Start-up from your own institution
Personal donations and philanthropy
Pilot grant funding (departmental or institutional)
Regional Veterans Integrated Service Network (VISN) pilot funding
Department of Veterans Affairs
Cancer centers, clinical and translational science institutes (CTSIs)
National Institutes of Health
Diversion of clinical funds to research (if you are clinically profitable and you take a salary reduction)
Department of Defense
National Science Foundation
Special issues, e.g., cancer (Komen, American Cancer Society [ACS]), health disparities, pharmaceutical
Do not forget about career development awards. They usually provide less money but are often easier to obtain and typically cover more years of funding. Although the biggest hurdle for the budding surgeon-scientist is obtaining a first grant, obtaining a second grant by the time the first expires is almost as difficult, as it takes time to not only perform the work proposed in the first grant but also refine a hypothesis and establish preliminary data for the next one. It is probably more important to get long-duration funding at the outset, therefore, than to get a large amount of funding in the short term, and this is where some 5-year career development awards excel.
Most career development awards are directed toward the junior investigator. Stipulations require a mentor or a mentor team. Typically one-third of the review is focused on the science; one-third on the candidate’s promise for future development, as exemplified by previous accomplishments, letters of recommendation, and personal statements; and one-third on mentorship and the environment. Junior faculty members sometimes conclude from this that the scientific proposal itself is therefore relatively less important, but this is untrue. A poorly written or supported proposal casts doubt on the candidate’s ability and the ability of the mentor(s) to help the candidate, as well as on the feasibility of the proposal itself. However, there may be relatively less emphasis in a career development review on the overall novelty and scientific significance of the proposal. It is probably not realistic to expect a junior faculty member to do Nobel-prize-winning work in his or her first efforts, and reviewers will recognize this in a career development review. Note that reviewers are far less likely to make substantial allowances of this sort in reviewing more traditional investigator-initiated awards.