Accepting an academic position in a soft money environment, where scientists bring in external funding to support their research, meant that I was taking a bet on myself. After finishing my Ph.D. at the University of Minnesota in 2021, navigating the COVID-19 academic job market, and finishing a two-year postdoctoral fellowship at the Harvard-MIT Center for Regulatory Science, I felt ready to take that bet. In June 2023, I was offered an Instructor (non-tenure track) position at the Washington University School of Medicine in St. Louis. A key term in the job offer was that by July 2026, I was expected to cover 95 percent of my salary through external grants, ideally through a competitive career development award from the federal government.
The prospect was daunting. I had three years to sell peer reviewers and government officials on the idea that my research agenda, which focuses on how federal regulation affects medical device safety, was unique and worth funding. Three years sounds like a long time, but when the typical timeline for reviewing a federal grant proposal is about eight months, you only get a few shots at funding before the clock runs out. Nonetheless, I felt up to the task. I had taken courses on grant writing, funded my dissertation research through a federal grant, and had a good network of supportive mentors and collaborators. Other people at Washington University and other medical schools had been successful in similarly structured Instructor positions before transitioning to tenure track roles, and I figured that I had as good of chance of succeeding as anyone else.
But since starting my position, it feels like the rug has been repeatedly pulled out from under me. In February 2025, I submitted a proposal to examine the effects of regulatory policy on medical device recall rates to the Agency for Healthcare Research and Quality (AHRQ). However, when it came time to review the proposal in May 2025, I did not hear anything from AHRQ, good or bad. I eventually learned through the grapevine, not through any formal AHRQ communication, that AHRQ was simply not reviewing grant proposals anymore. So, eight months after submitting my original proposal, I withdrew it and rewrote it for submission to the National Institutes of Health (NIH) in October 2025. Review of the proposal was delayed due to the 2026 government shutdown, and I finally learned in May 2026 that I received a decent, but not fundable, score.
I plan on resubmitting a revised proposal in November 2026. However, there are also a growing number of anecdotal reports that NIH will no longer accept proposals on research that evaluates the impact of policy decisions, to the point where program officers are asking applicants to remove the word “policy” from project aims and abstracts. As with the breakdown of AHRQ’s extramural grant program, there is no formal communication clarifying these procedures. Instead, I am learning about things as they happen (or rather, don’t happen) and changing plans on the fly. To paraphrase a helmeted man from Star Wars, the terms of the bet I made when I took my current position are altered every few months, and I can’t seem to do anything but hope that the terms aren’t altered any further.
Part of what has made the past few years so frustrating is the way government officials talk about my situation. The director of the NIH has dismissed researchers’ concerns about reductions in grant funding and increasing political review of grant proposals as “fake news” and “politicized” attacks. These dismissals add a level of cognitive burden where not only do I have to navigate the uncertainty of the current funding environment, but I also feel like I’m some sort of partisan hack for just pointing out that the current situation is uniquely challenging.
As of today, I still have a job in academia, but it’s hard to say whether it’ll stay that way. I managed to fund 95 percent of my time by joining colleagues’ projects. I would not be in my position today without the help and support of colleagues who have given me opportunities to contribute to meaningful research that can improve the American health care system. At the same time, I took a bet on myself because I believed that my unique research agenda could find new ways for policy to improve patients’ access to safe and effective medical technologies. Due to changing circumstances outside of my control, I don’t know if I’ll ever pursue that research.