Basic research by vascular surgeons: why it is important and how to keep it going

Individual and Program-Related Predictors of Academic Vascular Surgery Practice

BACKGROUND

Several studies have explored factors affecting academic employment in surgical subspecialties; however, vascular surgery has not yet been investigated. We examined which elements of surgical training predict future academic productivity and studied characteristics of NIH-funded vascular surgery attendings.

METHODS

With approval from the Association of Program Directors in Vascular Surgery (APDVS), the database of recent vascular surgery fellowship (VSF) and integrated vascular surgery residency (IVSR) graduates was obtained, and public resources (Doximity, Scopus, PubMed, NIH, etc.) were queried for research output during and after training, completion of dedicated research years, individual and program NIH funding, current practice setting, and academic rank. Adjusted multivariate regression analyses were conducted for postgraduate academic productivity.

RESULTS

From 2013 to 2017, there were 734 graduates. Six hundred three completed VSF and 131 IVSR; 220 (29%) were female. Academic employment was predicted by MD degree, advanced degree, training at a top NIH-funded program, number publications by end of training, and H-index. Dedicated research time before or during vascular training, advanced degree, or graduating from a top NIH-funded program were predictors of publishing >1 paper/year. Number of publications by end of training and years in practice were predictive of H-index ≥5. VSF versus IVSR pathway did not have an impact on future academic employment, annual publication rate as an attending, or H-index. Characterization of NIH-funded attendings showed that they often completed dedicated research time (72%) and trained at a top NIH-funded program (79%). Mean publications by graduation among this group was 15.82 ± 11.3, and they averaged 4.31 ± 4.2 publications/year as attendings.

CONCLUSIONS

Research output during training, advanced degrees, and training at a top NIH-funded program predict an academic vascular surgery career. VSF and IVSR constitute equally valid paths to productive academic careers.

A 22-Year Analysis of the Society for Vascular Surgery Foundation Mentored Research Career Development Award in Fostering Vascular Surgeon-Scientists

OBJECTIVE

Vascular surgeon scientists shape the future of our specialty through rigorous scientific investigation and innovation in clinical care as well as train the next generation of surgeon-scientists. The Society for Vascular Surgery Foundation (SVSF) supports the development of surgeon-scientists through the Mentored Research Career Development Award (SVSF-CDA) Program, providing supplemental funds to recipients of NIH K08/K23 grants. The ongoing success of this mission was evaluated.

METHODS

Curriculum vitae of the 41 recipients of the SVSF supplemental funding between 1999-2021 were collected and reviewed to evaluate academic achievements to define the programmatic accomplishments, return on investment, and to identify areas for strategic improvement.

RESULTS

For nearly 22 years, the SVSF awarded supplemental funds for 31 K08 and 10 K23 grants to SVS members from 32 institutions. Thirty-four have completed K-funding while 7 are still being supported. Eleven (27%) awardees have been female including 6 (75%) of the current awardees. However, there has only been little ethnic/racial diversity in the program. Awardees obtained K-funding approximately 4 years after becoming faculty. Eleven awardees (27%) were supported by Howard Hughes, NIH F32, or T32 grants during training. To date, the SVSF has committed $12 million to the SVSF-CDA Program. Among the 34 who have completed their K-funding, 21 (62%) successfully obtained NIH R01, Veterans Affairs, or Department of Defense funding. The awardees have secured over $114M in federal funding, representing a 9.5-fold financial return on investment for the SVSF. In addition to research endeavors, 11 awardees (27%) hold endowed professorships and 19 (46%) have secured tenure at their institutions. Many of the awardees hold or have held leadership positions including 18 (44%) Division Chiefs, 11 (27%) Program Directors, 5 (12%) Chairs of Departments of Surgery, and one (2%) Dean. Eleven (27%) have served as president of a regional or national society and 24 (59%) participate in NIH study sections. Of the 34 who have completed their K-funding, 15 (44%) continue to maintain active independent research funding.

CONCLUSION

The SVSF-CDA Program is highly effective in the development of vascular surgeon-scientists who contribute to the leadership and growth of academic vascular surgery with a 9.5-fold return on investment. The number of female awardees has increased in recent years but ethnic/racial diversity remains poor. Despite the fact that 62% successfully transitioned to federal funding, less than half remained funded over time. Retention in research and increasing diversity for the awardees are major concerns and are important areas of strategic focus for the SVSF.