Some researchers and students in three of the University of Pittsburgh School of Medicine’s physician scientist training programs have been using their research skills to examine the effectiveness of their own education. And they are finding that having an extra year of basic science training embedded in medical education offers a significant increase in confidence, especially for female students.
The work is covered in a pair of published studies led by Richard Steinman, associate professor of medicine and of pharmacology; associate dean and director, Medical Scientist Training Program; and director, Physician Scientist Training Program (PSTP), School of Medicine. Most recent was a study in the Journal of Clinical and Translational Science, related to an earlier one in Cancer Cell.
The latest paper measured the impact of Pitt’s physician-scientist training programs on trainees’ confidence in professional, personal and scientific competencies, using a survey measuring self-rated confidence in 36 competencies across two timepoints. It included 100 students enrolled between 2020 and 2023 in three graduate programs: the MD/PhD program, known as the MSTP; the five-year medical student program called the PSTP, and the resident fellow program called the Burroughs Wellcome Foundation program.
The findings show that women, whether medical students, residents or fellows, reported an increase in their level of confidence during training.
Steinman pointed to some of the supports built into Pitt’s training programs, such as offering executive coaching services, as differentiators from other medical schools.
“Even while women MD/PhD trainees are as successful as their male counterparts in securing funding as trainees and junior faculty, they are missing from the ranks of National Institutes of Health-funded established investigators. Women physician-scientists are disproportionately leaving the investigator track,” the researchers wrote in the Cancer Cell paper, published in May.
Therefore, female scientists coming through an MD track may have less role modeling and sponsorship, explained Jocelyn Fitzgerald, assistant professor of obstetrics, gynecology, and reproductive sciences and urogynecology specialist with UPMC, who was a 2013 graduate of the PSTP program and is now a faculty adviser for several students in the program.
“There can be a ‘leaky pipeline’ because of leaves for child care, female attrition, lack of mentorship and sponsorship,” she said. “This program is protective for helping women stay on the path.”
The study measured five domains of professional development: career sustainability, science productivity, grant management, goal setting and goal alignment.
During Pitt’s training programs, confidence in scientific, professional and personal skills increased significantly in postgraduate trainees and at all training levels among women. This positive trend in women’s confidence during training may contribute to reducing gender gaps in persistence in academic medicine.
The findings aim to assist physician-scientist training program leaders as they evaluate their trainees and develop their curriculum, Steinman said.
Regarding the five domains, Steinman said that women initially reported lower confidence than men. After one or two years in the program, men’s self-reported confidence increased a little, but women’s went up significantly.
“With time in this program, this gender gap was disappearing,” Steinman said.
“So, what's the secret sauce? We cannot answer it definitively, as far as the gender effects. What we can do from the article is say, ‘What kinds of things about the programs here increased confidence in this area or increased confidence in that area?’ So, for instance, with goal setting and career sustainability, the fact that in all of our programs—which is unique to Pitt—we employ executive coaches that was cited as, perhaps that's making a difference for those particular things. In all of these programs, we do a lot of whiteboard talks and not PowerPoint talks, and that was another thing that was cited as making a difference.”
He continued: “the career coaching made a difference in all three of the programs, and so did structured peer interactions as well as informal peer interactions.”
Steinman explained that in whiteboard presentations, students “put forward their project and their science or their clinical stuff, and everybody will comment and give them feedback. I think with PowerPoints, you have a passive speaker and a passive audience.”
In a perspective piece published last year, “Promoting female physician-scientists: Perspectives from a unique learning environment,” two students in the PSTP program, Ashti M. Shah and Rashmi J. Rao, write that “fostering relationships with a diverse set of mentors and exercises to increase self- and peer promotion are central to creating a level playing field in academia.”
Steinman said the data also support the need to make personal decisions about time management, as far as saying no to things that are a drain on one’s time.
“The context for the importance of the issue is outlined in that Cancer Cell paper, the fact that we do have these disparities,” he said. “And I think that the framing of this newer article in terms of confidence levels is, can we build the practical reality-grounded confidence among women through our training so that they are better prepared to negotiate this challenging landscape.”
Steinman added: “The path ahead for physician-scientists is still rocky on a gender basis, and our hope is that we do our best to build skills for everyone, men, women or other gendered individuals.”
photo caption: Students from all three PSTP groups