This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (19)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

A Historical Perspective on the "Endangered Species"

Howard B. Dickler, MD; Di Fang, PhD; Stephen J. Heinig, MA; Elizabeth Johnson, MS; David Korn, MD

JAMA. 2007;297:2496-2501.

Context  Although concerns have persisted for decades about the production of new physician clinical scientists and their success in receiving and sustaining research supported by the National Institutes of Health (NIH), no comprehensive analysis documents the experiences of first-time investigators with an MD over a long period.

Objective  To ascertain the perseverance and comparative success of physician-scientists competing for NIH research (R01) grants awarded over 40 years.

Design, Setting, and Participants  A longitudinal, comparative study of all first-time applicants and recipients of NIH R01 grants between 1964 and 2004 stratified by the principal investigators' major degrees (MD, PhD, or MD and PhD) and their proposed involvement in research of humans or human tissues.

Main Outcome Measures  Number of first- and second-time NIH R01 grant applicants and recipients by academic degree and by research type (clinical vs nonclinical).

Results  The annual number of first-time investigators with an MD only as NIH R01 grant applicants remained remarkably stable over 4 decades (41-year mean of 707 [range, 537-983] applicants). Among first-time applicants, those with an MD consistently had less success in obtaining funding (mean annual percentage [MAP], 28%) than either investigators with a PhD (MAP, 31%; P = .03 vs MD only) or both an MD and a PhD (MAP, 34%; P<.001 vs MD only and P = .002 vs PhD only). Among investigators who obtained a first R01 grant, those with an MD were consistently less likely (MAP, 70%) than those with a PhD (MAP, 73%; P = .04 vs MD only) or those with an MD and a PhD (MAP, 78%; P<.001 vs MD only and P = .007 vs PhD only) to obtain a subsequent R01 grant. First-time applicants with an MD were much more likely to propose clinical research (MAP, 67%) than applicants with an MD and a PhD (MAP, 43%) and applicants with a PhD only (39%). First-time applicants with an MD only who proposed clinical research were funded at lower rates than their MD-only counterparts proposing nonclinical research (23% vs 29%, respectively; P<.001).

Conclusions  From 1964-2004, the number of physician-investigators applying for first R01 grants showed little net change. Physician-investigators consistently experienced higher rates of attrition and failure, even after receiving a first R01 grant, and those proposing clinical research were less successful in obtaining funding than physicians proposing nonclinical research.

Author Affiliations: Division of Biomedical and Health Sciences Research, Association of American Medical Colleges, Washington, DC (Drs Dickler and Korn and Mr Heinig); American Association of Colleges of Nursing, Washington, DC (Dr Fang); and Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md (Ms Johnson).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Sex Differences in Attainment of Independent Funding by Career Development Awardees
Jagsi et al.
ANN INTERN MED 2009;151:804-811.
ABSTRACT | FULL TEXT  

A Radical Proposal: Integrate Clinical Investigation into the U.S. Health Care System
Rudick and Cosgrove
Sci Transl Med 2009;1:4cm4-4cm4.
FULL TEXT  

Gender Differences in Research Grant Applications for Pediatric Residents
Gordon et al.
Pediatrics 2009;124:e355-e361.
ABSTRACT | FULL TEXT  

Off the Roadmap? Family Medicine's Grant Funding and Committee Representation at NIH
Lucan et al.
Ann Fam Med 2008;6:534-542.
ABSTRACT | FULL TEXT  

The Future of the Orthopaedic Clinician-Scientist. Part I: The Potential Role of MD-PhD Students Considering Orthopaedic Surgery
Ahn et al.
JBJS 2008;90:1794-1799.
ABSTRACT | FULL TEXT  

Transitioning from Fellowship to a Physician-Scientist Career Track
Melnick
ASH Education Book 2008;2008:16-22.
ABSTRACT | FULL TEXT  

An Introduction to Foundation and Industry-Sponsored Research: Practical and Ethical Considerations
Margolin et al.
ASH Education Book 2007;2007:498-503.
ABSTRACT | FULL TEXT