Differences in First and Fourth Year Medical Students' Attitudes Towards Pursuing a Career in Academic Medicine


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Cross-sectional study of first and fourth year medical students regarding their consideration of going into academic medicine with pilot data as presented at the 2013 Southern Group on Education Affairs meeting in Savannah, GA on April 19, 2013.

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Differences in First and Fourth Year Medical Students' Attitudes Towards Pursuing a Career in Academic Medicine

  1. 1. Differences in First and Fourth YearMedical Students’ Attitudes TowardsPursuing a Career in Academic MedicineMonica Hagan Vetter, 4thYear Med Student, and Mary B. Carter, M.D. Ph.D.
  2. 2. Background• University of Louisville’s Medical Educationelective– 4thyear medical student status– Requirements:• Capstone medical education research project• Meetings with a mentor• Attendance at educational sessions• Attendance of meetings about educational policy orcurriculum
  3. 3. BackgroundAcademic Medicine Faculty:•Perceived diminished facultyworkforce in AcademicMedicine•Concern that the number offuture Academic Physicianswill be unable to meet thedemand of increasing USmedical school enrollment
  4. 4. Background• Literature review relating to AcademicMedicine career paths reveals:– Factors positively associated with pursuingcareer in Academic Medicine:• Research experience• Gender (men more likely than women)• Having a Mentor or Role Model– Debt/salary a concern– Residents tend to lose interest in academiccareers throughout residencyBorges, NJ, Navarro AM, et al. Acad Med 2010; 85:680–686.
  5. 5. Background• Few studies explore medical students’interest in Academic Medicine careers– Limited number of studies that explore whatinfluences medical students’ career choices– No studies that demonstrate differencesbetween naïve (newly enrolled first years) andupperclassmen medical students
  6. 6. Hypotheses• A higher proportion of fourth year medical studentswould report considering a career in AcademicMedicine than first years• Several factors would positively correlate with aself-reported probability of pursuing AcademicMedicine:– Previous teaching experience– Presence of a mentor– Previous advanced degree– Interest in a distinction track during medical school– Research experience
  7. 7. Methods• This study was determined exempt by the UofL IRB• Surveyed first and fourth year students (n=165 perclass) via electronic survey (SurveyMonkey™)• Survey items included:– Demographics– Months of prior teaching and research experience– Perceived probability of pursuing an Academic Medicinecareer (Yes/No, and scale from 0% to 100%)– Perceptions of agreement to positively worded stems(5-point Likert scale)
  8. 8. Methods• Categorical data were compared with Chi square• Continuous data were compared with Pearson orSpearman correlation (as appropriate) and unpairedt-tests• Likert scale data were compared using Mann WhitneyU test• Data expressed as– Mean ± SD– Proportion of respondents as %• Null hypothesis was rejected at p < 0.05
  9. 9. ResultsVariable First Years Fourth Years p ValueGender 39% female 49% female p = 0.236Race 21% minority 21% minority p = 0.947Response Rate 38% of class 47% of class p = 0.075Advanced Degrees 18% of respondents 8% of respondents p = 0.071Age 24.0 ± 2.5 years 26.4 ± 2.5 years *p < 0.001Teaching experience (months) 9.7 ± 10.9 14.8 ± 14.7 *p = 0.030Research experience (months) 15. 2 ± 17.1 18.8 ± 20.0 p = 0.303
  10. 10. Yes / No Response: Are you considering aCareer in Academic Medicine?1st YearStudents%Yes0204060801004th YearStudentsp = 0.004
  11. 11. ResultsSelf-Reported % Probability of Pursuing aCareer in Academic Medicine1st YearStudents0204060801004th YearStudentsp = 0.022
  12. 12. ResultsVariable Correlation Coefficient p ValueInterest in a distinction tract 0.35 *p = 0.001Total number of co-authoredpapers/posters/ presentations0.24 *p = 0.006Had a significant relationship with a mentor 0.21 *p = 0.016Had an advanced degree 0.20 p = 0.175Research experience 0.20 *p = 0.026Teaching experience 0.18 *p = 0.049Probability of pursuing an Academic Medicine career correlatedwith:
  13. 13. ResultsStatement First Year Fourth Year p ValueI want to be involved in research duringresidency3.2 ± 1.2 3.8 ± 1.2 *p = 0.003Academic medicine increases opportunities forresearch3.8 ± 0.9 4.3 ± 0.8 *p = 0.006I want to teach during residency 3.7 ± 1.1 4.6 ± 0.7 *p < 0.001I want to teach after residency 3.8 ± 1.1 4.3 ± 0.7 *p = 0.010I want to be a role model 4.3 ± 0.7 4.7 ± 0.5 *p = 0.003Likert-scale responses by year in medical school year
  14. 14. ResultsBelieve a career in Academic Medicinewould reduce potential salary1st YearStudents5-PointLikert0123454th YearStudentsp < 0.001
  15. 15. ResultsVariableCorrelationCoefficientp ValueAcademic medicine would reduce hours oftaking care of patients0.26 *p = 0.004Considering academic medicine 0.24 *p = 0.007Probability of pursuing a career in academicmedicine0.20 *p = 0.022Belief that a career in Academic Medicine would reduce salarycorrelated with:
  16. 16. Conclusions• Fourth year students:– Greater self-reported probability of pursuing a career inAcademic Medicine than first year students but– More strongly perceive that Academic Medicine career wouldreduce salary potential• Probability of pursuing a career in academic medicine ispositively correlated with:– Interest in distinction tract– Publications– Role modeling– Research experience– Teaching experience
  17. 17. Discussion• Possible reasons why more fourth years desire acareer in Academic Medicine than first years:– Increased awareness of the variety of careeropportunities• Clinical sciences with basic sciences teaching• Clerkship director• Office of Medical Education– Increased interaction with academicphysicians– Increased idealism about the future?
  18. 18. Discussion• Medical Educators may support a greaterproportion of students entering intoAcademic Medicine by:– Utilizing distinction tract options– Facilitating mentorships with academicians– Offering more structured researchopportunities in the 4-year curriculum– Increasing teaching opportunities for students
  19. 19. Discussion• The pervasive opinion among medical studentswas that a career in Academic Medicinecorrelates with a lower salary.– Yet probability of entering Academic Medicinepositively correlated with the lower salary opinion• As students proceed through medical school, theyrealize other benefits of an Academic Medicine Career.– Questions need to be asked:• Do we need to support a culture shift?• Do we need to support academic salaries more?
  20. 20. Limitations• Single institution• Study design– Cross-sectional versus prospective cohort• Confined to medical student population
  21. 21. Further Research• Multi-institutional study– Increase power of study– Provide a more representative sample• Prospective cohort study– Monitor how attitudes and desires changethroughout the course of medical school andresidency• Survey of naïve versus graduating residents
  22. 22. Take Home Message• More research is needed to see howattitudes of medical students andresidents change over time.• Medical educators need to foster thedesire for careers in Academic Medicinethroughout the entire span of medicaltraining.
  23. 23. SGEA 2013We extend a warm Thank You to:SGEA for the opportunity to present our dataEmily Carr for the assistance with the IRB processDr. Ruth GreenbergKent Gardner for the assistance with data collectionContact Information:Monica Hagan Vettermhvetter@gmail.comMary B. Carter, M.D. Ph.D.mary.carter@louisville.edu
  24. 24. Thank You!