Medical Experts Issue Alert: Diminished Funding Threatens Future of Surgeon-Scientists

According to emerging research, surgeon-scientists are experiencing difficulty in acquiring consistent financial backing for their research, putting at risk advancements in surgical procedures as well as patient care. The research emphasizes that while junior surgeon-researchers are often successful in acquiring initial research grants, the burden of clinical responsibilities and the necessity to maintain surgical competencies make it challenging for them to sustain financial support, thereby affecting progress in diverse areas of medicine.

Medical professionals who specialize in surgery and concurrently conduct vital biomedical research are confronting obstacles in obtaining sustained research funding. This jeopardized funding pathway, termed a “broken pipeline” by experts from UVA Health, could lead to the dwindling number of surgeon-scientists and consequently impede patient-focused innovations unless addressed promptly.

The investigation, helmed by Bruce Schirmer, MD, from the Department of Surgery at UVA, found that although surgeon-scientists frequently secure initial research funding, they find it considerably more difficult than their colleagues in internal medicine to transform that into sustained financial support for research.

The underlying causes for this precarious situation are multifaceted, according to a scholarly article by Schirmer and his associates. These include the substantial clinical workload surgeons undertake, along with the continual need to refine their medical skills, leaving them with limited time to compete for research funding and to engage in patient-beneficial research.

Schirmer and his team warn that the implications of this development could be severe for the future. “Surgeons have been at the forefront of groundbreaking treatments for a range of illnesses, including but not limited to cardiovascular, digestive, neurological, endocrine, pulmonary, and urologic diseases, as well as multiple forms of cancer. The scarcity of ongoing funding for surgical research could inhibit such contributions moving forward,” stated Schirmer. “This data serves as a crucial signal for the surgical community to reevaluate the optimal timing for research within surgical training and the best strategies for securing subsequent research support.”

A Concerning Funding Disparity

Schirmer and his research team scrutinized the grants received by medical trainees in both surgical and internal medicine disciplines. While both groups secured F32 grants from the National Institutes of Health at comparable rates, internal medicine trainees were almost six times more likely to subsequently obtain R01 grants, which are highly competitive NIH grants. Additionally, these internal medicine researchers were five times more likely to secure career development K-awards from the NIH.

The researchers describe this precipitous decline in funding as a “shocking drop-off,” representing a “significant problem” for the field of surgery.

Bruce Schirmer, MD, of UVA Health, along with Adishesh K. Narahari, MD, caution that this impaired funding infrastructure for surgeon-scientists could be detrimental to innovation in patient care.

“Surgeons face substantial difficulties in acquiring funding, with many remaining unsuccessful despite a decade-long effort. The contributions of surgeon-scientists in biomedical research fields such as transplantation, oncology, and diabetes are numerous,” commented Adishesh K. Narahari, MD, PhD, the principal author of the scholarly article. “It is imperative for surgeons to apply for funding early in their careers and master the intricacies of the biomedical research funding landscape. Failure to do so could lead to a stagnation in medical innovation across various biomedical fields.”

Narahari, Schirmer, and their colleagues propose urgent corrective measures, which include:

• Introducing alternative funding models specifically designed for surgeon-scientists;
• Implementing institutional programs to support surgical trainees interested in conducting research;
• Reassessing performance metrics for surgeon-scientists to encourage research participation.

The UVA research team warns that should these issues remain unaddressed, the field of surgical research will be adversely affected.

“We hope our findings catalyze efforts to cultivate surgeon-scientists through academic, programmatic, and financial support systems that enable those passionate about such careers to flourish,” concluded Schirmer. “We strongly urge entities overseeing surgical education and training to give serious consideration to these insights.”

The study, titled “Postdoctoral National Institutes of Health F32 Grants – Broken Pipeline in the Development of Surgeon-Scientists,” was published in September 2023 in the Annals of Surgery. The research received financial support from the National Institutes of Health.

Frequently Asked Questions (FAQs) about Surgeon-Scientists Funding Crisis

More about Surgeon-Scientists Funding Crisis

• Full Study on Surgeon-Scientists Funding Crisis in Annals of Surgery
• National Institutes of Health Research Grants
• UVA Department of Surgery
• Overview of F32 Grants
• Guide to NIH’s R01 Grants
• Information on Career Development K-awards
• UVA Health Research Initiatives
• Latest Trends in Biomedical Research Funding