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To examine the careers of career development award recipients.In 2009, a postal survey was conducted of 818 recipients of K08 and K23 awards in 2000–2001 to examine career paths and personal characteristics.Of 589 respondents (72% response rate), 211 (35.9%) were female. Women were less likely to have children (P < .001) than men. The vast majority of respondents (89.6%) remained in academic medicine. Among those, over three-quarters continued to spend significant time on research. On univariate analysis, women were not significantly less likely to report promotion, leadership positions, or application for R01 grants. They were less likely to have received an R01 (P = .006) and to perceive themselves as successful (P = .002), and they published fewer papers (P = .001). Overall, 118 women (55.9%) and 274 men (72.5%) met at least one of the following criteria for success: serving as principal investigator on an R01 or grants >$1,000,000 since K award receipt, publishing at least 35 publications since K award year, or serving as dean, department chair, or division chief. In a multivariate model, gender (odds ratio 1.72, P = .003) was associated with the likelihood of success by this definition, and analysis revealed no significant interactions (including with parental status).Most of these promising investigators of both genders remained in academia and received promotions. However, gender differences in success existed, unrelated to parental status, suggesting a need for ongoing investigation of the causes of gender differences in academic medical careers.