DESCRIPTION OF THE PROBLEM
A successful career in academic radiology requires research productivity and scientific publications. In fact, the rate of publications has been found to be the most important determinant of academic promotion (1). Expressing creativity through research and innovation has also been shown to reduce burnout and bring joy to daily clinical work. In addition, the involvement of clinicians in problem-based innovation will help identify and solve unmet medical needs and advance our field (2). However, with the current shortage of academic radiologists coupled with increasing imaging volumes, the amount of non-clinical time available to perform research is limited (3). In fact, academic radiologists felt that it was harder to publish now than 10 years ago because of increasing clinical workload, insufficient academic time, and increasing administrative burden associated with performing research, requiring faculty to work on research projects outside normal working hours (4). Moreover, the devastating financial impact of the COVID-19 pandemic on radiology departments (5) and the unprecedented labor shortages make investments in research by means of protected time for clinical radiologists difficult, leading to faculty departures, and exacerbating a self-perpetuating cycle of burnout and growing workforce shortages.
WHAT WAS DONE
In 2020 we implemented a new departmental grant mechanism for small grants for early-career clinical radiology faculty to support research endeavors. These “microgrants” of $1000 are intended to involve graduate or undergraduate students in research and scholarly projects to reduce the burdens associated with research, such as IRB submissions, formatting and submitting manuscripts, literature searches, or assembling clinical data. The goal was to support students to work on research projects that would advance their careers and those of our clinical radiologists and make them feel valued. Students were hired, onboarded, and paid through our hospital temp service. On average, a grant supported 30 hours of support. An additional goal was to create an opportunity for early career faculty to serve as mentors for graduate and undergraduate students as studies have shown greater career satisfaction and reduced rates of burnout in mentors (6, 7).
A call for applications is issued once a year for clinical faculty at the Instructor or Assistant Professor level. Due to the challenges of the COVID-19 pandemic affecting both clinical and research faculty, we extended the award to our research faculty starting 2021, and in 2023 we also allowed Associate Professors to submit grant proposals. Applicants were asked to provide a one-page summary of their research project and how they would like to use the award. The proposals were reviewed by our departmental awards committee, consisting of 8 faculty members, 6 MDs and 2 PhDs, and scored from a scale of 10 best to 1 worst, with the main focus on innovation followed by feasibility.
A brief survey was administered yearly to all grant recipients to evaluate the impact of the award on career advancement for the first three cohorts. The last survey was sent in January 2023. Grant recipients were asked whether the award resulted in scientific publications, follow-up projects or grant submissions with the option to provide free text comments. We also recorded whether grant recipients were promoted or left the institution. The study was exempted by our IRB.
OUTCOMES AND LIMITATIONS
We received 90 submissions and awarded 54 grants of $1000 each over a 4-year period from January 2020 to January 2023. Demographics of grant recipients are shown in Table 1. Twelve faculty members submitted more than one proposal. Fifty-two proposals were submitted by clinical faculty and 38 proposals by research faculty members. We aimed to fund at least one proposal from clinical faculty per funding cycle, resulting in a funding rate of 83% for clinical faculty. Starting in 2021, we allowed research faculty to submit grant proposals and decided to fund 3–4 proposals per year which resulted in a funding rate of 29% for research faculty. Six faculty members received more than one grant over the past 4 years.
Table 1:
Demographics of 54 grant recipients
| Number (%) | |||||
|---|---|---|---|---|---|
| 2020 | 2021 | 2022 | 2023 | Total | |
| Awarded grants | 10 | 17 | 12 | 15 | 54 |
| Awarded clinical faculty | 10 (100%) | 13 (76%) | 9 (75%) | 11 (73%) | 43 (80%) |
| Awarded research faculty | 0 (0%) | 4 (24%) | 3 (25%) | 4 (27%) | 11 (20%) |
| Gender | |||||
| Male | 6 (60%) | 15 (88%) | 10 (83%) | 7 (47%) | 38 (70%) |
| Female | 4 (40%) | 2 (12%) | 2 (17%) | 8 (53%) | 16 (30%) |
| Academic Rank | |||||
| Instructor | 5 (50%) | 9 (53%) | 8 (67%) | 7 (47%) | 29 (54%) |
| Assistant Professor | 5 (50%) | 8 (47%) | 4 (33%) | 6 (40%) | 23 (43%) |
| Associate Professor | 0 | 0 (0) | 0 | 2 (13%) | 2 (3%) |
Over the first 3 years from 2020 to 2022, 33 awardees received 39 grants. Of those, 64% were promoted and 6% are in the late stages of the promotion process with approvals anticipated this year. Of the 33 award recipients, three left the institution over three years, resulting in a separation rate of 3% per year, which is significantly below the annual reported separation rate of 13.9% for academic radiologists (8). Of those who left the institution, one received a leadership position as division chief at another academic institution, and two left for family reasons and accepted faculty positions at academic institutions in a different geographic location.
The three cohorts that received 39 grants from 2020 to 2022 were surveyed to determine the impact of the grants to allow for at least 1-year follow-up. Faculty members were asked to fill out a survey for each grant proposal. Of those, 36 awardees (92%) responded to the survey. The funds were used for salary support for students/research assistant and/or study-related expenses (equipment, scan time). The award led to at least one publication in 27/36 (75%) of the proposals and in 32/36 (89%) of the proposals the award led to a follow-up project. The awards laid the foundation for the receipt of two NIH grants, a grant from the National Academy of Medicine, one institutional grant, and two NIH grant submissions.
Faculty felt that the awards advanced their careers and felt valued by the institution as indicated by the following comments:
“The program has motivated us for applying the proposed methodology into more clinical applications and eventually led us to a follow-up NIH grant proposal.”
“This is a great program and I’m glad to see opportunities like this in the department!”
“This is a great way of helping startup research. It adds up and leads to big things.”
“The grant helped provide a boost to lessen the personal cost of the project I am working on. I appreciate all the help.”
“The project was a success, with time spent transferring data now minimized, and errors are near-zero. We want to expand this to other parts of our service soon.”
“This is the first grant I’ve ever been awarded. It has helped enormously with my research and boosted my confidence in developing quality software to solve problems of real clinical interest. This is among the best programs for junior researchers.”
This case study is limited primarily by studying only a single academic department and the lack of a control group. We only had a maximum of three years of follow up and one year follow-up for the last cohort. We cannot determine causality that the grants were the direct reason for academic promotion and faculty retention. However, the results are promising with regards to academic productivity, including scientific publications, continued involvement in research, and grant submissions. Given the current workforce shortages, this may serve as a mechanism to attract and retain clinical faculty.
Leadership roles
All authors are non-partner/non-partnership track/employees.
Miriam Bredella, MD, MBA, is Vice Chair for Faculty Affairs and Clinical Operations, Department of Radiology and Director of the MGH Center for Faculty Development
James Brink, MD, is Radiologist-in-Chief, Department of Radiology, Massachusetts General Hospital and Chief, Enterprise Radiology, Mass General Brigham
James Thrall, MD, is Chair Emeritus, Department of Radiology, Massachusetts General Hospital
The study was supported in part by NIH grant K24DK109940
Footnotes
Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Conflict of interest:
The authors declare no conflict of interest.
References
- 1.Vydareny KH, Waldrop SM, Jackson VP, Manaster BJ, Nazarian GK, Reich CA, et al. The road to success: factors affecting the speed of promotion of academic radiologists. Acad Radiol. 1999;6(10):564–9. [DOI] [PubMed] [Google Scholar]
- 2.Davis Rebekah A, Lee Kachiu C, Lee Ivy A, Levin Yakir S, Garibyan L. Innovating on innovation training with the Virtual Magic Wand (VMW) program: a qualitative study. Arch Dermatol Res. 2022:1–7. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Chen JY, Vedantham S, Lexa FJ. Burnout and work-work imbalance in radiology-wicked problems on a global scale. A baseline pre-COVID-19 survey of US neuroradiologists compared to international radiologists and adjacent staff. Eur J Radiol. 2022;155:110153. [DOI] [PubMed] [Google Scholar]
- 4.Kelly AM, Cronin P, Dunnick NR. Junior faculty satisfaction in a large academic radiology department. Acad Radiol. 2007;14(4):445–54. [DOI] [PubMed] [Google Scholar]
- 5.Cavallo JJ, Forman HP. The Economic Impact of the COVID-19 Pandemic on Radiology Practices. Radiology. 2020;296(3):E141–E4. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Bredella MA, Fessell D, Thrall JH. Mentorship in academic radiology: why it matters. Insights Imaging. 2019;10(1):107. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Sambunjak D, Straus SE, Marusic A. Mentoring in academic medicine: a systematic review. JAMA. 2006;296(9):1103–15. [DOI] [PubMed] [Google Scholar]
- 8.Santavicca S, Hughes DR, Fleishon HB, Lexa F, Rubin E, Rosenkrantz AB, et al. Radiologist-Practice Separation: Recent Trends and Characteristics. J Am Coll Radiol. 2021;18(4):580–9. [DOI] [PubMed] [Google Scholar]