Veterans Affairs: Information on Protected Research Time for Clinician-Scientists

What GAO Found

According to VA, the majority of the Department of Veterans Affairs’ (VA) nearly 4,000 VA researchers are clinician-scientists—those who conduct research and provide care to veteran patients. The dual role of clinician-scientists in VA’s health system allows them to identify the needs of veteran patients and then make discoveries that can move from the research setting to the patient care setting.

Providing clinician-scientists with time that they can dedicate solely to research (protected research time) helps VA recruit and retain top clinician-scientists. In particular, officials and clinician-scientists said VA’s Career Development Award, which provides up to 30 hours of protected research time per week to early career researchers, attracts young clinician-scientists and helps establish their research careers. Officials and clinician-scientists also said protected research time improves clinician-scientists’ productivity by increasing their ability to initiate research and by providing dedicated blocks of time in which they can focus on research.

VA medical center leaders determine the amount of protected research time to provide clinician-scientists by considering recommendations from VA’s Office of Research and Development (ORD) and other factors such as such as the type of research, project funding source, and patient care needs.

Examples of VA Guidance for Protected Research Time Provided to Clinician-Scientists

Due to limitations in the data provided by VA, GAO was not able to report on aggregate or average amounts of protected research time provided to clinician-scientists. However, medical center officials described that they have processes to obtain the information they need related to individuals’ protected research time.

Clinician-scientists described variability in how protected research time meets their expectations and needs. For example, clinician-scientists at VA medical centers with well-supported research programs said they were generally able to spend their protected time on research. However, at VA medical centers where support focused on patient care rather than research, clinician-scientists reported more regularly having to forgo protected research time to address patient care needs.

Some VA medical centers can draw on a greater availability of clinical staff than others because they are affiliated with a nearby university or medical school, which enables them to use staff from those institutions to provide clinical care coverage. In contrast, rural VA medical centers may be located hundreds of miles from an academic affiliate and not have any local agreements about sharing staff.

Clinician-scientists at several VA medical centers said that the availability of protected research time generally does not affect their use of resources, but that the availability of resources such as research and laboratory space, information technology support, and study coordinators can affect how efficiently they can use their protected research time.

Why GAO Did This Study

For nearly 100 years, the VA’s research program has focused on enhancing the well-being of veterans and the nation through scientific discovery. However, leaders of VA medical centers and their clinical departments face difficult resource decisions in finding a balance between supporting research and providing patient care. The high demand for patient care may present a challenge to providing protected research time for clinician-scientists, particularly if they are working in a VA medical center that has staffing constraints.

The Consolidated Appropriations Act, 2023, includes a provision for GAO to review the amount of time dedicated for research by VA clinician-scientists. This report provides information on VA’s policies and practices for research time and how research time relates to clinician-scientist recruitment, retention, resource use, and productivity at selected VA medical centers.

GAO reviewed VA data on selected VA medical centers’ research funding, analyzed VA guidance and other documents, and interviewed officials from VA’s Office of Research and Development, Office of the Chief Operating Officer, Veterans Integrated Service Networks, and a non-generalizable sample of seven VA medical centers. GAO selected medical centers that provided diversity in research program size, geographic location, and program features such as areas of specialty.  From these medical centers, GAO interviewed 36 clinician-scientists and 23 clinical chiefs from a variety of disciplines. GAO also interviewed each medical center’s leaders and officials from research offices. GAO collected data from each selected medical center on the amount of protected research time provided to clinician-scientists, but data were not available on the actual amount of time clinician-scientists spend on research or how they use their research time.

For more information, contact Candice N. Wright at (202) 512-6888 or WrightC@gao.gov.