Creation of a comprehensive training and career development approach to increase the number of neurosurgeons supported by National Institutes of Health funding

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  • 1 Department of Neurological Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio;
  • 2 Office of Training and Workforce Development, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland; and
  • 3 Department of Neurological Surgery, University of Washington, Seattle, Washington
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OBJECTIVE

To increase the number of independent National Institutes of Health (NIH)–funded neurosurgeons and to enhance neurosurgery research, the National Institute of Neurological Disorders and Stroke (NINDS) developed two national comprehensive programs (R25 [established 2009] for residents/fellows and K12 [2013] for early-career neurosurgical faculty) in consultation with neurosurgical leaders and academic departments to support in-training and early-career neurosurgeons. The authors assessed the effectiveness of these NINDS-initiated programs to increase the number of independent NIH-funded neurosurgeon-scientists and grow NIH neurosurgery research funding.

METHODS

NIH funding data for faculty and clinical department funding were derived from the NIH, academic departments, and Blue Ridge Institute of Medical Research databases from 2006 to 2019.

RESULTS

Between 2009 and 2019, the NINDS R25 funded 87 neurosurgical residents. Fifty-three (61%) have completed the award and training, and 39 (74%) are in academic practice. Compared to neurosurgeons who did not receive R25 funding, R25 awardees were twice as successful (64% vs 31%) in obtaining K-series awards and received the K-series award in a significantly shorter period of time after training (25.2 ± 10.1 months vs 53.9 ± 23.0 months; p < 0.004). Between 2013 and 2019, the NINDS K12 has supported 19 neurosurgeons. Thirteen (68%) have finished their K12 support and all (100%) have applied for federal funding. Eleven (85%) have obtained major individual NIH grant support. Since the establishment of these two programs, the number of unique neurosurgeons supported by either individual (R01 or DP-series) or collaborative (U- or P-series) NIH grants increased from 36 to 82 (a 2.3-fold increase). Overall, NIH funding to clinical neurological surgery departments between 2006 and 2019 increased from $66.9 million to $157.3 million (a 2.2-fold increase).

CONCLUSIONS

Targeted research education and career development programs initiated by the NINDS led to a rapid and dramatic increase in the number of NIH-funded neurosurgeon-scientists and total NIH neurosurgery department funding.

ABBREVIATIONS BRIMR = Blue Ridge Institute of Medical Research; NIH = National Institutes of Health; NINDS = National Institute of Neurological Disorders and Stroke; NRCDP = Neurosurgeon Research Career Development Program.

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Contributor Notes

Correspondence Russell R. Lonser: Ohio State University Wexner Medical Center, Columbus, OH. russell.lonser@osumc.edu.

INCLUDE WHEN CITING Published online August 7, 2020; DOI: 10.3171/2020.5.JNS201008.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

  • 1

    DeLong MR, Benabid AL. Discovery of high-frequency deep brain stimulation for treatment of Parkinson disease: 2014 Lasker Award. JAMA. 2014;312(11):10931094.

    • Search Google Scholar
    • Export Citation
  • 2

    Chen M, Dong Y, Simard JM. Functional coupling between sulfonylurea receptor type 1 and a nonselective cation channel in reactive astrocytes from adult rat brain. J Neurosci. 2003;23(24):85688577.

    • Search Google Scholar
    • Export Citation
  • 3

    Liau LM, Jensen ER, Kremen TJ, Tumor immunity within the central nervous system stimulated by recombinant Listeria monocytogenes vaccination. Cancer Res. 2002;62(8):22872293.

    • Search Google Scholar
    • Export Citation
  • 4

    Bobo RH, Laske DW, Akbasak A, Convection-enhanced delivery of macromolecules in the brain. Proc Natl Acad Sci U S A. 1994;91(6):20762080.

    • Search Google Scholar
    • Export Citation
  • 5

    Chiocca EA, Yu JS, Lukas RV, Regulatable interleukin-12 gene therapy in patients with recurrent high-grade glioma: results of a phase 1 trial. Sci Transl Med. 2019;11(505):eaaw5680.

    • Search Google Scholar
    • Export Citation
  • 6

    Lonser RR. Advance, Adapt, Achieve: The 2016 Congress of Neurological Surgeons Presidential Address. Neurosurgery. 2017;64(CN_suppl_1):4551.

    • Search Google Scholar
    • Export Citation
  • 7

    Jannetta PJ. Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg. 1967;26(1):159162.

    • Search Google Scholar
    • Export Citation
  • 8

    Oldfield EH, Doppman JL, Nieman LK, Petrosal sinus sampling with and without corticotropin-releasing hormone for the differential diagnosis of Cushing’s syndrome. N Engl J Med. 1991;325(13):897905.

    • Search Google Scholar
    • Export Citation
  • 9

    Spetzler RF, Martin NA. A proposed grading system for arteriovenous malformations. J Neurosurg. 1986;65(4):476483.

  • 10

    Hopkins LN, Ecker RD. Cerebral endovascular neurosurgery. Neurosurgery. 2008;62(6)(suppl 3):14831502.

  • 11

    Penfield W. Temporal lobe epilepsy. Br J Surg. 1954;41(168):337343.

  • 12

    Cushing H. Landmark article April 28, 1900: A method of total extirpation of the gasserian ganglion for trigeminal neuralgia. By a route through the temporal fossa and beneath the middle meningeal artery. JAMA. 1983;250(4):519528.

    • Search Google Scholar
    • Export Citation
  • 13

    Cushing H. The hypophysis cerebri clinical aspects of hyperpituitarism and of hypopituitarism. JAMA. 1909;53(4):249255.

  • 14

    Cushing H. Electro-surgery as an aid to the removal of intracranial tumors. Surg Gynecol Obstet. 1928;47:751784.

  • 15

    Mixter WJ, Barr JS. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med. 1934;211(5):210215.

  • 16

    Penfield W, Boldrey E. Somatic motor and sensory representation in the cerebral cortex of man as studied by electrical stimulation. Brain. 1937;60(4):389443.

    • Search Google Scholar
    • Export Citation
  • 17

    Hunt WE, Hess RM. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg. 1968;28(1):1420.

    • Search Google Scholar
    • Export Citation
  • 18

    Oldfield EH, Vortmeyer AO. Development of a histological pseudocapsule and its use as a surgical capsule in the excision of pituitary tumors. J Neurosurg. 2006;104(1):719.

    • Search Google Scholar
    • Export Citation
  • 19

    Spetzler RF, Hadley MN, Rigamonti D, Aneurysms of the basilar artery treated with circulatory arrest, hypothermia, and barbiturate cerebral protection. J Neurosurg. 1988;68(6):868879.

    • Search Google Scholar
    • Export Citation
  • 20

    Rhoton AL Jr. Anatomy of saccular aneurysms. Surg Neurol. 1980;14(1):5966.

  • 21

    Rhoton AL Jr. The cerebrum. Neurosurgery. 2002;51(4)(suppl):S1S51.

  • 22

    Thompson EM, Hielscher T, Bouffet E, Prognostic value of medulloblastoma extent of resection after accounting for molecular subgroup: a retrospective integrated clinical and molecular analysis. Lancet Oncol. 2016;17(4):484495.

    • Search Google Scholar
    • Export Citation
  • 23

    Barrow DL, Spector RH, Braun IF, Classification and treatment of spontaneous carotid-cavernous sinus fistulas. J Neurosurg. 1985;62(2):248256.

    • Search Google Scholar
    • Export Citation
  • 24

    Penfield W. The passing of Harvey Cushing. Yale J Biol Med. 1940;12(3):323326.

  • 25

    Guglielmi G, Viñuela F, Dion J, Duckwiler G. Electrothrombosis of saccular aneurysms via endovascular approach. Part 2: Preliminary clinical experience. J Neurosurg. 1991;75(1):814.

    • Search Google Scholar
    • Export Citation
  • 26

    Kells AP, Hadaczek P, Yin D, Efficient gene therapy-based method for the delivery of therapeutics to primate cortex. Proc Natl Acad Sci U S A. 2009;106(7):24072411.

    • Search Google Scholar
    • Export Citation
  • 27

    Ono M, Rhoton AL Jr, Peace D, Rodriguez RJ. Microsurgical anatomy of the deep venous system of the brain. Neurosurgery. 1984;15(5):621657.

    • Search Google Scholar
    • Export Citation
  • 28

    Chang EF, Anumanchipalli GK. Toward a speech neuroprosthesis. JAMA. 2020;323(5):413414.

  • 29

    Pilon RN, Baker AR. Chronic pain control by means of an epidural catheter: report of a case with description of the method. Cancer. 1976;37(2):903905.

    • Search Google Scholar
    • Export Citation
  • 30

    Hopkins LN, Ecker RD. Cerebral endovascular neurosurgery. Neurosurgery. 2008;62(suppl_3):SHC1483SHC1502.

  • 31

    Heiss JD, Lungu C, Hammoud DA, Trial of magnetic resonance-guided putaminal gene therapy for advanced Parkinson’s disease. Mov Disord. 2019;34(7):10731078.

    • Search Google Scholar
    • Export Citation
  • 32

    Serbinenko FA. Balloon catheterization and occlusion of major cerebral vessels. J Neurosurg. 1974;41(2):125145.

  • 33

    Grady MS, Howard MA III, Dacey RG Jr, Experimental study of the magnetic stereotaxis system for catheter manipulation within the brain. J Neurosurg. 2000;93(2):282288.

    • Search Google Scholar
    • Export Citation
  • 34

    Dandy WE. Ventriculography following the injection of air into the cerebral ventricles. Ann Surg. 1918;68(1):511.

  • 35

    Horsley V, Clarke RH. The structure and functions of the cerebellum examined by a new method. Brain. 1908;31(1):45124.

  • 36

    Moniz E. L’encéphalographie artérielle, son importance dans la localisation des tumeurs cérébrales. Rev Neurol (Paris). 1927;2:7290.

    • Search Google Scholar
    • Export Citation
  • 37

    Leksell L. The stereotaxic method and radiosurgery of the brain. Acta Chir Scand. 1951;102(4):316319.

  • 38

    Cloward RB. The anterior approach for removal of ruptured cervical disks. J Neurosurg. 1958;15(6):602617.

  • 39

    Keswani SG, Moles CM, Morowitz M, The future of basic science in academic surgery: identifying barriers to success for surgeon-scientists. Ann Surg. 2017;265(6):10531059.

    • Search Google Scholar
    • Export Citation
  • 40

    Goldstein AM, Blair AB, Keswani SG, A roadmap for aspiring surgeon-scientists in today’s healthcare environment. Ann Surg. 2019;269(1):6672.

    • Search Google Scholar
    • Export Citation
  • 41

    More surgeons must start doing basic science. Editorial. Nature. 2017;544(7651):393394.

  • 42

    Rangel SJ, Efron B, Moss RL. Recent trends in National Institutes of Health funding of surgical research. Ann Surg. 2002;236(3):277287.

    • Search Google Scholar
    • Export Citation
  • 43

    Rangel SJ, Moss RL. Recent trends in the funding and utilization of NIH career development awards by surgical faculty. Surgery. 2004;136(2):232239.

    • Search Google Scholar
    • Export Citation

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