National institutes of health funding for surgical research

Objective: The objective was to compare National Institutes of Health (NIH) funding rates and application success rates among surgeon and nonsurgeon-scientists over the past 2 decades. Summary Background Data: Surgeons may be capable of accelerating the translation of basic research into new clinical therapies. Nevertheless, most surgeon-scientists believe they are at a disadvantage in competing for peer-reviewed funding, despite a recent emphasis on "translational science" by organizations such as the NIH. Methods: We accessed databases from the NIH and the American Association of Medical Colleges. Results: Although total competing NIH awards rose 79.2% from 5608 to 10,052, the much smaller number of surgical awards increased only by 41.4% from 157 to 222. There was a small but statistically significant difference between total NIH and surgical application success rates (29% vs. 25%, P < 0.01). However, the persistently low percent of NIH funding going to surgical investigators was due primarily to the very small number of surgical applications, and to a much smaller increase in the absolute number of applications over time (464 vs. 23,847). As a result, the number of grants per 100 faculty members, was more than 4 times higher among nonsurgical than surgical faculties at US medical schools. Conclusion: NIH funding to academic surgeons is declining relative to their nonsurgical colleagues. This trend will likely be reversed only by an increase in the number of grant applications submitted by surgeon-scientists. Structural changes in surgical training programs, and in the economics of academic surgery, may support a greater contribution of surgeon-scientists to the success of translational research.