Implications of Cuts to Federal Research Funding for Plastic Surgery

Federal funding is a traditional pillar for the accomplishment of research in the United States that has resulted in leading advancements across traditional and basic science research. Federally funded research in plastic surgery has historically pioneered major breakthroughs for patients, including solid organ transplantation, advanced microsurgical reconstruction, limb salvage and replantation, and targeted muscle reinnervation, among others. Funding facilitates capital and material expenditures, protects research time, and supports staff scientists and facilities. Furthermore, funding is a key revenue generator for institutions. Recently proposed cuts to National Institutes of Health (NIH) funding and indirect costs pose notable implications for the progression of medicine by limiting support for academic plastic surgeons. Before these proposed cuts, surgeon-scientists noted a lack of funding as the primary barrier to the pursuit of basic science research.1,2 This holds especially true for the current landscape of plastic surgery, where a relative dearth of NIH funding is present within the field.3 Federal funding remains underused by academic surgeons but remains vital for basic and translational research faculty leading established laboratories, with whom surgeons collaborate to conduct much of this work.1 As a result, major cuts to federal funding—on top of existing pressures of increasing clinical productivity and decreased remuneration—risk possible reductions and delays in therapeutic advancements and helping patients receive the most optimal care. In an era where decreasing amounts of plastic surgery experimental science are being published and fewer surgeons are pursuing basic science paths,1,3,4 cuts to federal funding will only exacerbate this decline. Moreover, at an institutional level, inconsistent grant funding may deter new junior faculty during recruitment, further propagating the impacts of short-term budgetary changes and long-term financial strategies. Research additionally plays a uniquely integral role in residency training, both by equipping trainees with an evidence-based skillset and fostering a desire to continue to advance the field. Residents in plastic surgery training programs report research participation as enhancing their use of medical literature for application within patient care, with self-reported translation to improved clinical understanding.2 The ability to provide protected research time throughout training or as a dedicated research year is predicated upon departmental or external funding, with NIH institutional training grants playing a major supportive role.3 Consequently, the effects of federal research funding cuts within the context of surgical training are multifactorial. Most immediately, institutions’ ability to protect research time for residents will likely become strained, resulting in cohorts of junior surgeons with less opportunity to leverage the demonstrated benefits of research experience within clinical practice. Long-term, decreasing research exposure may discourage trainees’ pursuit of academic careers, yielding downstream repercussions. Such immediate effects have already been observed across the scientific field, with newly trained PhD scientists pivoting away from academia toward private industry.5 In the current turbulent landscape of clinical reimbursements and decreasing experimental science in plastic surgery, federal funding is critical to bolster support for research more than ever. Without continued support, attrition of physician-scientists and academic surgeons will have lasting implications for the next generation. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.