admission committees and the decline of physician scientists

[Habari]

i thougt this was an interesting article on the role admission committees have played in the past resulting in the decline of physician scientists:

http://www.jci.org/cgi/content/full/111/6/765

people often ask me why the decline matters. while it seems self-evident to us, it is often harder to explain to others who have more sophisticated counter arguments. the following article is well written and offers more substantial reasons/data in the attempt to justify the importance of physician scientists:

http://www.jci.org/cgi/content/full/103/12/1621

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[pathdr2b]

Students of science who miss the cut for MSTP should not be tainted by their failure to be chosen for these extraordinarily competitive positions. They still can make a research contribution as physicians through another training pathway later.

So what I gather from this is that if you don't make the cut for and MSTP MD/PhD, then just forget about getting the combined degree altogether? How about MD/PhD WITHOUT the MSTP funding? A talented student CAN find funding for both programs yet this possibility was NEVER mentioned in the first article.

The MSTP program should be expanded and modified to permit sequential study toward the M.D. and Ph.D. degrees and to include students with interests in such fields as biostatistics, computer science, epidemiology, and population health.

I also like the second article and I think they may have hit the nail on the head with this one statement.

 

[fonzy]

An excerpt from:
http://www.jci.org/cgi/content/full/111/6/765

"Only 6% of first-year matriculants think curing disease is the most important purpose of medicine (17) ? the average person on the street (19) seems more committed to medical research than our students. So how did all this happen?"

 

[superdevil]

the point of the first article was very interesting, and i like the whole "insider's perspective" thing, too.

modern admissions committees actually resist applicants who have aptitude for scientific achievement. I began ruminating about such a "gatekeeper effect" several years ago when a female baccalaureate with a strong research bibliography found herself wait-listed for admission because she had not done much volunteer work. I admit to being skeptical about our preoccupation with measuring levels of volunteerism under these circumstances. Applicants should have some life experience with clinical medicine to be sure they understand what commitments are necessary to succeed in this profession, but too much is not of special value

hey, i've been on that soapbox for years!!! this guy rules!

 

[Doctor&Geek]

http://www.jci.org/cgi/eletters/111/6/765

There are three e-mails, including a counter response from Wake Forest's Adcom that might be worth responding to.

Yours,

 

[dl2dp2]

These articles confirmed my intuition...these days it's almost easier to get admitted to a medical school as a humanities major than a science major (I was telling my premed friend to try to steer away from science as a concentration just to beat the system)...there is something kinda sad about it because, i mean...unfair as it sounds, i REALLY REALLY would love to have my personal physician raving about the Heisenberg uncertainty principle.

Premeds aren't really geeks...they are more like prelaws these days.

 

[dl2dp2]

"After all, some say, there are plenty of well-trained Ph.D.s and many of them are now doing clinical research. If M.D.s are unwilling to take the risks of a very competitive research career, so be it. My reply is as follows. It may be true that a medical education does not adequately prepare one to answer scientific questions, but it is the ideal setting in which to ASK them."

very nice quote from the second article...i approve

 

[Ceremony]

I actually had the opportunity to see Dr. Rosenberg speak at our MD/PhD retreat a couple of years ago. He is incredibly thoughtful and his arguments are very well thought out. The sad thing is, it seems like he is the only person that seems to publicly ask why MD's are not going into research, and then to ask "isn't this troubling?" All of the trends are very disturbing, and pretty soon we will be pretty screwed if we don't try and address this problem. Even at my med school, most ppl who graduate do NOT go into research as a career. Of course they do research during their med school years to get some experience and boost the resume, but most are headed towards purely clinical careers. I think this is a pretty unfortunate position, because as Dr. Rosenberg noted, MD have made significant contributions to science and medicine through their research, and we will now come to the point where there won't be many around to do the research. I also agree that MD/PhD programs should be expanded. It is sad that only 2% of the incoming medical school class is in the MD/PhD program. At least there is one person from the old school that recognizes this problem, Dr. Rosenberg rocks.

 

[HeLaDeala]

I actually had the opportunity to see Dr. Rosenberg speak at our MD/PhD retreat a couple of years ago. He is incredibly thoughtful and his arguments are very well thought out. The sad thing is, it seems like he is the only person that seems to publicly ask why MD's are not going into research, and then to ask "isn't this troubling?" All of the trends are very disturbing, and pretty soon we will be pretty screwed if we don't try and address this problem. Even at my med school, most ppl who graduate do NOT go into research as a career. Of course they do research during their med school years to get some experience and boost the resume, but most are headed towards purely clinical careers. I think this is a pretty unfortunate position, because as Dr. Rosenberg noted, MD have made significant contributions to science and medicine through their research, and we will now come to the point where there won't be many around to do the research. I also agree that MD/PhD programs should be expanded. It is sad that only 2% of the incoming medical school class is in the MD/PhD program. At least there is one person from the old school that recognizes this problem, Dr. Rosenberg rocks.

As an MD student who invested heavily in research in undergrad, part of the problem is the difficulty that MDs have in transitioning to a research career.

Once you enter an MD-only program, you are almost entirely excluded from getting a PhD. The only exception is programs that have a backdoor Md/PhD program. Even then, forget about tuition forgiveness. For students who realize too late that they want to do research, the only option is to follow residency up with multiple low-paying post-docs. Forget paying off your student loans. Multiple mentors have told me that it's also way harder to get grants as an MD than as an MD/PhD, regardless of post-docs.

To be a research physician, you really have to commit to applying MD/PhD. Otherwise, the lifestyle and career path is much more difficult.

I would love to hear adcoms weigh in on the possibility of transfer into MD/PhD from a different MD program. I'm guessing it's impossible.

On a similar note, after talking about my extensive basic/translational research resume, I had an adcom at a top research school tell me that I should be more interested in clinical research. Probably not why I got WL, but it really made me wonder if the adcoms were screening out physician scientists.

 

[dl2dp2]

Wow, way to resurrect a 12 year old thread on which I barely remember a much much younger version of myself. Dear god SDN...

Wonder if the decline of the MD entering into research has stabilized...

What *is* interesting to me now that I've seen more, the bottleneck is no longer at the medical school. People are not really not being encouraged into research any more because everyone knows that people drop out at every stage. Even R01 renewal is becoming precarious. e.g. fully trained independent physician scientists are declining in number because there's not sufficient funding to always guarantee sustained salary support. The salary differential between physicians and scientists has increased, sometimes dramatically, and the more sustaining model now is 25% of MD effort covering 50-75% of physician scientist salary support. Extremely few MDs do basic science after residency, and the competitiveness of even top PhD programs is declining substantially.