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.

Do the activities of Yale’s MD/PhD program produce a strong pipeline of physician-scientists whose work sustains and strengthens the biomedical and clinical workforce? To answer this question we track:

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 activities, 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 enrolled in Yale's NIGMS-funded Yale MD/PhD program between AY2009-10 to AY2023-24. 185 were training-grant eligible (TGE).

Among the most important aspects of our training program is the selection of a diverse and excellent group of students who are committed to physician-scientist training, genuinely interested in careers strongly focused on biomedical research, and able to make best use of the full range of resources available at Yale. We review all MD-PhD applications holistically, assessing applicants for evidence of curiosity, creativity, accomplishments in research, and a demonstrated commitment to a physician-scientist career. No MCAT or GPA cutoff is used, and significant weight is given to academic records that demonstrate improvement during college; access/opportunity are considered when evaluating research experience and accomplishments. This approach has led to a substantial increase in the numbers of students (interviewed and accepted) who belong to underrepresented ethnic and racial groups, are first generation/low-income, or socioeconomically disadvantaged. Program faculty, staff, and students attend multiple recruitment fairs each year to meet, inform, and recruit diverse students to Yale.

We support our students through academic, financial, community, family (e.g., family healthcare subsidies and parental leave), and professional development activities and resources. Between AY2009-10 to AY2023-24, only 15 out of 345 (4.3%) students withdrew from the dual-degree program, with 13 completing either the MD or PhD degree.

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; 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.

The average TTD for students graduating between 2010-2024 is 7.99 y (median, 7.77; range, 4.77-10.77). Students who entered the program as matriculated MD students (“onboards”, n=28) had an average TTD of 8.06 y (median, 8.27; range, 5.77-10.77). Graduates from groups underrepresented in medicine "UR" (n=19) had an average TTD of 8.09 y (median, 8.77; range, 5.77-9.77). These average TTDs are not different (one-way ANOVA, p=0.9).

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

Grant writing is a foundational competency for physician-scientists which we support through workshops and individual coaching. The program 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 an application for NRSA F30 or F31 predoctoral fellowships. 88 of 185 (48%; 77 F30s and 11 F31s) TGE graduates between 2010 and 2024 were awarded NRSA predoctoral fellowships. Fifteen graduates had other extramural pre-doctoral fellowship support from foundations and private charities. The report on "Interventions to support fellowship application success among predoctoral physician-scientists" can be found here.

Our 196 graduates have entered a broad range of residency programs following graduation. Twenty-one of these 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 on 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.

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.