Distribution of research awards from the National Institutes of Health among medical schools

Background: Previous studies have demonstrated that a small number of the 125 medical schools in the United States receive a disproportionately large share of the research awards granted by the National Institutes of Health (NIH). We assessed whether the distribution of NIH research awards to medical schools changed between 1986 and 1997. Methods: We used NIH data to rank medical schools in each year from 1986 to 1997 according to the number of awards each school received (as a measure of each school's activity in research, also referred to as research intensity). The proportion of awards received by schools ranked 1 to 10, 11 to 30, 31 to 50, and 51 or lower in research activity was then calculated, and changes over time were examined. We also examined changes in the distribution of awards and changes in award amounts according to the type of department, the type of academic degree held by the principal investigator, and the awarding institute. Results: Between 1986 and 1997, the proportion of research awards granted by the NIH to the 10 most research-intensive medical schools increased slightly (from 24.6 percent of all awards to 27.1 percent), whereas the 75 least research-intensive medical schools (those ranked 51 or lower) received proportionately fewer awards (declining from 24.3 percent to 21.8 percent). The increased proportion of awards to top-10 schools consisted primarily of increases in awards to clinical departments, awards to physicians, and awards from highly competitive NIH institutes. Basic-science departments received a smaller proportion of awards than clinical departments, both in 1986 and in 1997. Conclusions: Research funded by the NIH is becoming more concentrated in the medical schools that are most active in research. (N Engl J Med 2000;342:250-5.) (C)2000, Massachusetts Medical Society.