Growth and development of pediatric research.

Pediatric research may be entering a period of failure to thrive. This is despite impressive scientific achievements, significant financial benefits, intriguing unanswered questions and a rewarding life for the pediatric researcher. Many of the difficulties are financial and situational, including small departments and divisions, few pediatric research mentors, impecunious pediatric hospitals and services, ethical constraints on pediatric research and competing responsibilities. Grants to pediatric departments represent about 3% of the total NIH research project support. The two largest federal programs supporting Pediatric Research are the Clinical Research Center (CRC) program (20% of an +28,000,000/yr budget) and the National Institutes of Child Health and Human Development (17% of a +123,000,000/yr budget). There are 75 CRCs of which 60 admit children; 10 CRCs are in children's hospital and 6 other CRCs have a clear pediatric focus. Pediatric Departments receive 3% of NIH funds; this represents 10% of funds to clinical departments. By contrast medicine departments receive 17% of NIH funds (47% of funds to clinical departments). NIH research support to pediatrics (+82,000,000/yr) is centered in a few large departments; 14 pediatric departments receive 343 of the 572 NIH grants (60%). By contrast, 66 of 120 pediatric departments have no (45) or 1 (21) NIH grants. Obstacles are identified and suggestions are offered for future (students and residents), beginning (fellows and assistant professors), established (associate and full professors) and women pediatric researchers.