The national MD-PhD program outcomes study: Relationships between medical specialty, training duration, research effort, and career paths

MD-PhD programs were established in the 1950s as a new curriculum for training physician-scientists. Since then, the number of programs has grown considerably; however, concerns about the health of the US physician-scientist workforce have grown, as well. The largest attempt to date to assess whether MD-PhD programs are fulfilling their mission was the national MD-PhD program outcomes study, which was released as an American Association of Medical Colleges report in 2018. That study gathered information on 10,591 graduates of 80 MD-PhD programs over 50 years and concluded that most graduates have followed careers consistent with their training. Here, we provide additional analysis, drawing on survey data provided by 64.1% of alumni (75.9% of alumni with valid email addresses), plus program-supplied current workplace data for survey nonresponders to examine the relationships between medical specialty choices, training duration, research effort, and success in obtaining research funding. The results show that residency choices affect critical aspects of the physician-scientist career path, including where graduates work, how long it takes them to obtain an independent appointment in academia, and the amount of their professional time that is devoted to research. Entrants into MD-PhD programs are older, on average, now than when the programs were first established and are taking longer to graduate and complete postgraduate training. Although we found a positive relationship between professional effort devoted to research and the likelihood of having research funding, we found little evidence that the increase in training duration produces an increase in subsequent research effort. These data should provide both guidance for anyone considering this career path and insights for those who train and hire the next generation of physician-scientists.