U.S. Medical School Participation in Nationally Funded Biomedical Research: A New Accounting of NIH Award Dollars.

ABSTRACT: To better understand the amount of National Institutes of Health (NIH) funding received by U.S. medical schools with Liaison Committee on Medical Education-accredited medical education programs, the Association of American Medical Colleges (AAMC) developed a new methodology that crosswalks faculty NIH grants with medical schools and their affiliated organizations (e.g., teaching hospitals). This approach offers a more comprehensive and methodologically transparent accounting of NIH extramural funding to academic medicine than existing processes.The AAMC Crosswalk utilized publicly available grants data from the NIH and resources unique to the AAMC, such as the Faculty Roster and Council of Teaching Hospitals and Health Systems records. Using a multi-step algorithm, the AAMC Crosswalk linked individual faculty with NIH grants, their organizations, and partner medical schools, aggregated at the level of the medical school and its affiliated organizations for fiscal year (FY) 2017-2021.The AAMC Crosswalk attributed on average $3.7 billion more per year in NIH funding to U.S. medical schools, representing a 24% increase compared to the NIH and Blue Ridge Institute for Medical Research (BRIMR) methodologies. In FY 2021, the AAMC Crosswalk attributed 60% of NIH funding to U.S. medical schools compared with 47% by NIH and 50% by BRIMR. An exploration of limitations showed no medical school affiliations were missed by the AAMC Crosswalk among 90 randomly sampled organizations, and medical school affiliations for 30 randomly sampled principal investigator faculty members were attributed correctly.These findings indicate that academic medicine's contribution to biomedical research may be greater than historically reported. Systematically accounting for grants awarded to faculty across medical schools and their affiliated organizations provides a more comprehensive understanding of NIH funding to U.S. medical schools. The AAMC Crosswalk provides a new tool to better estimate the true investment and role of academic medicine in advancing biomedical research.

Have first-time medical school deans been serving longer than we thought? A 50-year analysis.

PURPOSE: To describe the lengths of service of deans at accredited U.S. MD-granting medical schools from academic years 1959 to 2008 and to determine whether the median length of service of deans changed over time. METHOD: The authors used the database of the Council of Deans of the Association of American Medical Colleges to seek data, from July 1, 1959 to June 30, 2009, on lengths of service of 842 deans and interim deans at all 125 accredited U.S. MD-granting medical schools existing in 2007. All but 8 schools verified their data, which included the date of the beginning of service, the date of the end of service, and whether the individual served in a permanent or interim capacity. RESULTS: Across five-year cohorts of the first-time deans and interim deans studied, the median length of service was 4.4 years. When the authors excluded individuals who were interim deans exclusively and focused the analysis on the 639 persons who were "permanent" deans, the median length of service was 6.0 years across five-year cohorts. Analysis of one-year cohorts of deans showed similar results (median = 6.1 years), although the medians for six of the seven most recent one-year cohorts ranged from 5.0 to 5.7 years. CONCLUSIONS: Through cohort analysis, the median length of service of permanent medical school deans was longer than that found in previous studies, and it has remained relatively stable.

First-time department chairs at U.S. medical schools: a 29-year perspective on recruitment and retention.

PURPOSE: Given the resources that medical schools expend to recruit and develop department chairs, the authors carried out the investigation reported here to address the scarcity of national information on the recruitment and retention of first-time chairs. METHOD: The authors used data from the Association of American Medical Colleges (AAMC) Faculty Roster. The data included first-time chairs at all Liaison Committee on Medical Education accredited medical schools from July 1978 through June 2007 (a total of 125 schools). Primary outcome measures were the annual percentages of new chairs, retention rates of chairs, and retention curves of chairs. RESULTS: The annual frequencies of first-time chairs to recruit were remarkably similar between clinical and basic science departments, yet recruitment was more frequent for larger clinical departments. On average, 8.2% of all chair positions were filled each year by new chairs. Today's first-time chairs tend to be older, with there being a gradual emergence of more women. Retention curves revealed the median tenure to be 8.0 years for the most recent cohort of chairs (starting 1994 through 1998), which was down from 9.9 years for the earliest cohort analyzed (chairs starting 1979 through 1983). Chairs with longer tenures were more likely to be less than 50 years old, hold a professor rank, and be external candidates. CONCLUSIONS: Retention of academic chairs in both clinical and basic science departments is cyclic but has declined in more recent years. The methodology presented here may serve as a template for calculating recruiting and retention rates of chairs in individual disciplines and at individual medical schools, to compare rates between schools.

Contributions of international medical graduates to US biomedical research: The experience of US medical schools.

International medical graduates (IMGs) constitute an appreciable fraction of full-time faculty at US medical schools and of principal investigators (PIs) on National Institutes of Health (NIH) research project grants. Information from the Faculty Roster of the Association of American Medical Colleges (AAMC) and from the NIH Consolidated Grant Applicant File (CGAF) was examined to assess IMGs' contribution to US medical school faculty and research. The study found that the number of IMG full-time faculty more than doubled over two decades-from 7,866 individuals in 1984 to 17,085 individuals in 2004, but that IMGs remained relatively stable as a share of physician full-time faculty (from 18.8 to 19.4%); the share is somewhat higher (20.0% of full-time physician faculty in 1984 to 23.7% in 2004) if faculty with degrees of unknown provenance are included. From 1984 to 2004, IMGs increased as a share of full-time physician faculty who are principal investigators on NIH research grants from 16.5% (540) to 21.3% (1,143). Including faculty with incomplete data on degree provenance, the corresponding IMG share increases to 18.0 and 24.0% respectively. Thus, IMGs comprise at least one-fifth and more likely one-fourth of all full-time faculty physicians who are PIs on NIH research project grants. The proportion of IMG full-time physician faculty who are in basic science departments is about twice that of their US/Canadian counterparts, as is the proportion of IMG physician PIs. Slightly fewer than half (48%) of full-time IMG faculty PIs pursue human subjects research (as coded by the NIH), while the majority of US/Canadian counterparts pursue human subjects research.