Research: a vital component of optimal patient care in the United States.

In 1975, a trend began in which applications of MDs to the National Institutes of Health for research funding became less successful than applications from PhDs or MD/PhDs. MD/PhDs were the most successful applicants. Concomitantly, proposals for clinical research were less successful than nonclinical proposals. Since 1975, surgeons have fared disproportionately worse than researchers in other clinical disciplines in obtaining funding from the National Institutes of Health. Despite the efforts of surgical organizations, surgeons continue to fall farther behind in getting National Institutes of Health support for research. The most likely cause of this problem is that the surgical profession has failed to develop and sustain an adequate research workforce.