Longitudinal Evaluation of Research Career Intentions Among US Medical Students

Importance: The physician-scientist workforce has been in decline for decades, and the shortage of physician-scientists from racial and ethnic groups that are underrepresented in medicine (URiM) is particularly acute. Medical school is a key developmental period during which research career intentions (RCI) may change, yet little is known about RCI evolution during this period. Objective: To evaluate factors associated with RCI among first-year medical students, overall and by URiM status. Design, Setting, and Participants: This is a cross-sectional analysis of baseline data from the ongoing Longitudinal Evaluation of Research Career Intentions Among Medical Students Study. Participants were first-year medical students enrolled during the 2024 to 2025 academic year at US medical schools accredited by the Liaison Committee on Medical Education. MD-PhD students were excluded. Exposures: The baseline survey collected information on sociodemographic factors, pre-medical school and first-year research experiences (eg, research education, research participation, mentorship, and authorship), medical school learning environment, and psychosocial characteristics. Main Outcomes and Measures: The primary outcome was RCI in year 1 of medical school, defined as intending to be significantly or exclusively involved in research during one's medical career. Characteristics associated with RCI were evaluated using stability selection. Results: Among 1136 first-year medical student respondents (mean [SD] age, 24.7 [2.7] years; 790 female [69.5%]) at 134 US medical schools, 26.9% (306 students) reported RCI, with a slightly higher prevalence among URiM students than non-URiM students (246 students [28.2%] vs 60 students [23.9%]; standardized mean difference, 0.097). Prematriculation factors associated with RCI among all students included research participation (odds ratio [OR], 1.51; 95% CI, 1.13-2.00), conference presentation (OR, 1.56; 95% CI, 1.16-2.09), and manuscript authorship (OR, 1.38; 95% CI, 1.03-1.86). Postmatriculation factors included research participation (OR, 1.74; 95% CI, 1.31-2.30) and having a physician-scientist role model (OR, 1.72; 95% CI, 1.31-2.30). Factors uniquely associated with RCI among URiM students included prematriculation research experiences (OR, 1.51; 95% CI, 1.14-2.01) and presentation of research (OR, 1.57; 95% CI, 1.17-2.11) and postmatriculation manuscript authorship (OR, 1.84; 95% CI, 1.04-3.25). Among non-URiM students, only postmatriculation factors were uniquely associated with RCI, including having a research mentor (OR, 1.76; 95% CI, 1.34-2.31) and receiving education about physician-scientist work-life balance (OR, 1.63; 95% CI, 1.24-2.15). Conclusions and Relevance: This cross-sectional analysis of baseline data from an ongoing cohort study found that RCI was prevalent among first-year medical students and was associated with characteristics and experiences prior to matriculation and during year 1. Some factors associated with RCI differed between URiM and non-URiM medical students, suggesting distinct pipelines to research career development. These findings highlight opportunities to support physician-scientist training through tailored education, exposure, and mentorship.