By Margaret (Peggy) Rosenzweig, PhD, FNP-BC, AOCNP®, FAAN
ONS Scholar-in-Residence
For researchers, it may feel that changes from the federal government are coming at a breakneck speed. The National Institutes of Health (NIH) funding environment directly affects all scientists, including oncology nurse researchers. Understanding and trying to navigate these changes is essential for developing competitive grant applications and sustaining research programs focused on cancer care across multiple scholarship topics.
Know Your Institutional Indirect Cost Rates
Indirect costs from funded research are dollars awarded in addition to the direct costs of the grant that help to support institutional research infrastructure such as freezers, lab equipment, software, training programs, and institutional review boards. Scientists should work closely with their sponsored research offices to understand institutional rates and how changes to institutional indirect cost rates may affect grant budgets. Some grants offer no indirect costs, some use a fixed rate such as 10% direct costs, and others, such as the federal government, allow each institution to negotiate their indirect cost rate. Most institutions charge the federal government 50%–60% of total costs for the indirect rate.
In early 2025, the NIH to cap indirect costs at 15% for most grants. The news was quite distressing for the academic community, which pushed back with several lawsuits. Academic institutions began implementing -saving measures in preparation for dramatic decreases in institutional funding. In early 2026, U.S. Court of Appeals for the First Circuit supported the universities and preserved the existing practice of each institution negotiating their own indirect rate. Right now, the 15% cap is off the table. As a scientist, you should know your institution’s federal indirect rate and stay informed about policy change.
Understand Fundability Categories and Payline Dynamics
Grant review outcomes are determined by impact scores, and historically the NIH has used impact scores to decide grant review outcomes, comparing each score with a set payline or threshold specific to its institutes or centers to determine which applications get funded. However, we are seeing dramatic changes in the review and funding process that are still evolving.
Effective January 2026, the NIH away from paylines as a primary cutoff for funding, limiting predictability around scores and summary statements for the likelihood of funding. The funding decisions are now in accordance with scores and each institute or center’s research priorities. This holds implications for researchers.
In addition, through the May 2026 Advisory Council, the text and the detail of the summary statements will be shortened. All of those factors have great implications for all researchers:
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Extended decision timelines: Because funding decisions now require additional internal review at the institute level to assess alignment with research priorities, the already-long timeline between submission, review results, and funding decisions may increase. This poses challenges for labs and research team stability and for junior faculty working in traditional tenure timelines.
This transition represents a fundamental shift from objective, score-based funding decisions toward more subjective priority-based determinations, creating significant uncertainty for the research community.
Tailor Your Applications for the Centralized Review Process
The NIH’s Center for Scientific Review (CSR) assigns most applications to study sections for peer review. This is now a centralized process where are not reviewed at the individual institute level. Understanding the centralized process helps researchers craft applications that speak to appropriate reviewer expertise.
For oncology nurse scientists, applications might be reviewed by nursing-specific study sections, cancer-focused panels, or interdisciplinary groups, depending on the research focus. There may not be a nurse on the review panel at all. A community-based intervention addressing end-of-life care disparities might go to a different study section than a symptom science study examining chemotherapy-related toxicities. This may be a particular concern for educational or training grants requiring expertise in nursing pedagogy and training traditions.
To best support the ONS members’ research, ONS held a meeting with CSR leadership to discuss the new process, and the challenges nurse scientists were facing and to garner advice on how to best navigate centralized review as a nurse researcher. Key strategies for navigating centralized review include:
NIH Peer Review Criteria Changes
The Simplified Framework for NIH Peer Review Criteria retains the five regulatory criteria (significance, investigators, innovation, approach, and environment) but reorganizes them into three factors. Two factors receive numerical criterion scores, and one is evaluated for sufficiency, but all three are considered to arrive at the overall impact score.
Reframing the criteria focuses reviewers’ evaluation on three central questions:
The change to having peer reviewers assess the adequacy of investigator expertise and institutional resources as a binary choice is designed to have reviewers evaluate investigator and environment with respect to the work proposed. It is intended to reduce the potential for general scientific reputation to have an undue influence.
Consider DEI in the Current Environment
In 2025, terminated active research grants related to diversity, equity, inclusion (DEI), gender, and LGBTQ+ issues with no recourse for remediation. Researchers received a letter stating the grants were not in alignment with the current NIH priorities and did nothing to “advance the health of Americans.” Furthermore, NIH institutes were ordered to review awards for any DEI-related activities. Throughout 2025, the funding messages from the government remained mixed, with some grants that seem to have an equity lens getting funded, with others still abruptly terminated. In August 2025, the that the termination actions were legal.
Under current NIH guidance, proposed projects are classified into one of four DEI-related categories.
Only projects in categories 3 and 4 are eligible for funding, and only if no DEI-related language appears in the application or subsequent progress reports.
The scrutiny and threat of funding loss prompted academic institutions and organizations to eliminate DEI wording not only from grant proposals, but also websites, biographies, and curriculum vitae. Scientists are now reluctant to pursue those areas of research. At this point, the strategies to address these barriers and continue research focused on cancer equity may include avoiding applying to the federal government if language cannot be altered without sacrificing the research aims.
For those on the promotion ladder, research leadership at academic institutions must be made aware of the impact the federal priority change has on researchers interested in issues of health equity. Alternative funding and scholarship metrics need to be considered for tenure and promotion so that a generation of researchers interested in health equity is not lost. Alternative funding sources include foundations, internal institutional grants, and pharmaceutical companies.
Move Forward Strategically
Oncology nurse scientists can navigate this evolving NIH landscape by:
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Staying informed: Monitor NIH institute websites, subscribe to funding opportunity announcements, and participate in professional organizations that track policy changes.
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Building strong preliminary data: In tight funding environments, robust feasibility studies proving that “you can do this” become even more critical for competitive applications.
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Leveraging collaborative networks: Partnerships with community organizations, cancer centers, and interdisciplinary research teams strengthen applications and demonstrate established research infrastructure.
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Articulating nursing science distinctiveness: Clearly communicate what nursing brings to cancer research that other disciplines cannot. Focus on our patient care expertise, symptom experience, care delivery, patient-centered outcomes, and the clinical practice–research interface.
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Emphasizing rigor and innovation: Whether investigating health disparities, testing interventions, or examining mechanisms, demonstrate scientific rigor in design, measurement, and analysis.
The NIH funding environment will always present challenges, but oncology nursing research addresses critical gaps in cancer care that align with federal priorities. Our work in reducing symptom burden, addressing care access barriers, and optimizing care delivery for all populations represents essential science that advances both nursing knowledge and patient outcomes. By understanding the structural and policy changes at NIH while maintaining focus on scientific excellence and clinical relevance, oncology nurse scientists can continue building the evidence base that improves cancer care for all patients.