BACKGROUND
The purpose of this study is to compare the compositions of federally-funded surgical research between 2003 and 2013, and to assess differences in funding trends between surgery and other medical specialties.
DATA SOURCES
The NIH RePORTER database was queried for grants within core surgical disciplines during 2003 and 2013. Funding was categorized by award type, methodology, and discipline. Application success rates for surgery and five non-surgical departments were trended over time.
RESULTS
Inflation-adjusted NIH funding for surgical research decreased 19% from $270M in 2003 to $219M in 2013, with a shift from R-awards to U-awards. Proportional funding to outcomes research almost tripled, while translational research diminished. Non-surgical departments have increased NIH application volume over the last 10 years; however, surgery’s application volume has been stagnant.
CONCLUSIONS
To preserve surgery’s role in innovative research, new efforts are needed to incentivize an increase in application volume.
Background
Funding toward surgical research through the National Institutes of Health (NIH) has decreased relative to other medical specialties. This study was initiated to characterize features of academically successful, surgeon-scientists and departments of surgery. We hypothesized that there may be decreases in young investigators obtaining independent NIH awards and that successful academic departments of surgery may be depending increasingly on PhD faculty.
Methods
The NIH RePORTER database was queried for grants awarded to Departments of Surgery during fiscal years 2003 and 2013. Grant summaries were categorized by research methodology. Training of the principal investigator training and academic position were determined through the RePORTER database and publicly-available academic biographies. Institutions were ranked by number of grants funded.
Results
Between 2003 and 2013, total surgery grants awarded decreased by 19%. The number of NIH-funded, clinically-active surgeons (MDsMDs) decreased 11%, while funded PhDs increased 9%; however, clinically active junior faculty have comprised an increasing proportion of funded MDs (from 20% to 38%). Shifts in research topics include an increasing proportion of investigators engaged in outcomes research. Among institutions ranking in the top 20 for surgical research in both 2003 and 2013 (N = 15), the ratio of MDs to PhDs was 2:1 in both fiscal years. Among institutions falling out of the top 20, this ratio was less than 1:1.
Conclusions
There has been an expansion of outcomes-based surgical research. The most consistently successful institutions are those that actively cultivate MD researchers. Encouragingly, the number of young, independently-funded surgeon-scientists in America appears to be increasing.
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