Abstract
PURPOSE: Mentored K (K01/K08/K23) career development awards are positively associated with physicians' success as independent investigators; however, individuals in some racial/ethnic groups are less likely to receive this federal funding. The authors sought to identify variables that explain (mediate) the association between race/ethnicity and mentored K award receipt among U.S. Liaison Committee for Medical Education-accredited medical school graduates who planned research-related careers. METHOD: The authors analyzed deidentified data from the Association of American Medical Colleges and the National Institutes of Health Information for Management, Planning, Analysis, and Coordination II grants database for a national cohort of 28,690 graduates from 1997-2004 who planned research-related careers, followed through August 2014. The authors examined 10 potential mediators (4 research activities, 2 academic performance measures, medical school research intensity, degree program, debt, and specialty) of the association between race/ethnicity and mentored K award receipt in models comparing underrepresented minorities in medicine (URM) and non-URM graduates. RESULTS: Among 27,521 graduates with complete data (95.9% of study-eligible graduates), 1,147 (4.2%) received mentored K awards (79/3,341 [2.4%] URM; 1,068/24,180 [4.4%] non-URM). All variables except debt were significant mediators; together they explained 96.2% (95%, CI 79.1%-100%) of the association between race/ethnicity and mentored K award. CONCLUSIONS: Research-related activities during/after medical school and standardized academic measures largely explained the association between race/ethnicity and mentored K award in this national cohort. Interventions targeting these mediators could mitigate racial/ethnic disparities in the federally funded physician-scientist research workforce.