Commentary: Beating the odds: Success in extramural funding renewal

Abstract

Central MessageCardiothoracic surgeons face slim chances of stable, long-term NIH R01 grant funding, and alternative sources will be needed to sustain research and innovation in cardiothoracic surgery.See Article page 162. Advances in cardiothoracic surgery are rooted in basic science discoveries, such as use of cross-circulation developed by C. Walt Lillehei, brought from the proverbial bench to the bedside (Figure 1). The most prestigious source for extramural basic science research funding for independent investigators has been the National Institutes of Health (NIH) R01 program. However, obtaining and maintaining R01 funding is extremely challenging for cardiothoracic surgeons for several reasons. In the present study, Wang and colleagues1Wang H. Bajaj S.S. Heiler J.C. Aravind A. Williams K.M. Woo Y.J. et al.Quantitative goals for research output and scholarly impact to enhance basic science R01 grant renewal for cardiothoracic surgeons.J Cardiovasc Thorac Surg Open. 2022; 9: 162-175Scopus (5) Google Scholar used publicly available data from NIH online sources to detail the chances of R01 grant renewal, and most importantly, they identify factors associated with R01 grant renewal. The authors focused on basic science R01 awards and possible pathways for R01 grant renewal. The most striking point of this analysis is that the odds of attaining and maintaining R01 grant funding through renewal are slim. Going back to 1985 and including 992 academic cardiothoracic surgeons, the authors identified 49 (4.9%) cardiothoracic surgeons who obtained 76 R01 grants encompassing 102 award cycles, and of these, only 33 (32.4%) were subsequently renewed to fund ongoing basic science research by 20 (2%) academic cardiothoracic surgeons. This finding highlights the limitation of NIH funding and the need for alternative funding sources for cardiothoracic academic surgeons to be successful. The authors identified 2 factors associated with grant renewal: (1) the number of publications associated with the R01 grant award during the initial cycle, and (2) the relative citation ratio defined as an article's citation rate divided by that of R01-funded publications in the same field. These findings, despite any limitations of the study, provide a much-needed pace setter for academic cardiothoracic surgeons striving to attain extra-mural funding renewal. To match the 50th percentile of R01 grant awards that are renewed, R01-funded investigators need to publish 16 articles on average during the funding cycle, and the scholarly impact of these articles ought to be on par with other publications in the field. The authors hypothesize that these factors are associated with increased criterion scores in the Approach, Significance, and Innovation during NIH study section review. This is certainly a plausible explanation, but for basic science R01-funded cardiothoracic surgeons, the pressing question is why or how some investigators achieve enough impactful publications during the initial award cycle while others do not. All the other factors compared between the group that was renewed versus that which was not renewed were similar, suggesting that other obscure factors are at play. One major factor that cannot be assessed in the present study is the clinical burden of cardiothoracic surgeons in the 2 groups. Whatever the causative factors, the present study suggests that even in the best of circumstances, basic science R01 grant renewal is not a reliable source for long-term funding. Cardiothoracic professional societies, private industry, and philanthropy are better sources of scientific funding that promote the elusive but critical careers of cardiothoracic surgeon scientists. Quantitative goals for research output and scholarly impact to enhance basic science R01 grant renewal for cardiothoracic surgeonsJTCVS OpenVol. 9PreviewCardiothoracic (CT) surgeons with National Institutes of Health (NIH) R01 funding face a highly competitive renewal process. The factors that contribute to successful grant renewal for CT surgeons remain poorly defined. We hypothesized that renewed basic science grants are associated with high research output and scholarly impact during the preceding award cycle. Full-Text PDF Open Access