title: Predictors of full-time faculty appointment among MD-PhD program graduates: a national cohort study.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA; andrioled@wusm.wustl.edu.
authors.forename: Dorothy A
authors.initials: DA
authors.lastname: Andriole
authors.affiliation: Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Donna B
authors.initials: DB
authors.lastname: Jeffe
mesh_terms: D035843:Biomedical Research / Q000193:education* / Q000706:statistics & numerical data*; D002321:Career Choice; D004503:Education, Medical, Graduate / Q000706:statistics & numerical data*; D005180:Faculty, Medical; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008913:Minority Groups; D014146:Training Support; D014481:United States
keywords: Medical Scientist Training Program; biomedical research workforce; diversity; physician debt; physician–scientist; specialty choice