New insights into an old question: can the MD-PhD physician-scientist pipeline be improved?

The US needs more physician-scientists. This was a major conclusion of the NIH-sponsored 2014 Physician-Scientist Workforce Report (1). As noted in that report, physician-scientists constitute only 1.5% of the total physician workforce. This percentage has been decreasing, and the average age of physician-scientists has been increasing, which leads to the conclusion that the current physician-scientist pipeline is inadequate to meet our country’s future needs. MD-PhDs are a critical component of this pipeline. They constitute about 50% of the physician-scientist workforce and are uniquely trained to integrate the complexities of basic biomedical science with those of clinical medicine. In 1964, the National Institute of General Medical Sciences (NIGMS) established Medical Scientist Training Program (MSTP) institutional T32 grants to foster and support combined MD-PhD degree education. Currently, there are approximately 50 NIGMS-funded MSTPs and nearly as many non-NIH-funded MD-PhD programs, which together awarded 620 combined MD-PhD degrees in 2020 (20,387 MD degrees were awarded by US medical schools in 2020) (2). It is not difficult to think of reasons why the MD-PhD pipeline is so small. Commonly cited reasons include, among others, the length of training and its associated opportunity costs, and the difficulty of sustaining research funding over the course of a career. Data from the American Association of Medical Colleges (AAMC) National MD-PhD program outcomes study (3, 4) showed that […] The US needs more physician-scientists. This was a major conclusion of the NIH-sponsored 2014 Physician-Scientist Workforce Report (1). As noted in that report, physician-scientists constitute only 1.5% of the total physician workforce. This percentage has been decreasing, and the average age of physician-scientists has been increasing, which leads to the conclusion that the current physician-sci-entist pipeline is inadequate to meet our country’s future needs. MD-PhDs are a critical component of this pipeline. They constitute about 50% of the physician-scientist workforce and are uniquely trained to integrate the complexities of basic biomedical science with those of clinical medicine. In 1964, the National Institute of General Medical Sciences established Medical Scientist Training Program (MSTP) institutional T32 grants to foster and support combined MD-PhD degree educa-tion. Currently, there are approximately 50 NIGMS-funded MSTPs and nearly as many non-NIH-funded MD-PhD programs, which together awarded 620 combined MD-PhD degrees in 2020 (20,387 MD degrees were awarded by US medical schools in 2020) It is not difficult to think of reasons why the MD-PhD pipeline is so small. Commonly cited reasons include, among others, the length of training and its associated opportunity costs, and the difficulty of sustaining research funding over the course of a career. Data from the American Association of Medical Colleges (AAMC) National MD-PhD program outcomes study (3, 4) showed that the average time