Surgery investigators funded through the National Institutes of Health: A rebirth

Abstract

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.

Patterns of Recent National Institutes of Health (NIH) Funding in General Surgery: Analysis Using the NIH RePORTER System

“…Recent data has shown that there was also a 19% decrease in the total amount of NIH-awarded grants to general surgeons from 2003 through 2013 [3]. Furthermore, many surgical subspecialties have noted a gender disparity in those being awarded NIH grants [4].…”

Association of Surgeon Representation on NIH Study Sections With Receipt of Funding by Surgeon-scientists

“…Negotiated “protected time” (such as months or weeks purely devoted to research) can be challenging or even impractical for surgeons 5 . One strategy undertaken by many departments of surgery has been to increase the number of nonclinical faculty dedicated to surgical research, 18 a strategy that is reflected in the findings of this study and others 19 . This strategy allows for departments to engage in the research mission, while continuing to encourage surgeons to be clinically productive.…”

“…5 One strategy undertaken by many departments of surgery has been to increase the number of nonclinical faculty dedicated to surgical research, 18 a strategy that is reflected in the findings of this study and others. 19 This strategy allows for departments to engage in the research mission, while continuing to encourage surgeons to be clinically productive. This suggests that surgeon-scientists may struggle to balance research and clinical demands, let alone have time to serve as NIH reviewers.…”

Growing the Next Generation of Trauma Surgeon Scientists – Reflections on 20 Years of Research Investment

“…21,22 The combination of decreased available funding to surgeons, decreased number of surgeons seeking funding, fewer surgeon-scientist mentors, and increased emphasis on academic surgery as a business has resulted in a marked decrease in surgeon-directed research in recent years. 3,21,23,24 The proportion of surgeons with NIH funding is less than 25% of our nonsurgeon medical colleagues. 23 play a vital role in overcoming some of these challenges in fostering the growth of the next generation of surgeon-scientists.…”