Abstract

Context: Despite equal enrollment proportions in MD and PhD programs, there are fewer women than men in MD-PhD programs and academic medicine. Factors important in degree program selection, including the perception of gender disparities, among undergraduate students were characterized. Methods: In 2017, women pre-health students at four public North Carolina universities were invited to participate in an online survey regarding career plans, decision factors, and perceptions of gender disparities in MD, PhD and MD-PhD pathways. This study characterizes factors important to program selection, and evaluates the association of intended graduate program with perceived gender disparities using Fisher’s exact tests. Results: Among the n=186 female survey participants, most were white (54 %) and intended MD, PhD, and/or MD-PhD programs (52 %). Sixty percent had heard of MD-PhD programs, over half had no research experience, and half were considering but uncertain about pursuing a research career. The most common factors influencing degree program choice were perceived competitiveness as an applicant, desired future work environment, and desire for patient interaction. Twenty-five percent of students considering MD, PhD, and MD-PhD programs stated that perceived gender disparities during training for those degrees will influence their choice of program, however intended degree was not statistically associated with perceived gender disparities. Discussion: Perceived gender disparities may influence choice of graduate training program but are not among the top factors. Perceived competitiveness as an applicant is an important career consideration among undergraduate women. Strategies to increase awareness of MD-PhD programs, to encourage women to consider all training paths for which they are qualified are needed. What is known: Though men and women are nearly equally represented in MD-only and PhD-only programs, women are underrepresented in MD-PhD programs, which train physician-scientists. Prior studies have shown gender is not associated with rates of attrition from MD-PhD programs or differences in academic preparation, research interest, or research experience, suggesting enrollment differences by gender may be due to fewer women applying to MD-PhD programs. Gender parity in the physician-scientist workforce is critical to equitably serving a diverse patient population. What this study adds: This study is the first to examine the role of gender disparities in the career choices of undergraduate women. Given the moderate familiarity with MD-PhD training and lack of research experience among respondents, increased awareness of MD-PhD programs and expanded research opportunities may help undergraduates make informed career choices. This may increase women MD-PhD applicants, creating a more balanced physician-scientist workforce to address the needs of patients from all backgrounds. Keywords: Education, Graduate, Sexism, Career Choice, Biomedical Research/education, Female

Highlights

  • Women are underrepresented in academic medicine, in high-ranking leadership positions,[1] as physician-scientists,[2] and in full-time clinical positions.[3]

  • Prior studies have shown gender is not associated with rates of attrition from MD-PhD programs or differences in academic preparation, research interest, or research experience, suggesting enrollment differences by gender may be due to fewer women applying to MD-PhD programs

  • What this study adds: This study is the first to examine the role of gender disparities in the career choices of undergraduate women

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Summary

Introduction

Women are underrepresented in academic medicine, in high-ranking leadership positions,[1] as physician-scientists,[2] and in full-time clinical positions.[3]. Research,[15] or in program attrition rates.[16] The proportion of women compared to men among applicants and among matriculants are similar and both below gender parity of 50%,17 suggesting that programs have fewer women than men primarily because fewer women choose to apply to MD- PhD programs Faculty with both MD and PhD training represent 45% of the NIH-funded physician-scientist workforce even though dual degree students are a small minority of students pursuing MD degrees.[18] Equalizing the gender balance in MD-PhD training programs and in the physician-scientist workforce is a priority for the future[11,19] and necessitates an examination of why women are currently underrepresented in MD-PhD programs. The authors consider the example of MD-PhD programs and hypothesize that female undergraduates’ perception of gender disparities in graduate program training is negatively associated with their stated intention to matriculate to an MD-PhD program

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