PROMOTING RESEARCH CAREERS AMONG UNDERREPRESENTED MINORITY PHYSICIANS

描述(由申请人提供)：大多数美国对抗性医学毕业生从事全日制临床实践；但是，在美国医学院协会(AAMC)1997-2004年全国毕业问卷(GQ)的一项研究中，我们发现29%的美国对抗性医学毕业生计划从事涉及基础或临床研究和教学的职业。在计划从事研究工作的毕业生中，99.7%的人打算进入学术医学领域。研究和教学活动定义了学术内科医生。尽管医生只占美国所有参与生物医学研究的科学家的一部分，但美国国立卫生研究院(NIH)授予医学院的研究奖金中，大约有一半流向了医生首席研究员。来自某些少数族裔/民族(即黑人、美国原住民/阿拉斯加人和西班牙裔)的医生在学术医学教职员工中的比例低于他们在美国人口和美国对抗性医学生人口中的比例。增加和保持学术医学内科教师的多样性不仅对于充分和公平地代表未被充分代表的少数族裔(URM)作为未来内科研究人员的教师、导师和榜样至关重要，而且对于满足日益人口结构多样化的美国社会的医疗需求也是至关重要的。为了制定战略，增加学术医学医生研究人员的多样性，必须首先确定那些与追求学术医学职业相关的因素，这些因素可以作为干预的目标。由于绝大多数从事研究的医生都是在学术机构进行研究，我们感兴趣的最终结果将是进入学术-医学职业生涯。我们提出了一项回溯性队列研究，使用从医学院入学到毕业、研究生医学教育、国家医学执照、专业委员会认证成就以及最终进入(或未进入)学术-医学职业生涯的现有纵向数据。重要的是，我们将能够分析来自AAMC和美国医学会(AMA)的几个数据来源之间的个性化记录，包括AAMC 1993-2000入学学生问卷(MSQ)和GQ，这两个数据声称在研究年份的回复率为80%，以确定与计划的职业参与研究和追求学术-医学职业相关的因素。我们将使用多变量回归模型来确定与规划和最终从事学术-医学职业相关的因素。这项拟议的研究将对有关URM学生从预科到最终进入学术-医学职业生涯的整个医学教育过程中对研究感兴趣的相关因素的文献做出实质性贡献。我们的结果可以为干预措施的设计提供参考，以增加学术-医学内科研究人员的人口多样性，这有望减少美国的健康差距。

DESCRIPTION (provided by applicant): 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.