Building the Pipeline: Surveying Medical Student Interest in Hematology and Rare Disease Research

Introduction: Leading organizations like the American Society of Hematology and the National Heart, Lung, and Blood Institute have signaled an imminent and growing shortage of both classical and malignant hematology specialists nationwide. This shortage is largely due to many hematology/oncology fellows preferring oncology over hematology as their subfield of specialization¹. A 2019 survey of hematology-oncology trainees revealed that 29.2% of trainees identified medical school as the first point of subfield differentiation, which was the second most common answer after residency (32.5%), followed by fellowship (23.3%). The same survey found that participating in hematology research during training results in nearly a seven-fold increase in trainee interest in pursuing a hematology-only career (OR = 7.06, p < 0.01)². To address this upcoming shortage of hematology specialists, the University of Texas Southwestern Medical Center established an interest group to provide mentorship, clinical exposure, and research experience in hematology. This study aims to follow up on previous results³ to further demonstrate the effectiveness of student interest groups in promoting (1) academic medicine, (2) rare disease research, and (3) specific specialty interest, particularly hematology.

Methods: The Bone Marrow Failure Research Group at UT Southwestern was surveyed anonymously (n=17). A control group (n=51) consisting of non-interest group medical students was also surveyed anonymously. The survey included questions establishing interest in hematology, academic medicine, and rare diseases, measured using a 5-point Likert scale. The survey also assessed characteristics such as age (years), training stage (MS1-MS4), total research experience (in years), and prior participation in hematological and rare disease research (yes/no).

Results: Survey responses were analyzed using descriptive statistics (means, median, standard deviation, confidence intervals), ordinal logistic regression, Mann-Whitney U test, independent t-tests, and chi-squared regression. Members of the interest group showed significantly higher career interest in hematology, with mean Likert scale responses of 3.64/5 for members and 2.25/5 for non-members (p<0.01). Ordinal logistic regression revealed a strong correlation between career interest in hematology and current or past participation in hematology research (r=2.32, p< 0.001). Interest group members also displayed a higher average interest in pursuing a career in rare disease research (3.18/5 vs 2.33/5, p<0.01). Career interest in hematology was negatively correlated with the training stage (r=0.763, p<0.009). Years of research experience was positively correlated with interest in academic medicine (r=0.387, p<0.01). There was no significant difference between groups in career interest in academic medicine (p=0.083), research experience (p=0.56), or age (p=0.284).

Conclusion: These results suggest that medical student participation in research and mentorship can increase career interest in hematology practice and rare disease research. Potential limitations of this study include the low response rate from non-member first-year medical students (n=2, 3.9%) and the absence of baseline survey data to assess changes in professional interests throughout group membership. Future studies will address these limitations, and expand the study population to include trainees such as residents and fellows.

References:

1. Wallace NH, Hafler JP, Hurwitz ME, Podoltsev NA, Lacy J, Lee AI. Factors influencing hematology career choice in hematology and oncology fellows at a major academic institution [abstract]. Blood. 2016;128(22):3538

2. Masselink LE, Erikson CE, Connell NT, et al. Associations between hematology/oncology fellows' training and mentorship experiences and hematology-only career plans. Blood Adv. 2019 Nov;3:3278-86.

3. Toprak AC, Sahin SF, Ozturk M, Bat T. Student Research Group Promotes Interest in Rare Disorders: An Institutional Experience. Poster presented at: 2023 National Organization of Rare Disorders (NORD) Annual Breakthrough Summit; October 17, 2023.

Mehta:Regeneron Pharmaceuticals: Consultancy. Bat:Novartis: Other: Advisory Board; Recordati Rare Diseases: Other: Advisory Board; Alexion: Other: Advisory Board; Sanofi: Other: Advisory Board.