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Central Surgical Association

49th Annual Meeting

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Current Status of NIH Funding for Thoracic Surgeons in the United States: Beacon of Hope or Candle in the Wind?
Frank Villa-Hernandez1, Tuana Tolunay1, Lindsay A. Dembloski2, Haitao Wang1, Shamus R. Carr1, Chuong D. Hoang1, Martha A. Zeiger2, David S. Schrump1
1Thoracic Surgery, NIH/NCI, Bethesda, Maryland, United States, 2Surgical Oncology Program, NIH/NCI, Bethesda, Maryland, United States

Objective: Research initiated by Thoracic surgeons (TS) has been linked to academic productivity and career trajectories as well as wide-ranging healthcare innovations. Increasing clinical demands, complexity of bench research, highly-competitive funding environment, and paucity of surgeons on study sections pose significant barriers to TS-initiated research. This study examined the current status of NIH funding for TS.
Methods: TS principal investigators (PIs) on NIH-funded grants during June 2010 and June 2020 were identified using NIH iSearch Grants (version 2.4). American Association of Medical Colleges data were used to identify all surgeons in the US. Types and total costs of NIH-funded grants were collected. A chi-square test of independence and an independent t-test were performed to examine the proportion of TS-PIs vs PIs in other surgical subspecialties and evaluate gender funding disparities; a p-value <0.05 was considered significant.
Results: 60 of 4681 (1.3%) and 60 of 4479 (1.3%) TS were PIs on NIH-funded grants in 2010 and 2020, respectively. The proportion of NIH-funded TS (males as well as females) was higher than other surgical subspecialties combined for 2010 and 2020 (p ≤ 0.01). In contrast to Thoracic Surgery, other surgical subspecialties experienced an increase in the proportion of NIH-funded PIs (p < 0.01) during that decade. Total NIH costs for TS-initiated grants increased from $36,788,721 in 2010 to $58,964,735 in 2020 (indirect costs remained steady at ~30%); this 60% increase in costs for TS-PIs outpaced the 33% increase in total NIH budget ($31.238B-$41.685B) during that decade. Of 60 TS-PIs in 2010, 4 (6.7%) were female (women comprised 4.6% of the TS workforce). Of 78 TS-PI grants in 2010, 72 (92%) were funded by NHLBI (n=58), NIAID (n=4), or NCI (n=10). Of 60 TS-PIs in 2020, 6 (8.6%) were female (women comprised 8% of the TS workforce). Of 87 TS-PI grants in 2020, 82 (94%) were funded by NHLBI (n=59), NIAID (n=8), or NCI (n=15). Types and costs of grants funded in 2010 and 2020 are summarized in Table 1. Per-capita costs were highest for transplant-related grants during both years. Whereas R01 grants increased from 40 (total cost = $20,124,632) in 2010 to 55 (total cost = $31,613,760) in 2020, the proportion of R01-to-total costs for TS-PI grants remained constant at 55%. Rates and levels of funding for female TS did not differ from male TS with comparable grants. Awards to 5 surgeons accounted for 33% of total NIH costs for TS-PIs in 2020; a similar phenomenon was observed for 2010.
Conclusions: Despite increased NIH expenditures for TS-initiated grants, the number of PIs remains flat. The low number of female TS-PIs reflects gender composition of our subspecialty. Long-term structural changes must be implemented to increase and more effectively nurture the next generation of Thoracic surgeon-scientists.


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