Thread by @KimberlyBlumen1

I am going to write part of my (unfinished) story about the K to R transition as a woman in medicine and physician scientist in a multi-disciplinary research space in a tumultuous time. I am oversharing to encourage others in a similar 🚤#medtwitter #IDTwitter #AIMedEd. /1 of 20

I study #drug #allergy. It was the inferior antibiotic choices we made for people with vague antibiotic allergies during my residency @MGHMedicine @mghmedres that initially gave me the idea. Too often the allergy lists were impeding clinical care. /2 of 20

I hypothesized that drug allergies were a problem -- that penicillin allergies alone were linked to important antibiotic stewardship and public health outcomes. I set off to prove this, and address the burden of unclear drug allergies across populations. /3 of 20

Mentored by @RWalensky @mgh_mpec, I submitted a K to @NIAIDNews @NIAIDFunding and it was funded on my first submission. Although I knew this was lucky (she told me so), I had no idea of the struggles that would follow in securing additional funding. /4 of 20

I completed all of the K aims and more. During this time, I was also able to get other supplementary internal @MGH_RI and external grants —@AaaaiFoundation @CRICOtweet. I got a 6m funded K extension because of #COVID . These sustained me and my team. /5 of 20

I am proud to be well published, even published in my "reach" journals – like high impact general medicine journals, which I think and hope may have made drug allergy more relevant (even to you?). I expanded to study COVID vaccine allergies a they emerged mid-pandemic. /6 of 20

I had the best time studying penicillin allergy — it’s harm when you think it exists, it’s epidemiology, and methods to improve clinical care by addressing it. Some of my favorites @ericashenoy ncbi.nlm.nih.gov/pmc/articles/P…
ncbi.nlm.nih.gov/pmc/articles/P…
ncbi.nlm.nih.gov/pmc/articles/P… /7 of 20

I first submitted an R01 in year 3 of my K. It was not discussed. My heart sank. Tears flowed. Self-doubt entered. I read the critiques, discussed with my mentors, I bent over backwards to respond to all critiques, my resubmission score was worse. /8 of 20

I entered a 3.5 year period where I would submit a total of 13 grants - 10 R01, 2 R21 and 1 DP2. These submissions were variations of 5 different projects. This was all during COVID, which made it harder, especially on us women (our 3rd 👶was 2 y/o 🧷now almost 6 y/o). /9 of 20

My grants were reviewed by variable study sections -that I deliberately targeted because there is no natural home for my research. Reading the study section rosters I could not tell at all who was reviewing my grant...no one seemed a good match /10 of 20

This process has been tough. Scored and no resubmission improvement (x3), not discussed (x3). Mentoring others, many #WomeninMedicine or URiM, despite my shaken confidence. @LaceyRobinson @NeelamPhadke @CaitlinNLi @AnnaWolfsonMD @JaggersJordon @Dr_SAlvarez /11 of 20

A silver lining is the connections I made with others, the new collaborations and directions, and the team science. I submitted 3 multiple PI grants @DrEstherFreeman @sokol_mdphd @IDDoc1978. I have hopes and plans for even more directions @KevFromRI @MegSise /12 of 20

Ultimately, yesterday, I am happy to share that I received notice that an R01 is going to be funded: R01HS029319 @AHRQNews with @IDDoc1978. I am THRILLED get to continue to study #penicillin #allergy for the next 5 years in Boston! 🙌 /13 of 20

I also get to do this research with fantastic people who enthusiastically signed on to the project. Thanks to @ValStoneMD @MLouisiasMD @PhDiva0618 #StephenBartels #JulieLevison #YuqingZhang @MonganInstitute @TuftsMedicalCtr /14 of 20

Sometimes it is easy to do what you want to do and sometimes it is unnecessarily and excruciating hard. Keep persevering if it is what you want. Try many approaches. Set up meetings with people interested (or at least willing) to work with you. Keep submitting /15 of 20

Don't perseverate on your failures. Pick out themes across your reviews to strategize next steps. Actually meet with a mentorship team and consider their feedback. @katrinaarmstrong @jmetlay @AleenaBanerjiMD @vumc_cdsi_rsch @DBatesSafety #CarlosCamargo /16 of 20

The system needs fixing. It should not be so hard. I have many lost opportunities while grant-writing (to actually do research). People are leaving academia. Amazing mentees have left academic medicine in this period...did my struggles deter them? /17 of 20

This is not the end of my funding problems. But today, for now, I will stop long enough to celebrate with my team @MGH_ClinEpi , my colleagues @MGHAllergy @mghaifellows, and family. I will let the June (and maybe even July resubmission) NIH deadlines come and go./18 of 20

I will splurge for the ridiculous bouncy house party that I promised our kids once I got a grant. @blumenthalDM1 /19 of 20

And, I will focus on how to sustain a long and happy career in academic medicine while realizing we have to make it better in the future for others. My experience may be atypical, but it may not be, and we should talk about it! /20 of 20

CC @AllergyKidsDoc @ATLergist @TanyaLaidlawMD @elizabethmatsui @theeffortreport @TaisonBell @UREssien @neilthepcist @mattkrantz @TamaraPerryMD @sarabarmettler @drjessigold @MGoldbergLab @DavidBlumenthal @JonnyPeter7 @TrubianoJason @EricMacyMD