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Physician-Scientist Workforce (PSW) Report 2014

Effects of Early Career NIH Programs on Physician-Scientists with a Medical Degree


  • In 2012, 1,630 MDs and 365 MD/PhDs were appointed to Postdoctoral Training appointments under a T32 grant. Only 20 MDs and 9 MD/PhDs were awarded Postdoctoral F32 Fellowships. Additional information about trends of postdoctoral fellowships and training appointments maybe found in Appendix IV.
  • Analysis of a cohort of individuals who received their first postdoctoral appointment to a T32 grant between 1999 and 2008 shows that only one-quarter subsequently applied for an RPG. While half of those who applied were successful, only 10 percent of those with a T32 appointment subsequently received an RPG (Table 3.1 below).37

    Table 3.1. RPG Applications and Awards Among T32 Postdoctoral Appointees, 1999-2008

    Table 3.1. RPG Applications and Awards Among T32 Postdoctoral Appointees, 1999-2008

    Source: IMPACII

  • MD and MD/PhD applicants to LRP and K award programs have declined significantly over the past 5 years, despite stable award rates. Specifically, MD applicants for LRPs declined 36 percent (from 557 in 2008 to 359 in 2012); among MD/PhDs in the same period, applicants declined by 34 percent (from 88 to 58). PhD applicants declined by 45 percent (718 in 2008 to 391 in 2013) (Figure 3.29). Figure 3.29. Individual NIH Loan Repayment Program (L) Applicants, PhD, MD, and MD/PhD Degree, without Prior RPG (FY2003-2012)
  • For the individual K award programs, MD applicants declined 21 percent (from 733 in 2008 to 582 in 2012); MD/PhD applicants declined 35 percent (from 413 in 2008 to 270 in 2012) (Figure 3.30). During approximately the same period, however, PhD applicants increased, primarily because of the launch of the K99/R00 program (see below). At the same time, appointments of individuals with MDs and MD/PhDs to K12 and KL2 institutional career development awards were also increasing, due in part to the introduction of Clinical and Translational Science Awards (CTSAs) and their associated institutional career development programs. By 2012, appointments to NIH institutional career development awards had grown to include 487 individuals with MDs and 106 holding MD/PhDs, as seen in Figure 3.31 below. Figure 3.30. Individual NIH Career Development Award (K) Applicants, PhD, MD, and MD/PhD Degree, without Prior RPG (FY1999-2012) Figure 3.31. Institutional Career Development Appointees, PhD, MD, and MD/PhD Degree (FY2010-2012)
  • Introduction of the K99/R00 program in 2007 has increased K applications from PhDs by 48 percent (979 K applications from PhDs in 2006 vs. 1,446 in 2012). Very few of the applicants and awardees are physicians: In 2012, 93 percent of all K99/R00 applicants were PhDs, and 87 percent of the awardees (189/207) were PhDs, as seen in Figure 3.32. Figure 3.32. Individual NIH K99 Award Applicants, PhD, MD, and MD/PhD Degree (FY2006-2012)
  • About 50 percent of LRP recipients (from 2003-2008) have applied for RPGs, and nearly 50 percent have been successful, as seen in Table 3.2, although the numbers are significantly lower for RO1s.

    Table 3.2. Total Number of Individuals and Percentage of L awardees (FY 2003-2008) that Applied, were Awarded Subsequent RPG, Subsequent R01

    Table 3.2. Total Number of Individuals and Percentage of L awardees (FY 2003-2008) that applied, were Awarded Subsequence RPG, Subsequent R01

    Source: IMPACII

  • More than 80 percent of K program recipients (1999 through 2008) have applied for RPGs. Of those who applied, more than 60 percent have been successful, for an overall K to RPG rate of just 54 percent (Table 3.3).

    Table 3.3. Total Number of Individuals and Percentage of K awardees (FY 1999-2008) that Applied, were Awarded Subsequent RPG, Subsequent R01

    Table 3.3. Total Number of Individuals and Percentage of K awardees (FY 1999-2008) that Applied, were Awarded Subsequent RPG, Subsequent R01

    Source: IMPACII

  • The award rates for first-time RPG applicants with a prior LRP or K award are much higher than for those without: For MDs: 44.1 percent vs 9.2 percent; for MD/PhDs: 60.0 percent vs 10.1 percent; and for PhDs: 66.3 percent vs 10.9 percent.
  • Although more successful in their award rates, physician-scientists with LRP and/or K awards comprised only a small part of the First Time Applicant pool. In 2012, only 14.8 percent of MDs and 13.4 percent of MD/PhDs had a prior LRP or K award.
  • Most physician-scientists who were appointed to NIH funded Medical Scientist Training Programs (MSTP) slots in the 1980s have applied for and received RPG and/or RO1 awards. Nearly 80 percent of a cohort of MD/PhDs with initial MSTP appointments in 1980-1989 have applied for RPGs, and approximately 78 percent have been successful (Table 3.4). This cohort was chosen to allow for MSTP appointees (often in the first years of their medical education) to complete education (up to 8 years) and subsequent residency and postdoctoral training.

    Table 3.4. RPG Applications and Awards Among MSTP Appointees, 1980-1989

    Table 3.4. RPG Applications and Awards Among MSTP Appointees, 1980-1989
  • The award rates for first-time RPG MD/PhD applicants with a prior MSTP appointment are much higher than for those without: in 2012, 36.2 percent for those with MSTP appointments and 12.3 percent for those without, as illustrated in Figure 3.33. Figure 3.33. Award Rates of NIH Research Project Grant Applicants, MD, PhD Degree, with/without Prior MSTP Appoinment (FY1999-2012)
  • MD/PhDs with past MSTP support comprise only a small part of the total pool of RPG applicants with MD/PhDs (for all applicants as well as first time). In 2012, only 13.4 percent of MD/PhD applicants had prior MSTP support (Figure 3.34) and 7.4 percent of first-time applicants with MD/PhDs had prior MSTP support (Figure 3.35). Figure 3.34. Individual NIH Research Project Grant Applicants, MD/PhD Degree, with/without Prior MSTP Appoinment (FY1999-2012) Figure 3.35. Individual First-time NIH Research Project Grant Applicants, MD/PhD Degree, with/without Prior MSTP Appoinment (FY1999-2012)

Current Status of the Physician-Scientist Workforce

Based on our analysis of the current workforce, we estimate that there are currently 14,000 physician-scientists in the United States, of whom ~8,000 have Research Project Grants from the NIH. The total number of physician-scientists with a medical degree is now slowly declining. If the average career of physician-scientists is 30 years in duration, we estimate that about 1,000 individuals will need to enter the pipeline each year to maintain the steady state, assuming that 50 percent of people who enter the pipeline will not succeed. About 500 of these individuals currently come from among those who hold both an MD and PhD (earned in a combined program or sequentially in the United States or abroad). The rest must come from the pool of MDs who become interested in research during their clinical training. The average age of physician-scientists is steadily increasing due to factors that include longer training times, higher grant success rates for established investigators, and postponement of retirement.


37 The 1980-1989 appointees were chosen in order to have a cohort of individuals who have had time to complete all levels of subsequent training. Since MSTP T32 appointments typically begin in year 1 of an MD/PhD program and completion of the program was 7-8 years on average at that time, this cohort would have graduated in 1987 to 1997.

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