Predictors of Full-time Faculty Appointment Among MD-PhD Program Graduates: a National Cohort Study

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.