NIH funding trends for neurosurgeon-scientists from 1993–2017: Biomedical workforce implications for neurooncology

Abstract

Introduction: Neurosurgeons represent 0.5% of all physicians and currently face a high burden of disease. Physician-scientists are essential to advance the mission of National Academies of Science (NAS) and National Institutes of Health (NIH) through discovery and bench to bedside translation. We investigated trends in NIH neurosurgeon-scientist funding over time as an indicator of physician-scientist workforce training. Methods: We used NIH Research Portfolio Online Reporting Tools (RePORTER) to extract grants to neurosurgery departments and neurosurgeons from 1993 to 2017. Manual extraction of each individual grant awardee was conducted. Results: After adjusting for U.S. inflation (base year: 1993), NIH funding to neurosurgery departments increased yearly ( P <0.00001 ). However, neurosurgeon-scientists received significantly less NIH funding compared to scientists (including basic scientists and research only neurosurgeons) (P = 0.09). The ratio of neurosurgeon-scientists to scientists receiving grants was significantly reduced ( P = 0.002 ). Interestingly, the percentage of oncology-related neurosurgery grants significantly increased throughout the study period ( P = 0.002). The average number of grants per neurosurgeon-scientists showed an upward trend ( P <0.001 ); however, the average number of grants for early-career neurosurgeon-scientists, showed a significant downward trend ( P = 0.05 ). Conclusion: Over the past 23 years, despite the overall increasing trends in the number of NIH grants awarded to neurosurgery departments overall, the proportion of neurosurgeon-scientists that were awarded NIH grants compared to scientists demonstrates a declining trend. This observed shift is disproportionate in the number of NIH grants awarded to senior level compared to early-career neurosurgeon-scientists, with more funding allocated towards neurosurgical-oncology-related grants.

IDH–wild-type glioblastoma cell density and infiltration distribution influence on supramarginal resection and its impact on overall survival: a mathematical model

“…GBM prognosis remains dismal despite millions spent developing aggressive multimodal treatment. [1][2][3][4][5]31,32 While tumor molecular features such as the absence of an IDH mutation and MGMT promoter methylation strongly predict treatment response and OS in patients with GBM, there are several additional tumor-and patient-specific factors that also contribute to prognostication and to inform surgical planning. [33][34][35] In recent years, the tumor invasiveness profile has emerged as a potential new marker predicting GBM response to resection.…”

Presidential Address to the 2021 Annual Meeting of the Congress of Neurological Surgeons

“…7 The number of newly funded early career neurosurgeon-scientists continues to fall. 8 We do see some positive news. Fortunately, the NIH recognizes the importance of neurosurgeon-scientists.…”

Roadmap for Development of a Strong, Diverse Research Workforce in Neurosurgery

“…Neurosurgery department chair and society support remain essential factors in a junior faculty's NIH grant success. Neurosurgery broadly has also benefited, 5 as overall research funding to clinical neurosurgery departments increased 2.2-fold within 6-10 years of the start of these programs. 4 As junior faculty, neurosurgeons require continued mentorship on how to balance research careers with clinical demands, including protected research time as advocated by their chairs.…”

“…Neurosurgery department chair and society support remain essential factors in a junior faculty's NIH grant success. Neurosurgery broadly has also benefited, 5 as overall research funding to clinical neurosurgery departments increased 2.2-fold within 6–10 years of the start of these programs. 4…”

“…4 These programs have contributed to a more than doubling in the number of neurosurgeons holding independent NIH grants, as well as a dramatic increase in research funding to neurosurgeons, in just a 5-year period. 4,5…”