Outcomes

The mission of the Yale School of Medicine is “to educate and inspire scholars and future leaders who will advance the practice of medicine and the biomedical sciences.” The training of MD/PhD students has been central to this mission for more than 50 years, with the establishment of a MD/PhD training program in 1969 that has graduated 442 students as of May 2024. Most of these graduates have engaged in careers that combine basic, translational, and/or clinical research with clinical care, and “can translate clinical observations to the laboratory to help identify the mechanisms of disease, as well as applying the finding of basic science to patient care”, unique and critical roles identified by the NIH Physician-Scientist Workforce (PSW) Report in 2014. Yale’s MD/PhD Program has been supported by NIH National Institute of General Medical Sciences (NIGMS) Medical Scientist Training Program awards since 1975.

Both institutional and program-specific resources are used to evaluate whether the activities of the program succeed in producing a strong pipeline of physician-scientists whose work sustains and strengthens the biomedical and clinical workforce.

Key career-relevant outcomes that we will continue to track are:

1. the career sectors and medical specialties of our alumni
2. the duration and type of training followed by alumni
3. the proportion of time spent in research, clinical activity, education, and administration
4. the types of research carried out by alumni. Both process and outcome evaluation questions are used to inform program decision-making.

Here we report on the one hundred ninety-six (196) alumni were enrolled in the NIGMS-funded Yale MD/PhD program between AY2009-10 to AY2023-24. 185 were training-grant eligible (TGE).

All MD-PhD students have passed the USMLE Step I and Step 2 CS/CK exams, which are a requirement for graduation with the MD degree. MD and MD-PhD students do equally well on the required C-OSCE exams taken in Year 2 and in Year 4 (after return to wards). MD-PhD graduates match to highly competitive residencies, and increasingly enter “research track” residencies as these become more common.

Yale does not admit MD or MD-PhD students to honor societies such as AOA or “rank” students.

All MD/PhD who graduated between 2010-2024 passed the USMLE Step I and Step 2 CK exams, which are requirements for graduation with the MD degree. Yale does not admit MD students to honor societies or rank students, so while no information on MD/PhD outcomes is available in these domains, MD/PhD graduates continue to match to highly competitive residencies, and increasingly enter “research track” residencies as these become more common. Review MD/PhD Match results.

For each of the 196 students who graduated between 2010-24 are shown in Figure 2 (“1st”, first author; “All”, first and co-authorships). Only 12 of the 196 graduates did not have a 1st author publication associated with their Yale MD/PhD dissertation work due to a variety of reasons, including pending manuscripts at the time of graduation, departure of PIs from the institution. The program instituted a requirement for students to submit a 1st author manuscript before graduation in 2014. View the most recent student publications.

Grant-writing is a foundational competency for physician-scientists which we support through workshops and individual coaching. The program now requires that all students participate in a proposal development workshop series in the summer before their fourth year in the program. Most students now submit a NRSA F30 or F31. 88 of 185 (48%) TGE graduates between 2010 and 2024 held NRSA predoctoral fellowships (77 F30s and 11 F31s). Fifteen graduates had other extramural pre-doctoral fellowship support from foundations and private charities. Review the report on "Interventions to support fellowship application success among predoctoral physician-scientists."

111 of the 196 graduates (57%) since 2010 are currently "in-training": this includes 19 current year graduates entering residencies plus 92 who were in residency or fellowship during the 2023-24 AY. Residency or post-UME choices of all 196 graduates are shown in Figure 3.

Twenty-one graduates have received K awards (13 K08, 3 K99, 2 K23, 2 IK2, and one K25), with an average time to award of 7.9y (median 7.6, range 6-10). Seven of the 21 (33%) K awardees had an F30 during their predoctoral training. Ten of the 43 Asst/Assoc Professors in this cohort hold NIH RPG awards (R00, R01, R03, R21, DP2, DP5); we do not have data about foundation awards or other types of funding. Seven of the 10 (70%) RPG awardees held prior K awards, consistent with published data suggesting a correlation between K and RPG success.

The professional sector of all MD/PhD graduates from 2010-24 (Fig 4) was determined from several sources. These include the Yale ITG-HUB database, the MD/PhD Program database of all students enrolled in the MD/PhD Program since 1970 (information gathered from legacy program records, application data and institutional databases, public search engines and databases such as PubMed, NIH Reporter, LinkedIn and Google/Google Scholar), and ongoing tracking of alumni through periodic surveys. 111 graduates (57%) remain in-training as residents, fellows, and postdocs. Of the 85 “post-GME” alumni, 78% are in research-related roles in academia, government, and industry. Our outcomes are in line with those reported by Brass et al. (2019) and the 2014 NIH Physician-Scientistist Workforce Working Group (PSW-WG) Report.