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Gaps between college and starting an MD-PhD program are adding years to physician-scientist training time
Lawrence F. Brass, Reiko Maki Fitzsimonds, Myles H. Akabas
Lawrence F. Brass, Reiko Maki Fitzsimonds, Myles H. Akabas
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Perspective Physician-Scientist Development Aging

Gaps between college and starting an MD-PhD program are adding years to physician-scientist training time

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Abstract

The average age when physician-scientists begin their career has been rising. Here, we focused on one contributor to this change: the increasingly common decision by candidates to postpone applying to MD-PhD programs until after college. This creates a time gap between college and medical school. Data were obtained from 3544 trainees in 73 programs, 72 program directors, and AAMC databases. From 2013 to 2020, the prevalence of gaps rose from 53% to 75%, with the time usually spent doing research. Gap prevalence for MD students also increased but not to the same extent and for different reasons. Differences by gender, underrepresented status, and program size were minimal. Most candidates who took a gap did so because they believed it would improve their chances of admission, but gaps were as common among those not accepted to MD-PhD programs as among those who were. Many program directors preferred candidates with gaps, believing without evidence that gaps reflects greater commitment. Although candidates with gaps were more likely to have a publication at the time of admission, gaps were not associated with a shorter time to degree nor have they been shown to improve outcomes. Together, these observations raise concerns that, by promoting gaps after college, current admissions practices have had unintended consequences without commensurate advantages.

Authors

Lawrence F. Brass, Reiko Maki Fitzsimonds, Myles H. Akabas

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Figure 1

Gaps between college and MD-PhD program matriculation.

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Gaps between college and MD-PhD program matriculation.
(A) Gap prevalenc...
(A) Gap prevalence by matriculation year. Data on matriculating medical students (MD and MD-PhD) were obtained from the AAMC MSQ (n = 12,779–16,668). MD-PhD data from current survey respondents (matriculation year 2013–2020, n = 306, 355, 391, 419, 424, 472, 451, and 519, respectively). (B) Shorter versus longer gaps by matriculation year. (C) Comparison of gap prevalence for current MD-PhD matriculants derived from present survey data with gap prevalence derived from AAMC data on all MD-PhD program matriculants from 2013–2020 (n = 605–707/year, 5223 total). (D) Comparison of AAMC gap prevalence data for MD-PhD matriculants from 2013 to 2020 (n = 605–707/ year, 5223 total) with gap prevalence data for those who were not accepted (n = 957–1064/year, 8007 total). Comparison of gap duration for MD-PhD matriculants compared with those who were not admitted. (E) Average gap prevalence for trainees in NIGMS MSTP training grant-supported programs (n = 49 programs, n = 3068 respondents, 70% participation rate) versus trainees from programs without MSTP grants (n = 25 programs, n = 474 respondents, 76% participation rate) in 2021. Mean + SD. Boxes indicate the 25th to 75th percentiles; lines within the boxes indicate medians, and whiskers indicate the 10th and 90th percentiles. Points outside of whiskers are shown. Differences are not statistically significant by ANOVA with Tukey’s HSD post hoc test. (F) Programs were grouped by those with fewer than 60 trainees (group 1, n = 33 programs, n = 803 respondents, 75% participation rate), programs with 60–99 trainees (group 2, n = 26 programs, n = 1482 respondents, 72% participation rate), and programs with 100 or more trainees (group 3, n = 14 programs, n = 1257 respondents, 67% participation rate). Mean + SD. Differences are not statistically significant by 1-way ANOVA. (G) Gap prevalence by gender. NB, nonbinary; NA, declined to answer. (H) Gap prevalence by race/ethnicity. NA, declined to answer. (G and H) Parenthetical number represents total number of respondents in each group.

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ISSN 2379-3708

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