Exploring intentions of physician-scientist trainees: factors influencing MD and MD/PhD interest in research careers
PURPOSE To determine whether prematriculation characteristics and career-setting preferences of MD-PhD graduates differ according to their schools' funding from the National Institute of General Medical Sciences' Medical Scientist Training Program (MSTP). METHOD The Association of American Medical Colleges provided deidentified records for the national cohort of all 1993-2000 U.S. medical school matriculants, 3,180 of whom graduated with dual MD-PhD degrees by March 2, 2009. The authors examined prematriculation characteristics, educational outcomes, and career-setting preferences at graduation in association with MD-PhD program graduation from schools with long-standing MSTP-funded, recent MSTP-funded, and non-MSTP-funded programs. RESULTS Of 3,142 MD-PhD graduates with prematriculation data, 30% were women and 36% were nonwhite. Graduates from long-standing MSTP-funded schools (63% of 3,142 graduates) composed a more highly selective group academically (based on Medical College Admission Test scores) than did graduates from recent MSTP-funded (6%) and non-MSTP-funded schools (31%). Women and nonwhite graduates were more likely to have graduated from long-standing MSTP-funded schools. Controlling for MSTP funding and other variables, graduates with total debt of $100,000 or more were more likely to indicate non-research-related career-setting preferences (nonuniversity clinical practice: odds ratio [OR] 3.58, 95% confidence interval [CI] 1.86-6.87; undecided/other: OR 2.15, 95% CI 1.29-3.60). Neither gender nor race/ethnicity was independently associated with graduates' career-setting preferences. CONCLUSIONS Women and nonwhite MD-PhD graduates more likely graduated from long-standing MSTP than non-MSTP-funded schools. Controlling for institutional MSTP funding, MD-PhD graduates with high debt were more likely to indicate non-research-related career-setting preferences.