Physician researchers with only an M.D. degree are less likely to receive NIH research grants than researchers with a Ph.D. degree or those with both M.D. and Ph.D. degrees, according to a study in the June 13 issue of JAMA.
"Declines in the number of physician-scientist applicants and recipients of National Institutes of Health (NIH) research and training awards in the 1970s generated concerns that physician clinical investigators would become an 'endangered species' if trends continued unaltered," the authors write. There has been no comprehensive analysis over a long period of the outcomes for first-time investigators with an M.D. applying for research grants.
Howard B. Dickler, M.D., of the Association of American Medical Colleges, Washington, D.C., and colleagues assessed the annual number of first-time applicants with an M.D., a Ph.D., or both, and the likelihood of them applying and receiving an NIH research (R01) grant for clinical and non-clinical research, between 1964 and 2004.
The researchers found that the annual number of first-time physician (M.D. only) applicants was stable during the four decades studied. The average annual percentage of first-time applicants with an M.D. who were awarded grants was 28 percent, while that for applicants with a Ph.D. was 31 percent and for applicants with an M.D. and a Ph.D. was 34 percent. When those first-time applicants who had received funding for a first R01 grant applied for a second R01 grant, a lower percentage of applicants with an M.D. only received funding (average annual percentage of 70 percent) than applicants with a Ph.D. (average annual percentage of 73 percent) and applicants with a M.D. and a Ph.D. (average annual percentage of 78 percent).
An average of 67 percent of individuals with an M.D. who apply annually for a first R01 grant application pursue clinical research. The percentage is much lower for physicians who also have a Ph.D. (43 percent) and for investigators with a Ph.D. only (39 percent). The annual percentage of applications by individuals with an M.D. who are funded for their first R01 grant is on average lower for those who conduct clinical research than those who conduct nonclinical research (23 percent vs. 29 percent). When first-time applicants who had received their first R01 grant applied for a second R01 grant, the difference in obtaining funding between clinical and nonclinical research was again substantial.
"We agree with others that physician-scientists bring unique skills, experience, motivation, and perspective to biomedical research. They play an indispensable role, especially in designing and conducting the translational and clinical research by which scientific advancements are brought into medical practice," the authors write. "For medical schools and teaching hospitals, the challenge is to create a more attractive and supportive academic culture that not only attracts and trains but also actively nurtures and sustains clinical and translational scientists."
(JAMA. 2007;297:2496-2501. Available pre-embargo to the media at www.jamamedia.org)
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