Making the Match or Breaking it? Values, Perceptions, and Obstacles of Trainees Applying into Physician-Scientist Training Programs.

Abstract

Background. Replenishing the physician-scientist workforce remains a central mission of medical education, but the hemorrhaging of qualified trainees threatens the physician-scientist role. Among the barriers facing physician-scientists is the game-like model of residency matching, which applies several flawed assumptions regarding the comparability of applicants' qualifications, cohort size, and the institutional breadth of applicant training needs. Methods. The current report summarizes the collective views and experiences of physician-scientist trainees following the 2021-2022 application cycle of physician-scientist training programs (PSTPs). We obtained survey-based feedback by 27 PSTP applicants from 17 U.S. medical universities, among whom 85% matched into a PSTP. Results. 93% PSTP applicants recognized scientific community as the most important feature of postgraduate training, and 65% of respondents found waiting for interviews as the most stressful aspect of the application cycle. Half of the survey respondents perceived at least one NRMP policy violation by a PSTP, most of which occurred during post-interview communication. Specifically, 93% respondents were contacted by a PSTP following interviews, and one-third admitted feeling pressured into sharing their rank preference during these interactions. Conversely, 65% of applicants visited at least one program or following interviews. Conclusion. Overall, we believe the values and needs of physician-scientist trainees are poorly represented by the current PSTP selection framework, including inconsistent timelines and communication throughout the process. We therefore propose a series of modifications that, if implemented, would better equip applicants to gauge programs according to the clinical, scientific, and academic communities that we seek to join as physician-scientists.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

M.E.P. was supported by funding from the Alexander von Humboldt Forschungsstipendium, Deutsches Zentrum fur Herz-Kreislauf-Forschung (DZHK), and Deutsche Gesellschaft fur Kardiologie (DGK).

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval for this work was provided by the Office of the Institutional Review Board at the University of Alabama at Birmingham (IRB-300001128). A waiver of informed consent was provided, since no personally-identifying information was obtained through this voluntary survey.

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Yes

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I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

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Data Availability

All aggregated data produced in the present study are available upon reasonable request to the authors.

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