NIH Research Funding Directly Affects Primary Care Physician Workforce

Graham Center study finds link between greater support and students choosing family medicine

WASHINGTON — High levels of NIH funding at a medical school are associated with fewer medical students from that school entering Family Medicine, according to a one-page research summary in the February issue of American Family Physician. The one-pager points out that the amount of NIH research funding has a direct and inverse correlation with the number of medical students who choose family medicine and the size of family medicine faculty at a medical school.

"It’s long been noted among departments of family medicine that the 'research culture' that attracts high levels of NIH funding often devalues primary care in general and family medicine specifically," said Andrew Bazemore, MD, MPH, director of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, and a co-author of the one-pager. "This analysis at least confirms that association. In a time when grants such as Clinical and Translational Science Awards (CTSA) put more emphasis on studies that look at multiple health conditions in frontline clinical settings, we hope institutions will see that the primary care/family medicine training environment and 'research culture' are closely associated if not synonymous."

Efforts to shift some NIH funding away from basic and bench science, and toward whole-patient, clinical, and outpatient care could help cement the link between research funding and primary care medical education. Some of that shift could include emphasis on cross-disciplinary, community-based, and truly translational research such as through CTSA awards.

"The Universities of Washington and North Carolina are models for demonstrating strength in both their NIH-funded research and primary care enterprises," Bazemore said. "However, between 2006 and 2010, the family medicine departments were awarded less than $354 million of the NIH’s total research grants of $57.6 billion. That represents less than one-half of one percent."

The one-pager was written by Erica Brode, MD, MPH, visiting scholar at the Robert Graham Center for Policy Studies in Family Medicine and Primary Care; Stephen Petterson, PhD, research director at the Graham Center, and Bazemore. It was based on NIH award amounts acquired from publically available lists of 2009 NIH funding by institution and logs of medical students entering family medicine by institution, tracked by the American Academy of Family Physicians.


The Robert Graham Center for Policy Studies in Primary Care and Family Medicine conducts research and analysis that brings a family practice perspective to health policy deliberations in Washington. Founded in 1999, the center is an independent research unit working under the personnel and financial policies of the American Academy of Family Physicians.

The information and opinions contained in research from the Graham Center do not necessarily reflect the views or policy of the AAFP.

February 08, 2013