Perspective
Abstract
The American Physician Scientists Association (APSA) was founded in 2003 with a mission to build a unified community for physician-scientist trainees. Over the past 2 decades, the APSA has played a pivotal role in fostering the development of future physician-scientists through mentorship, advocacy, and professional development. This year, the APSA hosted its 20th Annual Meeting in Chicago in collaboration with the Association of American Physicians and the American Society for Clinical Investigation. This milestone marks a moment of celebration and reflection, highlighting APSA’s enduring impact on the future of physician-scientist training.
Authors
Cynthia Y. Tang, Alex D. Waldman, Daniel C. Brock
Abstract
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.
Authors
Gary Koretzky
Abstract
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.
Authors
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
Abstract
The 2014 NIH Physician-Scientist Workforce Working Group predicted a future shortage of physician-scientists. Subsequent studies have highlighted disparities in MD-PhD admissions based on race, income, and education. Our analysis of data from the Association of American Medical Colleges covering 2014–2021 (15,156 applicants and 6,840 acceptees) revealed that acceptance into US MD-PhD programs correlates with research experience, family income, and research publications. The number of research experiences associated with parental education and family income. Applicants were more likely to be accepted with a family income greater than $50,000 or with one or more publications or presentations. Applicants were less likely to be accepted if they had parents without a graduate degree, were Black/African American, were first-generation college students, or were reapplicants, irrespective of the number of research experiences, publications, or presentations. These findings underscore an admissions bias that favors candidates from affluent and highly educated families, while disadvantaging underrepresented minorities.
Authors
Darnell K. Adrian Williams, Briana Christophers, Timothy Keyes, Rachit Kumar, Michael C. Granovetter, Alexandria Adigun, Justin Olivera, Jehron Pura-Bryant, Chynna Smith, Chiemeka Okafor, Mahlet Shibre, Dania Daye, Myles H. Akabas
Abstract
Authors
Enze Xing, Rieham Owda, Charisse Loder, Kathleen Collins
Abstract
MD-PhD trainees constitute an important source of physician-scientists. Persistence on this challenging path is facilitated by success in garnering independent (R grant) support from the NIH. Published research tracks academic appointments and global R01 success for MD-PhD trainees but has not included information on future funding success of individual MD-PhD predoctoral grant holders. Here, we used data from the NIH RePORTER database to identify and track the funding trajectory of physician-scientists who received predoctoral grant support through the F30 mechanism, which is specific for dual-degree candidates. Male and female F30 awardees did not differ in their success in garnering K (postdoctoral training) grants, but, among F30 grant awardees, men were 2.6 times more likely than women to receive R funding. These results underscore the need for analysis of factors that contribute to the disproportionate loss of NIH-supported female physician-scientists between the predoctoral F30 and the independent R grant–supported stages.
Authors
Shohini Ghosh-Choudhary, Neil Carleton, S. Mehdi Nouraie, Corrine R. Kliment, Richard A. Steinman
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
Abstract
Authors
Ronald J. Koenig
Abstract
Postgraduate physician-scientist training programs (PSTPs) enhance the experiences of physician-scientist trainees following medical school graduation. PSTPs usually span residency and fellowship training, but this varies widely by institution. Applicant competitiveness for these programs would be enhanced, and unnecessary trainee anxiety relieved, by a clear understanding of what factors define a successful PSTP matriculant. Such information would also be invaluable to PSTP directors and would allow benchmarking of their admissions processes with peer programs. We conducted a survey of PSTP directors across the US to understand the importance they placed on components of PSTP applications. Of 41 survey respondents, most were from internal medicine and pediatrics residency programs. Of all components in the application, two elements were considered very important by a majority of PSTP directors: (a) having one or more first-author publications and (b) the thesis advisor’s letter. Less weight was consistently placed on factors often considered more relevant for non-physician-scientist postgraduate applicants — such as US Medical Licensing Examination scores, awards, and leadership activities. The data presented here highlight important metrics for PSTP applicants and directors and suggest that indicators of scientific productivity and commitment to research outweigh traditional quantitative measures of medical school performance.
Authors
Emily J. Gallagher, Don C. Rockey, Christopher D. Kontos, Jatin M. Vyas, Lawrence F. Brass, Patrick J. Hu, Carlos M. Isales, Olujimi A. Ajijola, W. Kimryn Rathmell, Paul R. Conlin, Robert A. Baiocchi, Barbara I. Kazmierczak, Myles H. Akabas, Christopher S. Williams
Abstract
This Perspective discusses disparities in COVID-19 infection and outcome in ethnically diverse groups and considerations that should be taken to rectify this disparity going forward.
Authors
John M. Carethers
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