MD/PhD Training in Canada: Results from a national trainee and program director review.

PURPOSE: There has been limited examination of clinician scientist training in Canada, particularly regarding training integration and funding. This study assessed program structure, funding, tuition and mentorship structures available at Canadian MD/PhD programs. METHODS: Clinician Investigator Trainee Association of Canada administered an anonymous survey to current trainees and program directors that captured program structure, trainee funding, tuition and mentorship opportunities and needs across institutions. RESULTS: In June 2015, 101/228 (44%) trainees and 9/13 (69%) program directors completed the online survey. In all programs, students completed the PhD degree prior to clerkship training. Seven programs offered research training upon completion of pre-clerkship, four offered concurrent clinical and research training, and three offered alternative structures. Nine held seminars exposing students to clinical and research integration and two offered clinician scientist skills courses. Stipend funding and tuition varied, especially during clinical training years. Regarding mentorship, all programs held regular meetings, though eight programs do not have formal mentorship opportunities. Both trainees and program directors identified the need for further career planning and development support as a student priority. CONCLUSION: MD/PhD programs varied by program structure, funding, tuition and mentorship opportunities. Mechanisms to share and spread program innovations should be instated. Students may benefit from concurrent research and clinical training as well as courses specific to clinician scientist skill development. Decreasing debt burden may attract and retain trainees in this demanding path. To ensure mentorship programs align with trainee priorities, program directors should directly collaborate with students in their development and evaluation.

Social class, gender, and time use: implications for the social determinants of body weight?

BACKGROUND: The social gradient in body weight (for example, obesity) departs from the social gradient in other health outcomes. Innovative approaches are needed to understand the observed patterns. This study examines time-use patterns by indicators of socio-economic position, and considers the implications of variations in time use for the social gradient in weight reported in other studies. DATA AND METHODS: The data are from respondents aged 25 to 64 to Canada's 1986 and 2005 General Social Surveys, which focused on time use. Participation in various activities was examined by sex, and by personal income and education, stratified by sex, in both years. RESULTS: Higher-income men and women were more likely than those of lower income to spend time in paid work, commuting and eating out, and less likely to spend time sleeping. Men and women with higher education were more likely than those with lower education to spend time in physical activity (2005 only) and reading. These time-use patterns plausibly contribute to the social gradient in obesity reported in other Canadian studies. INTERPRETATION: The findings suggest that there is value in looking beyond a narrow range of health behaviours toward broader measures of daily routines to gain insight into the social determinants of weight and health.