To collect national trainee-derived data about the educational process and experience of MD-PhD students. Eight hundred sixty-eight MD-PhD students enrolled in 15 training programs nationally were surveyed in spring 2003 via a 29-item Web-based questionnaire. Closed-ended questions assessed students' opinions, attitudes, and goals concerning education and future careers, as well as demographic characteristics. Programs were categorized by size; students were categorized by stage of training. Statistical analyses included chi-square tests and ANOVAs. From 13 institutions, 492 questionnaires were received, for a 57.6% response rate. Generally, satisfaction with overall education was highest at the beginning of training, lowest during graduate school, and rebounded after the PhD. Students at smaller programs were less satisfied with information received regarding future residency/career choices and coordination between training stages. Later-stage students showed greater satisfaction in obtaining the philosophical goals of their education and a different array of clinical interests than early-stage students. A majority of students chose research as their future primary activity, academic centers as their primary practice setting, and disease oriented as their future primary research activity. Many students did not agree with the current working definition of a physician-scientist. Findings indicate that students have clinical interests that develop over time, a variety of future career goals, and ambivalence concerning the appropriate balance of clinical and research activities. This information may provide a basis for future improvements in the education of MD-PhDs in the United States and abroad.
