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I am a PhD student focusing in psychiatric genetics, hoping to become a professor someday. It is my understanding that a lot of the PhDs in my field end up working in schools of medicine in positions that are 80-100% soft money (even though they are tenure-track).

That sounds... terrifying. You're not a clinician so you can't make up salary with patient care, you're in a school of medicine so there isn't much opportunity to cover part of your salary with teaching... it sounds like you would have to spend your entire career living in fear of a grant dry spell, even once you had tenure (no grants = no salary).

Am I misunderstanding how this works, or is it really that bad? How do people survive in that situation?

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    What you describe as "terrifying" is the typical level of job security for, say, most non-academic employees in the US (probably better, in fact). They survive somehow. – Nate Eldredge May 8 '16 at 2:17
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    The reason I think it's so terrifying with professor jobs is because the hiring cycle for getting another one is so long (if you can get another at all, being forced out due to lack of grants would not look good in an applicant!), and you might have to move halfway across the country for another job in your field. With most non-academic positions if you are laid off you can start applying for other jobs in your field immediately, there is less stigma to layoffs and it probably won't count against you as an applicant, and you probably wouldn't have to move. – Tapeworm May 8 '16 at 2:57
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For soft money position, especially NIH funded one, there are a number of things working in your favor. You might be PI on 2 or 3 grants and CI on another 1 or 2 which means that no grant has more than 30 percent of your salary. Since NIH grants are generally 5 years long, it means you write a new grant every year.

The amount of time between getting an NIH grant and starting it can be 12 months. This means you have lead time before you run out of money. The NIH also allows you to get a no cost extension, which allows you to stretch what money you have.

Universities also will often allow you to either front pay or back pay your salary while you wait for a grant that has been awarded to start. This again allows you to cover gaps.

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    "Since NIH grants are generally 5 years long, it means you write a new grant every year." That's the part that's working in your favor? Ugh. Makes me glad that my money (what little there is of it) is hard. – Pete L. Clark May 9 '16 at 0:18
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    @PeteL.Clark some people are on soft money where grants are 12-36 months long. – StrongBad May 9 '16 at 0:42
  • Thanks for the reply! It's good to know that the risk is at least spread across a few grants instead of having all eggs in one basket. What happens if you are going to come up short though... how common is it for that to happen, and what options do people tend to use (colleague adds you to their grant? just take a 30% pay cut for a year?) when it does happen? – Tapeworm May 12 '16 at 1:10
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Medical schools have minimum salaries, even for faculty, so even if you have 0% effort on grants, you will still be paid a salary (although a low one--think postdoc salary). Faculty are typically incentivized to meet the % effort goal set by their school through a yearly bonus. The bonus will be the first thing to be cut if you don't meet their goal. If your gap looks like a temporary one, the school will likely cut you some slack for one or two years, especially if this is a tough year for funding (think sequestration), and not reduce your salary. But the pressure will be very high to get a new grant.

There are things you can do to cover a temporary gap. Even in a medical school, you can teach and get a little funding that way. You can also work on the side as a consultant. Finally, you can change your effort allocation on your remaining grants to cover for the budget shortfall. NIH allows you to increase your effort on a grant if the project requires it.

The biggest impact your funding situation will have is on your chances of getting tenure. If you can maintain stable funding during your assistant years, usually it is a good indicator that you will be able to continue to do so once you get tenure.

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As someone who looked at a number of these positions: Basically, the answer to your question is: "Yes, this is just as daunting as you think it is."

There are however some caveats to this, both good and bad:

  • Recognizing this, there are many schools that will not put a PhD in that position by not allowing them to apply on tenure track. This was the case with one position I looked at - they were fairly frank that the reason was exactly what you suggested: if my grants all went away, as I couldn't make up it up with clinic hours, they wanted to reserve the right to be able to fire me. Similarly, there are many medical schools where tenure is extremely rare.
  • While @Jim is correct that there are minimum salaries, they are low, and there are myriad other ways that the school can penalize someone whose grants have fallen through. For example, cutting down on their lab space is a common one.
  • Many institutions do have bridge funding for the unexpected gaps in funding, which can help smooth out minor funding problems.
  • As @StrongBad noted, not all the grants have to be yours. At an old institution of mine, it was fairly common for a considerable %-effort for new faculty to be covered by incorporating them into large, existing, fairly reliable grants.
  • Because it's so common, the NIH is organized around the assumption that PIs may be claiming significant %-effort in their grant, unlike some other funding agencies.

But yes, a 100% soft money position does have some very real pressures behind it.

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