Variables Associated With Full-Time Faculty Appointment Among Contemporary U.S. Medical School Graduates: Implications for Academic Medicine Workforce Diversity

Abstract

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.

Racial and Ethnic Minority Medical Students’ Perceptions of and Interest in Careers in Academic Medicine

“…18 Recent research has shown that career preference for a full-time faculty position on the GQ is predictive of actually being appointed to such a position. 13 However, unlike Jeffe et al, 12 we did not find differences in academic medicine career interest by race and ethnicity. Our survey sample differed from that of Jeffe et al 12 in numerous ways, however; for example, ours had greater proportions of female respondents, of black and Hispanic respondents, and of respondents with medical education debt greater than $150,000.…”

“…Additionally, Andriole and colleagues 13 found that among recent medical school graduates, being female or an MD-PhD program graduate was independently associated with a greater likelihood of full-time faculty appointment, whereas race and ethnicity were not. Little else is known about when, why, and how racial and ethnic minority medical students make their decisions about academia.…”

The Doris Duke Clinical Scientist Development Award

“…20 Private philanthropic organizations similarly are starting to analyze awardee data to address these issues. 21 The percentage of CSDA applicants, for example, from different racial and ethnic groups is similar to estimates of that of full-time medical faculty, 22 but some racial and ethnic groups remain underrepresented as compared with the U.S. population. 23 Still, the percentage of underrepresented minorities in the CSDA applicant pool is similar to that of the K23 applicant pool.…”

A National Long-term Outcomes Evaluation of U.S. Premedical Postbaccalaureate Programs Designed to Promote Health care Access and Workforce Diversity

“…15-21 However, few control group studies of practicing physicians have evaluated long-term outcomes of PBPs such as what patient populations are served by PBP physician alumni. 22-23 …”

“…22-23 The first study by McDougle, et al found that physicians who were graduates of Ohio State University’s (OSU’s) PBP were more likely than their control group counterparts to be practicing medicine in federally designated medically underserved areas (29.4% versus 5.1%, p≤.01) or to be providing services where 40% or more of the patients were medically indigent or poor (67.6% versus 33.3%, p≤.01). 22 The second study by Lupton, et al, found that alumni from five premedical postbaccalaureate programs across the University of California system (UCPB) were more likely than their control group counterparts to enter primary care (53.1% versus 40.1%, p≤.001), and work in high-poverty communities (16.2% versus 8.7%, p≤.05), high-Latino communities (18.3% versus 8.7%, p≤.01), or high-African American communities (29.8% versus 19.8%, p≤.02). 23 …”