Radiology residency program directors associate combined MD-PhD degrees with inferior clinical performance

A small percentage of radiology residents have a combined MD-PhD degree. What do the individuals managing residency programs think of this trend? How do they perceive MD-PhD residents overall?

A group of researchers, including lead author Petrice M. Cogswell MD, PhD, department of radiology and radiological sciences at Vanderbilt University Medical Center in Nashville, Tennessee, surveyed residency program directors from diagnostic radiology departments about this topic, publishing their findings in Academic Radiology.

Residency program directors were given a 15-question online survey in September 2015. Twenty-three directors, from both small and large residency programs, completed the survey. Overall, the represented programs included more than 2,200 residents, and more than 5 percent had a MD-PhD degree. Eighty percent of the represented programs reported having 1-4 trainees with MD-PhD degrees.

Respondents viewed residency applicants with a MD-PhD degree “in general as positive” compared to non-PhD applicants, but many directors view those two groups equally. And the mean clinical performance of MD-PhD residents was found to be inferior compared to non-PhD residents. However, the clinical performance of both MD-PhD residents and non-PhD residents “actively engaged in research” was found to be superior compared to residents not busy with additional research.

“As some of the respondents commented, this suggests that the performance of residents during residency, in both clinical work and research, is often not directly related to their prior degree path but rather inherent motivation of the resident,” the authors wrote. “Also, despite a perception of inferior clinical performance of the MD-PhD residents, program directors view MD-PhD residency applicants overall positively.”

Cogswell et al. added that all represented programs answered that they offer dedicated research time to residents, although some only offer it until year R4. More than 60 percent of programs offered it in years R1-R3. And they noted a “slight trend” toward residents with a MD-PhD degree being viewed as more likely to enter a career in academics and obtain research funding after completing their residency.

“The spectrum of responses regarding research productivity during residency may again indicate that research productivity is more individually driven, and programs directors may have a perception of MD-PhD residents being more or less productive during residency based on a limited sample,” the authors wrote. “Also, MD-PhD residents may choose to solely focus on their clinical training during residency because they already have a solid research background and determine they need to concentrate on developing their clinical skills, regardless of whether or not they plan to engage in research during their career.”