Most U.S. allopathic medical graduates pursue careers in full-time clinical practice;but, in a study of the Association of American Medical Colleges'(AAMC) national 1997-2004 Graduation Questionnaire (GQ), we found that 29% of U.S. allopathic medical graduates planned to pursue careers involving basic or clinical research and teaching. Of the graduates planning careers involving research, 99.7% intended to enter academic medicine. Research and teaching activities define the academic-medicine physician. Although physicians account for only a portion of all scientists involved in biomedical research in the U.S., roughly half of all National Institutes of Health (NIH) research award dollars to medical schools go to physician principal investigators. Physicians from certain minority racial/ethnic groups (i.e., Black, Native American/Alaskan, and Hispanic) are disproportionately underrepresented among academic-medicine faculty compared to their representation in the U.S. population and the U.S. allopathic medical-student population. Increasing and sustaining the diversity of academic-medicine physician faculty are crucial not only for the sake of adequate and equitable representation of underrepresented minorities (URM) as teachers, mentors and role models for future physician researchers, but also for meeting the healthcare needs of an increasingly demographically diverse American society. To develop strategies to increase the diversity of academic-medicine physician researchers, it is imperative first to identify those factors associated with pursuing academic-medicine careers that can be targeted for intervention. Since the vast majority of physicians who conduct research do so in academic institutions, our final outcome of interest will be entering an academic-medicine career. We propose a retrospective cohort study, using existing longitudinal data that was collected from or about medical students from the time of medical-school matriculation, through graduation, graduate medical education, state medical licensure, specialty-board certification achievement and ultimately entering (or not entering) an academic- medicine career. Importantly, we will be able to analyze individualized records linked across several data sources from the AAMC and the American Medical Association (AMA), including the AAMC 1993-2000 Matriculating Student Questionnaire (MSQ) and GQ, which boast >80% response rates for the years of study, to identify factors associated with extent of planned career involvement in research and pursuit of an academic-medicine career. We will use multivariable regression models to identify factors associated with planning and ultimately engaging in an academic-medicine career. The proposed study will make a substantial contribution to the literature about factors associated with the advancement of URM students interested in research along the medical-education continuum from matriculation to their ultimate entry into an academic- medicine career. Our results can inform the design of interventions to increase demographic diversity among academic-medicine physician researchers, which hopefully can lead to reducing health disparities in the U.S.
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