New Physician-Investigators Receiving National Institutes of Health Research Project Grants: A Historical Perspective on the “Endangered Species”

CONTEXT Although concerns have persisted for decades about the production of new physician clinical scientists and their success in receiving and sustaining research supported by the National Institutes of Health (NIH), no comprehensive analysis documents the experiences of first-time investigators with an MD over a long period. OBJECTIVE To ascertain the perseverance and comparative success of physician-scientists competing for NIH research (R01) grants awarded over 40 years. DESIGN, SETTING, AND PARTICIPANTS A longitudinal, comparative study of all first-time applicants and recipients of NIH R01 grants between 1964 and 2004 stratified by the principal investigators' major degrees (MD, PhD, or MD and PhD) and their proposed involvement in research of humans or human tissues. MAIN OUTCOME MEASURES Number of first- and second-time NIH R01 grant applicants and recipients by academic degree and by research type (clinical vs nonclinical). RESULTS The annual number of first-time investigators with an MD only as NIH R01 grant applicants remained remarkably stable over 4 decades (41-year mean of 707 [range, 537-983] applicants). Among first-time applicants, those with an MD consistently had less success in obtaining funding (mean annual percentage [MAP], 28%) than either investigators with a PhD (MAP, 31%; P = .03 vs MD only) or both an MD and a PhD (MAP, 34%; P