Predictors of full-time faculty appointment among MD–PhD program graduates: a national cohort study

Abstract

Purpose

The authors sought to identify variables associated with MD–PhD program graduates’ academic medicine careers.

Methods

We analyzed data for a national cohort of MD–PhD program graduates from 2000 to 2005, using multivariable logistic regression to identify independent predictors of full-time academic medicine faculty appointment through 2013.

Results

Of 1,860 MD–PhD program graduates in 2000–2005, we included 1,846 (99.2%) who had completed residency training before 2014. Of these 1,846 graduates, 968 (52.4%) held full-time faculty appointments. Graduates who attended schools with Medical Scientist Training Program (MSTP) funding (vs. no MSTP funding; adjusted odds ratio [aOR], 1.41; 95% confidence interval [CI], 1.14–1.74) and participated in ≥1 year of research during residency (vs. no documented research year; aOR, 1.85; 95% CI, 1.50–2.28) were more likely to have held full-time faculty appointments. Asian/Pacific Islander (aOR, 0.74; 95% CI, 0.60–0.93) and under-represented minority (URM; aOR, 0.68; 95% CI, 0.48–0.98) graduates (each vs. white graduates), graduates who reported total debt of ≥$100,000 (vs. no debt) at graduation (aOR, 0.58; 95% CI, 0.39–0.88), and graduates in surgical practice (aOR, 0.64; 95% CI, 0.48–0.84) and other practice (aOR, 0.66, 95% CI, 0.54–0.81) specialties (each vs. ‘medicine, pediatrics, pathology, or neurology’) were less likely to have held full-time faculty appointments. Gender was not independently associated with likelihood of full-time faculty appointment.

Conclusions

Over half of all MD–PhD program graduates in our study had full-time faculty appointments. Our findings regarding variables independently associated with full-time faculty appointments can inform the design of strategies to promote academic medicine career choice among MD–PhD program graduates. Further research is warranted to identify other factors amenable to intervention, in addition to those included in our study, which will foster the further development of a diverse academic medicine physician–scientist workforce nationally.

• physician–scientist
• Medical Scientist Training Program
• biomedical research workforce
• diversity
• physician debt
• specialty choice

Acknowledgements

We thank our colleagues at the Association of American Medical Colleges, Washington, DC, Paul Jolly, PhD (now retired) and Emory Morrison, PhD, for their support of our research efforts through provision of data and assistance with coding. We also thank Radha K (RK) Allam at Net ESolutions Corporation (NETE), Bethesda, MD, for grants data acquisition from the NIH IMPAC II database, and our colleagues at Washington University, James Struthers, BA, and Maria Pérez, MA, for data management, and Yan Yan, MD, PhD.