Gender Disparity in National Institutes of Health Funding Among Surgeon-Scientists From 1995 to 2020

Abstract

ImportanceSurgical diseases account for approximately 30% of the global burden of disease. Gender diversity in biomedical research is critical to generate innovative patient-centered research in surgery.ObjectiveTo examine the distribution of biomedical research funding by the National Institutes of Health (NIH) among women and men surgeon-scientists during a 25-year period.Design, Setting, and ParticipantsThis cross-sectional study used publicly available data from the NIH RePORTER (Research Portfolio Online Reporting Tools: Expenditures and Results) database for research project grants awarded to women and men surgeon-scientists who were principal investigators between 1995 and 2020. Data were retrieved between January 20 and March 20, 2022. The representation of women surgeon-scientists among academic surgeons was compared with the representation of men surgeon-scientists over time.Main Outcomes and MeasuresDistribution of NIH funding to women and men surgeon-scientists was examined via 2 metrics: holding a large-dollar (ie, R01-equivalent) grant and being a super principal investigator (SPI) with $750 000 or more in total annual research funding. Statistical analysis was performed between April 1 and August 31, 2022.ResultsBetween 1995 and 2020, 2078 principal investigator surgeons received funding from the NIH. The proportion of women academic surgeons who were surgeon-scientists remained unchanged during this same period (1995, 14 of 792 [1.8%] vs 2020, 92 of 3834 [2.4%]; P = .10). Compared with their men counterparts, women surgeon-scientists obtained their first NIH grant earlier in their career (mean [SD] years after first faculty appointment, 8.8 [6.2] vs 10.8 [7.9] years; P < .001) and were as likely to obtain large-dollar grants (aRR, 0.99 [95% CI, 0.95-1.03]) during the period 2016 to 2020. Despite this success, women surgeon-scientists remained significantly underrepresented among SPIs and were 25% less likely to be an SPI (aRR, 0.75 [95% CI, 0.60-0.95] during the period 2016 to 2020).Conclusions and RelevanceThe findings of this cross-sectional study of NIH-funded surgeons suggest that women surgeons remained underrepresented among surgeon-scientists over a 25-year period despite early career success in receiving NIH funding. This is concerning and warrants further investigation to increase the distribution of NIH funding among women surgeon-scientists.

Rates of National Institutes of Health Funding for Surgeon-Scientists, 1995-2020

“…Female surgeons report significant tension between clinical and research responsibilities, and there are greater numbers of female academic surgeons on clinical tracks in their departments . In 2020, among all female academic surgeons, less than 30% receive NIH funding . In this study, we found that despite incremental increases in representation in NIH grants, female surgeons received less than 20% of NIH funding support to surgeon-scientists.…”

“…20 In 2020, among all female academic surgeons, less than 30% receive NIH funding. 21 In this study, we found that despite incremental increases in representation in NIH grants, female surgeons received less than 20% of NIH funding support to surgeon-scientists. In 2 surveys administered by the Society of University Surgeons in the past 2 decades, surgeons have called for institutions to recognize the value of surgical research and decrease the barrier to research by lowering clinical demands.…”

Workforce Attrition Among Male and Female Physicians Working in US Academic Hospitals, 2014-2019

“…Female physicians are promoted at a slower rate, are less likely to be in leadership positions, and receive less compensation than male physicians . Uneven distribution of academic and research support, such as time and space, funding, or personnel assistance, further contributes to the problem . Furthermore, female physicians are more likely to be asked to volunteer for tasks and committees that are not relevant to or not beneficial for career advancement than their male colleagues .…”

Oncology Physician Workforce Diversity

“…A repeat analysis in 2019 noted this number had not changed that much 5 . In another study, despite receiving early career success in receiving NIH grant funding, many women surgeons remained underrepresented as surgeon-scientists pointing to other barriers during their career 48 . A recent oncology-specific analysis of 7 major hematology and oncology societies from 1994 to 2019 found women and minority groups to be underrepresented among award recipients.…”

“…5 In another study, despite receiving early career success in receiving NIH grant funding, many women surgeons remained underrepresented as surgeon-scientists pointing to other barriers during their career. 48 A recent oncology-specific analysis of 7 major hematology and oncology societies from 1994 to 2019 found women and minority groups to be underrepresented among award recipients. Finally, it is worth noting that barriers in oncology also extend beyond what is noted above and include significant geographic and care disparities.…”