For hospitalists who love taking part in clinical research, it feels like the hits keep coming. Research funding has dropped dramatically in the past few years. It began with freezing or cutting billions of dollars in previously approved research grants through agencies such as the National Institutes of Health (NIH) and the National Science Foundation (NSF). It has included requests to Congress for further budget cuts to scientific research, to a tune of $44 billion. And as Congress looks ahead at fiscal year 2027’s budget, President Donald Trump is again seeking additional cuts to NIH and NSF research dollars.

Just recently, yet another source of federal funding dried up. In July, the federal government informed the Agency for Healthcare Research and Quality (AHRQ) that it would receive no further funding. According to the AcademyHealth Situation Report, the scope of cuts will impact nearly 80 grants, worth $200 million. Due to layoffs, the AHRQ is operating with a skeleton crew and has not awarded any grants since spring 2025.

“That was a big loss,” said Margaret Fang, MD, MPH, chief of the Division of Hospital Medicine at the University of California, San Francisco. “That funding supported hospital-based research and halted many investigations around the country.”

For many hospitalists who actively seek out a role in clinical-based research, these are tough times. Fang worries not just about current hospitalist researchers, but about future ones as well. “When you’re coming out of residency, it can look much harder to make it as a researcher than a clinician,” she said. “I worry about their decision points early on in their careers.”

It would be easy as a new doctor to take the faster route and begin clinical practice. Research careers can take years to build and have a delayed gratification. It also requires more training and lower pay. Throw in an uncertain future with funding, and Fang is justified in her concern about the up-and-coming generation of hospitalists choosing research. 

“So much of our work is geared toward improving patient safety and the systems overall,” said Fang. “When the government halted that funding, it impacted many investigators around the country. Now everyone is trying to find ways to keep doing what we love to do, which is research.”

There’s another layer to this, too, and that’s the fact that the type of research hospitalists get involved in — typically health solutions science — begins behind the 8-ball. Even in a good year, where the government doles out research dollars generously, solutions science gets a very small fraction of the coffers. 

“We’re talking about bench-to-bedside funding here,” said Lisa Marceau, MPH, PMP, founder and CEO at Alpha Millennial Health. “What’s important is that all these steps are connected. You need bench research to get to clinical trial stages. It’s a challenge.” 

Compounding the funding cuts is the fact that more clinicians are vying for research dollars, making the landscape extra competitive. 

While funding cuts have been difficult — even devastating — for many hospitalist researchers, all is not lost. There are other avenues to seek funding, if you’re invested in that career path. With an idea of other funding streams, coupled with a dogged attitude, even in the current environment, it’s possible to pursue a role in clinical research.

Where to Hunt for Dollars 

Depending on your age, this may or may not be the first round of research funding cuts you’ve faced. While just about everyone agrees that the sheer size of these cuts outstrips any in the past, it’s important to remember that they aren’t the first and likely won’t be the last either, said Marceau. 

“These are very painful cuts with ripple effects that impact staff, data, and patients,” she said. “But it’s also important to recognize that this will continue to happen, and we must address funding as a plan heading into the future state.” 

Also keep in mind that, while NIH cuts were deep, they aren’t gone entirely. “The NIH is still issuing grants, and I encourage people to apply for funding,” said Fang. “The surest way not to get funding is to not apply.” 

After federal funding, do a thorough search of other avenues. The Patient-Centered Outcomes Research Institute (PCORI) funds patient-centered comparative clinical effectiveness research (CER), making it a good match for hospitalists. PCORI issues grants multiple times each year and looks for a range of projects such as methodology studies and others. “PCORI has become a major destination for hospital-based research,” said Fang.

There are also professional societies that issue grants. By nature, hospitalists are generalists, but if you have an interest in cancer, cardiovascular, or other specialty research, there are aligned professional societies that offer grants. 

Other options for funding include private streams, such as biotech and pharma. Many of these companies support research every year, and there can be room for hospitalists in this space. 

Philanthropic organizations are another place worth exploring. These often have specific purposes — such as the Catherine Foundation for Reproductive Medicine, or the Thoracic Surgery Outcomes Research Network — but there are also plenty that are more generalized and may support hospitalist research. The Robert Wood Johnson Foundation, for instance, funds studies that are focused on achieving health equity. A good starting point is philanthropy.org for a listing of various foundations supporting health research.

If you’re part of a study and you lose funding mid-stream, Marceau recommends staying engaged and connected with your team and others. “Look beyond the standard walls,” she said. “Where are the opportunities to continue to innovate and contribute outside the traditional pathways?”

Also remember to support your professional societies, which lobby for research dollars. The Society of Hospital Medicine, for instance, recently submitted comments to the government on proposed revisions to the requirement for federal grant awards. Likewise, the Society of General Internal Medicine took legal action against the cuts to AHRQ. 

While the research funding landscape is particularly bleak now, both Marceau and Fang recommend optimism in the face of adversity. 

“In the tension and despair, there’s still room for hope and opportunity,” said Marceau. “It’s important not to take a narrow view of ‘right now,’ but look forward. Reconsider how you can partner and collaborate outside of the traditional experience.” 

No disclosures reported.