Purpose: To describe educational outcomes for a national cohort of students who enrolled in MD–PhD programs at medical school matriculation (MD–PhD matriculants).
Method: The authors used multivariate logistic regression to identify factors independently associated with overall MD–PhD program attrition (MD-only graduation or medical school withdrawal/dismissal) compared with MD–PhD program graduation among the 1995–2000 national cohort of MD–PhD matriculants at medical schools with and without Medical Scientist Training Program (MSTP) support.
Results: Of 2,582 MD–PhD matriculants, 1,885 (73.0%) were MD–PhD graduates, 597 (23.1%) were MD-only graduates, and 100 (3.9%) withdrew/were dismissed from medical school by July 2011. MD–PhD matriculants at non-MSTP-funded schools (adjusted odds ratio [AOR], 1.96; 95% confidence interval [CI], 1.60–2.41) and who had lower Medical College Admission Test scores (< 31 versus ≥ 36: AOR, 1.60; 95% CI, 1.20–2.14; 31–33 versus ≥ 36: AOR, 1.31; 95% CI, 1.01–1.70) were more likely to leave the MD–PhD program; matriculants who reported greater planned career involvement in research (AOR, 0.65; 95% CI, 0.51–0.84) and matriculated more recently (AOR, 0.90; 95% CI, 0.85–0.96) were less likely to leave the MD–PhD program. Gender, race/ethnicity, and premedical debt were not independently associated with overall MD–PhD program attrition.
Conclusions: Most MD–PhD matriculants completed the MD–PhD program; most of those who left were MD-only graduates. Findings regarding variables associated with attrition can inform efforts to recruit and support students through successful completion of MD–PhD program requirements.
Dr. Jeffe is research professor of medicine, Washington University School of Medicine, and director, Health Behavior, Communication, and Outreach Core, Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri.
Dr. Andriole is assistant dean for medical education and associate professor of surgery, Washington University School of Medicine, St. Louis, Missouri.
Dr. Wathington is assistant professor, Curry School of Education, University of Virginia, Charlottesville, Virginia.
Dr. Tai is associate professor, Curry School of Education, University of Virginia, Charlottesville, Virginia.
Editor's Note: A commentary on this article by A.C. Bonham appears on pages 21–23.
Funding/Support: This study was funded in part by grants from the National Institute of General Medical Sciences (NIGMS; 2R01 GM085350-04 and R01 GM094535-02) and the National Cancer Institute (NCI) Cancer Center Support grant to the Siteman Cancer Center (P30 CA091842-07) for use of the Health Behavior, Communication, and Outreach Core data management services. The NIGMS and NCI were not involved in the design or conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review or approval of the manuscript.
Other disclosures: None reported.
Ethical approval: The study was approved by the institutional review board at Washington University School of Medicine.
Disclaimer: The conclusions of the authors are not necessarily those of the Association of American Medical Colleges, National Institutes of Health, or their respective staff members.
Previous presentations: Preliminary results of this study were presented in part at the Association of American Medical Colleges Graduate Research, Education, and Training (GREAT) Group, MD–PhD section, 2011 Annual Meeting, Minneapolis, Minnesota, July 28–30, 2011; at the 5th Annual Conference on Understanding Interventions That Broaden Participation in Research Careers, Baltimore, Maryland, May 10–12, 2012; and at the 51st Annual Conference on Research in Medical Education, 123rd Annual Meeting of the Association of American Medical Colleges, San Francisco, California, November 2–7, 2012.
Correspondence should be addressed to Dr. Jeffe, Division of Health Behavior Research, Department of Medicine, Washington University School of Medicine, 4444 Forest Park Ave., Suite 6700, St. Louis, MO 63108; telephone: (314) 286-1914; e-mail: email@example.com.