METHODS

We obtained de-identified data from the Association of American Medical Colleges (AAMC) for 91,987 medical school matriculants between academic years 2007–2008 and 2011–2012. Students’ consideration of MD-PhD was obtained by student self-report from the Pre-Medical College Admission Test (MCAT) Questionnaire administered to registrants, and program enrollment was obtained from the AAMC Student Record System (SRS). We obtained self-reported sex, race/ethnicity, age at matriculation, parental education, MCAT scores, undergraduate institutions’ Carnegie classification, self-reported premedical loans (yes/no), and prior research experiences from the AAMC Data Warehouse. Students were considered first-generation college graduates if neither parent held a 4-year college degree. We used summary statistics to describe matriculant characteristics by first-generation college graduate status. We used multivariable logistic regression models to examine the associations between first-generation college graduate status and consideration of an MD-PhD degree, and whether students who considered MD-PhD program training matriculated into an MD-PhD program. This study was approved by the Albany Medical College Institutional Review Board, and followed the Strengthening the Reporting of Observational Studies in Epidemiology reporting guideline. 4 Statistical analyses were performed using STATA v 16.1 (StataCorp).

RESULTS

After excluding matriculants who did not complete the PMQ or were missing data, our study sample included 61,247 students representing 66.6% of all matriculants between 2007–2008 and 2011–2012. The proportion of first-generation college graduates in excluded and included cohorts did not differ significantly (11.9% vs 12.1%, respectively, chi-squared test p= 0.56). Compared to continuing-generation peers (Table 1), a smaller percentage of first-generation college graduates identified as White (52.2% vs. 63.7%, p< 0.001), reported prior research experience (52.5% vs. 57.7%, p< 0.001), and scored in the highest MCAT quartile (14.1% vs. 27.2%). First-generation college graduates comprised 12.3% of all medical school matriculants but just 7.3% of all MD-PhD program matriculants.