TRAINING OF CARDIOVASCULAR PHYSICIAN-SCIENTISTS: RESULTS OF SPECIFIC TRAINING PATHWAYS
James D. Marsh, M.D. ,
University of Arkansas for Medical Sciences, Little Rock, AR, USA
Objectives: Determine factors that predict successful career development for physician-scientists mediated by three programs: MD-PhD, Physician-Scientist Residency, and NIH-funded K-awards.
Background: Physician-scientists play a crucial role in biomedical research in the United States. However, the number and portion of MDís who commit a major portion of their professional time to research and who receive major external funding is diminishing.
Methods: National data on outcomes and career success rates for three physician-scientist development programs were examined (MD-PhD, American Board of Internal Medicine Research Pathway, and NIH K-award programs.) The intersection of these programs for trainees and their subsequent career success rate was determined.
Results: MD-PhD programs have expanded over ten years (2002-2012) by 40%., with 73% of matriculants actually receiving both the MD and PhD. Predictors of attrition from the PhD program include MCAT score <34, age >23 at matriculation, and being at an institution that does not have NIH support for the MD-PhD program. Having received an MD-PhD is an important element for entering an Internal Medicine Research Pathway, as 60% of program members have a PhD and 13% a Masterís degree. Earning a PhD prior to residency is the strongest predictor of future success in a funded research career. An additional strong predictor is having received personal external grant funding, notably a K-award from the NIH. Funding of research career development awards from the NIH have been declining since 2006. NIH K08 and K23 award success rate is 35-42%; at the NHLBI the current rate is 25-30%.
Conclusion: Completing an MD-PhD prior to residency and receiving a K award from the NIH are key elements that predict research career success. MD-PhD programs have recently expanded. Research Pathway trainees are few, and K award funding is declining.