INTERVIEW WITH CMB OPEN COMPETITION PROPOSAL REVIEWER
美国中华医学基金会公开竞标项目(CMB-OC)公开竞标项目审稿人访谈
By Donglan Zhang
张冬兰
The interviewee is an anonymous proposal reviewer for China Medical Board (CMB) 2012 Open Competition (OC).
受访者为美国中华医学基金会(CMB)公开竞标项目匿名审稿人。
Donglan Zhang is a PhD candidate in the Department of Health Policy and Management at University of California, Los Angeles.
张冬兰为洛杉矶加州大学卫生政策与管理专业博士研究生。
Donglan: What is your overall assessment of the proposals submitted to CMB 2012 OC? Do you have any suggestions for applicants in light of the comparison between this year (2012)’s OC proposals and those submitted in earlier years or proposals submitted for other funding opportunities?
张冬兰：请问您对于此次CMB公开竞标项目提交的申请标书总体评价如何？和前几年提交的项目申请或其他资金的项目申请比，您有哪些特别的建议？
Interviewee: The OC proposals share the following common features: 1) high policy relevance; 2) lack of familiarity with the existing evidence and theory; 3) room for improvement in terms of research method; 4) excellent teamwork and collaboration. This is the first time I am reviewing for the competition, so I cannot speak about comparison over time.
受访者：公开竞标项目的申请标书有以下共同特点：1) 与政策高度相关; 2) 不够熟悉研究领域内现有的证据和理论; 3) 研究方法仍有待加强; 4) 具有相当程度的团队合作。这是我第一年做评审，所以尚没有比较。
Donglan: What are the areas that need improvement of the proposals? Can you elaborate on one or two areas that you think are the most critical?
张冬兰：您觉得这些项目申请书有什么需要改进的地方？能否解释一下您认为最关键的一个或两个方面？
Interviewee: Many applicants have not had a thorough survey of the field. They show a lack of knowledge about the research and practice within and outside of China in their areas of research. This is even more critical than the deficiency in research method.
受访者：很多申请者对他们的研究领域缺乏足够阅读，不少项目申请缺乏对中国国内和国外研究与实践的了解，而这一点比方法上的缺陷更严重。
Donglan: We really appreciate and admire your effort in improving the quality of health research in China. Do you have any suggestions for junior researchers who plan on submitting proposals for CMB funding?
张冬兰：我们非常景仰和感激您对提高中国卫生研究质量所做的努力，您对计划申请CMB项目的年轻学者有什么建议吗？
Interviewee: I have two suggestions. The first is to form collaborative relationship with senior researchers. By “senior” I mean those having substantial international research/publication experience. The second is to collaborate with health practitioners. These are professionals who are experienced in clinical/hospital management practice within and outside of China.
受访者：两点建议：1）与资深研究者合作，“资深”意味着具有更多的国际研究经验和论文发表经验；2）与卫生执业者合作，主要指在国内外具有丰富临床或医院管理实践的人。
Donglan: From your perspective, could you please recommend some future research directions or identify existing gaps in health research in China?
张冬兰：从您的角度，能否推荐一些中国卫生研究中有前景的研究方向或目前的研究空白？
Interviewee: Qualitative study is a huge gap in health research in China. Case study, participatory observation, cognitive interview, and focus groups are all very important tools and methods in formulating hypotheses.
受访者：定性研究是个很大的空白。案例研究，参与性观察，认知访谈和焦点组访谈等都对形成研究假设非常重要。
Donglan: Do you have any words of wisdom for junior scholars in Health Policy and Systems Science (HPSS)? Do you have any suggestions as to how CHPAMS may contribute to the capacity building of HPSS research in China?
张冬兰：您对卫生政策与系统科学研究领域的年轻学者有何建议？您认为我们中国卫生与管理学会应如何帮助提高中国卫生政策与系统研究的能力？
Interviewee: Matching overseas scholars with Mainland Chinese scholars might be a good strategy. CHPAMS could facilitate the process of matching overseas mentors with young scholars in China. Many Chinese scholars are able to obtain financial support for visiting scholar programs with international institutions. However, there is no good mechanism to pair them up with the appropriate mentors through the program. Therefore they cannot make full use of their time while studying abroad.
受访者：海外学者与中国国内学者的匹配合作可能是个不错的方案。中国卫生政策与管理学会能很快帮助初级学者找到合适的海外导师。不少中国学者能申请到资金成为海外访问学者，但目前没有一个成熟的机制帮助他们匹配合适的导师，所以浪费了很多他们在海外学习的时间。
INTERVIEW WITH DR. YU FANG (ASSOCIATE PROFESSOR, XI’AN JIAOTONG UNIVERSITY)
方宇博士(西安交通大学副教授)访谈
By Kun Zhang Ph.D.
张坤
Dr. Yu Fang is an associate professor in the Department of Pharmacy Administration at the School of Medicine, Xi’an Jiaotong University. Dr. Fang’s research interests focus on assessing the accessibility of essential prescription drugs in western China and evaluating outcomes of pharmaceutical care for patients with hypertension. Dr. Fang has published multiple peer-reviewed journal articles and book chapters.
方宇博士是西安交通大学医学院药学系副教授。他的主要研究方向为国家基本药物目录所涵盖的药物的可获得性评估及改进，以及对治疗高血压病人药物效果的评估。方宇博士已经发表了多篇同行评审学术论文，参与了多部学术著作的编写。
Kun Zhang is a Prevention Effectiveness Fellow at the Centers for Disease Control and Prevention
张坤博士是美国疾病控制与预防中心研究员。
Kun: What aspects of the CMB Open Competition (OC) grant you find the most appealing?
张坤：CMB 公开竞标项目的哪些方面吸引了你的参与？
Dr. Fang: What appeals to me the most is the purpose and theme of the CMB OC, which is to improve health policy and systems sciences (HPSS) research capacity in China through supporting researchers in medicine and public health across China. Second, CMB OC emphasizes emerging health challenges and the new healthcare reform in China, and it is willing to fund research in these areas to ensure that people in China have equitable access to healthcare. Third, CMBOC provides young researchers in China a great platform for international and domestic exchange.
方宇：有三个地方非常吸引我。第一，CMB公开竞标项目的目的是通过选拨并支持我们这些研究人员来改进中国的卫生政策与卫生体系科学的研究。第二：CMB 公开竞标项目强调支持对于中国当下医疗卫生体制改革以及目前医疗卫生面临的新挑战的研究，并且希望通过这些研究来确保每一个中国人都等平等的享受医疗卫生服务。第三，CMB给这一领域里中国年轻的学者们提供了一个前所未有的国际与国内交流的平台。
Kun: Are there any lessons learned from participating in the CMB OC?
张坤：这次申请CMB公开竞标项目过程中，哪些经验对你最重要？
Dr. Fang: The application for CMB Open Competition grant led to many new ideas for me when searching for research topics and carrying out HPSS studies. Moreover, in the second round of the review process, the reviewers provided constructive comments on study design, data collection, feasibility of the proposal, and the budget planning. These comments are extremely helpful to my future research and grant writing. I truly appreciate the effort and contribution of all the reviewers.
方宇：这次申请CMB公开竞标项目给了我很多关于选择研究课题以及具体实施卫生政策和卫生体系科学研究的启发。最重要的是，在项目审核的第二阶段，项目申请评审专家给了我很多建设性的意见，例如对于我的研究设计，数据收集，研究可行性等。这些建议对于我今后的研究以及继续的申请很重要。我衷心感谢这些评审专家所作出的努力与贡献！
Kun: As an expert in pharmaceutical policy research, what do you think are the major causes for the high price of pharmaceutical products in China?
张坤：作为一位药物政策研究领域的专家，你认为目前我国药价高的主要原因是什么？
Dr. Fang: In my opinion, the long-standing public hospitals' reliance on drug sales to generate revenue is the main reason of the high price of pharmaceutical products in China. In 2009, national health care expenditure in China totaled $240 billion, about 5% of China’s gross domestic product (GDP). Spending on drugs accounted for more than 40% of total expenditure, which is one of the highest in the world. The high pharmaceutical expenditure is associated with both high retail prices of drugs and high utilization, some of which are irrational and unnecessary. Furthermore, both price and utilization factors are deeply associated with policies including overall health sector regulation, health care financing policies, and pricing policies. Recognizing the major causes for the disproportionately high pharmaceutical expenditure, the new round of health care reform particularly emphasized the establishment of National Essential Medicines System (NEMS), and the implementation of public hospital reform and promoting rational use of medications.
方宇：公立医院长期依赖药物出售来创造收入是中国药价高的主要原因之一。2009年，中国的医疗卫生支出达到2400亿美元，占全国GDP的5%。其中药物支出就占到40%，这在全世界范围内来讲都是非常高的。药物方面的高支出是因为高药价以及高使用，其中对很多药物的使用都是非理性以及不必要的。高药价和高使用又与中央对于医疗卫生部门，例如制药企业以及公立医院的监管，以及定价政策紧密相连。正是因为对这些原因的及时认识，在新一轮的医疗卫生改革中，中央强调对了于国家基本药物目录的建立以及公立医院的改革，和促进合理用药。
Kun: What do you think are the pros and cons of establishing a National Essential Medicines system by the central government?
张坤：你认为由政府来制定国家基本药物目录的优势和劣势是什么？
Dr. Fang: According to the WHO Framework for Action, “access to health care including essential medicines is part of the fulfillment of the fundamental right to health. All countries are obligated to work towards the fulfillment of equitable access to health care services and commodities, including essential medicines necessary for the prevention and treatment of prevalent diseases. Appropriate policies and action plans need to be put in place to achieve this aim". In response, as one of the top five priorities of the Chinese government's systematic plan announced in 2009 aiming to achieve universal access to healthcare by 2020, the establishment of a NEMS to meet basic needs for treatment and prevention and ensure drug safety, quality, and supply was particularly emphasized. I am pretty optimistic that by improving access to existing essential medicines in China, more and more people will share the benefits of the healthcare reform. Meanwhile, it is urgent to generate evidence about the impact of the NEMS on access to and affordability of medicines, as well as to support the central government’s implementation of sound pharmaceutical policies.
方宇：根据世界卫生组织的行动框架，平等享有医疗卫生服务包括基本药物，是保证人类健康权利的一个根本。所有世卫组织成员国都应该努力让其国民平等享有医疗卫生服务和物品，包括基本药物，来预防和治疗疾病。成员国需要制定相关的政策和行动计划来保证这一目标的实现。中国政府对于这一框架做出了积极的回应。2009年，中国政府制定了一个系统的计划来保证在2020年前实现全民享有医疗卫生服务。这一计划强调了五个重点领域，其中一个就是建立全国基本药物目录。建立基本药物目录的目的就是保证人民对于疾病基本的预防的治疗，保障药品安全，质量，以及供给。我本人对于通过改善对基本药物目录药品的获取使人民最终享有医疗卫生改革的好处保持乐观的态度。同时，我们也亟需相关的研究来评估建立基本药物目录对于民众用药难用药贵问题的影响，这样才能更好地为中央实施药品政策提供建议与支持。
INTERVIEW WITH DR. JIN YAN (PROFESSOR, CENTRAL SOUTH UNIVERSITY)
严谨博士（中南大学教授）访谈
By Kun Zhang, Ph.D.
张坤
Dr. Jin Yan is a Professor and Deputy Director of the Department of Nursing at the 3rd Xiangya Hospital, Central South University in China. Dr. Yan’s research interests focus on care coordination between hospitals and communities for patients with chronic obstructive pulmonary disease (COPD) and care and education for children with HIV/AIDS in China. Dr. Yan has published multiple peer-reviewed journal articles.
严谨博士是中南大学护理学院教授并兼任护理学院护理部副主任。她的主要研究方向为如何协调并整合医院与社区资源来帮助患有慢性阻塞性肺病病人康复，以及对携带艾滋病毒和患有艾滋病未成年人的治疗与教育。严谨博士已发表了多篇同行评审学术论文。
Kun Zhang is a Prevention Effectiveness Fellow at the Centers for Disease Control and Prevention.
张坤博士是美国疾病控制与预防中心研究员。
Kun: What aspects of the CMB Open Competition (OC) grant are the most appealing to you?
张坤：CMB 公开竞标项目的哪些方面吸引了你的参与？
Dr. Yan: It is the theme of the CMB OC, which is to promote health policy and system sciences (HPSS) research in China through selecting and supporting researchers in this area that attracts me the most.
严谨：CMB公开竞标项目最吸引我的地方是它的目的和主题，即通过选拨并支持我们这些研究人员来推广并改进中国卫生政策与卫生体系科学的研究。
Kun: What aspects of your background and research experience do you think helped you get funded?
张坤：这次申请CMB公开竞标项目过程中，你认为你的研究背景和经验的哪些方面对你最有帮助？
Dr. Yan: I have to say that the training of CMB-991 in 2011 benefited me a lot. In addition, I believe my doctoral training and research in epidemiology and statistics helped me. Lastly, my visit and study in the Chinese University of Hong Kong in 2011 improved my writing in English which is also crucial for applying the CMB OC grant.
严谨：于2011 年举办的CMB-991培训让我在这次竞标中受益匪浅。其次，我认为我博士期间流行性病学和统计学的系统学习对我帮助也非常大。最后，我在香港中文大学期间的访问和学习对我的英文写作是一个提高，这个对于CMB公开竞标项目申请很重要。
Kun: In your CMB OC research, what measures did you use to ensure the validity of randomization?
张坤：在你的CMB OC研究项目中，你们运用了哪些方法保证该研究随机分组的有效性？
Dr. Yan: In addition to our own work and effort, we have professional consulting company in statistics and research design to ensure the validity of randomization.
严谨：我们在最大的保证该研究随机分组的科学性的过程中，获得了专业的研究咨询机构的参与和帮助。这对于确保随机分组的科学性和有效性会是一个帮助。
Kun: You mentioned that reform in hospital outreach is one of the focus areas in China’s public hospital reform since 2009. What is the impact of the reform so far? What else do you think should be done to improve hospital outreach intervention?
张坤：你提到过2009年的公立医院改革的一个核心方面是改革公立医院如何将疾病干预深入到社区。那么这次改革的成果如何？你认为这个方面的改革应该如何深化？
Dr. Yan: The reform is not sufficient so far. More reform is needed on the public hospital payment policy and delivery system. I think the next focus should on compensating public hospitals for community intervention. Hospital community outreach intervention would be improved if payments to public hospitals cover the cost of the intervention.
严谨：上一轮的改革还不是很彻底，特别是对于公立医院如何在社区提供疾病干预。我认为接下来的重点应该是有针对性的改善对于公立医院提在社区提供疾病干预进行补偿。如果这一点能得到一些改善，那么公立医院在社区提供疾病干预才有可能得到改进。
Kun: As you pointed out, air pollution and smoking are both important risk factors for COPD in China. What would be the impact of these factors on incidence of COPD in the near future given the deterioration in air pollution and expanding smoking population in China?
张坤：你提到过空气污染和吸烟都是慢性阻塞性肺病的风险因素，那么考虑到目前中国的空气污染状况在恶化，吸烟人群的扩大还不能得到有效控制，这对于慢性阻塞性肺病的发病率意味着什么？
Dr. Yan: I anticipate higher incidence of COPD if the air pollution in China continues to deteriorate. This will likely to be a heavy burden to the healthcare system in China in the near future. More research is needed to quantify the impact of air pollution.
严谨：我认为慢性阻塞性肺病的发病率只可能继续恶化，如果空气质量继续恶化，并且没有其他更好的预防手段的话。很有可能在不久的将来，这一疾病会给我们的医疗卫生系统带来沉重的负担。然后，我们也需要更多的研究来对这样影响进行量化。
INTERVIEW WITH DR. WENJIE GONG (SENIOR LECTURER, CENTRAL SOUTH UNIVERSITY)
龚雯洁博士（中南大学高级讲师）访谈
By Rui Li, Ph.D.
李蕊
Dr. Wenjie Gong is a senior lecturer in the School of Public Health at Central South University. As a clinician-turned public health researcher with reproductive medicine and gynecology background, Dr. Gong's research interests focus on women's health, especially in reproductive health and mental health.
龚雯洁，中南大学公共卫生学院讲师。龚博士有医学与妇产科临床背景，主要研究方向为妇女健康与精神健康。
Rui Li is a Senior Service Fellow at the US Centers for Disease Control and Prevention.
李蕊博士是美国疾病控制与预防中心高级研究员。
Rui: Could you please introduce yourself, your team, and your proposed project?
李蕊：能否介绍一下您和您的团队，以及您此次申请的研究项目？
Dr. Gong: I have a very diverse background. After I received my Bachelor of Medicine degree in clinical medicine, I went to work in the rural area for one year. For my Master’s degree, I studied genetics with a focus on women’s reproductive health. Afterwards, I worked as an obstetrician at a tertiary hospital for 2 years. In 2008 I became a Ph.D. student in social medicine and started to teach in the School of Public Health. Currently I am a lecturer in the Department of Adolescents and Women’s Health. The diverse working experience and the broad educational background helped me to be open-minded and interdisciplinary. At the same time, I had to learn many new things. Fortunately I work in a great academic team and they have helped me substantially with professional development. In two years, our team, led by Professor Shuiyuan Xiao, has received a CMB CP grant and three CMB OC grants. These achievements are attributed not only to the team members’ hard work, but also to the team members’ experience and scientific training accumulated over time.
My OC project is based in Liuyang, with which our team has a long-term collaborative relationship. My research design has also benefited tremendously from the deep knowledge of the operations of local mental health centers. The main purpose of our study is to explore an effective model for the rural area to address mental health problems. We aim to train the village doctors as a supplement to the “686” project, an ongoing government sponsored program focusing on managing severe mental disease, to effectively manage the bi-polar patients in the rural areas.
龚雯洁：我的经历比较复杂，临床医学本科毕业后曾在农村支教一年，硕士专业是遗传学，研究方向为女性生殖卫生，之后做了两年的三甲医院妇产科临床医生，2008年成为社会医学博士研究生，同时调动至公共卫生学院任教，目前是儿少与妇幼保健学系的讲师。这么多角色和专业的转换，尤其从临床到公卫，给了我相对开阔的视野思路和交叉综合的学术背景，但同时也让我总要重新学习和积累。很幸运的是，我身处非常优秀和团结的学术团队，我的迅速成长与他们的支持和培训密不可分。两年间，我们这个以肖水源教授为首的团队得到了CMB的CP一项及OC三项资助，除了成员的个人努力之外，整个团队长久以来的工作积累和科学训练也起到重要作用。我这次的OC项目现场便是团队合作多年的基地：浏阳，研究思路也脱胎于与当地精神卫生部门运作过程和工作模式的长期了解，主要目的是探索一种农村地区的有效模式，通过培训村医，对当地目前正实行的政府项目（重性精神疾病管理治疗项目，也叫“686”项目）起到积极补充作用，更有效地对精神分裂症患者进行病案管理。
Rui: Have you applied for any internationally funded projects before? How do you assess the selection process? What you have learned in this application process that might be useful for your grant-writing?
李蕊：您之前是否申请过其他国际研究项目经费？您如何评价此次选拔的过程？您认为在申请过程中的哪些收获对您今后撰写标书有所帮助？
Dr. Gong: Before applying for the 2012 OC grant, I did not have any experience applying for international grant as a PI. However, I have participated in the application and setting-up of several past CMB projects. Compared with the National Natural Science Foundation grant application, the OC grant application process is more focused on the significance and the feasibility of the project, instead of applicants’ background and experience. However the process was very rigorous and it was an extended process. In addition to the content of the project, it is a test of the perseverance and faith of the applicants. It is important to be confident while recognizing the weakness in my application and working hard to address them. Especially in responding to the review comments, it is critical to realize that no PI could ever be the expert in everything from research design to data analysis and to economic evaluation. In order to succeed in the grant application one needs to find support from other experts that addresses precisely the problem at hand.
龚雯洁：在参与2012年的OC之前，我没有作为PI申请过国际项目，但是不同程度地参与了团队成员以往CMB项目的申请以及前期开展。相对于国家自然科学基金的申报要求，我觉得CMB的OC项目筛选更多地把关注点从申报者的资历和学术积累转移到课题本身的现实意义和可行性，但是整个竞争过程非常严格和漫长，除了对研究本身的打磨之外，同时也在考验申请者的毅力和信念。在这个过程中，除了必要的自我肯定之外，承认自己的不足，然后努力弥补这个不足非常重要。尤其在对审稿人的评价做回复的阶段，要认识到没有一个PI可以做到每个相关方面的专家，从科研设计到数据统计，包括经济学评估等环节全部完美周全，那么需要寻找相应的支持，而且是真正有针对性的支持，对于申报的成功有至关重要的作用。
Rui: How did you choose the topic?
李蕊：您是如何选择研究课题的？
Dr. Gong: My experience of working in countryside got me interested in rural health. The long-term collaboration between our team and the Liuyang mental health centers helped me understand the role of village doctors in mental health. I also came to understand the issues and needs in implementing the 686 Project. Before the application, I was in charge of the baseline survey for the mental health patients in Liuyang district. The data showed that the proportion of schizophrenic patients who received comprehensive mental health treatment was quite low. So I chose this topic based on the above reasons.
龚雯洁：我在农村支教的经历让我关注到这个有特征性的地域。我们团队与浏阳精神卫生部门多年的合作使得我了解村医这个群体，并熟悉686项目执行中的盲点和需求，申报前不久的我负责了一次浏阳地区精神障碍患者的摸底调查，数据体现精神分裂症患者的系统治疗率较低，由此综合考虑，便选择了这个题目。
Rui: What kind of training/guidance/support do you hope the CMB can provide for the applicants in the future?
李蕊：您希望CMB 今后能够为申请者提供怎样的培训，指导或支持？
Dr. Gong: It might not be realistic to expect CMB to provide centralized training for all applicants on how to prepare for the application as 991 projects did. However, if CMB can provide the full abstracts of funded projects in the past or even 1 to 2 sample grant applications, that will be very helpful for the applicants in terms of understanding the requirements of the OC project and minimizing the confusion in the application process.
龚雯洁：对所有申请者进行991项目式的集中培训也许并不现实，但若能给其提供往年成功的完整摘要乃至1-2份完整标书，让其更直观地了解到OC项目的要求和方向，也许能使其在申报过程中不会过于茫然。
Rui: What is your most memorable experience in applying for this OC grant?
李蕊：您认为在此次申请OC项目中最难忘的经历是什么？
Dr. Gong: Although not sure if I am the least experienced among all awardees of the OC history, I am certainly the only lecturer among all PIs who have received OC funding at Central South University. This is just to make the point that all junior faculties should feel encouraged to participate in such competitions. Since I am still a junior faculty, I did not have much pressure when I applied for the OC grant. However, even failure appeared likely in the eyes of others, I had to do my best when preparing my application. Because the OC grant application was quite an extended process, it was very stressful for the applicants. The further along you are in the process, the more hope you have, but at the same time, the more stressed you become. It was very important to balance the expectation and the stress.
In the last round, CMB selected 13 applications, but did not provide the ranking of the applications nor the number of the applications that would be awarded the grant. The project officers e-mailed several applicants who were “on the margin”. I was one of them. To many applicants, it was perhaps crueler to fail during the last stage than at the beginning. However for me, I focused more on the process rather than the outcome. Although being prepared for the failure, I decided to take the slim odds seriously and spent whole week preparing my responses. At the same time I received full support from my team. We had a group discussion on the review comments. Professor Xiao Shuiyuan and Prof. Zhou Liang provided me with many constructive comments. I prepare very detailed responses to each review comments. For example, when the feasibility of the intervention was challenged, I provided a number of references on the success of similar interventions in the similar population targeted at similar diseases, instead of just putting down “we can try it” or “it should work”. One particular experience I want to emphasize is the response to the comment of adding a health economist to the team. As a medical doctor without any health economics training, I am not equipped to respond to the economic evaluation questions in a short period of time. However I could look for a health economist to join the team. I searched in the literature, asked for reference, sent e-mails to experts, and explained my project on the phone. On the last day before the deadline I secured the support from a U.S. based health economist. Although I was not sure how much of the improvement in my project scoring can be attributed to these efforts, I would like to share my experience with everyone. I hope you would benefit from my experience and succeed in your future career.
龚雯洁：我不知道自己是不是CMB历史上拿到OC的申报者中职称和资历最低浅的，但起码在中南大学历年拿到项目的PI中是唯一的讲师。强调这一点只是为了鼓励更多如我一般的青年教师参与到这个领域，也正因为这一点，我在整个申报过程中没有太大的心理压力。但即使失败在旁人看来是理所当然，自己也必须付出全力。尤其OC的申报过程非常漫长，从学校限额的竞争到递交摘要争取写完整标书机会，得出初步人选后要求其根据审稿人意见写回复并修改标书……这种逐步地筛选对于申报者绝对是一种煎熬，越到后面付出越多也会寄予更多的希望，这个时候如何平衡自己的期望和压力非常重要。
在最后回复环节，CMB筛选出13位候选人，但并没有公布评委第一轮的打分排名，也没有告知最后的幸运者会有多少位，负责人通过邮件向排名靠后的几位发出了“在边缘地段，希望渺茫”的提示，而我也在其中。也许对于大多数申请者来说，倒在终点前是比一开始就出局还残忍的结果，但是我觉得起码看到了这一路的风景，所以尽管怀有失败的准备，我依然决定认真站好最后一班岗，专门拿出一周的时间来写回复。同时我们团队也在尽全力地给予我支持，专门召开了针对回复的讨论会，肖水源教授和周亮教授都给予我许多针对性的建议。以这种学习的心态，我针对每一条意见详细解释和回复，尤其当干预方式的可行性被质疑时，我查找了一系列相关文献，用类似的地点、类似的人群、类似的疾病、成功的干预研究报导来说话，而不是简单地回答“应该可以”或者“试试看”。最后要提的是关于卫生经济学家的找寻，作为一个没有受过严格经济学训练的医学研究者，我没有办法靠短时间的自学来回答这个研究中相关的经济学评价问题，但是我认为可以找一个这个领域的专家来帮助我弥补这个缺陷，因此我查找了相关内容的文献，请人推荐作者，写邮件联系，电话解释自己的项目……在截止期的最后一天终于得到了这位美国卫生经济学家的支持。尽管我并不了解自己排名的上升与这些努力之间明确的相关系数，但是我认为，与大家真诚地分享这个过程，也是这次OC的终点风景之一，希望更多的人因此走得更远。