Demographics

A national survey conducted among neonatologist physician-scientists funded by the NIH yielded responses from 84 participants, resulting in a 53% response rate. Among the 70 surveys included in the analysis:

• 47% identified as male and 53% as female, with no respondents identifying as non-binary or other.
• Career phases were classified as follows: 39% early-career, 27% mid-career, and 34% late-career.
• Only 10% identified with racial or ethnic groups that the NIH considers underrepresented in medicine.
• 34% possessed a master’s degree, while 17% held a PhD.
• 80% were graduates of U.S. medical schools, with 20% being international medical graduates.

Scholarly Support and Productivity

Support for early-career respondents varied widely:

• 26% received NIH training grants (T32).
• 24% were supported by the NIH loan repayment program (LRP).
• 9% trained under the Physician-Scientist Development Program (PSDP).
• 51% did not receive any research support during training.

Gender comparisons revealed similar levels of institutional support across career stages. However, a significant disparity existed among international medical graduates (IMG)—92% reported no funding during training compared to 42% of American medical graduates (p = 0.001).

The majority (70%) of respondents received NIH mentored career development awards, with K08 awards (63%) being the most common. The median time from fellowship training completion to receiving an award was four years (IQR 2-5).

The prevalence of independent NIH research program investigators, particularly among mid- and late-career individuals, increased significantly. While 56% of these cohorts received both K- and R-series awards, their median time to obtaining an R-type award was 10 years post-fellowship.

Practice Settings

Upon starting their first professional role post-fellowship:

• 87% began in academic institutions, with 70% securing positions as assistant professors.
• Formal research expectations were reported by 83% of respondents, with late-career women more likely to report having these expectations than men (100% vs. 62%, p = 0.026).

Despite 10% beginning with NIH K-type awards, 54% received institutional start-up funding. The median annual support from these funds was $50,000, primarily allocated for research supplies and personnel.

Mentorship and Trainee Involvement

The impact of mentorship was significantly acknowledged, with 80% of respondents believing mentors aided in their career progression. Of these, 46% noted the influence of internal mentors. Furthermore, 61% reported having trainees involved in their research prior to achieving independent funding.

Among the current trainees, neonatology fellows were the most common group (56%), with funding typically sourced from grant funds and departmental resources.

Funding Gaps

Funding challenges arose for 39% of respondents, with the median duration of these gaps being two years. During these periods, the majority relied on internal funding resources or increased clinical duties to maintain salaries.

Work-Life Interaction

Most respondents (89%) had children, with 77% experiencing childbirth during their early-stage investigator phase. However, only 10% reported any accommodations made for childbirth.

Despite similar rates of time off for personal reasons across career stages, late-career women were more likely to experience higher instances of stress and feelings of sadness compared to their male counterparts.

Impact of COVID-19

The COVID-19 pandemic profoundly affected respondent workflows, with 96% reporting disruptions, including lab closures and suspension of studies. Notably, IMG respondents were significantly more likely to report interruptions in their projects.

Career Satisfaction

In terms of overall career contentment, an overwhelming 99% expressed they would again choose medicine, with 93% affirming their commitment to neonatology. Interestingly, while 89% aim to continue as physician-scientists over the next five years, this number drops to 65% among those in late-career stages.

Conclusion

These findings offer critical insights into the demographics, support mechanisms, and professional experiences of NIH-funded neonatologist physician-scientists, underlining various areas needing attention for improvement, particularly around mentorship and funding equity.