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NIH funding trends for neurosurgeon-scientists from 1993–2017: Biomedical workforce implications for neurooncology

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Abstract

Introduction

Neurosurgeons represent 0.5% of all physicians and currently face a high burden of disease. Physician-scientists are essential to advance the mission of National Academies of Science (NAS) and National Institutes of Health (NIH) through discovery and bench to bedside translation. We investigated trends in NIH neurosurgeon-scientist funding over time as an indicator of physician-scientist workforce training.

Methods

We used NIH Research Portfolio Online Reporting Tools (RePORTER) to extract grants to neurosurgery departments and neurosurgeons from 1993 to 2017. Manual extraction of each individual grant awardee was conducted.

Results

After adjusting for U.S. inflation (base year: 1993), NIH funding to neurosurgery departments increased yearly (P < 0.00001). However, neurosurgeon-scientists received significantly less NIH funding compared to scientists (including basic scientists and research only neurosurgeons) (P = 0.09). The ratio of neurosurgeon-scientists to scientists receiving grants was significantly reduced (P = 0.002). Interestingly, the percentage of oncology-related neurosurgery grants significantly increased throughout the study period (P = 0.002). The average number of grants per neurosurgeon-scientists showed an upward trend (P < 0.001); however, the average number of grants for early-career neurosurgeon-scientists, showed a significant downward trend (P = 0.05).

Conclusion

Over the past 23 years, despite the overall increasing trends in the number of NIH grants awarded to neurosurgery departments overall, the proportion of neurosurgeon-scientists that were awarded NIH grants compared to scientists demonstrates a declining trend. This observed shift is disproportionate in the number of NIH grants awarded to senior level compared to early-career neurosurgeon-scientists, with more funding allocated towards neurosurgical-oncology-related grants.

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Data Availability

The data that support the findings of this study are openly available in NIH RePorter (Research Portfolio Online Reporting Tools) at https://projectreporter.nih.gov/reporter.cfm.

Abbreviations

NAS:

National Academies of Science

NIH:

National Institutes of Health

RePORTER:

Research Portfolio Online Reporting Tools

GDP:

Global Domestic Product

CMS:

Centers for Medicare Services

SNS:

Society of Neurological Surgeons

CAST:

Committee for Accreditation of Subspecialty Training

ACGME:

Accreditation Council for Graduate Medical Education

RRC:

Residency Review Committee

AAMC:

Association of American Medical Colleges

NASEM:

National Academies of Sciences, Engineering, and Medicine

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Funding

AQH was supported by the Mayo Clinic Professorship and a Clinician Investigator award, and Florida State Department of Health Research Grant, and the Mayo Clinic Graduate School, as well as the NIH (R43CA221490, R01CA200399, R01CA195503, and R01CA216855). JFM receives support from the Earl & Nyda Swanson Neurosciences Research Fund and the Harley N. and Rebecca N. Hotchkiss Endowed Fund in Neuroscience Research, Honoring Ken and Marietta. K.R. was supported by the NIH/NINDS (U01-NS108916).

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Author notes

  1. Karim ReFaey and William D. Freeman have contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA

    Karim ReFaey, William D. Freeman, Shashwat Tripathi, Hugo Guerrero-Cazares, James F. Meschia & Alfredo Quinones-Hinojosa

  2. Department of Neurology, Mayo Clinic, Jacksonville, FL, USA

    William D. Freeman & James F. Meschia

  3. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Shashwat Tripathi

  4. University of Miami, Miller School of Medicine, Miami, FL, USA

    Tiffany A. Eatz

  5. Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA

    Rickey E. Carter

  6. Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA

    Leonard Petrucelli

  7. Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA

    Fredric B. Meyer

  8. Brain Tumor Stem Cell Laboratory, Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Rd. S, Jacksonville, FL, 32224, USA

    Alfredo Quinones-Hinojosa

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  1. Karim ReFaey
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by KR, ST, TAE, and REC. The first draft of the manuscript was written by KR, and WDF and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Alfredo Quinones-Hinojosa.

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Conflict of interest

The authors have no conflict of interest. The abstract was presented as an Oral Presentation during the 2019 Congress of Neurological Surgeons Annual Meeting, October 19–23, in San Francisco, CA.

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Ethical approval was not applicable for this study as only publicly accessible data was utilized.

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ReFaey, K., Freeman, W.D., Tripathi, S. et al. NIH funding trends for neurosurgeon-scientists from 1993–2017: Biomedical workforce implications for neurooncology. J Neurooncol 154, 51–62 (2021). https://doi.org/10.1007/s11060-021-03797-5

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