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Female Surgeon-scientists Are Significantly Underrepresented Among Nih Surgeon-scientists
Mytien Nguyen, MS1, Luis Gonzalez, BS1, Alan Dardik, MD, PhD, FACS2, Bohdan Pomahac, MD2, Sarwat Chaudhry, MD2, Ashley Newman, BS3, Shenika Zarebski, CNM4, Dowin Boatright, MD2.
1Yale School of Medicine, Hamden, CT, USA, 2Yale School of Medicine, New Haven, CT, USA, 3Howard University College of Medicine, Washington, DC, USA, 4Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA.

Purpose: Surgical research is critical to drive innovation across all surgical specialties. Although female scientists are more likely to generate innovative and novel research,1 they are often less likely to receive National Institute of Health (NIH) funding.2 To understand sex equity in distribution of National Institute of Health funding among surgeon-scientists, we examined the distribution of new R01 awards from the NIH in the past 5-years, from 2016 to 2020. Methods: NIH-funded principal investigators were identified from the NIH RePORTER database (report.nih.gov) for all newly awarded R01s from 2016 to 2020 to principal investigators in Department of Surgery. Surgeon-scientists were defined as MD or MD-PhD principal investigators with board certifications in one of the following surgical specialties: General Surgery, Colorectal Surgery, Neurological Surgery, Orthopaedic Surgery, Ophthalmology, Otolaryngology, Plastic Surgery, Vascular Surgery, Thoracic Surgery, and Urology. Surgeon-scientistsí sex identity was determined using institutional photographs. Female representation among surgeon-scientists were compared to female representation among all academic surgeons, which was retrieved from the Association of American Medical Colleges.3 Chi-square statistic was used to compare sex differences in NIH funding among surgeon-scientists. Results: Between 2016 and 2020, 274 new NIH R01 grants were awarded to 216 surgeon-scientists. Although female surgeons makes up 25.9% of all academic surgeons,3 only 40, or 18.5%, of the 216 NIH-funded surgeon-scientists were female (Fig1a). In addition, of the 274 R01 grants awarded to surgeon-scientists between 2016 and 2020, 44 (16.0%) were awarded to female surgeon-scientists. Thus, while 23.8% of male surgeon-scientists were awarded two or more new R01s between 2016 and 2020, only 10.0% of female surgeon-scientists were awarded two or more R01s during the same period (Χ2=3.73, p=0.05, Fig1b). Across all surgical specialty, Plastic Surgery has the highest proportion of female NIH-funded surgeon-scientists (37.5% female). Conclusion: Although diversity is important to drive innovative research, the majority of NIH R01 grants were awarded to male surgeon-scientists. Not only are female surgeon-scientists significantly underrepresented among NIH-funded surgeon-scientists, but they are also less likely to receive more than one R01 grants. Female representation significantly decreases in higher academic ranks, with only 7% of academic surgeons with full professorship identifying as female.4 As holding multiple grants is important for career promotions and security, closing the funding gap between female and male surgeon-scientists would not only promote innovation in surgical research, but may also have the potential of increasing the retention and promotion of female surgeon-scientists.
References: 1. Hofstra B, et al. The Diversity-Innovation Paradox in Science. PNAS. 2020;117(17):9284-9291. 2. Ginther DK, et al. Gender, Race/Ethnicity, and National Institutes of Health R01 Research Awards: Is There Evidence of a Double Bind for Women of Color? Acad Med. 2016;91(8):1098-1107. 3. Linscheid LJ, et al. Women in academic surgery over the last four decades. PLOS ONE. 2020;15(12):e0243308. 4. Blumenthal DM, et al. Sex Differences in Faculty Rank Among Academic Surgeons in the United States in 2014. Annals of Surgery. 2018;268(2).


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