Y. Hu1, B. L. Edwards1, K. Hu1, K. D. Brooks1, C. L. Slingluff1 1University Of Virginia,Surgical Oncology/Surgery/School Of Medicine,Charlottesville, VA, USA
Introduction: Over the past decade, funding toward surgical research through the National Institutes of Health (NIH) has diminished relative to other medical specialties primarily due to stagnant application volume. The purpose of this study is to characterize key features of academically-successful clinicians, researchers, and institutions. We hypothesized that PhD investigators comprise a growing workforce within the surgery research engine, and that clinically-active junior faculty (assistant and associate professors) are increasingly engaged in outcomes-based research.
Methods: The NIH RePORTER database was queried for all grants awarded in the United States to Departments of Surgery for research in core surgical disciplines during fiscal years 2003 and 2013. F- and T-awards were excluded. Grant summary descriptions were reviewed by two investigators and categorized by research methodology (basic science or translational, clinical trials, outcomes, and other). Principal investigator specialty training and academic position at the time of funding was determined through the RePORTER database and through online academic biographies. Institutions were ranked by number of grants funded. Categorical comparisons between 2013 and 2003 were assessed using Fisher’s Exact test.
Results:Between 2003 and 2013, the total number of grants awarded diminished by 19% (512 vs 613). The number of funded, clinically-active surgeons (MD’s) decreased by 11% (231 vs 264), while funded PhD’s increased by 9% (161 vs 148). Junior faculty are comprising an increasing proportion of funded MD’s (38% vs 19%). Among funded MD’s, an increasing proportion of both junior faculty (16% vs 2%, p = 0.005) and full professors (16% vs 5%, p = 0.018) are engaging in outcomes-based research. Among the top 20 institutions for surgical research in 2003, 15 remained in the top 20 in 2013. Within these 15 institutions, the ratio of MD’s to PhD’s was 2:1 in both fiscal years. Among institutions falling out of the top 20, this ratio was lower than 1:1 in both periods.
Conclusion:An expansion of outcomes-based research is evident across surgeons of all academic positions. Although an increasing fraction of the surgical research workforce is comprised of PhD investigators, the most consistently successful institutions are those that actively cultivate a robust roster of MD researchers. Encouragingly, the population of surgeon-scientists in America is becoming younger, foretelling a promising future for surgical innovation.