Abstract
Objectives
The Medical Student Research Programme (MSRP) was established in Norway in 2002 to recruit medical students into research and academic medicine. We aimed to describe long-term research and academic outcomes among former MSRP participants.
Design
We conducted an online cross-sectional survey.
Setting
The study was conducted at the Faculty of Medicine, University of Bergen, Norway.
Participants
All 262 alumni who had participated in the MSRP (2002–2024) and graduated before July 2024 were invited.
Outcome Measures
The primary endpoint was PhD completion. Secondary endpoints were recent publication, supervision, research leadership, academic appointment and self-identified research activity. Outcomes were self-reported and are presented with 95% confidence intervals (CI), overall and by time since graduation.
Results
Median time since graduation was 8 years (IQR 5–13). Overall, 71 of 133 (53%, 95% CI 45–62) had completed a PhD and 17 (13%) were PhD candidates. PhD graduates (n = 61) obtained their doctorate a median of 4 years (IQR 3–6) after graduation, at a median age of 31 years. Sixty respondents (45%, 95% CI 37–54) had published within the past two years. Excluding current PhD candidates, 47 of 116 (41%, 95% CI 32–50) identified as active researchers and 20 of 116 (17%, 95% CI 11–25) held an academic appointment. PhD completion rose from 2 of 27 (7%) among those <5 years from graduation to 19 of 21 (90%) among those ≥15 years, and PhD supervision from 0 of 27 to 10 of 21 (48%).
Conclusions
Two thirds of responding MSRP alumni had completed or were undertaking a PhD, typically within a few years of graduation, and research involvement extended well beyond doctoral training. These findings describe outcomes among survey respondents; comparative studies are needed to determine the programme’s contribution.
Keywords: medical student research programme, MSRP; medical student research recruitment; MD-PhD programme; physician-scientist education; cross-sectional survey
Introduction
Recruiting physicians into research remains a persistent challenge worldwide. At the beginning of the 21st century, a low and declining proportion of PhD candidates at the medical faculties in Norway held a medical degree.1 This trend raised concerns about the clinical relevance of medical research and the availability of academic physicians to educate future doctors in both academic thinking and clinical skills. In the United States and other parts of the world, the proportion of physicians engaged in research has steadily declined over recent decades, prompting calls for systemic reform and targeted interventions.2,3 Similar trends have been observed elsewhere, where clinical demands, financial disincentives and limited research infrastructure pose barriers to sustained research engagement.4,5
To address these barriers, MD-PhD programmes and other research-oriented educational pathways have been established. In Norway, the Medical Student Research Programme (MSRP) was established in 2002 by the Norwegian Research Council for students at the four medical faculties (University of Oslo, University of Bergen, Norwegian University of Science and Technology, and UiT The Arctic University of Norway), with the stated aim of recruiting medical students into research and preparing them for doctoral training.6 Participants complete all the formal training for a PhD and must reach defined academic milestones: each conducts a research project under supervision, is expected to publish a peer-reviewed article as first or second author, presents the work at scientific conferences and completes the mandatory PhD coursework of 30 ECTS. Publication is thus a central expectation of the programme, whereas the scientific impact of the research produced is not an explicit programme objective. The programme offers a personal research grant of 20,000 US dollars (2026 figure) for up to 10% of all Norwegian medical students, allowing them to begin a research career in parallel with their medical studies. Each student additionally receives a personal grant for research expenses.
A national evaluation conducted in 2007 reported high levels of student satisfaction and strong interest in pursuing a PhD among MSRP participants.7 A follow-up study in 2015 showed similar levels of satisfaction and interest in further research training.8 A national cohort study in 2018 reported that MSRP participants were ten times more likely to complete a PhD than non-participants.9 A single-centre study from the University of Bergen found that former programme students continued to conduct research, although the median follow-up after completion of the programme was only six years.10 Collectively, these findings have led some to describe the programme as an “unconditional success”.11
Despite the encouraging short-term outcomes, there is limited knowledge about long-term outcomes among MSRP participants, particularly regarding sustained research engagement and pursuit of an academic career following completion of a PhD. The present study is closely related to a previous single-centre evaluation of the same programme at the University of Bergen, in which the median follow-up after completion of the programme was six years.10 The present survey was distributed in 2024, includes graduates from the full programme period 2002–2024, and reports outcomes a median of 8 years (IQR 5–13) after medical graduation. Participants in the earlier evaluation were also eligible for the present survey, and some are therefore likely to be among the respondents; no data from the earlier study were reused, and all results reported here derive from the 2024 survey.
The aim of this study was to describe long-term research and academic outcomes among former MSRP participants at a single institution, up to 20 years after graduation. The primary endpoint was completion of a PhD, the milestone the programme was designed to enable. Because a PhD does not by itself show that research continues, the secondary endpoints describe research involvement after the doctorate: recent publication, supervision of graduate or PhD students, research group leadership, an academic or research appointment and self-identification as an active researcher. The rationale for each endpoint is given in the Methods. The study was designed to describe outcomes among programme participants, not to estimate the effect of the programme.
Materials and Methods
Study Design and Participants
All former students at the Faculty of Medicine, University of Bergen, who were enrolled in the MSRP between 2002 and 2024 and had completed their degree before July 2024 were eligible. Eligible alumni were identified from the programme’s administrative records, and all were invited to participate (census sampling); no sample size calculation was therefore performed. Participants were contacted by Email and invited to complete an online survey. Email addresses were obtained either from the MSRP administration or through the internal Email system of the Western Norway Regional Health Authority.
The survey was administered using SurveyXact (Rambøll) and distributed on 11 September 2024. Participants received four reminders before the survey closed on 6 November 2024. Only submitted questionnaires were analysed. All responses were de-identified; no names, Email addresses or other directly identifiable information were collected. Because the survey was answered anonymously, individual-level linkage between respondents and non-respondents was not possible, and no administrative data were available for the full eligible cohort.
Questionnaire Development
The questionnaire comprised 46 items, of which 39 were multiple-choice and seven were open-ended (Supplementary Material 1). Eight items were follow-up questions conditional on previous responses. No formal theoretical framework was used; the items were developed by the research team on the basis of the stated objectives of the MSRP and of the instrument used in the previous evaluation of the programme at the same institution.10 Prior to distribution, the questionnaire was reviewed and revised by all co-authors. It was not formally validated and was not pilot tested before distribution. The questionnaire was administered in Norwegian; the English version provided as Supplementary Material 1 is a translation prepared for publication and was not used for data collection. Respondents could report more than one current position; overlapping categories were retained as reported, so that respondents reporting both clinical work and a research or academic appointment are counted in both. Respondents reporting an ongoing PhD were classified as current PhD candidates irrespective of any concurrent clinical position. The seven open-ended items allowed free-text comments; they were not subjected to formal qualitative analysis and are not reported here.
Endpoints, Outcome Definitions and Missing Data
The primary endpoint was PhD completion, defined as a self-reported completed doctoral degree. It was chosen because recruitment to doctoral training is the stated purpose of the MSRP, because programme participants complete the formal components of PhD training during medical school, and because a completed PhD is a well-defined milestone that is recorded in the same way across programmes and was the principal outcome of the national controlled evaluation of the programme.9 A PhD is, however, an entry point to a research career rather than evidence that research continues. The secondary endpoints were therefore chosen to describe research involvement after the doctorate at increasing levels of academic responsibility. Publication within the two years preceding the survey was used as a marker of current research production. Supervision of graduate or PhD students and leadership of a research group reflect the role of academic physicians in training future researchers. An academic or research appointment was included as a marker of a formal academic career. Self-identification as an active researcher was added because it also captures research carried out outside formal academic positions, for example by hospital-employed physicians. These endpoints describe different, non-interchangeable aspects of a research career and are reported separately rather than combined. Citation-based measures of research impact were not assessed, because research impact is not an explicit objective of the programme and no bibliographic identifiers were collected. Long-term outcomes were defined as outcomes reported at the time of the survey, a median of 8 years (IQR 5–13, range 0–20) after graduation; because follow-up differed considerably between respondents, all endpoints are also reported by time since graduation.
An academic or research appointment was defined as a university or research post (associate professor, professor or postdoctoral fellow) or a combined clinical–academic post at these levels. PhD fellowships were counted separately, because they are time-limited training positions. Outcomes concerning current research activity and academic appointment are reported both for all respondents (N = 133) and after exclusion of the 17 respondents with an ongoing PhD (N = 116), because current PhD candidates are research-active by definition and hold a training position. Every proportion is reported as n/N (%) with the applicable denominator stated in the text and tables. Each item was analysed on a complete-case basis. There were no missing data for the non-conditional items used in this study; for conditional follow-up items, the applicable denominator is stated (the timing of thesis submission was answered by 70 of 71 PhD graduates and the year of PhD completion by 61 of 71).
Timing of thesis submission was self-reported relative to the nominal duration of the respondent’s PhD fellowship (ahead of, on or after nominal duration) and was not calculated from dates. Time since graduation was calculated as the survey year (2024) minus the self-reported year of graduation. Time from graduation to PhD completion and age at PhD completion were calculated from the self-reported years of graduation, PhD completion and birth.
Statistical Analysis
Descriptive statistics are presented as frequencies and percentages for categorical variables and as medians with interquartile ranges (IQR) for continuous variables. Every proportion is reported as n/N (%), and 95% confidence intervals for the principal outcomes were calculated using the Wilson score interval, which is preferred over the normal approximation when proportions approach 0 or 1 and when denominators are small. These intervals describe the precision with which each proportion is estimated within the respondent group. They reflect random error only and do not account for non-response bias.
Because respondents had widely differing lengths of available follow-up, all endpoints are also presented by time since graduation in four strata (<5, 5–9, 10–14 and ≥15 years). The stratified results are descriptive, and no formal tests of differences between strata were performed. Proportions among women and men were compared with Pearson’s chi-square test, or with Fisher’s exact test when an expected cell count was below five; the two respondents who did not report their sex were excluded from these comparisons. The study was not powered for subgroup comparisons, and non-significant differences are not interpreted as evidence of equivalence. No adjustment was made for multiple comparisons. Analyses were performed in Stata/SE version 18.0 (StataCorp, 2023).
Ethics
The study was approved by the Norwegian Agency for Shared Services in Education and Research (SIKT), on behalf of the Data Protection Officer at the University of Bergen (Approval ID: 100723). Approval from the Regional Committee for Medical and Health Research Ethics was not required, because the study did not generate health information about the participants and therefore falls outside the scope of the Norwegian Health Research Act. The first page of the survey informed participants that participation was voluntary, that responses were anonymous, that they could withdraw before submission, and that submitting the questionnaire constituted consent. The study was conducted in accordance with the Declaration of Helsinki.12
Patient and Public Involvement
No members of the public were involved in the design of the study, the development of the research question or the selection of outcome measures. Participants contributed data through survey responses. No participants were involved in the interpretation of results or in the dissemination of findings.
Results
Of 262 invited alumni, 133 (51%) completed the survey. Among these, 71 (53%) were women, the median age was 37 years (interquartile range [IQR] 33–42), and the median time since graduation was 8 years (IQR 5–13, range 0–20). Overall, 116 (87%) completed the MSRP with approval, and 102 (77%) had published at least one peer-reviewed article before completing their MSRP degree. Baseline characteristics are summarised in Table 1.
Table 1.
Characteristics of Respondents to the Survey of Former Medical Student Research Programme Participants
| Variable | N = 133 Respondents |
|---|---|
| Female sex, n (%) | 71 (53) |
| Age in years, median (IQR) | 37 (33–42) |
| Years since graduation, median (IQR) | 8 (5–13) |
| Intended an academic career while a medical student, n (%) | 72 (54) |
| Uncertain about an academic career while a medical student, n (%) | 25 (19) |
| Completed the MSRP with approval, n (%) | 116 (87) |
| Research category of the programme project, n (%) | |
| Epidemiological research | 30 (23) |
| Clinical research | 33 (25) |
| Translational research | 16 (12) |
| Basic research | 44 (33) |
| Other | 10 (8) |
| Peer-reviewed articles as first or second author before graduation, n (%) | |
| None | 31 (23) |
| One | 59 (44) |
| Two | 30 (23) |
| Three or more | 13 (10) |
| Career after graduation | |
| Took up a PhD fellowship immediately after graduation, n (%) | 61 (46) |
| Consultant (specialist), n (%) | 51 (38) |
| Consultant or specialising within the field of the programme project, n (%) | 37 (28) |
| Currently working at a university hospital, n (%) | 70 (53) |
| Not currently working in specialist health services, n (%) | 17 (13) |
Notes: All data are self-reported. Denominators are 133 unless stated; there were no missing data for the variables shown. Sixty respondents (45%) were men and two (2%) did not report their sex.
Abbreviations: IQR, interquartile range; MSRP, Medical Student Research Programme.
Primary and secondary endpoints are presented in Table 2 and stratified by time since graduation, in Table 3. Of the respondents, 71 (53%, 95% CI 45–62) had completed a PhD and 17 (13%) had a PhD in progress, giving 88 (66%, 95% CI 58–74) who had completed or were undertaking doctoral training. For 65 of these 88 (74%), the doctoral project was a continuation of their MSRP project. Of the 70 PhD graduates who answered the item, 36 (51%) reported submitting their thesis ahead of nominal duration, 20 (29%) on time and 14 (20%) later. Among the 61 PhD graduates who reported the year of completion, the median time from graduation to PhD was 4 years (IQR 3–6), and the median age at completion was 31 years (IQR 30–35).
Table 2.
Long-Term Research and Academic Outcomes Among Respondents
| Outcome | N = 133 Respondents |
|---|---|
| Doctoral training | |
| PhD completed, n (%, 95% CI) | 71 (53, 45–62) |
| PhD in progress, n (%) | 17 (13) |
| PhD completed or in progress, n (%, 95% CI) | 88 (66, 58–74) |
| Doctoral project a continuation of the MSRP project, n/N (%) | 65/88 (74) |
| Thesis submitted ahead of nominal duration, n/N (%) | 36/70 (51) |
| Years from graduation to PhD completion, median (IQR); n = 61 | 4 (3–6) |
| Age at PhD completion in years, median (IQR); n = 61 | 31 (30–35) |
| Publication output | |
| Peer-reviewed articles, total, median (IQR); range | 4 (1–9); 0–140 |
| Original articles as first, second or last author after graduation, median (IQR) | 2 (0–5) |
| At least one first-author article after graduation, n (%) | 85 (64) |
| At least one article within the past 2 years, n (%, 95% CI) | 60 (45, 37–54) |
| Research engagement | |
| Self-identified active researcher, all respondents, n (%, 95% CI) | 63 (47, 39–56) |
| Self-identified active researcher, excluding ongoing PhD | 47/116 (41, 32–50) |
| Supervision of graduate or PhD students, any level, n (%) | 41 (31) |
| — of PhD candidates | 19 (14) |
| — of graduate students only | 22 (17) |
| — other supervision only | 3 (2) |
| — no supervision | 89 (67) |
| Member of research group leadership, n (%) | 19 (14) |
| Academic employment | |
| Academic or research appointment, all respondents, n (%, 95% CI) | 20 (15, 10–22) |
| Academic or research appointment, excluding ongoing PhD | 20/116 (17, 11–25) |
| Academic or research appointment or PhD fellowship, n (%, 95% CI) | 31 (23, 17–31) |
| — associate professor or professor | 15 (11) |
Notes: Confidence intervals for proportions were calculated using the Wilson score method and reflect random error only; they do not account for non-response bias. An academic or research appointment comprises university and research posts (associate professor, professor, postdoctoral fellow) and combined clinical–academic posts at these levels; PhD fellowships are counted separately because they are time-limited training positions. Self-identification as an active researcher is a single questionnaire item and was not combined with the activity-based outcomes into a composite measure. All outcomes were self-reported and were not verified against publication databases or institutional records. Rows labelled “excluding ongoing PhD” exclude the 17 respondents with a PhD in progress (N = 116). “At least one article within the past 2 years” combines respondents reporting their most recent article in the current year or within the preceding two years; three respondents who had submitted but not yet published a manuscript were not counted. Timing of thesis submission was self-reported relative to the nominal duration of the PhD fellowship; one PhD graduate did not answer this item, and 10 did not report the year of PhD completion.
Abbreviations: CI, confidence interval; IQR, interquartile range; MSRP, Medical Student Research Programme.
Table 3.
Research and Academic Outcomes Among Respondents, Stratified by Time Since Graduation
| Outcome | <5 Years (n=27) |
5–9 Years (n=47) |
10–14 Years (n=38) |
≥15 Years (n=21) |
All Respondents (n=133) |
|---|---|---|---|---|---|
| Doctoral training | |||||
| PhD completed | 2/27 (7) | 22/47 (47) | 28/38 (74) | 19/21 (90) | 71/133 (53; 45–62) |
| PhD ongoing | 9/27 (33) | 5/47 (11) | 3/38 (8) | 0/21 (0) | 17/133 (13; 8–20) |
| PhD completed or ongoing | 11/27 (41) | 27/47 (57) | 31/38 (82) | 19/21 (90) | 88/133 (66; 58–74) |
| Publication output | |||||
| Peer-reviewed articles, total, median (IQR) | 1 (0–3) | 3 (0–6) | 8 (3–11) | 11 (5–30) | 4 (1–9) |
| Peer-reviewed articles, total, range | 0–7 | 0–39 | 0–65 | 0–140 | 0–140 |
| First-author articles since graduation, median (IQR) | 0 (0–1) | 1 (0–2) | 3 (1–4) | 3 (1–8) | 1 (0–3) |
| Published within the past 2 years | 11/27 (41) | 16/47 (34) | 20/38 (53) | 13/21 (62) | 60/133 (45; 37–54) |
| Research engagement | |||||
| Self-identified active researcher, all respondents | 11/27 (41) | 16/47 (34) | 24/38 (63) | 12/21 (57) | 63/133 (47; 39–56) |
| Self-identified active researcher, excluding ongoing PhD | 2/18 (11) | 12/42 (29) | 21/35 (60) | 12/21 (57) | 47/116 (41; 32–50) |
| Supervision of students, any level | 5/27 (19) | 10/47 (21) | 15/38 (39) | 11/21 (52) | 41/133 (31; 24–39) |
| PhD supervision | 0/27 (0) | 3/47 (6) | 6/38 (16) | 10/21 (48) | 19/133 (14; 9–21) |
| Member of research group leadership | 0/27 (0) | 3/47 (6) | 7/38 (18) | 9/21 (43) | 19/133 (14; 9–21) |
| Academic employment | |||||
| Academic or research appointment, all respondents | 0/27 (0) | 5/47 (11) | 8/38 (21) | 7/21 (33) | 20/133 (15; 10–22) |
| Academic or research appointment, excluding ongoing PhD | 0/18 (0) | 5/42 (12) | 8/35 (23) | 7/21 (33) | 20/116 (17; 11–25) |
| Academic or research appointment or PhD fellowship | 8/27 (30) | 6/47 (13) | 10/38 (26) | 7/21 (33) | 31/133 (23; 17–31) |
Notes: Data are n/N (%) unless otherwise stated; for all respondents, 95% confidence intervals (Wilson score method) follow the percentage. Time since graduation was calculated as the survey year minus the self-reported year of graduation; median 8 years (IQR 5–13, range 0–20). PhD status was taken from the item on doctoral completion; “ongoing” denotes a PhD in progress at the time of the survey. All outcomes were self-reported and were not verified against publication databases or institutional records. “Published within the past 2 years” combines respondents reporting their most recent article in the current year or within the preceding two years. Rows labelled “excluding ongoing PhD” exclude the 17 respondents with a PhD in progress (N = 116). Strata are descriptive. Differences between strata reflect both career stage and change in the programme over time and cannot be attributed to the programme itself.
The median number of peer-reviewed articles per respondent was 4 (IQR 1–9, range 0–140), and 85 (64%) had published at least one first-author article after graduation. Sixty respondents (45%, 95% CI 37–54) had published within the two years preceding the survey.
Excluding the 17 respondents with an ongoing PhD, 47 of 116 (41%, 95% CI 32–50) identified themselves as active researchers and 20 of 116 (17%, 95% CI 11–25) held a part-time or full-time academic or research appointment; 15 of all 133 respondents (11%) were associate professors or professors. When PhD fellowships were included, 31 of 133 (23%, 95% CI 17–31) held a research or academic position. Of the 52 respondents who had graduated at least five years earlier and identified themselves as active researchers, 30 (58%) held neither an academic or research appointment nor a PhD fellowship. In this group, 24 of these 30 had published at least one peer-reviewed article within the past two years.
Forty-one respondents (31%, 95% CI 24–39) had supervised, or were currently supervising, graduate or PhD students, including 19 (14%) who had supervised PhD candidates. Among those who had completed a PhD, 35 of 71 (49%) had acted as supervisors. Nineteen respondents (14%) were members of research group leadership.
Outcomes that require time to accrue increased with time since graduation (Table 3). PhD completion rose from 2 of 27 (7%) among respondents less than five years from graduation to 19 of 21 (90%) among those at least 15 years from graduation, PhD supervision from 0 of 27 to 10 of 21 (48%), membership of research group leadership from 0 of 27 to 9 of 21 (43%), and academic or research appointment from 0 of 27 to 7 of 21 (33%). Among the most recent graduates, 9 of 27 (33%) had a PhD in progress. Publication within the past two years was reported in every stratum, by between 34% and 62% of respondents.
Outcomes were similar among women and men for PhD completion (40 of 71 [56%] vs 30 of 60 [50%]; p = 0.47), publication within the past two years (31 of 71 [44%] vs 28 of 60 [47%]; p = 0.73), self-identification as an active researcher after exclusion of ongoing PhDs (26 of 63 [41%] vs 20 of 51 [39%]; p = 0.82) and academic or research appointment after exclusion of ongoing PhDs (13 of 63 [21%] vs 7 of 51 [14%]; p = 0.33). The confidence intervals for these differences were wide, and the comparisons do not exclude moderate differences between women and men.
Discussion
This study describes long-term research and academic outcomes among former MSRP participants at the University of Bergen, up to 20 years after graduation. Two thirds of respondents had either completed a PhD or were current PhD candidates, and most PhD graduates had obtained their doctorate within a few years of graduation. Excluding those still in doctoral training, 41% identified themselves as active researchers and 17% held an academic or research appointment. About half of those who had completed a PhD had supervised graduate or PhD students, and among respondents at least 15 years from graduation, nine in ten had a PhD and almost half had supervised PhD candidates.
Previous studies have described high levels of research activity during and shortly after the MSRP.8–10 The present findings describe research involvement among respondents at a longer interval after graduation.
More than half of respondents had completed a PhD, which is higher than the national average among Norwegian physicians.13 This comparison should be interpreted with caution: programme participants differ from physicians generally in prior research interest, access to supervision, university affiliation and earmarked funding, and the two groups are therefore not directly comparable. A Norwegian national cohort study that compared MSRP participants with matched controls reported a ten-fold higher rate of PhD completion,9 and that design, rather than the present one, is the appropriate basis for inferences about programme effect. We have restricted the comparative discussion to PhD completion, because it is defined consistently across studies; publication counts and definitions of academic appointment vary too widely between programmes for meaningful benchmarking.
Respondents who completed a PhD did so early in their careers, a median of 4 years after graduation and at a median age of 31 years, and half reported submitting ahead of nominal duration. By comparison, the mean age at doctoral degree in medicine and health sciences in Norway was 40.6 years in 2024,14 although that figure includes non-physician candidates and is not directly comparable. The national controlled study likewise found that MSRP graduates obtained their doctorate in about half the time after graduation of matched peers.9 This pattern is consistent with the structure of the programme. MSRP students complete the mandatory PhD coursework and a substantial part of the doctoral research, often including the first publication, while still at medical school, and for three quarters of respondents with a completed or ongoing PhD the doctoral project continued their MSRP project. Participants therefore enter doctoral training with an established project, supervisor and research group, and with a commitment to research made early in their education. Early completion leaves more of the subsequent career for postdoctoral research and supervision. Specialist training has, however, been reported to take longer among MSRP participants,9 and the balance between an earlier doctorate and later specialist qualification merits further study.
The stratified results show that outcomes accrue differently over time. Formal milestones such as PhD completion, PhD supervision, research group leadership and academic appointment were rare among recent graduates and common among those who had graduated at least 15 years earlier, whereas recent publication was reported at every stage of follow-up. This is expected in a cross-sectional design in which respondents are at very different career stages.
Worldwide, there are numerous reports of programmes and interventions intended to increase research engagement among medical students, but their structure, scope and outcomes vary considerably.15,16 A study from the United Kingdom found that common barriers to student research participation were lack of time, insufficient mentorship, limited funding and inadequate integration of research training into the curriculum.17 One of the few programmes similar to the Norwegian one is the medical student research programme at the University of California.18 Students in that programme reported increased self-perceived research competence but a decline in long-term research intention, which differs from the pattern observed here. The Norwegian MSRP is nationally coordinated, fully funded and integrated into the formal academic system, and participants complete all formal PhD training during medical school; whether these features account for the difference cannot be determined from the present data.
Several of our findings deserve an individual comment. Twenty-three per cent of respondents (31 of 133) had not published a peer-reviewed article before graduation, although publication is an expected outcome of the programme; of these 31, 20 reported having completed a publication-ready manuscript, 8 had not completed their project, and 21 nevertheless completed the programme with approval. Only 28% had specialised or were specialising within the field of their programme project. These figures describe a gap between the programme’s stated requirements and the outcomes observed among respondents; the survey was not designed to establish why the gap exists, and the free-text comments, which were not analysed formally, suggest that project scope and supervision quality varied.
Notably, more than half of respondents who had graduated at least five years prior to the survey and identified themselves as active researchers held neither an academic appointment nor a PhD fellowship, and most of these had published within the past two years. By contrast, research group leadership was reported almost exclusively by respondents who held an academic or research appointment, suggesting that this particular milestone is tied to formal employment in a way that continued publication is not. This suggests that many physicians continue research activity without protected research time or formal academic employment, which is consistent with the structural barriers described in the literature17 and with the limited number of academic positions relative to the number of qualified candidates.19 Alternative explanations for the outcomes observed here should also be considered: respondents who chose to enter a competitive research programme may have been research-oriented beforehand, and more than half reported an academic career intention while still a medical student. Access to supervision, earmarked PhD funding and employment at a university hospital may likewise contribute to the outcomes independently of the programme itself. At the same time, these factors are not fully separable from the programme, which introduces students to research at an early stage, provides structured methodological training and supervision, and enables an academic trajectory to begin several years earlier than would otherwise be possible.
Limitations
This study has several limitations. First, and most importantly, the design is cross-sectional and there is no comparison group, so the findings describe outcomes among respondents and cannot establish causality with the programme. Second, 133 of 262 eligible alumni responded (51%), which is comparable to the mean response rate of 54% reported for published surveys of physicians.20 Respondents who remained research-active were plausibly more likely to answer, so the reported proportions may overestimate research activity in the full cohort; because the survey was anonymous, respondents and non-respondents could not be compared. Third, all outcomes were self-reported and were not verified against publication databases or institutional records, and no bibliographic identifiers were collected, so citation-based measures such as publication impact or h-index could not be examined. Fourth, respondents had widely differing lengths of follow-up; outcomes are therefore reported by time since graduation, and outcomes that require time to accrue are underestimated among recent graduates. Fifth, this is a single-centre study of one institution’s participants, and the findings may not apply to the programme at the other three Norwegian faculties. Sixth, the sample provides limited power for subgroup comparisons, including comparisons between women and men, and non-significant differences should not be read as evidence of equivalence. Finally, the questionnaire was not validated or pilot tested.
Conclusions
Former MSRP participants commenced and completed doctoral training at an early career stage. A substantial proportion maintained research engagement well beyond the doctorate, both in academic institutions and in clinical settings. These findings suggest that a research programme integrated into medical school can be associated with sustained research engagement and academic careers among its graduates. Comparative longitudinal studies with verified data are needed to establish how much of this reflects the programme itself.
Acknowledgments
We thank Christoffer Drabløs Velde, Ingeborg Eskerud, Marianne Heldal Stien and Astrid Olsnes for their guidance and feedback.
Funding Statement
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Abbreviations
MSRP, Medical Student Research Programme; PhD, Doctor of Philosophy; MD, Doctor of Medicine; IQR, interquartile range; CI, confidence interval; SIKT, Norwegian Agency for Shared Services in Education and Research; ECTS, European Credit Transfer and Accumulation System.
Data Sharing Statement
The datasets generated and analysed during the current study are available from the corresponding author upon reasonable request.
Ethics Approval and Informed Consent
This study was approved by the Norwegian Agency for Shared Services in Education and Research (SIKT), on behalf of the Data Protection Officer at the University of Bergen (Approval ID: 100723). Approval from the Regional Committee for Medical and Health Research Ethics was not required, as set out in the Methods. The study was conducted in accordance with the Declaration of Helsinki.12 All participants provided informed consent by submitting the survey.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work. NL is fully responsible for the conduct of the study, had access to the data and controlled the decision to publish.
Disclosure
Several authors have had a professional relationship with the programme evaluated in this study: ABG as Director of the MSRP, and NL, ATB and KEM as former MSRP students. ATB, ABG and KEM co-authored an earlier evaluation of the same programme.10 This is reported as a potential non-financial competing interest. The authors report no other conflicts of interest in this work.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The datasets generated and analysed during the current study are available from the corresponding author upon reasonable request.