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.