An analysis of the National Institutes of Health database reveals surgeon scientists have become more diverse in their research efforts, while still keeping a focus on basic science.
Since 2010, National Institutes of Health (NIH) funding to support surgeon scientists has, remarkably, risen significantly while funding to support other non-surgeon physicians has significantly decreased.
This growth has occurred despite an overall decrease in NIH funding and an increase in demand for clinical productivity. These findings are according to a "published on the website of the Journal of the American College of Surgeons ahead of print.
"Our findings challenge the notion that overall funding to support surgeon scientists has decreased; instead, it has dramatically increased," said Martha A. Zeiger, MD, FACS, Director of the Surgical Oncology Program, National Cancer Institute, NIH.
"When we looked at funding to support surgeons alone, we were surprised to find that funding has increased by 40 percent in terms of both numbers of surgeons being supported and the amount of funding. So, it's quite a remarkable and surprising finding."
About the study
Using an NIH portfolio database, study researchers were able to conduct a thorough analysis of funding to support all surgeons, including all surgical specialties and subspecialties in the U.S. Other studies have only captured funding patterns of entire surgical departments, certain institutions, or individual surgical specialties.
For this study, Dr. Zeiger and colleagues searched NIH databases for 2010 and 2020 to identify all active and awarded NIH grants to support surgeon scientists by surgical specialty, total costs, and whether the grant-supported basic science, clinical outcomes or clinical trials research.
The researchers also compared total funding to support surgeon scientists with funding granted to support non-physician scientists with PhDs and funding granted to support other non-surgeon physicians.
The analysis showed increases in both the number of surgeons and the amount of funding for each surgical specialty. The percentage of NIH-funded surgeons (compared with the total number of surgeons) increased by 40 percent. In contrast, the percentage of other NIH-funded physicians dropped by 27 percent.
- In June 2010, 715 surgeon scientists were supported by 1,113 grants, totaling $614 million in NIH funding. In June of 2020, 1,031 surgeon scientists were supported by 1,453 grants, totaling $872 million in NIH funding.
- General surgery-based subspecialties topped the list, comprising one-quarter of the funded specialties and close to 40 percent of the total funding.
- Obstetrics/gynecology was the second most funded surgical specialty.
- Neurological surgery was third.
Surgical oncology funding remains strong
General surgeons with a sub-sub specialty in surgical oncology led the group of general surgery-trained surgeons in a number of NIH-funded surgeons and total grant awards in both 2010 and 2020.
- In 2020, 27 percent of those trained in general surgery were surgical oncologists, holding about 44 percent of the total grant cost for all general surgeons.
- In 2010, surgical oncology also represented the majority of general surgery subspecialties, holding more than one-third of the funding for surgeons trained in general surgery.
Focus on basic science stable
We also found that basic science has remained stable since 2010. In fact, 70 percent of principal investigator-initiated grants are in basic science, and surgeons have maintained that percentage over the past 10 years."
Martha A. Zeiger, MD, FACS, Director of the Surgical Oncology Program, National Cancer Institute, National Institutes of Health
From 2010 to 2020, the researchers also found an increase in cooperative research grants, underscoring the fact that surgeon scientists working in multidisciplinary team research is on the rise.
"Surgeons contribute a tremendous amount to science, and, historically, they always have. They are very challenged these days because obtaining NIH funding has become more competitive," Dr. Zeiger said. "We also have increasing administrative responsibilities because of the electronic medical record, and clinical productivity is emphasized more and more across the country, especially for surgical subspecialties."
"Overall, I think it's remarkable that surgeon scientists have not only maintained but significantly increased the amount of NIH funding they are supported by over the past 10 years. Most importantly, they have also maintained a strong emphasis on basic science research," she concluded.
"Surgeon scientists have made outstanding gains in securing more NIH research funding. These exciting results show the dedication that they have to life-long learning and innovative research, along with a passion for science. Moreover, these findings show how committed surgeons are to seeking scientific pathways to continually improve the quality of surgical care for our patients, which is our highest priority," said ACS Executive Director David B. Hoyt, MD, FACS, a study coauthor.
Demblowski, L. A., et al. (2021) NIH Funding for Surgeon-Scientists in the US: What Is the Current Status? Journal of the American College of Surgeons. doi.org/10.1016/j.jamcollsurg.2020.12.015.