Making the Match or Breaking it? Values, Perceptions, and Obstacles of Trainees Applying into Physician-Scientist Training Programs

Abstract

BackgroundReplenishing the physician-scientist workforce remains a central mission of medical education, but the hemorrhaging of qualified trainees threatens the physician-scientist role. Among the barriers facing physician-scientists is the game-like model of residency matching, which applies several flawed assumptions regarding the comparability of applicant qualifications, cohort size, and the institutional breadth of applicants’ training needs.MethodsThe current report summarizes the collective views and experiences of physician-scientist trainees following the 2021-2022 application cycle of physician-scientist training programs (PSTPs). We obtained survey-based feedback by 27 PSTP applicants from 17 U.S. medical universities, among whom 85% matched into a PSTP.Results93% PSTP applicants recognized “scientific community” as the most important feature of postgraduate training, whereas gender-specific worth was assigned to institutional aspects of personal and/or family support. 65% of respondents found “waiting for interviews” as the most stressful aspect of the application cycle. Half of the survey respondents perceived at least one NRMP policy violation by a PSTP, most of which occurred during post-interview communication. 93% of respondents were contacted by a PSTP following interviews, and one-third admitted to feeling pressured into sharing their ranking preferences.ConclusionOverall, we believe the values and needs of physician-scientist trainees are poorly represented by the current PSTP selection framework, including inconsistent timelines and communication throughout the process. We propose a series of modifications that, if implemented, would better equip applicants to gauge programs according to the clinical, scientific, and academic communities that we seek to join as academic physician-scientists.