TY - JOUR
T1 - Predictors of sustained research involvement among MD/PhD programme graduates
AU - Canadian MD/PhD Program Investigation Group
AU - Skinnider, Michael A.
AU - Twa, David D.W.
AU - Squair, Jordan W.
AU - Rosenblum, Norman D.
AU - Lukac, Christine D.
N1 - Funding Information:
To date, the factors that determine sustained involvement in research after all training has been completed have not been well defined, in part as a result of the lack of outcomes data that directly evaluate participation in research. In the absence of such data, investigators have analysed outcomes that reflect academic careers more generally. Andriole and Jeffe11 found that factors associated with full-time faculty appointment among US MD/PhD graduates included attending a school with medical scientist training programme (MSTP) funding and completing a research year during residency, whereas debt at graduation and completing a surgical residency were negatively associated with likelihood of full-time faculty appointment. Brass et al.9 suggested that graduates of some US residency programmes, notably those in family medicine, emergency medicine, dermatology and ophthalmology, were more likely to pursue careers in private practice. Data on National Institutes of Health (NIH) grant application rates further indicate that female physician-scientists are significantly less likely than their male counterparts to be funded by research project grants.12 Given the investment of public funds in physician-scientist training, it is reasonable to ask whether there are identifiable factors associated with sustained research involvement following the completion of all physician-scientist training, using outcomes data that directly reflect research effort.
Funding Information:
We considered five outcomes as indicators of sustained research involvement: (i) presence of protected research time in the current appointment; (ii) total percentage of time dedicated to research in the current appointment; (iii) planned substantial involvement in future research; (iv) having acted as principal investigator (PI) on a funded project within the previous 36 months, and (v) receipt of funding from a federal granting agency since completion of a combined MD/PhD degree. These independent variables were selected based on factors that have been suggested in the literature to reflect the degree of research involvement among clinician-scientists. In particular, protected research time, during which the investigator is released from other responsibilities such as those for clinical practice or teaching, has been suggested to be essential if physician-scientists are to establish and lead independent research programmes as faculty members.15,16 The percentage of time an investigator dedicates to research is similarly an indicator of the depth of research involvement9 and concern has been expressed about insufficient support for physician-scientists who can dedicate 50% or less of their time to research within Canada.2 Planned substantial involvement in future research was previously assessed in a survey of MD/ PhD programme matriculants.10 We therefore included this factor in our analysis, reasoning that as the majority of MD/PhD programmes in Canada are relatively young, the median age of the survey population was expected to be low and consequently many graduates who had completed all training would be early-career investigators. Accordingly, planned substantial involvement in future research may be a more robust indicator of research involvement than the holding of competitive funding or protected research time among investigators who are still establishing independent careers. Finally, research funding has also been investigated previously as an indicator of sustained research involvement among MD/PhD programme graduates.9 These outcomes do not limit our assessment to basic science, but may also comprise involvement in clinical and translational research.
Publisher Copyright:
© 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education
PY - 2018/5
Y1 - 2018/5
N2 - Context: MD/PhD programmes provide structured paths for physician-scientist training. However, considerable proportions of graduates of these programmes do not pursue careers in research consistent with their training. Objectives: We sought to identify factors associated with sustained involvement in research after completion of all postgraduate training. Methods: Anonymised data from a national survey of Canadian MD/PhD programme graduates who had completed all physician-scientist training (n = 70) were analysed. Multivariable logistic regression was used to measure the associations between characteristics of graduates and five indicators of sustained research involvement following postgraduate training: (i) protected research time in the current appointment; (ii) percentage of time dedicated to research; (iii) planned future involvement in research; (iv) role as a principal investigator on a recent funded project, and (v) receipt of funding from a federal granting agency since graduation. Results: The majority of graduates were significantly involved in research on the basis of at least one outcome. Completion of a research fellowship, number of first-authored or co-authored manuscripts published during MD/PhD training, and duration of MD/PhD training were positively associated with continued research involvement. Completion of a Masters degree prior to MD/PhD training, female gender, debt greater than CAD$50 000 at completion of training, and pursuit of a clinical specialty other than internal medicine, paediatrics, neurology, pathology and the surgical specialties were negatively associated with sustained research involvement. Conclusions: Most MD/PhD programme graduates remain significantly involved in research, but this involvement often does not correspond to traditional physician-scientist roles, in which a majority of time is dedicated to research. To minimise loss of investment in physician-scientist training, MD/PhD programmes should prioritise research productivity during training and the pursuit of additional research training during residency, and policymakers should establish stable sources of funding to reduce debt among graduates. Our data suggest further study is warranted to identify interventions to reduce attrition among female MD/PhD programme graduates.
AB - Context: MD/PhD programmes provide structured paths for physician-scientist training. However, considerable proportions of graduates of these programmes do not pursue careers in research consistent with their training. Objectives: We sought to identify factors associated with sustained involvement in research after completion of all postgraduate training. Methods: Anonymised data from a national survey of Canadian MD/PhD programme graduates who had completed all physician-scientist training (n = 70) were analysed. Multivariable logistic regression was used to measure the associations between characteristics of graduates and five indicators of sustained research involvement following postgraduate training: (i) protected research time in the current appointment; (ii) percentage of time dedicated to research; (iii) planned future involvement in research; (iv) role as a principal investigator on a recent funded project, and (v) receipt of funding from a federal granting agency since graduation. Results: The majority of graduates were significantly involved in research on the basis of at least one outcome. Completion of a research fellowship, number of first-authored or co-authored manuscripts published during MD/PhD training, and duration of MD/PhD training were positively associated with continued research involvement. Completion of a Masters degree prior to MD/PhD training, female gender, debt greater than CAD$50 000 at completion of training, and pursuit of a clinical specialty other than internal medicine, paediatrics, neurology, pathology and the surgical specialties were negatively associated with sustained research involvement. Conclusions: Most MD/PhD programme graduates remain significantly involved in research, but this involvement often does not correspond to traditional physician-scientist roles, in which a majority of time is dedicated to research. To minimise loss of investment in physician-scientist training, MD/PhD programmes should prioritise research productivity during training and the pursuit of additional research training during residency, and policymakers should establish stable sources of funding to reduce debt among graduates. Our data suggest further study is warranted to identify interventions to reduce attrition among female MD/PhD programme graduates.
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U2 - 10.1111/medu.13513
DO - 10.1111/medu.13513
M3 - Article
C2 - 29532953
AN - SCOPUS:85043537841
SN - 0308-0110
VL - 52
SP - 536
EP - 545
JO - Medical Education
JF - Medical Education
IS - 5
ER -