The Road from NIH-training Grants for Surgeons: What is the Return on Investment?

Objective: This study examines the success of surgeon-scientists to non-surgeon physician-scientists in obtaining NIH funding after participation on a research training grant.

Summary Background Data: Dedicated research time during postgraduate training for physician-scientists is advantageous for obtaining future independent funding from NIH.

Methods: NIH Reporter was used to identify F32 and T32 grants awarded to internal medicine and surgery departments from 2005-2015, and an internal NIH database was used to determine funding outcomes. Success rates were recorded for surgeon vs. internist PIs who applied for either a mentored career grant or research project grant (RPG). The median time in years from the final year of the training grant and clinical graduation to the first awarded grant was investigated. Chi-squared tests, Fisher's exact tests, and Wilcoxon rank sum tests were used.

Results: A greater proportion of surgeons transitioned directly to an RPG, 27% (68 internist PIs) compared to 72% (63 surgeon PIs) (P<0.001). Both T32 and F32 trained surgeons were able to obtain an RPG sooner than internists, taking a median of 5 years from the end of clinical training vs. a median of 7 years for internists [P=0.033 (F32), P=0.034 (T32)].

Conclusions: Although fewer F32 and T32-funded surgeons apply for subsequent NIH-funding compared to non-surgeons, more surgeons apply for an RPG instead of a K-grant. Remarkably, surgeons obtained independent funding sooner after clinical graduation compared to internists, despite the extensive gap in time between post-graduate training and first faculty appointment, an amazing accomplishment given their clinical training and surgical practice challenges.