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The Future of Basic Science in Academic Surgery: Identifying Barriers to Success for Surgeon-scientists

Keswani, Sundeep G. MD*; Moles, Chad M. BSPH*; Morowitz, Michael MD; Zeh, Herbert MD; Kuo, John S. MD, PhD§; Levine, Matthew H. MD, PhD; Cheng, Lily S. MD|| , **; Hackam, David J. MD, PhD††; Ahuja, Nita MD††; Goldstein, Allan M. MD**Basic Science Committee of the Society of University Surgeons

doi: 10.1097/SLA.0000000000002009
FEATURES

Objective: The aim of this study was to examine the challenges confronting surgeons performing basic science research in today's academic surgery environment.

Summary of Background Data: Multiple studies have identified challenges confronting surgeon-scientists and impacting their ability to be successful. Although these threats have been known for decades, the downward trend in the number of successful surgeon-scientists continues. Clinical demands, funding challenges, and other factors play important roles, but a rigorous analysis of academic surgeons and their experiences regarding these issues has not previously been performed.

Methods: An online survey was distributed to 2504 members of the Association for Academic Surgery and Society of University Surgeons to determine factors impacting success. Survey results were subjected to statistical analyses. We also reviewed publicly available data regarding funding from the National Institutes of Health (NIH).

Results: NIH data revealed a 27% decline in the proportion of NIH funding to surgical departments relative to total NIH funding from 2007 to 2014. A total of 1033 (41%) members responded to our survey, making this the largest survey of academic surgeons to date. Surgeons most often cited the following factors as major impediments to pursuing basic investigation: pressure to be clinically productive, excessive administrative responsibilities, difficulty obtaining extramural funding, and desire for work-life balance. Surprisingly, a majority (68%) did not believe surgeons can be successful basic scientists in today's environment, including departmental leadership.

Conclusions: We have identified important barriers that confront academic surgeons pursuing basic research and a perception that success in basic science may no longer be achievable. These barriers need to be addressed to ensure the continued development of future surgeon-scientists.

*Division of Pediatric Surgery, Laboratory for Regenerative Tissue Repair, Texas Children's Hospital and Baylor College of Medicine, Houston, TX

Children's Hospital of Pittsburgh of UPMC and University of Pittsburgh, Pittsburgh, PA

Department of Surgery, University of Pittsburgh, Pittsburgh, PA

§Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI

Transplant Surgery, Perelman School of Medicine at the University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, PA

||Department of Surgery, University of California San Francisco, San Francisco, CA

**Department of Pediatric Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA

††Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.

Reprints: Allan M. Goldstein, MD, Department of Pediatric Surgery, Massachusetts General Hospital, 55 Fruit Street, Warren 1151, Boston, MA 02114. E-mail: agoldstein@partners.org.

S.G.K. and C.M.M. contributed equally.

N.A. has grant funding from Astex and Cepheid Inc.

Authors’ contributions: all authors approved the final manuscript; S.G.K., M.M., N.A., H.Z., and A.M.G. contributed to the conception, design, and data collection; C.M.M. performed data analysis; all authors contributed to data interpretation and writing and editing the manuscript.

The authors report no conflicts of interest.

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