Siebert Aisha L, Chou Shinnyi, Toubat Omar, Adami Alexander J, Kim Hajwa, Daye Dania, Kwan Jennifer M
Northwestern University, Chicago, USA.
University of Pittsburgh, Pittsburgh, USA.
BMC Med Educ. 2020 Nov 11;20(1):422. doi: 10.1186/s12909-020-02328-6.
Recently, 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.
A 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.
There 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).
These 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.
最近，人们齐心协力提高医学科学家队伍中的种族和民族多样性。确定医学和科学领域代表性不足人群职业选择的相关因素是推进这一目标的必要第一步。本研究的目的是评估代表性不足的博士前医学科学家对学术和研究职业兴趣的态度及相关因素。
2012年至2014年，一项包含70个问题的横断面调查被分发给美国32所医学院的所有博士前单学位（医学博士或医学博士）和双学位（医学博士/哲学博士或医学博士/哲学博士）学员。主要结果包括对学术医学发展重要的因素、预期的医学专业和未来职业规划。为了检验代表性不足群体的学员与其他学员在职业轨迹和障碍认知上是否存在差异的事后假设，我们使用卡方检验和费舍尔精确检验，根据自我认定的种族/民族身份评估回答。所有检验均为双侧检验，显著性水平设定为<0.05。
共收到代表所有博士前培训阶段的4433份回复。回复率为27%。大多数受访者是单学位学员（医学博士/医学博士占79%，医学博士/医学博士 - 哲学博士占21%）。大多数受访者自我认定为白人（67%），其次是多种族或其他（14.3%）、亚裔或太平洋岛民（10.4%）、西班牙裔（6%）以及黑人或非裔美国人（4.1%）。不同种族/民族群体在期望的职业领域、职业意向和临床专业兴趣方面存在差异。在职业选择因素方面，这些群体在住院医师培训期间预期的非工作相关职责也存在显著差异。通过多变量回归分析，黑人或非裔美国学员选择学术职业（比值比0.496，95%置信区间0.322 - 0.764）和基础研究职业（比值比0.314，95%置信区间0.115 - 0.857）的可能性显著低于白人学员，而多种族或其他学员选择学术职业的可能性也低于白人学员（比值比0.763，95%置信区间0.594 - 0.980）。
这些数据代表了对人口统计学上代表性不足和代表性充足的博士前医学科学家学员在职业抱负、认知和兴趣方面的首次深入调查。我们的结果确定了这些队列之间的关键差异，这可能为改善医学科学家队伍中的多样性提供指导。
