General Medical Sciences, currently funds 40 programs involving 45 degreegranting institutions. 2 Approximately 75 US allopathic medical schools offer MD/PhD degree programs not supported by MSTP grants. 2 Historically, the primary intent of these joint MD/ PhD degree programs, regardless of their funding mechanisms, has been to produce highly trained physicianscientists who will engage in biomedical science research careers.The medical education environment in which MD/PhD programs are offered has changed markedly in the past 15 years. The demographic characteristics of medical school graduates have changed; most notably, the proportions of women among matriculating medical student populations have steadily increased and are now approaching parity. 3 Specialty choice preferences for graduate medical education (GME) among recent US allopathic medical graduates have shifted away from the generalist specialties of family medicine, internal medicine, and pediatrics as greater proportions of gradu-ates have chosen to pursue GME in "controllable lifestyle" specialties. 4,5 In addition, professional setting options for physicians have expanded well beyond the dichotomy of academic medicine or private clinical practice. 6 Moreover, US allopathic medical graduates are faced with steadily increasing debt loads. 7 The extent to which the characteristics and professional plans of recent US allopathic medical graduates may differ between MD/PhD program gradu-ates and other MD program graduates has not been investigated. Therefore, we sought to identify factors associated For editorial comment see p 1208.

Generalist-primary care specialty choices declined since 1997, whereas primary care subspecialty and no-board-certification specialty choices increased. Associations between primary care specialty choices and demographic, attitudinal, and career intention variables can inform the design of interventions to address expected primary care workforce shortages.

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Purpose Educational outcomes for a national cohort of MD-PhD program matriculants have not been described. Method The authors used multivariate logistic regression to identify factors independently associated with overall MD-PhD program non-completion (both MD-only graduation and medical-school withdrawal/dismissal) compared with MD-PhD program graduation among the 1995–2000 national cohort of MD-PhD program enrollees at matriculation at medical schools with and without National Institutes of Health Medical Scientist Training Program (MSTP) support. Results Of 2,582 MD-PhD program enrollees in this national cohort (1,729[67.0%] men; 853[33.0%] women), 1,885 (73.0%) were MD-PhD-program graduates, 597 (23.1%) were MD-only graduates, and 100 (3.9%) withdrew/were dismissed from medical school. Enrollees at non-MSTP-funded schools compared with MSTP-funded schools (adjusted odds ratio [AOR], 1.96; 95% confidence interval [CI], 1.60–2.41) and who had lower Medical College Admission Test (MCAT) scores (<31 vs. ≥36: AOR, 1.60; 95% CI, 1.20–2.14; 31–33 vs. ≥36: AOR, 1.31; 95% CI, 1.01–1.70)were more likely to have left the MD-PhD program; enrollees who reported greater planned career involvement in research (AOR, 0.65; 95% CI, 0.51–0.84) and matriculated in more recent years (AOR,0.90; 95% CI, 0.85–0.96) were less likely to have left the MD-PhD program. Gender, race/ethnicity, and pre-medical debt were not independently associated with overall MD-PhD program non-completion. Conclusions Most MD-PhD matriculants completed the MD-PhD program, and 85.7% (597/697) of non-completers graduated from medical school. The authors’ findings regarding variables associated with MD-PhD program attrition can inform efforts to recruit and support MD-PhD program enrollees through successful completion of the dual-degree program.

Purpose To determine whether pre-matriculation 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 de-identified 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 non-white. Graduates from long-standing MSTP-funded schools (63% of all graduates) composed a more highly selective group academically (based on MCAT scores) than did graduates from recent MSTP-funded (6%) and non-MSTP-funded schools (31%). Women and non-white 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 (non-university 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 non-white 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.

As the AAMC initiates a pilot for the Core Entrustable Professional Activities (EPAs) for Entering Residency, we are seeking baseline data from residency program directors about the readiness of graduates of LCME-accredited US medical schools to perform the 13 Core EPAs without direct supervision upon entry to residency. These EPAs are based on the work of a thirteen-member expert panel informed by the literature and by feedback from the academic medicine community. Your response will be helpful in establishing a baseline against which we can assess impact as some schools implement the Core EPAs for Entering Residency.Your participation in this project is voluntary. All responses are confidential. The data will be reported in aggregate by specialty type for research purposes. No individual respondent or individual program will be identified in any report of these data. This data collection activity has been reviewed according to AAMC policies and procedures and its Institutional Review Board and is considered to be minimal risk. The AAMC has taken extensive measures to ensure the security of the data and the confidentiality of the responses. Nevertheless, if individually identified data were made public, it could prove embarrassing. If you have any questions about your rights as a participant, contact the AAMC Office of Human Subjects Research Protection by email

Purpose The authors sought to identify variables independently associated with full-time faculty appointment among recent medical graduates. Method With institutional review board approval, the authors developed a database of individualized records for six midwestern medical schools’ 1997–2002 graduates. Using multivariate logistic regression, they identified variables independently associated with full-time faculty appointment from among demographic, medical-school-related, and career-intention variables. They report adjusted odds ratios (OR) and 95% confidence intervals (CI). Results Of 1,965 graduates in the sample, 263 (13.4%) held full-time faculty appointments in 2007–2008, including 14.4% (123/853) of women graduates and 8.6% (17/198) of underrepresented minority (URM) graduates. Women (OR: 1.386, 95% CI: 1.023–1.878), MD/PhD program graduates (OR: 2.331, 95% CI: 1.160–4.683), and graduates who reported a career-setting preference for “full-time university faculty” on the Association of American Medical Colleges’ Graduation Questionnaire (OR: 3.164, 95% CI: 2.231–4.486) were more likely to have a full-time faculty appointment. Graduates who chose family medicine (OR: 0.433, 95% CI: 0.231–0.811) and surgical specialties (OR: 0.497, 95% CI: 0.249–0.994) were less likely to have a full-time faculty appointment. URM race/ethnicity was not independently associated with full-time faculty appointment (OR: 0.788; 95% CI: 0.452–1.375). Conclusions Efforts to increase representation of women graduates in academic medicine seem to have met with greater success than efforts to increase representation of URM graduates. Greater participation of URM students in MD/PhD programs and in interventions during medical school that promote interest in academic-medicine careers may increase URM graduates’ representation in academic medicine.

PurposeThe authors sought to identify variables associated with MD–PhD program graduates’ academic medicine careers.MethodsWe 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.ResultsOf 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.ConclusionsOver 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.