Discoveries made by surgeon-scientists have driven and continue to drive innovation in urology. A few examples of such discoveries include phosphodiesterase type 5 inhibitors and novel imaging modalities for prostate cancer. Despite the importance of surgeon-scientists to the growth of our field, funding to support these investigators remains difficult to secure. This is reflected in the 27% decline in surgeon-scientists pursuing research careers during the period from 2007 to 2014.¹ Career development awards, including the National Institutes of Health (NIH) K08 funding mechanism, are crucial to preserving the pipeline of surgeon-scientists in urology.

As an Assistant Professor, I was fortunate enough to secure a K08 award. This award was crucial to helping ensure that I had salary support and protected time for my research, and ultimately positioned me to establish an NIH-funded laboratory. Similar experiences in leveraging a career development award into additional funding are shared by many of our field’s most prominent surgeon-scientists.

On January 5, 2021, the National Cancer Institute (NCI) issued a Request for Information (RFI) inviting feedback on the surgeon-scientist effort requirement on its K08 awards. Physician-scientists who are not surgeons have a requirement for at least 75% effort on their research and career development activities to be dedicated to their K08 grants. In recognition of the clinical obligations of surgeon-scientists, the NCI has permitted urological surgeons to have a minimum 50% effort on their research and career development activities under K08 awards. The RFI raised questions regarding whether the 50% effort exemption for urologist scientists should be continued.

Removal of this exemption for urologist scientists would likely have decimated our research workforce. To ensure that the NCI understood our concerns, the American Urological Association, led by recent AUA Research Chair Aria Olumi and Research Advocacy Committee Chair Toby Chai, organized a grassroots campaign. This campaign featured 25 individual responses to the RFI as well as a letter from the AUA. In response to our input, the NCI Director of the Center for Cancer Training stated, “I particularly appreciate that you gathered input from across your organization and included it in your reply” and that the NCI would “now allow surgeon-scientist applicants to reduce the percent effort required for conducting research career development on a K08 award below 75%... but no lower than 50%.”

This is an important victory for our field. Continued advocacy for urological interests will not only benefit researchers, but most importantly, serve our patients.