The Research Productivity of Canadian Physicians: How the Timing of Obtaining a PhD Has an Influence

PURPOSE: To determine whether the sequence of training to obtain MD and PhD degrees is associated with different career paths for physicians who have their PhD before medical school and those who obtain it after their MD, and to explore the factors that encourage or dissuade Canadian dual-degree physicians in pursuing a research career. METHOD: In 2003, questionnaires from the University of Alberta, Edmonton, Canada, were sent to all 734 Canadian physicians having MDs and PhDs, identified through the Canadian Medical Directory. Data collected were gender; year and country of MD; sequence of obtaining degrees; portion of time on clinical, research, teaching, and administrative duties; number of publications and currently held grant amounts; and perceived incentives and disincentives to research careers. Two focus groups were held with a subset of physicians to further explore themes. RESULTS: The response rate was 64%. On the basis of the timing of the PhD relative to the MD, physicians were designated early PhDs (26%), concurrent PhDs (12%), or late PhDs (62%). Late PhDs spent more time in research and less time on clinical practice than the other two groups and spent more time teaching and had published more papers than the early PhDs. Grant amounts were highest for late PhDs. Lack of time and resources were the major disincentives to research, and noteworthy incentives were the opportunity for intellectual challenge and creativity, and previous research experience. CONCLUSIONS: Physicians who obtain a PhD after an MD have a more research-focused career than those who enter medical school with a PhD.