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.

1. Differences in First and Fourth Year
Medical Students’ Attitudes Towards
Pursuing a Career in Academic Medicine
Monica Hagan Vetter, 4th
Year Med Student, and Mary B. Carter, M.D. Ph.D.

2. Background
• University of Louisville’s Medical Education
elective
– 4th
year medical student status
– Requirements:
• Capstone medical education research project
• Meetings with a mentor
• Attendance at educational sessions
• Attendance of meetings about educational policy or
curriculum

3. Background
Academic Medicine Faculty:
•Perceived diminished faculty
workforce in Academic
Medicine
•Concern that the number of
future Academic Physicians
will be unable to meet the
demand of increasing US
medical school enrollment

4. Background
• Literature review relating to Academic
Medicine career paths reveals:
– Factors positively associated with pursuing
career 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 academic
careers throughout residency
Borges, NJ, Navarro AM, et al. Acad Med 2010; 85:680–686.

5. Background
• Few studies explore medical students’
interest in Academic Medicine careers
– Limited number of studies that explore what
influences medical students’ career choices
– No studies that demonstrate differences
between naïve (newly enrolled first years) and
upperclassmen medical students

6. Hypotheses
• A higher proportion of fourth year medical students
would report considering a career in Academic
Medicine than first years
• Several factors would positively correlate with a
self-reported probability of pursuing Academic
Medicine:
– Previous teaching experience
– Presence of a mentor
– Previous advanced degree
– Interest in a distinction track during medical school
– Research experience

7. Methods
• This study was determined exempt by the UofL IRB
• Surveyed first and fourth year students (n=165 per
class) via electronic survey (SurveyMonkey™)
• Survey items included:
– Demographics
– Months of prior teaching and research experience
– Perceived probability of pursuing an Academic Medicine
career (Yes/No, and scale from 0% to 100%)
– Perceptions of agreement to positively worded stems
(5-point Likert scale)

8. Methods
• Categorical data were compared with Chi square
• Continuous data were compared with Pearson or
Spearman correlation (as appropriate) and unpaired
t-tests
• Likert scale data were compared using Mann Whitney
U test
• Data expressed as
– Mean ± SD
– Proportion of respondents as %
• Null hypothesis was rejected at p < 0.05

9. Results
Variable First Years Fourth Years p Value
Gender 39% female 49% female p = 0.236
Race 21% minority 21% minority p = 0.947
Response Rate 38% of class 47% of class p = 0.075
Advanced Degrees 18% of respondents 8% of respondents p = 0.071
Age 24.0 ± 2.5 years 26.4 ± 2.5 years *p < 0.001
Teaching experience (months) 9.7 ± 10.9 14.8 ± 14.7 *p = 0.030
Research experience (months) 15. 2 ± 17.1 18.8 ± 20.0 p = 0.303

10. Yes / No Response: Are you considering a
Career in Academic Medicine?
1st Year
Students
%Yes
0
20
40
60
80
100
4th Year
Students
p = 0.004

11. ResultsSelf-Reported % Probability of Pursuing a
Career in Academic Medicine
1st Year
Students
0
20
40
60
80
100
4th Year
Students
p = 0.022

12. Results
Variable Correlation Coefficient p Value
Interest in a distinction tract 0.35 *p = 0.001
Total number of co-authored
papers/posters/ presentations
0.24 *p = 0.006
Had a significant relationship with a mentor 0.21 *p = 0.016
Had an advanced degree 0.20 p = 0.175
Research experience 0.20 *p = 0.026
Teaching experience 0.18 *p = 0.049
Probability of pursuing an Academic Medicine career correlated
with:

13. Results
Statement First Year Fourth Year p Value
I want to be involved in research during
residency
3.2 ± 1.2 3.8 ± 1.2 *p = 0.003
Academic medicine increases opportunities for
research
3.8 ± 0.9 4.3 ± 0.8 *p = 0.006
I want to teach during residency 3.7 ± 1.1 4.6 ± 0.7 *p < 0.001
I want to teach after residency 3.8 ± 1.1 4.3 ± 0.7 *p = 0.010
I want to be a role model 4.3 ± 0.7 4.7 ± 0.5 *p = 0.003
Likert-scale responses by year in medical school year

14. ResultsBelieve a career in Academic Medicine
would reduce potential salary
1st Year
Students
5-PointLikert
0
1
2
3
4
5
4th Year
Students
p < 0.001

15. Results
Variable
Correlation
Coefficient
p Value
Academic medicine would reduce hours of
taking care of patients
0.26 *p = 0.004
Considering academic medicine 0.24 *p = 0.007
Probability of pursuing a career in academic
medicine
0.20 *p = 0.022
Belief that a career in Academic Medicine would reduce salary
correlated with:

16. Conclusions
• Fourth year students:
– Greater self-reported probability of pursuing a career in
Academic Medicine than first year students but
– More strongly perceive that Academic Medicine career would
reduce salary potential
• Probability of pursuing a career in academic medicine is
positively correlated with:
– Interest in distinction tract
– Publications
– Role modeling
– Research experience
– Teaching experience

17. Discussion
• Possible reasons why more fourth years desire a
career in Academic Medicine than first years:
– Increased awareness of the variety of career
opportunities
• Clinical sciences with basic sciences teaching
• Clerkship director
• Office of Medical Education
– Increased interaction with academic
physicians
– Increased idealism about the future?

18. Discussion
• Medical Educators may support a greater
proportion of students entering into
Academic Medicine by:
– Utilizing distinction tract options
– Facilitating mentorships with academicians
– Offering more structured research
opportunities in the 4-year curriculum
– Increasing teaching opportunities for students

19. Discussion
• The pervasive opinion among medical students
was that a career in Academic Medicine
correlates with a lower salary.
– Yet probability of entering Academic Medicine
positively correlated with the lower salary opinion
• As students proceed through medical school, they
realize 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. Limitations
• Single institution
• Study design
– Cross-sectional versus prospective cohort
• Confined to medical student population

21. Further Research
• Multi-institutional study
– Increase power of study
– Provide a more representative sample
• Prospective cohort study
– Monitor how attitudes and desires change
throughout the course of medical school and
residency
• Survey of naïve versus graduating residents

22. Take Home Message
• More research is needed to see how
attitudes of medical students and
residents change over time.
• Medical educators need to foster the
desire for careers in Academic Medicine
throughout the entire span of medical
training.

23. SGEA 2013
We extend a warm Thank You to:
SGEA for the opportunity to present our data
Emily Carr for the assistance with the IRB process
Dr. Ruth Greenberg
Kent Gardner for the assistance with data collection
Contact Information:
Monica Hagan Vetter
mhvetter@gmail.com
Mary B. Carter, M.D. Ph.D.
mary.carter@louisville.edu

24. Thank You!