Jeffe Donna B, Andriole Dorothy A
Department of Medicine, Washington University School of Medicine, Saint Louis, Missouri, USA.
Department of Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA.
J Investig Med. 2018 Feb;66(2):340-350. doi: 10.1136/jim-2017-000515. Epub 2017 Sep 27.
The size and diversity of the physician-scientist workforce are issues of national concern. In this retrospective, national cohort study of US medical school matriculants who graduated in 1997-2004, we describe the prevalence and predictors of federal F32, mentored-K, and R01 awards among physicians. In multivariable logistic regression models, we identified demographic, educational, and professional development variables independently associated with each award through August 2014, reporting adjusted odds ratios and 95% confidence intervals (AOR (95% CI)). Among 117,119 graduates with complete data (97.7% of 119,906 graduates in 1997-2004), 509 (0.4%) received F32, 1740 (1.5%) received mentored-K, and 597 (0.5%) received R01 awards. Adjusting for all variables except US Medical Licensing Examination Step 1 scores, black (vs white) graduates were less likely to receive F32 (0.48 (0.28-0.82)), mentored-K (0.56 (0.43-0.72)), and R01 (0.48 (0.28-0.82)) awards; Hispanic graduates were less likely to receive mentored-K awards (0.68 (0.52-0.88)), and women less likely to receive F32 (0.81 (0.67-0.98)) and R01 (0.59 (0.49-0.71)) awards. After adding Step 1 scores, these race/ethnicity effects were not significant, but women (0.62 (0.51-0.75)) were still less likely to receive R01 awards. Graduates reporting both (vs neither) medical school research elective and authorship were more likely to receive F32 (1.89 (1.45-2.48)), mentored-K (2.48 (2.13-2.88)), and R01 (2.00 (1.54-2.60)) awards. Prior F32 (2.17 (1.46-3.21)) and mentored-K (28.08 (22.94-34.38)) awardees more likely received R01 awards. Findings highlight the need for research-experiential interventions along the medical education continuum to promote greater participation and diversity of US medical graduates in the federally funded, biomedical research workforce.
医学科学家队伍的规模和多样性是国家关注的问题。在这项对1997 - 2004年毕业的美国医学院新生进行的回顾性全国队列研究中，我们描述了医生获得联邦F32、带指导K奖和R01奖的患病率及预测因素。在多变量逻辑回归模型中，我们确定了截至2014年8月与每项奖项独立相关的人口统计学、教育和职业发展变量，并报告了调整后的优势比和95%置信区间（AOR(95%CI)）。在117119名有完整数据的毕业生中（占1997 - 2004年119906名毕业生的97.7%），509人（0.4%）获得了F32奖，1740人（1.5%）获得了带指导K奖，597人（0.5%）获得了R01奖。在调整除美国医学执照考试第一步成绩外的所有变量后，黑人（与白人相比）毕业生获得F32奖（0.48(0.28 - 0.82)）、带指导K奖（0.56(0.43 - 0.72)）和R01奖（0.48(0.28 - 0.82)）的可能性较小；西班牙裔毕业生获得带指导K奖的可能性较小（0.68(0.52 - 0.88)），女性获得F32奖（0.81(0.67 - 0.98)）和R01奖（0.59(0.49 - 0.71)）的可能性较小。在加入第一步成绩后，这些种族/族裔效应不显著，但女性（0.62(0.51 - 0.75)）获得R01奖的可能性仍然较小。报告医学院研究选修课和论文发表情况的毕业生比未报告的毕业生更有可能获得F32奖（1.89(1.45 - 2.48)）、带指导K奖（2.48(2.13 - 2.88)）和R01奖（2.00(1.54 - 2.60)）。之前获得F32奖（2.17(1.46 - 3.21)）和带指导K奖（28.08(22.94 - 34.38)）的获得者更有可能获得R01奖。研究结果凸显了在医学教育连续过程中开展研究体验干预措施的必要性，以促进美国医学毕业生更多地参与联邦资助的生物医学研究工作队伍，并提高其多样性。
