Grant Writing for Osteopathic Family Physicians and Medical Educators
Key points and recommendations on how to write a successful grant to fund osteopathic medical education projects and programs.
By Anne Musser, DO, FACOFP
You have a great idea. It is a real opportunity for your department to make a profound difference in the education of your students and a significant impact on the health of your community. You have the passion. The students, institution and community have the need. You have rallied the faculty and they are on board. The administration supports it. All you need is the funding. Congratulations! You have just become a grant writer. Now what?
The purpose of this article is to take some of the angst and mystery out of grant writing. It is designed for those osteopathic medical educators who, because of a burning desire, a genuine interest and/or the lack of anyone else willing to do the job, are elected, appointed or otherwise delegated to the role of grant writer.
Whether you view grant writing as a science, an art or a necessary evil, it is a skill that can be taught, learned and practiced. It is a talent worth developing and I encourage you to try. The challenges can seem daunting, but the rewards can be tremendous.
Success Begets Success
In grant writing, success begets success. A $30,000 grant from a local business can lead to a $300,000 Health Resources and Services Administration (HRSA) grant and another $300,000 grant from the National Institutes of Health (NIH), which in turn can position you for a $3 million dollar grant from a private philanthropic foundation. Suddenly, your job as grant writer has gotten much more interesting, as well as a lot more fun.
Not every well-written grant proposal will be funded. However, every effort at developing a well-written grant proposal will reap rewards, a sense of team work, a renewed understanding of and commitment to the short- and long-term goals of your institution or organization and a better understanding of the process that will better position you for the next time around.
In this article, I present some basic ways to improve the chances of your proposal being both approved and funded:
• Preparation
• Finding the funding
• Writing the proposal
• Understanding the review process
I have summarized some basic information from a variety of Requests for Proposals (RFP)(1-5) and have included a number of recommendations based on my experience as a grant writer, a grant reviewer and a participant in many conversations with colleagues about the challenges and rewards of grant writing.
For the purpose of illustration, we will appoint you the chair of the department of family medicine at a hypothetical new private College of Osteopathic Medicine (COM). The clinical faculty is convinced that “real life” experiences with Osteopathic Manipulative Medicine (OMM) integrated throughout the 4-year curriculum will increase the percentage of graduates who integrate OMM in their practices, which is one of COM’s major goals.
There is a clinic in your community that provides care for migrant farm workers and day laborers. It is staffed by a family physician and several curanderos who welcome the participation of medical students from a local allopathic medical college. Some of your students have participated in the weekend clinics and want to know why your school doesn’t offer a similar opportunity. You think that the interests of the students, the faculty, the administrators and the community can all be served by
a project that incorporates musculoskeletal evaluations and basic OMM into the care of this population of patients. You have a great idea…
1. Preparation
Preparation is the key to a successful grant proposal. The time and energy spent preparing to write a proposal is well worth the effort. It is important to have (or to hire) a basic understanding of grant writing, a thorough understanding about your institution or organization and the ability to find potential sources for funding. Start early and plan ahead.
Step 1: Hire (or Develop) Grant Writing Expertise
Begin by carefully petitioning your administration for a grant writing department. Explain that the benefits far outweigh the costs. The initial expense will be just a fraction of the eventual revenue. Emphasize the fame and the fortune certain to befall the institution. Your physicians will be able to do what they do best – provide care, teach and bring in money from their clinical work. Extol the benefits to your department, the school and indeed the whole osteopathic profession. Eventually, resort to “everyone else does it.” When it is evident that your efforts have failed, write your own grant and then include funding for a grant writer in it!
Large universities often have entire departments devoted to grant writing and development. The benefits of an entire department devoted to grant writing is that the team has the expertise, personnel and time dedicated to writing grants. The downside can be that their focus is often on clinical research, not pre-doctoral education or community service projects. Their lack of enthusiasm can be reflected in the proposal. In many of our osteopathic schools, particularly the new, small, private schools without state funding, the role and responsibility of grant writing falls to us, the osteopathic physicians. We have the passion. We can develop the skill.
Now you need to educate yourself and involve other faculty. It is a lot more effective to work as a team. Learn as much as possible about the process. The single most effective learning strategy I experienced was participating on a HRSA grant review committee.(6) The most successful strategy for keeping up-to-date has been active participation in the Society of Teachers of Family Medicine (STFM).(7) Both strategies offer opportunities to network with peers and to learn what others are doing such as educational strategies that work, research projects that have had mixed results, potential sources for funding, etc.
I strongly encourage you to get involved with this group of family medicine educators (both osteopathic and allopathic) as the depth and breadth of their experience is both daunting and inspiring. Although, a word of warning is needed as the program for the annual springtime STFM meeting(8) can be overwhelming.
There are literally dozens of seminars, lectures, workshops and peer review sessions occurring simultaneously at the meeting. Many of them will be of great interest to you such as, pre-doctoral education, residency training programs and faculty development. I recommend that you go to the new member/attendee orientation in the evening before the conference begins. It is a great place to network and to learn how to optimize the time that you spend at the conference. Be sure to join your osteopathic colleagues for the osteopathic medicine interest group and special interest breakfast.
Step 2: Develop a Blueprint
This is the tough part, but it is absolutely worth the effort. Work with your colleagues to develop a blueprint for your group. Look at the big picture. Where are you now? Where do you want to be in five or ten years? What are the steps you need to get there? Are you early in your development such as, laying the foundation and building the infrastructure? Are you working to develop basic educational programs? Are you established and ready to experiment with new ideas? Be honest and realistic. Developing a good blueprint makes the rest of this easy.
Stay focused on your institution’s goals. A common and understandable mistake is to hear about a grant RFP that offers enough money to sound interesting, but doesn’t really seem applicable to your institution. It is tempting to write a proposal to address their issues.
Instead, have a clear idea of your direction and find appropriate sources to fund your issues. Although the prospect of any funding is attractive, remember that you actually have to do what you say you will do in the proposal. If the project is in line with your institution’s big picture, then your efforts will be rewarded with progress toward your goals. An extraneous project will require additional work and you will end up with many challenges and few rewards. A carefully developed and followed blueprint will increase the chance that the project/ program will continue after the funded period.
Compile the following information in a user-friendly format. Update it periodically and routinely – not just when you need it to complete a grant proposal. It is a good data bank to have available and allows you to cut, paste and polish the information that is important and relevant to each of your proposals.
Institution
This is one time that the institution’s vision and mission statements, goals, history and past accomplishments are particularly useful. This information is already available, but it is worth compiling it into a user-friendly form prior to submitting grant proposals.
The institutional vision, mission statement and values are usually relatively stable. Goals and educational objectives are more frequently revised and updated to reflect current trends in medicine, education and the American Osteopathic Association (AOA) accreditation standards.
Foundations and other potential sources of funding that share your institution’s vision and mission are often good potential sources of funding. Those who do not are unlikely to fund projects in line with your mission.
A thoughtful and honest discussion about departmental plans (short- and long-term), as well as individual faculty member’s interests is a great way to renew an understanding of and commitment to the overall goals of your department and to reaffirm that those goals are consistent with those of the institution.
History
Our osteopathic heritage, the history, philosophy and practices, will be important in some proposals. Make sure you include that information in the blueprint.
The history of your institution, in particular the history of previously funded grants and projects, can be very helpful in persuading potential sponsors that you will deliver what you promise.
Personnel
Grant writers, project directors, faculty and administrators each have specific roles and responsibilities. The lines separating these roles and responsibilities can be blurred, especially in some of our smaller, newer, private schools, but it is important to understand each person’s role in grant writing and the procurement of funding. Know and make use of your colleagues’ strengths. You should not be working alone on this endeavor. And, if you are, your school has more pressing needs than an educational grant.
Resources
Compile a list of the resources that you know are available to you, such as the college library, clinic space, laboratory space, equipment, personnel, etc.
Collaborators
Keep a list of the people/groups with whom you collaborate. A list within your university would consist of departments such as public relations, media, audiovisual or other clinical departments, as well other health professional programs. And, be sure to compile a list of nearby medical or graduate schools, undergraduate colleges, secondary schools and elementary schools. From your community you could also create a list of hospitals and other health care facilities, other osteopathic colleges, OSCE(s) and other agencies.
You can use your compiled information, complete with institutional vision and mission statements, departmental goals, osteopathic principles and practices, and your blueprint for development, to complete a proposal for each potential funding source.
In our new COM example, a community agency might be interested in funding a project that improves medical care for migrant farm workers. HRSA might fund an educational grant that evaluates the effectiveness of longitudinal clinical experiences. The NIH might fund a research project that evaluates the effectiveness of OMM in treating low back pain. The state or county government might fund research to determine how many health care dollars are saved by providing primary care (OMM included) in the community instead of the emergency room. A philanthropic foundation may be interested in funding efforts to promote cultural competence in primary care providers.
2. Finding the Funding
Take the time to research and find the right sources of funding.
First, you need to find the potential sources of funding. Then evaluate the potential sources to determine whether or not they are a good match for your goals. This process is similar to learning to read and evaluate journal articles, e.g., is this one really worth going after?
Share the blueprint with everyone at your institution. Administrators, faculty, staff, students all have different roles, responsibilities and contacts – use them all!
Potential Funding Sources
(references for these resources are included in “References”)
Funding Source Research Libraries are libraries used specifically for searching for foundation, corporate and government donors. These libraries have catalogs of supporters that are all cross-referenced according to name, location and areas of interest.
The internet has an alphabetical list of
supporters from which you can download
information and applications.
Network with peers through STFM and work on review committees.
What Makes a Good Match?
Attention to detail and honesty in analyzing potential matches will increase the chance that the project/program will continue after the funded period. Be sure to research, understand the criteria and confirm there is a good fit between your institution/blueprint and the potential funding source in terms of:
Philosophy and mission statements
What you need/what they will fund?
Do you need/will they provide funds for such as, “bricks and mortar,” “seed money,” general support, a specific project, restricted funds and/or unrestricted funds?
Basic eligibility/requirements
Read these and address them honestly. If you cannot meet them, then this funding source is not a good match for you. Do they require matching funds? If your administration/dean is not willing or able to pledge the matching funds that are a requirement of the grant, then it isn’t a good match. Don’t waste your time on grants that aren’t a good fit.
Research and pursue a diverse group of funding sources. Projects funded by one source have a habit of being lost after the funding period is over. Again, even the most fun and relevant project can lose its appeal when all of your time and effort is spent on a time-limited project and not incorporated into the curriculum or the institution.
3. Writing the Grant Proposal
If you have done your homework, actually writing the proposal is not all that tough. Look at your blueprint. Research the potential funding sources. Spend your time and effort writing proposals for projects that fit into the blueprint match the funding source and will help you and your institution to move toward your established goals. Write to your audience and be sure to cut, paste and polish.
A. Make it Easy for the Reviewers
Read and follow directions. The Requests for Proposals from the federal government (HRSA and NIH) have 60 to 80 pages of directions. Follow the directions. Community and Foundation RFPs are often less detailed and leave more room for discussion with the funding agency prior to submitting the application.
Organize the proposal as requested. Each reviewer will read and score many proposals. They are generally provided a template “scorecard” to complete. Reviewing the proposals becomes a routine and any proposal that does not follow the same pattern takes more time and energy to review. Reading a poorly organized proposal is like listening to a medical student who is presenting a case and mixing up findings that belong in the Review of Systems with those that belong in the Physical Examination. The student might eventually include all of the pertinent information, but if it is too hard to follow, you will lose interest in the presentation. If your proposal looks like it was written by a novice who cannot follow directions, it will cast doubt about your ability to complete the proposed project.
Use clear and concise language.
Label all materials clearly and use bullet points, lists, tables and graphs to bring attention to important points.
Make it easy for the reviewers to find the information that makes you look good. Flaunt
your strengths.
Have people who are not familiar with the project read the proposal and give you feedback regarding clarity of purpose.
B. The Request for Proposal
Each RFP is a little different, but they all contain essentially the same components. The RFP will outline what the specific funding source wants included in each section. I have included several additional recommendations.
Summary of Project.
The summary and budget sections are often the only things received and reviewed by all members of the review panel. Therefore, the summary should include all of the most important points detailed in the proposal.
Detailed Description of Project
• Rationale
Focus on the overall purpose of this project and how it fits into the institution’s big picture.
When possible, include a needs assessment – information that identifies the need for this project and the gaps it is intended to fill.
Highlight the components of the institution’s history and philosophy that are unique and pertinent to this proposal. This is a good place to include information about our osteopathic profession. Do not assume that because an allopathic institution has osteopathic graduates in their residency programs, that the peer reviewers from that institution will know about our profession. Limit this information to what is unique and pertinent to this proposal.
Project your enthusiasm and excitement (this is where grant writing departments can fall short and individuals can shine).
Include your plans to continue project after funding period.
• Objectives
Identify and describe measurable objectives. It is often tempting to resort to buzz words when writing your objectives. Most experienced peer reviewers already recognize the need for creating caring, compassionate, clinically and culturally competent, communicating healthcare providers. They will want to know exactly what you plan to achieve and how you will measure your success.
• Methodology
How and when will you achieve your objectives? You need to be specific. The reviewers will want to know that you have given this section some serious thought.
• Evaluation
Evaluation strategies should correlate explicitly to the project objectives and the proposed performance standards. Specify qualitative and/or quantitative evaluation measures for each objective. Describe what data will be collected, the methods for collection and how it is to be analyzed and reported. The detail you add here will help tremendously if and when you decide to publish your results.
• Timeline
A well-developed timetable that lists each objective, the methodology, personnel responsible, resources to be used and outcomes to be measured can help the reviewer to understand your project and will help you to identify and correct any flaws in your plans and to answer the very important question, “Is this realistic?”
• Budget
Personnel. Be realistic about what percentage of effort you list for each person included in the project. Peer reviewers are well acquainted with the competing requirements for our time and are likely to question the request for a large percentage of time for a project director of a grant who is also the associate dean, acting chief financial officer, curriculum coordinator, chair of the department of family medicine and full time clinic director.
Reviewers are instructed to check for reasonable costs that are clearly tied to specific objectives. They will check to see whether your request seems realistic and is justified by your objectives and methodology. Significant over- or under-estimating suggests that you do not understand the scope of the work.
Include your plans to continue the project after the funding period.
• Project Requirements
Read them and address them.
If you cannot meet them, do not waste your time applying for this grant.
“Statutory funding preferences” is a term used in the HRSA grant RFP (and may be called something else in others). It refers to the funding of a specific category or group of approved applications ahead of other categories or groups of approved applications.(1) In a practical sense, they are “requirements” for funding. If you do not meet them, you need to seriously weigh the time and effort it will take to complete the proposal with the strong probability that even a well-written and approved grant proposal is unlikely to be funded.
• Letters of Support
Request the required letters of support early. Reviewers will look for real, tangible support. It is often advisable for you to write a draft of the letter so that you can make sure that it includes the most important points that you want to be addressed. A letter from the dean detailing why they support the proposal, how it fits into the institution’s big picture, pledging financial and/or “in-kind” support and outlining how the project will be continued after the initial funding period will carry much more weight that a letter saying, “Hey, great idea!”
• Biographical Sketches
Unless otherwise specified, use the format generally recognized by the NIH or HRSA. They are easily recognized, uniform and short enough to keep the application to a reasonable size. These should be on hand and regularly updated so that when a grant opportunity arises, chaos does not ensue.
• Appendix
Limit the appendix to the material required by the RFP, but not located in the other sections, and those items referred to in other sections, such as letters from collaborators. Avoid using it as a dumping ground for materials that you think are important but are not really pertinent to this grant proposal.
• Checklist
You need to be sure to use it!
C. Need Help?
Most governmental agencies and some foundations offer technical assistance via teleconference. The contact information is generally included in the RFP or on the Web site. The teleconferences can be very helpful in answering your questions. You may learn even more by listening to the questions asked by other applicants.
Get input from others. People who routinely write and/or review grants are generally willing to help colleagues.
Have your colleagues read and review the proposal. Writing and rewriting can blur your perception and “outsiders,” especially those not familiar with the planned project, can give you valuable input.
3. The Review Process
Technical review. Agency staff will review the proposal and make sure that you meet the requirements and have followed the directions.
Peer review (HRSA, NIH, etc.). A panel of your peers will meet to review, discuss and score the proposals.
Primary reviewers receive a copy of the entire proposal, use a template to evaluate it in terms of the published “Review Criteria,” and prepare a brief summary to present to the review panel.
Other panel members get a copy of the executive summary and the budget summary. Make sure that these sections contain all of the information needed to sell your proposal.
The criteria used to review the proposals are generally not secret. They are often included in the RFP. Get a copy of them and make sure that you address them in your proposal. They can serve as an excellent checklist for you. It can be very helpful to you and to the reviewers if you include a separate “criteria reference list” with page references to highlight where in your proposal each criterion is addressed.
The review panel will determine whether or not your proposal is approved. They also score each proposal and the scores are used to determine which of the approved proposals will be funded.
Approved but not funded proposals are often returned with comments from the peer review committee. Read the reviewers’ comments as they can be very helpful for future proposals.
Foundations, corporations, local businesses and individual donors may have much less rigid review processes. You need to inquire about them and understand and follow the outlined process.
Once again, I strongly recommend that you participate on grant review boards. It can be
a tremendous learning opportunity and a
great chance to network with colleagues at other schools.
Failure? Get over it! You are a family physician. Use your professional coping skills to
re-evaluate and try again.
Success! Well, the good news is that you get to do your project! Share your success with everyone who had input into the process. The bad news is that it is time to start writing the next grant.
Success begets success. Even a small grant is a major accomplishment. That first $30,000 grant from a local business to provide OMM to migrant farm workers provides the impetus for your application to HRSA for a $300,000 educational grant to incorporate the clinic into your longitudinal clinical curriculum and another $300,000 from the NIH to research the difference OMM makes in workers with low back pain returning to their jobs. Success with these types of grants can draw the attention of a private foundation that has millions of dollars to spend on developing culturally competent primary care physicians.
You are moving forward with your blueprint
in a big way. Congratulations!
4. Key Points
Prepare. A well-developed blueprint for your development as an institution/college/ department/ program will make the task of grant writing much more successful. Educate yourself by participating on grant review committees and networking with colleagues.
Match. A good match between funding source and potential grantee is essential for successful grant writing and project implementation.
Write. Make it easy for the reviewers. Follow the directions. Flaunt your strengths.
Fund. Congratulations! Start writing the
next proposal.
Anne E. Musser, DO, FACOFP is a 1985 graduate from the University of Health Sciences/College of Osteopathic Medicine in Kansas City, Mo. She received a Master’s degree in Health Professions Education from Western University of Health Sciences in 1992. Dr Musser is currently a faculty member and pre-doctoral director in the department of family medicine at the University of California, Irvine College of Medicine. She has written successful grant proposals to HRSA and to a number of private foundations to fund a variety of projects in medical education.
References:
Health Resources and Services Administration (HRSA) Grant Application Form for Training in Primary Care Medicine and Dentistry. HRSA-04-015. http://www.hrsa.gov (follow prompts to grant applications)
John A. Hartford Foundation. Enhancing Gerontology and Geriatric Medicine Education in Undergraduate Medical Education. Call for Proposals 2000. Association of American Medical Colleges. http://www.aamc.org
The Donald W. Reynolds Foundation. Comprehensive Programs to Strengthen Physicians’ Training in Geriatrics. Call for Proposals. http://www.dwreynolds.org
A to Z Grantwriting Classroom Manual (Linda Vallejo). The Grant Institute: Grant Proposal Workshop 2004. Institute for Communication Improvement. 900 Wilshire Blvd., Suite 828, Los Angeles, CA 90017. Anthony C. Jones, Director.
Successful Grant Writing: How to write a grant and get it funded. UCI College of Medicine Office for Faculty Development 2003.
