if you add up the 11 and 28, you're looking at close to 51% of the budget is being spent. Now that sounds really good if you're an institute like NCI that has, what, $7.5 billion or something like that. That would be wonderful, right? We need that. We know that we're overburdened and underfunded. So keep that in mind, because as I said, we are an investigator-initiated institute. You bring us the ideas. About 95% of our grants are funded with what your ideas are. Maybe 5%, maybe 10% are what we would have as far as initiatives that would come out. And Lindsey has mentioned quite a few of those already. So I'm going to give you a little bit of an overview of what the portfolio that I oversee is currently comprised of. Roughly, I have one of the larger portfolios, obviously, if you look at the numbers from the previous slide, about 180 active awards. So if you think about it, that means that if I worked every day of the year, every other day, I'm talking to one of you. So that's how my day usually goes. I have, of those, about 30, plus I have more that are starting that aren't active yet, are clinical trials, where I spend a lot of time. So I have one of the largest clinical trial portfolios, too. The areas covered are basically sports medicine, obviously, and anything from cervical spine to your toes. And that includes musculoskeletal pain. It could be chronic low back pain, pain alleviation, different methods like CBD, different things, prosthetic joint infection. All musculoskeletal rehab comes through mine. And then, as Lindsey mentioned, we have career development awards. Some of the trials, which, again, I've heard a lot. It's always great to come to this meeting and then see a lot of the stuff that I am supporting being talked about, and talked about heavy, which is really, really great. And these include Kurt's Bare Moon, Jay Urgang's Stability 2, Jeff Katz's Tempo. There's the IMPACT, which is one I put on here because this is a pediatric distal radius fracture and medial epicondral fracture trial out of Lori Children's with Jay Janicki. And I bring this one in because it's a lot of young kids getting hurt and breaking arms. So this is one that's just starting. And then we have Elena Lesina's CARAT trial, which is a knee arthroplasty activity trial with coaching and incentives. So these are just a couple. This is, like I said, I have almost 30. A lot of them are also comprised within the K awards, because we allow trials within the K. Some are with the HEAL awards. So how do you get? I said you're investigator-initiated. How do you find it? Now, in the past, we used to call these funding announcements. Now they're called NOFOs. We're the government. We like to change every acronym we have, right? So these NOFOs, and again, I hope that Lynette can share these slides with you, because these links are all hot links. You can click on them, and you will go to it. This is how you find what you want to do. But the question is, if you don't know what to do, what do you do then? Well, if you don't know me, you're no program director, you go to, my tip is, use NIH Reporter or Matchmaker. When you go into NIH Reporter or Matchmaker, I have it circled there. You can actually click on this, and then go, and I just did a quick one. This is two slides. I usually have a bigger tutorial on this, so I apologize. But I typed in here, I typed in ACL repair, because I knew what I would get. And as you see, you get the list. You even picked up Jay's stability too. What you get off of here is a lot of data. It'll tell you the institutes. You can click on the program officials. That'll tell you the program directors. Who's funding it? How much? You can read abstracts. This is where you want to start. If you think something is, remember the slide that Lindsey put up that has the 27 institutes and centers, where we're the best at the top, well, and that little bit, how they're not all separated, there's a little bit of overlap, there's shared interests there. So if you want to see if something else, if it's an aging population, it might fit better with NIA. So this is what you do. You start here. It'll give you the contact information of all the program directors associated with that area. That's how you start talking to us. So what are the funding mechanisms? I mentioned this. So we have what are called parent awards, which are the NIH proper, R01 and R21, okay, which are either big grants, which are the R01s up to five years, or the small grants, which are R21s. Now, the R21s, we as an institute have just changed this to where we no longer participate. You all may have seen a notice that's listed there, AR2306. If you haven't, you want to read it. I'm going to go over this a little bit more, but basically, the gist of it says we aren't taking part in the R21 anymore, which is technically correct. And then we have training awards, which are F32s, F30s, F31, all the different things. K99s, the K01s, K08s, K23, K24, K25, all of those all are covered in our portfolios. So here's where it really becomes interesting to the orthopedic surgeons. The notice 16, AR1612, shows that we, this was done by Steve Katz many, many years ago, that for K08 and K23 orthopedic surgeons, we reduced the normal protected time from 75 down to 50 percent. There's an increase in salary to 100K, and then there's 30K in research. That's different. So if you're not an orthopedic surgeon, if you're a PT or anybody else, I'm sorry because you're going to have to meet the 75 and the other, and you're going to get a reduced salary part. Then if you have one of these awards, one of these K awards, and I'm actually happy to say that Johnny Elfar is in the audience, and he actually had his grant, his K award, and he had a R03, and now he's got his R01, right, John? So I mean, he's one of our true success stories of coming up through this. And what's nice about the R03 is it's limited competition. You have to have a K award to apply for it. So this is what's really nice. It throws another $50,000 for the last two years of your K. And then back to this notice of special interest that we have here, this NOSI, about the R21. What it means is we are not taking part in the R21. So if you submit something and you don't include this, what I have in red here, the AR2306 and Box 4B, what's going to happen is it'll go to every other institute but NIMES. But if you are within our mission and you wanted to come to our institute, you have to have that in the box. If not, there's nothing we can do. We will not take it. So what this does, it keeps us from having to take applications that are not as mission-oriented from other institutes. That's what this is set up to do. It's not to bar you from doing anything. The mechanisms still exist. So a lot of young people in the crowd, I'm sure, older guys and gals, don't worry about it. You don't have to worry about this too much because you're already at the very bottom there, the senior part. For others, this is something, again, take a look at. I'm not going to go through it. There's a lot of information. It just says what stage you're at, what you're eligible to apply for. Please take a look. I said my portfolio is heavily clinical, which means I'm like 99% clinical, 1% basic. What this is, is this is showing all the different clinical trials, mechanisms, and the pathways where you can start at the bottom with exploratory or observational studies. You can pair those and that could lead to data that would go to a mechanistic trial in the parent R01 or R21. Or you can go up and you have ancillary studies come into play. And then we have our main ones, which are clinical planning grant, which is an R34, and then our large trial, which is a U01. This is what we have to do. If you want to do a trial at NIMES, you have to come in through these mechanisms. We do not allow trials in the parent R01 and R21 unless they're mechanistic. What is mechanistic? Mechanistic means if you know the clinical outcome already and it's been proven, and now you want to know the mechanism by which that outcome happens, that's a mechanistic trial. So don't come in. It will either get reassigned to an institute that will take it or it will be withdrawn. All right, let's see. This is the verbiage summary of everything in that previous slide. These are all clickable links. It'll take you to every FOA. It has a description, whether there's direct cost cap requirements, which I don't have time to go through today. And then finally, this is it. If you have questions, you know, I heard a lot of things being said already. So some stuff Jason said, even what Lindsay said, and that is, you know, we are not a black box, okay? It's not submit. We are not unattainable and we're not unavailable to you. Contact us. My email's here. If you have trials questions, we have a clinical research management group that actually can read some of this and talk you through it. And if not, go to our clinical research funding page. It's all here. The information's there. We are available. As Lindsay said it best, we are civil servants. We serve you. And, you know, whenever I talk to you here, I'll say, how can I help you? That's our role as a program director. So with that, I think I'll stop, and if you have any questions, I apologize for the very quick talk and a lot of information in a short amount of time. Come hear the bigger talk at, like, ORS or the Clinical Scholar Development Program. Then I'll have more data for you. But thank you. Fantastic. You don't have to apologize. That was a great overview, and, of course, we'd love to hear more. When you, you know, when you said you're not a black box, I think this is really key for the young people in the audience to understand how involved, when I hear all of you, Jason and Lindsay, Chuck, know how much we do, it's actually quite impressive, right? So try to reach out. I think this is, don't be shy. So I love that comment a lot. Yeah. I mean, that's the main thing. And then I will echo one more thing that Jason said. And Volker, you asked the question about review committees. Remember this. If you're not around the table, your applications are not going to do well. So if, like Jason said, and I can't emphasize it enough, if you're asked to review, please do it, because otherwise, if you're not at the table, you're on the menu and you're getting chewed up. We need the support of your society around the table with our reviews. That's the one plug I can't say enough. And there's a lot of people sitting in the audience who do review for us, and I thank you all for that. And the young people, all right, and then to answer one of Volker's questions that he also had for Jason is, how do you become and how do you get on? Send me your CV. I will forward it to our scientific review officers, and I will make it happen. And they'll only call you when they have applications that fit your expertise. So don't think that because you're not called, you're not getting in. Can I just add, too, in terms of review, for early career investigators, there's now an opportunity, a program through the NIH Center for Scientific Review that allows early career investigators to serve as reviewers, and it provides great insight into the process. So I strongly encourage you, I'm sorry we didn't put that on our slides, but reach out to us and we can mention this, but there are eligibility criteria, so you have to be pretty early career investigator, but it's an amazing insight into what's happening in study section, what things they're looking for, and hence how to write a strong grant. So take advantage of that. Yeah, Lindsay's exactly right. The best thing you can do is sit on a review panel because you can learn what study sections like and what they don't like. It's very important. Most of the people that have sat on, so for example, our clinical trials that I posted up there very quickly, those are all reviewed in-house at our own study section called AMSE. It's a standing study section, and we have, Dr. Spindler used to be a standing member on that, and there's others here that are. The bottom line is it's a strong study section, and that one does not have the requirements that CSR does. So if they need you for one application, you review one application. So there are benefits, but you get to sit and listen and see how things are written, how they're prepared. Like I said, the good, bad, and the ugly. Along those lines, this session this morning, the grant maker, what was it called? Yeah, that was also another great opportunity to, you all did really well under FIRE, those of you that were standing up there. I was elbowing Chuck going, wow, that's a lot of interrogation for $25,000, but seriously, that's great experience, just to kind of be prepared to feel the sort of questions and anticipate the sort of questions that might be raised about your applications. That's the fun part of my job. I get to work with all of you. You come in with, as I said, investigator-initiated. I get to hear your ideas, and some of them are very, very on-point and amazing, and that's directions that we look for in the institute, because again, you have your finger on the pulse of the research. We don't. You tell us what is the best research, and that's where I'll end it. Fantastic. Well, I mean, you're talking about citizenship, but then you also get something back because you know what's going on. Same in the AOSSM. You're part of the research committee. It's the market square of our organization, and yeah, there's a workload with it, but then you understand what everybody is working on, and you're kind of right in the middle of it. I love those comments.

budget

funding mechanisms

joint diseases

research areas

peer review process