The latest post at Rock Talk is fascinating. This figure in particular. It depicts the fate of successful and unsuccessful applicants for the quasi-faculty level training mechanisms, the "mentored scientist" K awards K01 (mostly PhDs) the K08 (MDs, basic and translational research) and K23 (MD's, patient-focused research).
Apart from the specifics here, I think it is good to see some followup on the fate of unsuccessful applicants for a given mechanism. It lets us get a much better handle on the failure rate. An unsuccessful application rate only goes so far in telling us abut the state of the industry, so to speak. Lots of worried handwringing about "closing labs" because of dismal success rates for R01 grants can really only be evaluated by knowing how many labs have *actually* disappeared from the applicant pool. But I digress.
These differential outcomes on subsequent R01 or other NIH Research Project Grant funding for the un/successful applicants for each K mechanism are interpreted by the head of OER as reflecting the baseline need for training between the typical applicants for each type of K award.
"the benefits were more modest, as might be expected from a group that already has significant research training and experience."
I would suggest that the more likely explanation is to be found in the "No Subsequent NIH Activity" rates for unsuccessful K08/K23 applicants. They are generally MDs. They can simply return to the practice of medicine if the whole "research thing" isn't working out for them. Probably with fewer headaches and greater overall compensation as well!
Does it matter how you interpret this? Well, maybe. If the NIH is really keen to hook in the MDs to careers as NIH funded PIs then they have to adjust to this lower threshold for giving up. Bump up the success rates. If the disparity is indeed more to blame on the lack of prior training, they need to try to create more mechanisms to intervene before MDs reach the K-applicant stage.