Surgeons in the US are facing a looming crisis as they grapple with dwindling research funding.
And the situation could threaten medical innovation, surgical progress and patient care, experts say.
A team from UVA Health, the academic healthcare centre associated with the University of Virginia in Charlottesville, US, is sounding the alarm, labelling this situation a ‘broken pipeline’ that could lead to the extinction of surgeon-scientists and a sluggish pace of medical innovation.
Led by Dr Bruce Schirmer of UVA's Department of Surgery, the research reveals a troubling trend.
Surgeon-scientists initially secure research support early in their careers but need help obtaining ongoing funding.
This predicament often arises from the demanding clinical responsibilities surgeons face and the continual need to refine their skills, which leaves them limited time to vie for research grants and conduct crucial studies that benefit patients.
Dr Schirmer said: ‘Surgeons have been responsible for many significant advancements in treating various diseases, including cardiovascular, digestive, neurologic, endocrine, pulmonary, urologic conditions, and cancer. A lack of continuous funding for surgical research could severely hamper future contributions. These findings should serve as a wake-up call to the surgical community.’
Schirmer and his team conducted an in-depth analysis of research grants from surgery and internal medicine trainees. They discovered that trainees secured F32 grants from the National Institutes of Health at similar rates. However, internal medicine trainees were nearly six times more likely to transition to R01 grants, the NIH’s most prestigious and competitive funding mechanism. Internal medicine researchers were also five times more likely to obtain a career development K-award from the NIH.
This discrepancy, labelled a ‘shocking drop-off’ by the researchers, presents a significant problem for the surgical specialty.
Dr Adishesh K Narahari, the first research paper author and an intern at UVA Health, commented: ‘Surgeons are struggling to secure funding, with many unable to do so even after a decade of trying. Surgeon-scientists have made ground-breaking contributions in transplantation, oncology, diabetes, and more. In essence, surgeons need to start applying for funding early in their careers and become adept at navigating the world of biomedical research. Otherwise, we risk a decline in innovation and a dearth of new solutions, not only in surgical realms but across biomedical research.’
In response to these alarming findings, Drs Narahari and Schirmer and colleagues have proposed actionable recommendations:
Develop alternative grant-funding mechanisms to support surgeon-scientists
Establish programmes at individual institutions to support surgical residents interested in research
Evaluate surgeon-scientists using different job-performance metrics to non-research counterparts.
The UVA researchers caution that failure to take these steps could significantly setback surgical research.
Dr Schirmer added: ‘We hope this paper ignites a movement to nurture surgeon-scientists through curricular, programmatic, and supportive means that empower those interested in this career path to be both productive and successful. Those responsible for surgical education and training must seriously consider these findings.’
The findings have been published in the scientific journal Annals of Surgery.
Photo caption: UVA Health’s Bruce Schirmer, MD (left), and Adishesh K. Narahari, MD. Credit: Adishesh K. Narahari, MD
