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The national MD-PhD program outcomes study: Relationships between medical specialty, training duration, research effort, and career paths
Lawrence F. Brass, Myles H. Akabas
Lawrence F. Brass, Myles H. Akabas
Published October 3, 2019
Citation Information: JCI Insight. 2019;4(19):e133009. https://doi.org/10.1172/jci.insight.133009.
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Perspective Physician-Scientist Development

The national MD-PhD program outcomes study: Relationships between medical specialty, training duration, research effort, and career paths

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Abstract

MD-PhD programs were established in the 1950s as a new curriculum for training physician-scientists. Since then, the number of programs has grown considerably; however, concerns about the health of the US physician-scientist workforce have grown, as well. The largest attempt to date to assess whether MD-PhD programs are fulfilling their mission was the national MD-PhD program outcomes study, which was released as an American Association of Medical Colleges report in 2018. That study gathered information on 10,591 graduates of 80 MD-PhD programs over 50 years and concluded that most graduates have followed careers consistent with their training. Here, we provide additional analysis, drawing on survey data provided by 64.1% of alumni (75.9% of alumni with valid email addresses), plus program-supplied current workplace data for survey nonresponders to examine the relationships between medical specialty choices, training duration, research effort, and success in obtaining research funding. The results show that residency choices affect critical aspects of the physician-scientist career path, including where graduates work, how long it takes them to obtain an independent appointment in academia, and the amount of their professional time that is devoted to research. Entrants into MD-PhD programs are older, on average, now than when the programs were first established and are taking longer to graduate and complete postgraduate training. Although we found a positive relationship between professional effort devoted to research and the likelihood of having research funding, we found little evidence that the increase in training duration produces an increase in subsequent research effort. These data should provide both guidance for anyone considering this career path and insights for those who train and hire the next generation of physician-scientists.

Authors

Lawrence F. Brass, Myles H. Akabas

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Figure 2

Distribution of reported research and clinical effort.

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Distribution of reported research and clinical effort.
(A) Percent effor...
(A) Percent effort reported for research, clinical, teaching, and administrative effort for 3,017 survey responders with a current position in academia full-time broken down by research effort deciles. Boxes indicate the second and third quartiles. Whiskers are drawn using Tukey’s criteria of 1.5× the interquartile range. Outliers beyond the whiskers are shown. X indicates the average. Horizontal bar in the box indicates the median. In Supplemental Figure 1, the data are displayed in bar graph format showing the mean ± SEM. (B) Research effort for individual alumni in each of the current workplaces shown. Alumni are rank ordered from greatest reported percent research effort to least. AFT, academia full-time. The X axis has been normalized by the number of alumni to allow comparisons between workplaces that vary considerably in the number of alumni in each (n values are in parentheses). By 1-way ANOVA using Dunnett’s multiple comparisons test, the average research effort of those in industry and research institutes is significantly greater than those in AFT (P < 0.001), and the average of those in private practice is significantly less than those in AFT (P < 0.001). The average research effort of those in AFT and at NIH and other federal agencies is similar. (C) Percent of alumni in academia full-time reporting that they were a principal investigator (PI) with current grant support from either any source (red bars) or a NIH research project grant (RPG) (blue bars) as a function of reported percent research effort. Percentage above each pair of bars indicates the percent of those with PI grant support who are PI on NIH RPG as part of their grant portfolio.

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