Improving the surgeon's participation in research: Is it a problem of training or priority?

Background. Although numerous important contributions have originated from basic science research performed by surgeons, it seems that such dedicated work is becoming increasingly difficult to accomplish. What are the reasons for this change and what improvements can be made? This study aims to char acterize the basic research training and careers of senior academic surgeon s to assess and devise strategies for sustaining productive and quality sur gical research. Methods. A 25-item survey was sent to 850 senior-level members of academic societies, including the Association of Academic Surgeons, Society of Unive rsity Surgeons, and American Surgical Association. It addressed each surgeo n's clinical and research training and career, as well as opinions concerni ng surgical research. Results. Three hundred seventy-seven (44%) surveys were received. Mean age was 64 years, and 73% were full professors. Seventy-two percent of responde nts performed basic science research during training, and for 71% of this g roup, research was a significant reason for choosing a clinical specialty. Ninety-one percent performed research in the same specialty area during and after training. Of those who performed research during training, a full 99 % continued to perform research on completion of training. However, 38% sto pped performing basic research by age 39. Seventeen and twenty-three percen t stopped basic research between 40 and 49 and between 50 and 59 years of a ge, respectively. The most common factors causing them to stop were increas ed clinical load (40%) and increased administrative duties (38%). For respo ndents who had stopped research prior to age 40, 73% cited increased clinic al load as the primary reason. Eighty-five percent felt a dedicated researc h period should be included in surgery training. Conclusions. Most respondents had participated ill basic research during tr aining, and continued similar research after training. However, an overwhel ming clinical practice at the junior faculty level seemed to hinder researc h. We conclude: (1) the majority consensus is that research training is int egral to the development of academic surgeons; (2) such research training o pportunities appear adequate; however, (3) faculty performing research, par ticularly at the junior level, need to be better protected from other acade mic duties, such as clinical practice and administration. The challenge to the leadership of academic surgery will be to enhance such research product ivity in the context of increasing academic demands. (C) 2000 Academic Pres s.