S2984 Trends in NIH T32 Gastroenterology Training Grants: Funding Growth, Institutional Contraction, and Research Output (2008–2023)

Introduction: Physician-scientists are essential to advancing biomedical research and clinical care. However, over the past 2 decades, the pathway to this career has become increasingly difficult due to rising clinical demands, prolonged training, and reduced institutional support for protected research time. This study evaluates trends in National Institutes of Health T32 funding for gastroenterology (2008–2023) and examines how funding changes may affect scholarly productivity in the field. Methods: We extracted data from the publicly available National Institutes of Health RePORTER database, compiling information on all T32 awards related to gastroenterology from fiscal years 2008 to 2023. Inclusion criteria were T32 awards funded by the National Institute of Diabetes and Digestive and Kidney Diseases, within the spending category of digestive diseases and based in departments of internal medicine. Key variables assessed included the number of awards, total and average funding per year, and publication counts associated with each grant. Descriptive statistics were used to summarize trends. Linear regression analyses were conducted to assess temporal changes in award counts, funding levels, and scholarly output. Results: From 2008 to 2023, the National Institute of Diabetes and Digestive and Kidney Diseases allocated over $33.8 billion to digestive disease research, including $90 million for gastroenterology T32 training (402 awards; average $224,270). Award amounts increased from $246,283 to $268,746 (P = 0.004), but after adjusting for inflation, showed no significant change ($297,683 to $268,746; P = 0.54). The number of T32 grants declined by 1.16 per year (P < 0.0001). Scholarly output rose over time, with publications increasing from 68 in 2008 to 200 in 2023, a 2.94-fold rise. Conclusion: Although average T32 award amounts have increased nominally, inflation-adjusted analyses show no significant growth. Concurrently, the steady decline in funded programs raises concerns about the long-term sustainability of the physician-scientist workforce. Institutions relying on T32 support may face increasing difficulty maintaining research pipelines and training capacity. For GI divisions and academic centers, these trends highlight the need for proactive strategies—such as diversifying funding, strengthening institutional partnerships, and building internal support mechanisms.