It is an understatement to say that there has been substantial uncertainty for surgeon-scientists around the country regarding the future of scientific funding. As context, I am a PGY-5 general surgery resident, soon-to-be complex general surgical oncology fellow, and aspiring surgeon-scientist with an interest in running an independently funded basic and translational science lab. On January 22, 2025, I was the first of my class of chiefs to give their Grand Rounds talks. My talk focused on prior research I had completed and then turned toward my vision for my future work. After the talk, I remember being asked by a member of the audience what I anticipated the most difficult aspects of achieving independence was, to which I answered “funding.” Later that day, in almost comedic irony, a widely circulated article published by Science entitled “Trump hits NIH with ‘devastating’ freezes on meetings, travel, communications, and hiring” was released outlining what surgeon-scientists across our institution had already begun to experience that day, including pauses on grant confirmation, changes with study sections, concerns about cutting/capping of indirect costs, and generalized uncertainty about the future. Funding challenges are a common occurrence when running a laboratory, but these recent changes appear particularly concerning and therefore merit closer attention.
To put into perspective the current feelings among members of the scientific community, I contacted three early career surgeon-scientists at my institution. We discussed their thoughts on the latest news with the NIH, their feelings on the future of scientific funding, and their hopes for the future of science. My intentions with these discussions had several goals, including highlighting the current struggles faced by our colleagues and beginning to think about how I might conceptualize my future in scientific investigation.
When I asked about their thoughts on the recent changes with the NIH, the three surgeon-scientists that I interviewed were unanimous in their views that this was a negative step for scientific progress. One said: “The pace of research, the freedoms of research…because of these uncertainties, you cannot plan for hiring. All of these things you need to prospectively do, [you can’t] because you aren’t sure if the money will be there.” Another said: “I mean, it’s massively disruptive…There are many people who are waiting on grants right now. I have a fundable score. My mentor has a fundable score…This represents millions of dollars of research that we cannot do. The hard part is the personnel that we are responsible for that we cannot continue on the same trajectory that we thought we would…I decide in my lab who will have effort on mine and my co-mentor’s grants…what do we do when we cannot get that money? We will clearly just lose faculty”. The third is actively applying for their career development award now and said: “The big picture is how much funding exists…people are worried that they are going to get scored well and still not get funded. So, what do you do then?”
Importantly, despite the current uncertainty, all three surgeon-scientists were still hopeful for the future and had practical advice for those starting their career. The first said: “I guess that I am hopeful that goodness will prevail.” The second said “Still the hardest part coming out [of training] is having a good idea and proving to a department that you are worthy of spending departmental money on. For your stage, it will be similar no matter what…You still just plug for local pilots, get some money, get some people, and diversify where you are applying [for funding].” The last said: “What I have been told by program officers is that they are more protective of CDA funding. They are focused on protecting CDA’s at the VA and the NIH because the thing is that [funding] is a long-term investment in people…The return on their investment is considered to be better…That is what I am hopeful about.”
Scientific investigation has and will continue to have hoops to jump through to continue to make advancements. We all recognize that the landscape of funding may become more difficult before it gets better, but we must have hope that the public (and as an extension our legislators) will recognize the economic and public benefits derived from scientific progress and will lend us support. However, we cannot be passive bystanders. We also must continue to advocate for ourselves and for our patients who derive benefits from the science we conduct. Like my institutional mentors, I am hopeful that science will prevail.
Patrick Schwartz
In Pursuit of Professional Authenticity