In 2019, female surgeons and women of color received National Institutes of Health (NIH) grants at lower rates and in lower amounts than their male colleagues, researchers reported.

Men received 78.7% of the 1,235 NIH awards granted to surgeons in 2019 and 80.7% of the 671 RO1-equivalent grants, the “gold standard” of intervention research, reported Ankush Gosain, MD, PhD, of the Children’s Foundation Research Institute in Memphis, Tennessee, and colleagues.

Women also received less money than men when they did receive grants for all award types (mean $428,109 vs $499,631, P=0.04), as well as when they received multiple awards (mean $659,343 vs $840,037, P=0.01), they wrote in JAMA Surgery.

Strikingly, no Black women, Hispanic women, or female orthopedists received R01-equivalent grants, Gosain reported.

Although men are overrepresented in surgery overall, accounting for 72.4% of Association of American Medical Colleges faculty as of 2019, their share of NIH funding was even greater, Gosain noted, with consequences for women’s career prospects.

“Receipt of NIH funding or other external funding are objective benchmarks many institutions use in the promotion and tenure process,” Gosain told MedPage Today. “If you are not getting that funding, it may be harder to rise up the ranks into professor and beyond.”

Disparities in research funding have previously been attributed to differences in academic status, but women and women of color in this study still received fewer research dollars after controlling for professional level, said Patricia L. Turner, MD, MBA, director of the American College of Surgeons’ division of member services, who was not involved in the study.

These disparities may result from implicit bias or lack of support from one’s own institution, Turner said. But it can be cyclical, too, in that researchers nominated for NIH awards by their institutions will have more merit to be nominated again.

Factors unrelated to race and gender can affect funding success as well. For example, the NIH is more interested in certain specialties than others and tends to support more basic science research, Turner noted. However, basic research requires a lab, postdoctoral researchers, and means.

“If you, for example, are in a field that isn’t particularly interesting to the NIH, then you’re not going to get that funding,” Turner said.

In this study, women received less funding for RO1-equivalent grants than men within the same department of surgery (median $429,000 vs $475,196, P=0.02), Gosain reported.

To fully understand these disparities, researchers need to determine how many grant proposals were submitted by surgeons of various demographics, said Carisa M. Cooney, MPH, of Johns Hopkins University in Baltimore, who was not involved in this research.

“This is a helpful start and points out where we need to be looking more closely, but really knowing how many applications are submitted versus how many are funded [is important],” Cooney told MedPage Today. “The NIH may be trying really hard to fund more female scientists and there may just not be as many in the field as there are males.”

One way to ensure an even-handed approach is to implement a blind grant review to eliminate unconscious bias, Gosain noted.

“Trying to ensure appropriate mentorship and opportunities for underrepresented groups to pursue surgical science can help correct these disparities over time,” Gosain said.

Turner agreed, but said the bigger issue is competitiveness for research funding. RO1-equivalent grants, in particular, are hard to come by.

“At the end of the day, it’s not so much about not enough women or not enough people of color, it’s that talent is talent and if we are not being even-handed in the way grants are given, we are missing extraordinary people,” Turner said. “We as a profession benefit from the best science getting to see the light of the day.”

Last Updated December 10, 2020

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    Elizabeth Hlavinka covers clinical news, features, and investigative pieces for MedPage Today. She also produces episodes for the Anamnesis podcast. Follow

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The authors did not report any ties with industry.

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