Factors associated with underrepresented minority physician scientist trainee career choices

Aisha L Siebert,Hajwa Kim,Shinnyi Chou,Omar Toubat,Jennifer M Kwan,Dania Daye,Alexander J Adami

doi:10.1186/s12909-020-02328-6

Abstract

BackgroundRecently, there have been concerted efforts to improve racial and ethnic diversity in the physician-scientist workforce. Identifying factors associated with career choices among those underrepresented in medicine and science is a necessary first step to advance this objective. The aim of the present study was to assess the attitudes and factors associated with academic and research career interests among underrepresented predoctoral physician-scientists.MethodsA cross-sectional 70-question survey was distributed to all predoctoral single degree (MD or DO) and dual degree (MD/PhD or DO/PhD) trainees at 32 medical schools in the United States from 2012 to 2014. Main outcomes included factors important to advancement in academic medicine, intended medical specialty, and future career plans. To test the post-hoc hypothesis of whether trainees from underrepresented groups have differing perceptions of career trajectories and obstacles than their counterparts, we evaluated responses according to self-identified race/ethnic status using Chi-square and Fisher’s exact tests. All tests were two-sided and significance level of < 0.05 was used.ResultsThere were a total of 4433 responses representing all predoctoral training stages. The response rate was 27%. Most respondents were single degree trainees (MD/DO 79% vs MD/DO-PhD 21%). Most respondents self-identified as White (67%), followed by Multi-racial or Other (14.3%), Asian or Pacific Islander (10.4%), Hispanic (6%), and Black or African American (4.1%). Desired career sector, career intention, and clinical specialty interest differed across race/ethnic groups. With respect to career selection factors, anticipated non-work related responsibilities during residency were also significantly different between these groups. By multivariable regression analysis, Black or African American trainees were significantly less likely than White trainees to indicate a career in academia (OR 0.496, 95% CI 0.322–0.764) and basic research (OR 0.314, 95% CI 0.115–0.857), while Multi-racial or Other trainees were also less likely than White trainees to indicate a career in academia (OR 0.763, 95% CI 0.594–0.980).ConclusionsThese data represent the first in-depth survey of career aspirations, perceptions, and interests between demographically underrepresented and non-underrepresented predoctoral physician-scientist trainees. Our results identify key differences between these cohorts, which may guide efforts to improve diversity within the physician-scientist workforce.

Highlights

There have been concerted efforts to improve racial and ethnic diversity in the physicianscientist workforce
Recently, there have been significant efforts aimed at improving racial and ethnic diversity in physician-scientist training programs and the academic biomedical workforce. Organizations such as the National Institutes of Health (NIH) and the Association of American Medical Colleges (AAMC) have defined underrepresented individuals in medicine (URM) as those who self-identify with racial and ethnic groups that are underrepresented in medicine relative to their prevalence in the general population [1, 2]
Their analysis demonstrated that the number of MD/PhD applicants identifying as African American, Native American, or Hispanic have been stagnant for several years, and that physician-scientists from these groups have been persistently disproportionately underrepresented among NIH funded investigators

Summary

Introduction

There have been concerted efforts to improve racial and ethnic diversity in the physicianscientist workforce. Prior analyses have shown that even after controlling for academic productivity, URM faculty remain less likely to be promoted and more likely to hold part-time faculty positions than their non-URM peers, suggesting that there may be residual implicit bias in the academic environment and career advancement process [8,9,10] While addressing these issues is crucial for improving success among later stage URM physician-scienists, important to the effort of improving diversity in the physician-scientist workforce is understanding the intended career choices and obstacles of URM trainees entering the physician-scientist training pipeline. Despite the clear importance of understanding the perspectives of predoctoral URM physician-scientist trainees, there are currently no nationally representative data focusing on this topic

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