Climbing the Ladder: Analysis of Successful K-to-R Grant Conversion Among Plastic Surgeons

Background: Clinicians interested in a research career often seek established NIH-funded pathways to become independent clinician-scientists. This study identified American Society of Plastic Surgeons (ASPS) members that pursued such pathways and evaluated their success in transitioning from a K award to an R award, signifying a successful transition to becoming an independent researcher. Methods: ASPS members were identified and queried in the NIH RePorter database. Resultant grants were sorted to include K08, K23, K99, and R01 (or equivalents). Manual websearch was used to collect characteristics of the associated plastic surgeons at the date of successful, or expected, K-R transition. A cross-sectional analysis of these characteristics combined with grant-specific data was performed via logistic regression. Results: 7,986 ASPS members were identified and queried in the NIH RePorter database. Of these individuals, 18 plastic surgeons (13 male, 5 female) were identified to have received at least one K08 (n = 17), K23 (n = 1), or K99 (n = 0) award. Categorization of the areas of research funded by these grants placed them within areas of Composite Tissue Allotransplantation (n = 1), Crania/Maxillofacial/Head and Neck (n = 4), Nerve/Peripheral Nerve (n = 1), Outcomes (n = 3), Tissue Engineering (n = 1), Wounds/Scar (n = 6), and Other (n = 2). Of the 18 K award recipients, 9 (50%) successfully converted by subsequently obtaining at least one R01 (or equivalent); while 9 (50.0%) K award recipients failed to convert. Areas of research populated by the R01 (or equivalent) grants included Crania/Maxillofacial/Head and Neck (n = 1), Outcomes (n = 4), Wounds/Scar (n = 3), and Other (n = 1). Logistic regression of collected characteristics of plastic surgeons and grant-specific data identified that the mean Relative Citation Ratio (RCR) of K-series-associated articles published prior to the year of expected R grant receipt is a positive predictor of successful conversion (p = 0.047). Conclusion: As with any field, it is important to critically evaluate the successful acquisition of NIH funding and its use in the training of clinician-scientists within the field of plastic surgery. This study aimed to evaluate one mechanism of receiving NIH funding, the K to R pathway to research independence. Through this study, it was found that a researcher having published impactful articles pertaining to their K-series project has a positive effect in predicting their success of K-to-R conversion. Given the relatively low amount of NIH funding that this field has historically received, it is important to elucidate methods by which plastic surgeons interested in becoming clinician-scientists may increase their chances of advancing both their career and the field of plastic surgery.