JCI Insight is pleased to feature a special collection of Physician-Scientist Development articles that highlight the work, challenges, and goals faced along the physician-scientist career path.
Oliver Eickelberg, Christopher S. Williams, Kyu Y. Rhee
Efforts dating back to the 1950s have sought to formalize educating physician-scientists, individuals trained in both science and medicine and who devote the bulk of their professional time to investigative work. The return on investment has been huge, because, as a group, these individuals have made outsized contributions to advancing human health. However, efforts at supporting the physician-scientist career path have been accompanied by repeated concerns regarding the lack of intentional support needed to sustain trainees and faculty. This Perspective reviews the history of the career path, highlighting both opportunities and challenges, and offers seven recommendations with the potential to both promote its vitally and reinvigorate its future at all its stages.
Gary Koretzky
The Alliance for Academic Internal Medicine (AAIM) first convened a workshop in 2015 that brought a small group of internal medicine program directors together who recognized the growing success of early-phase physician-scientist training programs but the unclear path afterward for these trainees. The meeting subsequently evolved into what is now the annual American Society for Clinical Investigation/AAIM/Burroughs Wellcome Fund (ASCI/AAIM/BWF) Physician-Scientist Pathways Workshop, which continues to bring stakeholders together to discuss the obstacles to success that physician-scientists face at all stages of their careers. This perspective presents the history and goals of the workshop, with an emphasis on the most recent meeting in 2024, and looks ahead to the work that still needs to be done to ensure a robust physician-scientist workforce.
Kyu Y. Rhee, Charles W. Emala, Emily Jane Gallagher, Don C. Rockey, Patrick J. Hu, Jatin M. Vyas, Daniel P. Cook, Tiffany C. Scharschmidt, Olujimi A. Ajijola, ASCI Research Pathways Working Group, Christopher S. Williams
MD-PhD programs provide interdisciplinary training in medicine and research. Undergraduate pre-health advisors (PHAs) play a critical role in counseling prospective applicants, yet there have been no studies to our knowledge of MD-PhD pre-health advising. Here we surveyed 280 PHAs from US colleges and universities using both qualitative and quantitative measures that assessed their real-world advising behaviors as well as standardized evaluation of 1 of 2 fictional MD-PhD applicants, identical except for gender. We identified 3 factors that influenced advising behaviors: experience advising MD-PhD applicants, attitudes toward MD-PhD programs, and gender bias. Those PHAs with less experience and who held negative attitudes toward MD-PhD programs were less likely to initiate discussions about MD-PhD programs with qualified applicants and less likely to recommend the fictional applicants apply to MD-PhD programs. Finally, there was subtle gender bias that favored the male applicant. PHAs face challenges in advising MD-PhD applicants because there are relatively few MD-PHD applicants overall and there is a lack of resources to guide them. Addressing these challenges by strengthening collaborations with PHAs and providing comprehensive information about the value of and applicant qualifications for MD-PhD programs is crucial to enhancing MD-PhD advising, mitigating effects of bias, and expanding the pool of qualified applicants.
Amara L. Plaza-Jennings, Christie B. Ryba, Jessica Tan, Jennifer E.L. Diaz, Grace E. Mosley, Talia H. Swartz, Margaret H. Baron, Robert Fallar, Valerie Parkas
MD-PhD programs prepare physicians for research-focused careers. The challenge for admissions committees is to select from among their applicants those who will achieve this goal, becoming leaders in academic medicine and biomedical research. Although holistic practices are encouraged, the temptation remains to use metrics such as grade point average, Medical College Admission Test scores, and postbaccalaureate gap length, combined with race and ethnicity, age at college graduation, and sex to select whom to interview and admit. Here, we asked whether any of these metrics predict performance in training or career paths after graduation. Data were drawn from the National MD-PhD Program Outcomes Study with information on 4,659 alumni and 593 MD-PhD graduates of the Albert Einstein College of Medicine and the University of Pennsylvania. The Penn-Einstein dataset included admissions committee summative scores, attrition, and the number and impact of PhD publications. Output metrics included time to degree, eventual employment in workplaces consistent with MD-PhD training goals, and self-reported research effort. Data were analyzed using machine learning and multivariate linear regression. The results show that none of the applicant metrics, individually or collectively, predicted in-program performance, future research effort, or eventual workplace choices even when comparisons were limited to those in the top and bottom quintiles.
Lawrence F. Brass, Maurizio Tomaiuolo, Aislinn Wallace, Myles H. Akabas