Federal Funding Disruptions and the Emergency Medicine Research Pipeline: A National Analysis of National Institutes of Health Awards

Federal policy changes in 2025 raised concerns about disruptions to NIH-funded research, with potential implications for emergency medicine (EM) research efforts and workforce development. These concerns are particularly salient for career development (K-series) awards, which comprise a larger proportion of EM’s NIH research portfolio compared to other specialties and support early-career investigators in a relatively nascent research community. Whether EM grants—especially K-series awards—have been disproportionately affected remains unclear.

We identified NIH-funded clinical research projects expected to be active between January 19, 2025 and December 30, 2025 using the NIH RePORTER database. Grant characteristics included principal investigator department specialty, award activity, administering institute, costs, and geography. Funding disruptions were defined as any terminated, frozen, reinstated, or unfrozen grants through linkage with the GrantWitness database. We compared EM with other clinical specialties using count-based proportions of disrupted awards and the proportion of total NIH funding dollars affected by disruption, with secondary analyses restricted to K-series grants.

Among 84,226 NIH-funded projects, 2,171 (2.6%) experienced funding disruption. Of 879 EM projects, 19 (2.2%) were disrupted, a proportion similar to other clinical specialties (OR 0.84, 95% CI 0.52–1.33). Disrupted EM grants accounted for 1.7% of total NIH funding dollars allocated to EM, compared with 3.0% across non-EM specialties overall. K-series awards comprised a larger share of EM grants than non-EM grants (20.59% vs 11.71%; OR 2.21, 95% CI 1.88–2.61). Of 181 EM K-awards, 4 (2.2%) were disrupted, a rate comparable to the NIH-wide average (OR 1.01, 95% CI 0.36–2.83).

Emergency medicine did not experience disproportionate NIH funding disruption in aggregate dollars or total grants. However, because K-series awards constitute a larger share of EM’s research portfolio, comparable disruption rates may have outsized implications for early-career investigator development, departmental hiring decisions, and long-term research capacity in emergency medicine.