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.