Abstract
Background
Although the status of women in anesthesiology has advanced by many measures, obtaining career development funding remains challenging. Here, we sought to compare the characteristics of funded career development awards from the National Institutes of Health (NIH) between the specialties of anesthesiology and surgery. We hypothesized that the two groups differ in percentage of faculty with awards, gender distribution among principal investigators, as well as the number of awards promoting diversity.
Methods
The NIH grant-funding database RePORT was queried for career development awards for the years 2006–2016 using the filters “Anesthesiology” and “Surgery.” Grants were characterized based on the gender of the principal investigator and whether the funding opportunity announcement indicated promotion of underrepresented minorities (URM). The 2016 Association of American Medical Colleges (AAMC) report on “Distribution of U.S. Medical School Faculty by Sex and Rank” was used to adjust comparisons according to baseline gender distributions in anesthesiology and surgery departments. Cohorts were characterized using descriptive methods and compared using Chi-square or Fisher’s exact test.
Results
Based on our AAMC data query, in 2016, the number of women faculty members at the instructor or assistant professor level in U.S. medical schools was 2314 (41%) for anesthesiology and 2281 (30%) for surgery. Between 2006 and 2016, there were 88 career development grants awarded to investigators in anesthesiology departments compared to 261 in surgery departments. Of the grantees in each specialty, 29 (33%) were women in anesthesiology and 72 (28%) in surgery (P = 0.344). Awards to promote URM were identified for two grants (2%) in anesthesiology and nine grants (3%) in surgery (P = 0.737). Faculty members in surgery were more likely to receive an award than in anesthesiology (P < 0.0001), and women were less likely to receive an award than men (P = 0.026).
Conclusions
The major difference between US anesthesiology and surgery departments is that the number of faculty career development awards is significantly higher in surgery departments. Future efforts should aim to identify the reasons for such differences in order to inform strategies that can improve the likelihood for junior faculty members to receive career development funding.
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Background
Research performance in anesthesiology compared with other medical specialties has historically been low [1]. Accordingly, leaders in the field have called for improvement in academic development opportunities for trainees and junior faculty members [2, 3]. Indeed, professional societies such as the Foundation for Anesthesia Education and Research (FAER), the International Anesthesia Research Society (IARS), and the Anesthesia Patient Safety Foundation (APSF) have committed substantial resources to provide research funding to young investigators in the specialty of anesthesiology [4,5,6].
In his 2015 Rovenstine Lecture “Without Science There Is Little Art in Anesthesiology” at the American Society of Anesthesiologists’ annual meeting, Eisenach highlighted the ongoing critical importance of supporting young investigators in anesthesiology [7]. Such support may be especially important to early career women faculty members [8]. Historically, women have lagged behind men in career advancement. A 2008 assessment of the status of women in the field of academic anesthesiology in the United States highlighted the increased participation of women in many aspects of academic anesthesiology in the previous two decades [9]. Yet, the proportion of competitive research grants awarded to women had not changed. The reasons for this lack of improvement were not clear.
Consistent with work by others [22].
Observed funding success differences between women and men following career development awards indicate less favorable long-term funding outcomes for women [23]. Culley reported 30% of anesthesiology chair persons have a history of NIH funding, compared to 62% in surgery [10]. Hence, our finding that, regardless of gender, faculty members in anesthesiology departments are less likely to obtain career development funding compared to surgery may not come as a surprise. The reasons for this finding, however, remain uncertain. We can only speculate that junior faculty members in surgery departments are receiving better support and mentoring or that the observed differences are also based on diverse baseline characteristics of men and women choosing anesthesiology versus surgery as a career.
Our study has several limitations. First, we only included funding awarded through the NIH and the Agency for Healthcare Research and Quality and not from foundations such as the FAER or IARS. However, given that we wanted to include the comparison group of surgical career development grant funding, it was necessary to choose a funding agency to which both specialties have access. Second, we could only determine gender through the principal investigator’s first name and, if required, by searching on departmental faculty webpages. While self-identified gender determination would be preferable, our approach is consistent with published approaches for gender determination in database research [12]. We did not recognize other genders than men and women in our study. Third, while we assessed the grants for funding opportunity announcements geared to faculty members with URM background, we could not ascertain ethnicity and race for individual principal investigators. Given that the assessment for URM status included only the funding opportunity announcement (NIH career development awards to promote diversity), but not the characteristics of the principle investigators or applicants, our findings do not permit any conclusions on URM status of grant applicants or awardees. Fourth, the denominator used for the gender-specific funding rates was based on AAMC data for the year 2016, not 2006–2016. This was done intentionally, as K-type career development grants usually span 3–5 years and our intent was to provide a relative, but not absolute, comparator to adjust for the difference in faculty members represented in each specialty [13]. In addition, the AAMC-based denominator does not account for the number of grant applications submitted relative to the number of grants awarded, which may differ between specialties.
Conclusions
Based on the 2016 AAMC number of eligible faculty members, faculty members in surgery were more likely to receive an award than faculty members in anesthesiology, but the funding rates for women and men in both departments were only marginally different. Future efforts should focus on identifying the reasons for such differences in award rates to inform initiatives to boost opportunities for junior faculty members to successfully compete for NIH career development funding.
Abbreviations
- AAMC:
-
Association of American Medical Colleges
- APSF:
-
Anesthesia Patient Safety Foundation
- FAER:
-
Foundation for Anesthesia Education and Research
- IARS:
-
International Anesthesia Research Society
- NIH:
-
National Institutes of Health
- URM:
-
Underrepresented minorities
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Funding
This work was supported by an American Society of Anesthesiologists Mentoring Program grant from the Committee on Professional Diversity to Lena M. Mayes and by National Institutes of Health grant #K23DA040923 to Karsten Bartels. The aforementioned funding bodies had no role in the design of the study and collection, analysis, and interpretation of data, writing of the manuscript or the decision to submit it for publication.
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The datasets used and analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request.
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LMM secured funding for the study, contributed to the study design, data collection, interpretation of the results, and manuscript preparation. CAW contributed to the interpretation of the results and manuscript preparation. AFB contributed to the interpretation of the results and manuscript preparation. SZ contributed to the interpretation of the results and manuscript preparation. KB secured funding for the study, contributed to the study design, data analysis, interpretation of the results, and manuscript preparation. All authors read and approved the final manuscript.
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The Colorado Multiple Institutional Review Board approved this study for exemption (protocol # 17–0304).
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Mayes, L.M., Wong, C.A., Zimmer, S. et al. Gender differences in career development awards in United States’ anesthesiology and surgery departments, 2006–2016. BMC Anesthesiol 18, 95 (2018). https://doi.org/10.1186/s12871-018-0561-1
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DOI: https://doi.org/10.1186/s12871-018-0561-1