@article{5284b873b3144c27861655ae57a09876,
title = "Can lung transplant surgeons still be scientists? High productivity despite competitive funding",
abstract = "Background: Today's declining federal budget for scientific research is making it consistently more difficult to become federally funded. We hypothesized that even in this difficult era, surgeon-scientists have remained among the most productive and impactful researchers in lung transplantation. Methods: Grants awarded by the NIH for the study of lung transplantation between 1985 and 2015 were identified by searching NIH RePORTER for 5 lung transplantation research areas. A grant impact metric was calculated for each grant by dividing the sum of impact factors for all associated manuscripts by the total funding for that grant. We used nonparametric univariate analysis to compare grant impact metrics by department. Results: We identified 109 lung transplantation grants, totaling approximately $300 million, resulting in 2304 papers published in 421 different journals. Surgery has the third highest median grant impact metric (4.2 per $100,000). The department of surgery had a higher median grant impact metric compared to private companies (P <.0001). There was no statistical difference in the grant impact metric compared to all other medical specialties, individual departments with multiple grants, or all basic science departments (all P >.05). Conclusions: Surgeon-scientists in the field of lung transplantation have received fewer grants and less total funding compared to other researchers but have maintained an equally high level of productivity and impact. The dual-threat academic surgeon-scientist is an important asset to the research community and should continue to be supported by the NIH.",
author = "Narahari, {Adishesh K.} and Charles, {Eric J.} and {Hunter Mehaffey}, J. and Hawkins, {Robert B.} and Sharma, {Ashish K.} and Laubach, {Victor E.} and Tribble, {Curtis G.} and Kron, {Irving L.}",
note = "Funding Information: search terms: lung preservation, ischemia reperfusion, ex vivo lung perfusion, anti-rejection medication, and airway healing. A grant impact metric and publications per $1 million were calculated for each grant. The grant impact metric is shown in Figure 1 and Table 1 as median with interquartile range, and publications per $1 million is shown in Table 1 as an average ± standard deviation. Surgery departments had 27 grants, 934 papers, $102 million in funding, 15.38 publications per $1 million, and a median grant impact metric of 4.2. Surgeons (with an MD degree) comprise the majority of investigators within surgery department grants (n = 23; median grant impact metric = 4.2: average grant impact metric = 7.25). Of the departments with 4 or more grants, surgery ranked second in median grant impact metric. Internal medicine had 42 grants, 1057 papers, $119 million, 10.14 publications per $1 million, and a grant impact metric of 5.4. Private companies had 12 grants, 14 papers, $26 million, 0.14 publications per $1 million, and a median grant impact metric of 0. The complete departmental breakdown is shown in Table 1 and a box-and-whisker graphical representation is shown in Figure 1. Analysis of recent grants (2005-2015; Figure 2) has revealed similar trends as the entire time period (1985-2015). All departments have significantly greater grant impact metric per $100,000 compared to private companies. There are no significant differences between departments. Cell biology (44.1 [2.3-54.2]), internal medicine (5.408 [2.105-10.48]), anesthesiology (4.5 [0-15.2]), and surgery (4.5 [2.7-12.8]) have the highest median grant impact metric per $100,000 (interquartile range is shown in Figure 2). Internal medicine departments have received relatively consistent funding from the NIH ($3.2 billion per year) since 2006. However, funding for surgery departments has decreased from a peak of $320 million to $280 million in 2016 [Ranking Tables of NIH Funding 2017]. Funding Information: We used the NIH Research Portfolio Online Reporting Tools (RePORT) Expenditures and Results (NIH RePORTER) database to collect information on grants for this study (1985-2015). NIH RePORTER contains project information, funding records, abstracts, full-text articles, and information from the U.S. Patent and Trademark Office. We used the “Text Search” feature to query for grants with the following 5 terms related to lung transplantation: lung preservation, ischemia reperfusion, ex vivo lung perfusion, anti-rejection medication, and airway healing. Grants not related to lung transplantation were excluded by a secondary search for “lung transplant” in the description page of NIH RePORTER. We recorded the following information from each grant: grant number, title, type of grant, principal investigator, awardee organization, state, department, project start date, project end date, years of funding awarded, years of funding received, total amount of funding, NIH awarding institute, NIH study section, number Funding Information: Analysis of an NIH report has shown that surgery departments have consistently been funded at a lower percentage compared to the overall funding rate and especially compared to internal medicine departments [Division of Planning E 2016]. Although the lower amount of funding to surgery departments can be explained by fewer grants being submitted and funded, the lower percentage of funding cannot be accounted for. Academic surgeons have many pressures to operate and bring in revenue while they still are expected to run a research group. Recently, Keswani et al have reported that funding for surgeons has declined and determined the many pressures that surgeons face [Keswani 2017]. Here, we report that even though surgeons have external pressures, they are able to publish quality work and the reason for decreased research may be due to lower funding success rates. Publisher Copyright: {\textcopyright} 2019 Forum Multimedia Publishing, LLC.",
year = "2019",
month = jan,
doi = "10.1532/hsf.2024",
language = "English (US)",
volume = "22",
pages = "E1--E7",
journal = "Heart Surgery Forum",
issn = "1098-3511",
publisher = "Carden Jennings Publishing Co. Ltd",
number = "1",
}