Newswise — Surgeons engaged in vital biomedical research face challenges in securing research funding, and this "fractured pathway" may endanger surgeon-scientists and impede advancements for patients unless proactive measures are taken, caution UVA Health specialists.
Dr. Bruce Schirmer and his team of researchers from UVA's Department of Surgery discovered that surgeon-scientists frequently acquire research funding during the initial stages of their careers. However, they face significantly lower odds compared to their counterparts in internal medicine when it comes to sustaining that funding for continued research endeavors.
According to Schirmer and his colleagues, as outlined in their recent scientific publication, the factors contributing to this phenomenon are intricate. They highlight the substantial clinical responsibilities that burden surgeons and the continuous requirement to uphold and enhance their expertise. Consequently, this leaves them with limited opportunities to vie for research funding and dedicate time to conducting studies that would ultimately bring benefits to patients.
That, Schirmer and colleagues warn, could have dire implications for the future.
"Surgeons have played a pivotal role in advancing the treatment of various diseases, particularly those affecting the cardiovascular, digestive, neurologic, endocrine, pulmonary, urologic systems, and various types of cancer," expressed Schirmer. "The absence of sustained funding for surgical research has the potential to restrict future breakthroughs in these areas. These findings should serve as a wake-up call to the surgical community, urging them to reconsider the ideal timing for conducting research during surgical training and explore the most effective means of securing resources to support it."
Surgical Research Funding
Schirmer and his research team examined the research grants acquired by trainees in the fields of surgery and internal medicine. Their analysis revealed that trainees in both disciplines secured F32 grants from the National Institutes of Health (NIH) to support focused research endeavors at comparable rates. However, the study found a significant disparity in the subsequent progression of these grants. Internal medicine trainees were nearly six times more likely to transition their F32 grants into R01 grants, which are the NIH's prestigious and highly competitive funding mechanism. Moreover, the researchers in internal medicine were five times more likely to secure a career development K-award from the NIH.
The researchers label the discrepancy a “shocking drop-off” and say it represents a “major problem” for the surgical specialty.
"Surgeons are facing formidable challenges in securing funding, with a significant number unable to obtain support even after persisting for a decade. Surgeon-scientists have played a crucial role in advancing biomedical research, particularly in fields such as transplantation, oncology, and diabetes," emphasized Dr. Adishesh K. Narahari, MD, PhD, a surgery intern at UVA Health and the primary author of the recent scientific paper. "In essence, surgeons must proactively seek funding at an early stage and develop proficiency in navigating the realm of biomedical research. Failure to do so could lead to a decline in innovation and a dearth of novel solutions not only in surgical domains but across various areas of biomedical research."
Narahari, Schirmer and their collaborators say swift action is needed and have formulated recommendations to address the problem. These suggestions include:
- Develop alternate grant-funding mechanisms to support surgeon-scientists;
- Establish programs at individual institutions to support surgical residents who wish to do research;
- Encourage surgeons to do research by evaluating surgeon-scientists using different job-performance metrics than surgeons who do not do research.
If steps aren’t taken, the UVA researchers warn, surgical research will suffer.
"We anticipate that this paper will ignite a movement aimed at promoting the growth of surgeon-scientists by implementing curricular, programmatic, and supportive measures that facilitate the productivity and success of those who possess a strong interest in pursuing such career paths," stated Schirmer. "We sincerely hope that those responsible for overseeing surgical education and training will give serious consideration to these findings and take proactive steps to address the identified challenges."
Findings Published
The researchers have published their findings in the scientific journal Annals of Surgery. The team consisted of Narahari, Anirudha S. Chandrabhatla, Emily Fronk, Simon White, Shreya Mandava, Hannah Jacobs-El, J. Hunter Mehaffey, Curtis G. Tribble, Mark Roeser, John Kern, Irving L. Kron and Schirmer.
Narahari was supported by NIH grant F30CA236370.
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