Surgeons need to know that NIH funding is growing, but surgeon engagement in research is shifting, risking patient outcomes.

• NIH surgery funding surged 53% to $539 million, while the number of grants remained stable.
• MD-only investigators fell from 48.9% to 40.8% of grants; MD-PhDs rose from 15.2% to 24.9%.

The gap between credentialing and active practice is widening, with only 66.6% of credentialed MD surgeons billing Medicare.

• Surgeons and academic leaders must encourage pathways for clinically active surgeon-scientists to bridge this disconnect.