Current status of National Institutes of Health funding for thoracic surgeons in the United States: Beacon of hope or candle in the wind?

Abstract

Objective: Increasing forces threaten the viability of thoracic surgeon-initiated research, a core component of our academic mission. National Institutes of Health funding is a benchmark of research productivity and innovation. This study examined the current status of National Institutes of Health funding for thoracic surgeons.

Methods: Thoracic surgeon principal investigators on National Institutes of Health-funded grants during June 2010, June 2015, and June 2020 were identified using National Institutes of Health iSearchGrants (version 2.4). American Association of Medical Colleges data were used to identify all surgeons in the United States. Types and total costs of National Institutes of Health-funded grants were compared relative to other surgical specialties.

Results: A total of 61 of 4681 (1.3%), 63 of 4484 (1.4%), and 60 of 4497 (1.3%) thoracic surgeons were principal investigators on 79, 76, and 87 National Institutes of Health-funded grants in 2010, 2015, and 2020, respectively; these rates were higher than those for most other surgical specialties (P ≤ .0001). Total National Institutes of Health costs for Thoracic Surgeon-initiated grants increased 57% from 2010 to 2020, outpacing the 33% increase in total National Institutes of Health budget. Numbers and types of grants varied among cardiovascular, transplant, and oncology subgroups. Although the majority of grants and costs were cardiovascular related, increased National Institutes of Health expenditures primarily were due to funding for transplant and oncology grants. Per-capita costs were highest for transplant-related grants during both years. Percentages of R01-to-total costs were constant at 55%. Rates and levels of funding for female versus male thoracic surgeons were comparable. Awards to 5 surgeons accounted for 33% of National Institutes of Health costs for thoracic surgeon principal investigators in 2020; a similar phenomenon was observed for 2010 and 2015.

Conclusions: Long-term structural changes must be implemented to more effectively nurture the next generation of thoracic surgeon scientists.

Keywords: NIH funding; NIH grant; principal investigator; thoracic surgeon.

FIGURE 1.

Trends from 2010 to 2020 on a biennial basis. Left: Total costs of TS-initiated NIH grants. Right: Total number of NIH-funded TS PIs. TS, Thoracic surgeon; NIH, National Institutes of Health.

FIGURE 2.

Distribution of grant costs with percentages and relative amounts for thoracic surgery subspecialties in 2010, 2015, and 2020. CV, Cardiovascular.

FIGURE 3.

Distribution of costs with relative amounts based on grant types for 2010, 2015, and 2020. A, All TS-initiated grants. B, CV-related grants. C, Transplant-related grants. D, Oncology-related grants. CV, Cardiovascular.

FIGURE 4.

A, Distributions of grant costs with percentages and relative amounts of thoracic surgery subspecialties for awards given to TS Other PIs during 2020. B, Breakdown of costs with percentages and relative amounts of different grant types awarded to TS Other PIs in 2020. CV, Cardiovascular.

FIGURE 5.

Graphical Abstract depicting the number of NIH-funded TS PIs and total grant numbers and associated costs from 2010 to 2020. NIH, National Institutes of Health; TS, thoracic surgeon; PI, principal investigator.

CENTRAL MESSAGE

In light of a decreasing workforce, increasingly competitive funding climate, and stagnant funding landscape, we must consider structural changes to foster the next generation of TS scientists. The number of NIH-funded TS-PIs has remained unchanged in the past decade.

FIGURE E1.

A, Total cost of each activity code for TS-PI grants in 2010, 2015, and 2020. B, Total number of grants within each activity code for TS-PIs in 2010, 2015, and 2020. TS, Thoracic surgeon.