discrimination against MD/PhD students in academia

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The goal of this post is to inform prospective MD/PhD applicants the potential risk of doing a joint program.

My school has recently discontinued the MD/PhD program due to budget issues. It is true that there is discrimination against MD/PhD students in academia, especially in the basic science research field, and it has becoming more and more common.

The group my PI was in during his postdoc years stopped taking in MD/PhD students because his former PI viewed them (i.e. MD/PhD candidates) as ineffective grad students (compared to PhD students), cookie-cutters, or even "dead weight".

Reasons,

1. Most of the MD/PhD candidates were only willing to work enough to get by and fulfill the program requirement for the PhD degree.
2. Most of the MD/PhD candidates were only willing to acquire enough of manuscript data for "a" paper in a no-name journal, severely lack of motivation for high quality, high impactful papers.
3. Most of the MD/PhD candidates could not come up with an original, somewhat impactful project of their own, and had to be put on projects that were done, or already 4/5 completed by postdocs or other PhD students.
4. Most of the MD/PhD candidates had to "borrow" data from postdocs or other PhD students in order to complete "their" research on time.
5. Most of the MD/PhD candidates never wanted to do basic science research after graduation, they're in the program for the wrong reasons (i.e. free tuition). http://jama.jamanetwork.com/article.aspx?articleid=183357

Will MD/PhD students be forced to switch to the MD-track only if he/she cannot find sponsorship for the PhD work, and will the program make the student pay back all the tuition from Year 1 and 2?

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It is clear that your institution couldn't attract quality MD/PhD applicants and why it choose to discontinue the program, which is an expensive budget item. The applicants that I recruit for my MD/PhD program do not reflect any of the 5 statements/reasons. Now, I do recruit applicants for translational science careers as well as basic science careers. My hope is that my students have the tools to eventually become PI's if they choose that, but I don't expect that everybody will be doing bench research. I hope that all of them are in academic medicine or industry doing some research as part or all of their careers. I have gotten to meet (and review applications) at least a dozen of the MD/PhD applicants posting here (in SDN) and I don't think they fall into the group of 5 statements/ reasons.

Sure, I have a conflict of interest as MD/PhD Director...
 
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I graduated from an MD/PhD program several years ago, and I have to agree with Fencer. None of these things were the case. My colleagues were all willing to work, frequently published more papers than PhD only students, and never relied on other students/researchers. Many of us were leaders in our labs and departments. Now that we have moved on past graduation, we are involved in research to a varying degree, many in the context of residencies and fellowships but also in some atypical paths (e.g. industry). If your program had the issues listed above, it probably reflects poorly on the program and the students enrolled on it. Perhaps it is better that the program closes down in that case.

At my program, during the 8 years I was there, and the surrounding several years, I never heard of anyone not finding a lab to work in. It would be pretty much impossible.
 
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It is clear that your institution couldn't attract quality MD/PhD applicants and why it choose to discontinue the program, which is an expensive budget item. The applicants that I recruit for my MD/PhD program do not reflect any of the 5 statements/reasons. Now, I do recruit applicants for translational science careers as well as basic science careers. My hope is that my students have the tools to eventually become PI's if they choose that, but I don't expect that everybody will be doing bench research. I hope that all of them are in academic medicine or industry doing some research as part or all of their careers. I have gotten to meet (and review applications) at least a dozen of the MD/PhD applicants posting here (in SDN) and I don't think they fall into the group of 5 statements/ reasons.

Sure, I have a conflict of interest as MD/PhD Director...

The one that was closed down was a non-NIH MSTP program, and the incidents happened at a NIH-MSTP program at an Ivy MD school. I am asking because I know a couple of students had to leave the program last year because he/she couldn't find sponsorship after the first two years, for some reasons the students didn't think this was a serious issue until it was already too late. It's hard for research groups to take in extra students when the funding isn't there, I think this is more problematic in a non-NIH MSTP program than a NIH-MSTP one.
 
The goal of this post is to inform prospective MD/PhD applicants the potential risk of doing a joint program.

My school has recently discontinued the MD/PhD program due to budget issues. It is true that there is discrimination against MD/PhD students in academia, especially in the basic science research field, and it has becoming more and more common.

The group my PI was in during his postdoc years stopped taking in MD/PhD students because his former PI viewed them (i.e. MD/PhD candidates) as ineffective grad students (compared to PhD students), cookie-cutters, or even "dead weight".

Reasons,

1. Most of the MD/PhD candidates were only willing to work enough to get by and fulfill the program requirement for the PhD degree.
2. Most of the MD/PhD candidates were only willing to acquire enough of manuscript data for "a" paper in a no-name journal, severely lack of motivation for high quality, high impactful papers.
3. Most of the MD/PhD candidates could not come up with an original, somewhat impactful project of their own, and had to be put on projects that were done, or already 4/5 completed by postdocs or other PhD students.
4. Most of the MD/PhD candidates had to "borrow" data from postdocs or other PhD students in order to complete "their" research on time.
5. Most of the MD/PhD candidates never wanted to do basic science research after graduation, they're in the program for the wrong reasons (i.e. free tuition). http://jama.jamanetwork.com/article.aspx?articleid=183357

Will MD/PhD students be forced to switch to the MD-track only if he/she cannot find sponsorship for the PhD work, and will the program make the student pay back all the tuition from Year 1 and 2?

This is complete garbage, wish the moderators would just take it down.
 
aw man, i thought you got banned, seeing as how all your threads are getting deleted.
 
Even if the OP is way off base, I think it is worth reflecting that SOME in academia (often PhD "only"s but also MD "only"s) either do not understand what the MD/PhD is about or have strong biases for or against them. Most have taken a positive tone, but I have seen PhD students speak negatively of MD/PhDs (never heard faculty say so, perhaps they do behind our backs?), with allusions to not doing the same PhD course load, not having TA requirements, or having MD/PhD program pressures accelerate students out of grad school. I have also heard MDs say that they were surprised that such and such MD/PhD did so well clinically, because usually they have clinical deficits (and this was meant to imply residents just as well as students).
 
This is complete garbage, wish the moderators would just take it down.
aw man, i thought you got banned, seeing as how all your threads are getting deleted.

Personal attacks are not permitted on SDN. If you think the moderators should intervene in a post or thread, use the report post button. If you disagree, you may post as such in an inoffensive manner as multiple members have already done. If you find a user's material consistently objectionable, use the ignore feature.

I have seen PhD students speak negatively of MD/PhDs (never heard faculty say so, perhaps they do behind our backs?), with allusions to not doing the same PhD course load, not having TA requirements, or having MD/PhD program pressures accelerate students out of grad school. I have also heard MDs say that they were surprised that such and such MD/PhD did so well clinically, because usually they have clinical deficits (and this was meant to imply residents just as well as students).

I have experienced some of this negative stereotyping from MD and PhD faculty as well. It has been a minority of faculty in my experience, but perhaps there are departments out there where it is more a part of their culture. The one thing that really inflamed my lab when I did my PhD was having the oversight of the MD/PhD program to help me out of the lab in a timely fashion. Insisting on having a thesis committee meeting every 6 months and having my MSTP director come to a thesis committee meeting to find out why I was not ready to graduate despite my numerous achievements, infuriated my former lab. I suspect they are less likely to have an MD/PhD student in the future as a result.
 
aw man, i thought you got banned, seeing as how all your threads are getting deleted.
I was actually disappointed that the one on mental illness in medicine got deleted. There were some really good insights in that post that might have made a lot of posters with mental illness feel as if their coworkers were on their side, and possibly inspired those who were fearful of judgement but not currently in treatment to seek help.
 
I was actually disappointed that the one on mental illness in medicine got deleted. There were some really good insights in that post that might have made a lot of posters with mental illness feel as if their coworkers were on their side, and possibly inspired those who were fearful of judgement but not currently in treatment to seek help.
I was too, I thought that was a pretty good thread minus the ignorance
 
Even if the OP is way off base, I think it is worth reflecting that SOME in academia (often PhD "only"s but also MD "only"s) either do not understand what the MD/PhD is about or have strong biases for or against them. Most have taken a positive tone, but I have seen PhD students speak negatively of MD/PhDs (never heard faculty say so, perhaps they do behind our backs?), with allusions to not doing the same PhD course load, not having TA requirements, or having MD/PhD program pressures accelerate students out of grad school. I have also heard MDs say that they were surprised that such and such MD/PhD did so well clinically, because usually they have clinical deficits (and this was meant to imply residents just as well as students).

One of my colleagues is in a NIH sponsored MSTP program in Texas right now, and he said he also experienced stereotyping when choosing a research group. I am aware that people do not like to talk about stuff like this in general because it's depressing. However, it does not mean the issue doesn't exist. I am afraid a vast majority of MSTP applicants are probably not aware of this.

People do not like to talk about stuff like this in person because it's a very sensitive, touchy subject, especially for faculty. However, when the budget is tight, tough decisions will be made.
 
I was actually disappointed that the one on mental illness in medicine got deleted. There were some really good insights in that post that might have made a lot of posters with mental illness feel as if their coworkers were on their side, and possibly inspired those who were fearful of judgement but not currently in treatment to seek help.
I was too, I thought that was a pretty good thread minus the ignorance

The mental illness thread about depression and ADHD got deleted by me. I decided to take it down because it was no longer a healthy thread with meaningful conversation and feedback. Some of the feedback were very insightful, reasonable and had valid points. However, most of them were outright rude and personal attacks.
 
Regarding the OP's statement, I may be speculating but I feel like this may be more of an issue in MSTP programs compared to non-MSTP programs. I remember when I was on SDN during the application process and everyone wanted a coveted spot at an MSTP program (myself included), and I ended up getting a spot at a non-MSTP program. Things have a funny way of working out because I couldn't be happier where I ended up, but I digress. My program still offers funding for students but there is no defined "exit date" during the course of your PhD and there is very little oversight by the Program Director as to when we are finishing. The result is that we have to work our tails off to graduate in a timely manner, and in my particular lab, I get very little direction from my PI. Where many would view these as negative attributes, I think they are molding me into a self-sufficient scientist intellectually. And I am not the only case at my program. As a result, I get the impression that the MD/PhD's are highly valued by the PI's here as productive members of the lab. You have no choice. You have to work, you have to figure it out, because nobody's going to hold your hand here. This is an extremely valuable learning experience for those of us who want to stay in academia and start our own labs up. And for that, I'm quite grateful for where I ended up. I also wanted to share this to let all you applicants out there know that getting into a non-MSTP program isn't so bad :p
 
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there is very little oversight by the Program Director as to when we are finishing. The result is that we have to work our tails off to graduate in a timely manner, and in my particular lab, I get very little direction from my PI. Where many would view these as negative attributes, I think they are molding me into a self-sufficient scientist intellectually.

Everyone in an MD/PhD program works hard. What differentiates a strong program from a weak program is integration and oversight. Does the program not weigh the MD/PhD student down with unnecessary extra requirements? Does the program step in to help its students if they have problems in their lab?

You may feel like you don't need any support, and you may not. You may be fortunate and do just fine. But if things don't go well, often due to no fault of your own, you won't like being a 10+ year MD/PhD graduate because you had no support from your PI or anyone else outside your lab.

My article about this topic is here: http://www.neuronix.org/2011/09/meeting-about-return-this-past-week-i.html
 
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Everyone in an MD/PhD program works hard. What differentiates a strong program from a weak program is integration and oversight. Does the program not weigh the MD/PhD student down with unnecessary extra requirements? Does the program step in to help its students if they have problems in their lab?

You may feel like you don't need any support, and you may not. You may be fortunate and do just fine. But if things don't go well, often due to no fault of your own, you won't like being a 10+ year MD/PhD graduate because you had no support from your PI or anyone else outside your lab.

My article about this topic is here: http://www.neuronix.org/2011/09/meeting-about-return-this-past-week-i.html

These are all good points Neuronix. I did not mean to imply that I don't need any help, now or ever. Of course I do, I'm just a lowly grad student going through the learning process like everybody else. I simply wanted to make the point that sometimes it's a good learning experience to not have the road paved out for you. I can imagine that the path to becoming a well-funded PI is a bumpy one and dealing with adversity now will better prepare us for this. I believe that "unnecessary extra requirements" are subjective. I've grumbled through every required grad-school class along the way, only to find that I did actually learn something useful each time. I also don't want to make it seem like my particular program won't step in when a student is having a problem. They will when it's necessary, but the student has to deserve the intervention (ie. they are doing everything they can, but things out of their control are holding them up, as you mentioned). I have watched two other students in my program deal with particular situations like these. One ended up defending after 3 years without a first author publication because he/she went behind the PI's back and complained to his/her committee and they ended up not matching into a research-track residency because of it. The other was assigned to a dead-end project, but came in at 2pm everyday and sat on his/her hands for 4 years before deciding to seek outside help about it. Had these students been in MSTP programs with an "exit date", they both probably would have graduated in these situations, and I'm not so sure they would have deserved it. So, this brings me back to the OP's statements about the reasons why MD/PhD's might not be highly valued at some institutions. I don't know if this is actually the case, but I can understand why some faculty might feel that way. Again, these are simply the opinions and experiences of one person. You have to do the best you can with your particular situation, whatever that may be, but you can't expect someone to always be there holding your hand. And knowing that there is no safety net provides pretty good incentive to buckle down and put the work in.
 
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I have watched two other students in my program deal with particular situations like these. One ended up defending after 3 years without a first author publication because he/she went behind the PI's back and complained to his/her committee and they ended up not matching into a research-track residency because of it.

...

Had these students been in MSTP programs with an "exit date", they both probably would have graduated in these situations, and I'm not so sure they would have deserved it.

There is no such thing as an MSTP "exit date". Also, you said that the first student did graduate. I'm not sure what that means if you're trying to make the point that your program has more strict requirements for graduation than an MSTP would.

The second example student would not have been allowed to graduate where I went to MSTP. I saw something similar to this (insufficient effort), and he had to switch labs and start over.

So, this brings me back to the OP's statements about the reasons why MD/PhD's might not be highly valued at some institutions. I don't know if this is actually the case, but I can understand why some faculty might feel that way.

You have to do the best you can with your particular situation, whatever that may be, but you can't expect someone to always be there holding your hand. And knowing that there is no safety net provides pretty good incentive to buckle down and put the work in.

Oversight is a good thing. Unscrupulous faculty don't like oversight. I've seen over and over again where some faculty like to keep their graduate students in their lab indefinitely regardless of the student's achievements. There are other things that can happen that are beyond your control. You need backup sometimes. That is not hand-holding.

At the end of the day, I hope those reading my posts on SDN understand what I have said repeatedly. When it comes to residency and your future career, a PhD is not important on its own. You need at least a first author publication at a bare minimum. You should be aiming for numerous achievements and it is helpful to tailor your PhD to your future specialty of interest while performing above average (if not excellently) in medical school and on step exams. MSTPs are under no less pressure to do these things.
 
There is no such thing as an MSTP "exit date".

I have been told by students in other programs that there is some designated cut-off date by which an MD/PhD student is allowed to graduate. If this does not exist, then my point is completely invalid and I apologize. If this does exist, then a lack of incentive to produce in the lab my result, and I'm simply agreeing with the OP's speculation that MD/PhD's may be discriminated against as a result. My intention was not to argue about what makes a good or bad MD/PhD program, and I apologize if that is how my point came across.

Also, you said that the first student did graduate. I'm not sure what that means if you're trying to make the point that your program has more strict requirements for graduation than an MSTP would.

Let me clarify what I mean here. My program has quite lax requirements about when a student should graduate. Ideally, the goal time is 4 years, but several students in my program have stayed longer unfortunately. What I was trying to say is that I and many others in my program felt that this particular student didn't deserve to graduate. In my opinion, this is an example of a student to which the OP is referring. He/she didn't start producing any meaningful data until 6 months before graduating. This person even took credit for another student's work (that's something I wont get into). This situation is definitely an anomaly at my program, but I'm worried it may be the norm at other institutions if they are trying to get students out by 3 years. As a result, I don't have a lot of faith in this person's scientific capability or credibility. Would you?

The second example student would not have been allowed to graduate where I went to MSTP. I saw something similar to this (insufficient effort), and he had to switch labs and start over.

I'm glad to here this. And if this is true at every institution, my entire point is moot :/ but then the OP wouldn't have posted about this topic in the first place.

Oversight is a good thing. Unscrupulous faculty don't like oversight. I've seen over and over again where some faculty like to keep their graduate students in their lab indefinitely regardless of the student's achievements. There are other things that can happen that are beyond your control. You need backup sometimes. That is not hand-holding.

Yes, indeed this is where the committee comes in. But your committee won't support you if you haven't put the effort in and produced a meaningful body of work, or at least they shouldn't. Yes, publishing takes time. If you don't have it, this will only hurt you, as you know. I have a hard time supporting the shuffling around of students to whatever project seems to be working at the time, so the program can fulfill it's "student graduated on time" quota. I know there are extenuating circumstances, but this should not be the norm.

At the end of the day, I hope those reading my posts on SDN understand what I have said repeatedly. When it comes to residency and your future career, a PhD is not important on its own. You need at least a first author publication at a bare minimum. You should be aiming for numerous achievements and it is helpful to tailor your PhD to your future specialty of interest while performing above average (if not excellently) in medical school and on step exams. MSTPs are under no less pressure to do these things.

I agree with this statement 100%. You are wise Neuronix, I know this. You have been around the block and you have heaps of meaningful advice to give. Others should listen. However, we can each only offer our own perspective. I wanted to throw mine in to make a case for why the OP might have a point.
 
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I have been told by students in other programs that there is some designated cut-off date by which an MD/PhD student is allowed to graduate. If this does not exist, then my point is completely invalid and I apologize. If this does exist, then a lack of incentive to produce in the lab my result, and I'm simply agreeing with the OP's speculation that MD/PhD's may be discriminated against as a result. My intention was not to argue about what makes a good or bad MD/PhD program, and I apologize if that is how my point came across.

Generally speaking this does not exist. There may be some limited cases where a program can convince 1 or more committee members to go along with they group when otherwise they might not have. However, in my experience this most often occurred when the PI or a single committee member was being unreasonable. For example, one student in my program was allowed to graduate without a publication, because the PI insisted that the work had to be published in Science and more work had to be done before that could happen.

Let me clarify what I mean here. My program has quite lax requirements about when a student should graduate. Ideally, the goal time is 4 years, but several students in my program have stayed longer unfortunately. What I was trying to say is that I and many others in my program felt that this particular student didn't deserve to graduate. In my opinion, this is an example of a student to which the OP is referring. He/she didn't start producing any meaningful data until 6 months before graduating. This person even took credit for another student's work (that's something I wont get into). This situation is definitely an anomaly at my program, but I'm worried it may be the norm at other institutions if they are trying to get students out by 3 years. As a result, I don't have a lot of faith in this person's scientific capability or credibility. Would you?

I obviously cannot comment on this specific situation, but it is quite common for PhD (not just MD/PhD) students to achieve nothing meaningful for several years, prior to a short segment of high productivity in which they publish a couple papers and then graduate. Part of this is due to the increasing pressure of wanting to finish as time goes on. At the beginning, it just seems so far away, but after about 4 years with no papers you start to think "WTF? I better get my a$$ in gear". I've seen PhD students go for 2 years without a thesis committee meeting. You could make an argument that MD/PhD students may progress more quickly because they know that there is added pressure to finish in a reasonable amount of time.

At my institution, MD/PhD students were desirable as members in labs and on average published as many or more papers as PhD only students. At most, you had one MSTP program committee member on your thesis committee who could pressure your other members to ease off if the demands became unreasonable. At the same time, that person would also put pressure on you to have timely meetings, produce meaningful results, and not sit around, so it cut both ways.
 
Generally speaking this does not exist.

Alrighty. Seems like I've been misled with some erroneous info. Can anyone else, then, offer up a possible explanation for this sentiment directed at MD/PhD students? It can't be completely untrue if several other posters experienced similar things.

it is quite common for PhD (not just MD/PhD) students to achieve nothing meaningful for several years, prior to a short segment of high productivity in which they publish a couple papers and then graduate. Part of this is due to the increasing pressure of wanting to finish as time goes on. At the beginning, it just seems so far away, but after about 4 years with no papers you start to think "WTF? I better get my a$$ in gear".

I agree, this happens all the time, but I never understood this attitude if you are a dual degree student. How do you expect to graduate quickly if you don't get your a$$ in gear right away? A lot of this has to do with being picky about project selection (ie. staying away from mouse-heavy projects since they take so much time), or the PI already having established cellular models up and running in the lab. If you chose wisely in this regard, there's no reason not to get moving right away. Just my opinion.

Thanks for jumping in Shifty B, it's interesting to get the perspective of others as they go through this process or as they reflect back on it. I enjoyed reading these types of posts when I was an applicant. I hope I didn't end up offending anybody with my opinionated posts :p
 
With regard to the OP and the responses: Yes, there are perceptions (and some with conviction) among the PhDs and MDs about MD/PhDs. MD/PhD is a long term program and only the very best, and more importantly, motivated and hardworking should be admitted. Not all applicants will know everything about the field they are about to enter, and it is the job of the admission committees to take the best and SUITABLE for their programs. Of course, best students want to work with the best advisors, and if a program/advisor do not get the best students, they need some introspection. Just as in any program MD/PhD graduates will be compared with other peers, and naturally, the program and the advisor they trained under will count when they enter their careers. Of the 80+ MD/PhD programs, there are at least 30 programs that operate for the sake of prestige. Many good students, if they have an alternative, may not even want to do PhD or MD (alone) in these schools. The MD/PhDs may be better than other grad/med students in their respective schools but unlikely to be as good as other MD/PhDs from other schools - mainly due to a lack of sufficient top-notch advisors and/or facilities.

[I am just a dad of a MSTP MD/PhD student, and hence, I research, analyze, and follow posts on this forum and on other sites for at least 5 years. I talk to the classmates and as a non-medical academician and a clinical health care provider, I am particularly interested in PhD, MDs and MD/PhD programs.]
 
I agree, this happens all the time, but I never understood this attitude if you are a dual degree student. How do you expect to graduate quickly if you don't get your a$$ in gear right away?

That's what I meant. I think many dual degree students are more self-motivated to get things done from the very beginning, which is about half the battle. Otherwise, you are facing a very long haul.
 
Alrighty. Seems like I've been misled with some erroneous info. Can anyone else, then, offer up a possible explanation for this sentiment directed at MD/PhD students? It can't be completely untrue if several other posters experienced similar things.

There might be a number of reasons PhD basic science faculty members would be somewhat skirmish at taking the MD/PhD students. To a certain degree, MD/PhD students have a completely different trajectory compared to the PhD only students. They don't "need" high impact journals. The goal of an MD/PhD is to translate high impact science to clinical applications, which in itself is a stated goal of NIH and makes a much better sell to Congress, which is why translational investigators often get millions of dollars without having to publish at all in high impact journals.

For a basic scientist faculty, however, not publishing in high impact journals means not being included in an elite club of investigators who study-section a small pool of grant money, losing your grant, not getting tenured, getting your lab shut down, etc. and all kinds of badness. Most basic science faculty around country now are gunning for the most competitive journals, and having MDPhD students coming in not interested in doing these things at the get-go can be problematic. However, MD/PhDs students have the advantages. First, they fund themselves. Second, they are usually more "together" in terms of efficiency and emotional intelligence. So the tradeoff is something, albeit perhaps not a million bucks (MD/PhD), as opposed to possibly 6 years with no paper at all (PhD). And the best MD/PhD students tend to be the best students, period.

It's a very rare thing for someone in a MSTP to be unable to place himself in a lab if he is willing to do whatever science is available for him to do--i.e. the preposterous scenario where you have a good student, a good fit for the lab, but the only reason he was rejected is because he's MD/PhD, which leads to the student to drop out. The more common scenario is that the student and the advisors in the department that he/she looked into cannot come to a consensus as to what his/her project should be. The breakdown triggers an examination of his/her own goals, which led to a dropout.

Finally, the tension in the academy between clinicians and researchers, especially basic researchers, especially at lower-tier institutions, is at an all time high, which can also potentially explain PhD faculty bitterness. In lower-tier institutions, the salaries of the basic science researchers, compared to MDs primarily working in clinical roles, are so hugely different (we are talking about a 100k salary for a full professor, internationally known, compared to a 300k+ starting junior faculty faculty salary as a specialist in a clinical division). This huge economic difference creates distortions in incentives and various other psycho-sociological problems that should not be underestimated. The PhD faculty might very well not like the MD/PhD student because he/she is utterly envious that even though this said student is "lazy", and "not interested in doing creative science", he/she will be making triple his retirement salary in a decade, and have more respect from society at large, live a very different lifestyle if he wants, and should he choose to take a pay cut and do "translational science", which the faculty member considers scientifically inferior, he/she would have an easier time getting published, getting grants and getting tenured. Something people are afraid to say in public but worth thinking about on SDN.
 
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Of the 80+ MD/PhD programs, there are at least 30 programs that operate for the sake of prestige. Many good students, if they have an alternative, may not even want to do PhD or MD (alone) in these schools.

I disagree that MD/PhD programs in lower tier schools are operating on "prestige". MD/PhD programs even from lower tier schools, for the reasons you've stated, can place into top tier residency programs, which can be a great launching point for a great research or clinical career.

PhD programs from lower tier schools, however, I agree, should be SHUT DOWN completely given the vast overproduction of PhDs in biological sciences we have in the country. PhD training grants should be given out much more sparingly--perhaps altogether eliminated--and researchers should only be allowed to hire time-limited RAs and postdocs. While there are behind the scene incentives that makes this drastic policy change difficult, in terms of advising students and in very general terms, unless there are some other personal and compelling reasons, straight PhD programs in biological sciences after perhaps the top 20 are not worth going into. And most of the US students know this already, which is why most of these PhD programs are filled primarily of international students.
 
I disagree that MD/PhD programs in lower tier schools are operating on "prestige". MD/PhD programs even from lower tier schools, for the reasons you've stated, can place into top tier residency programs, which can be a great launching point for a great research or clinical career.

PhD programs from lower tier schools, however, I agree, should be SHUT DOWN completely given the vast overproduction of PhDs in biological sciences we have in the country. PhD training grants should be given out much more sparingly--perhaps altogether eliminated--and researchers should only be allowed to hire time-limited RAs and postdocs. While there are behind the scene incentives that makes this drastic policy change difficult, in terms of advising students and in very general terms, unless there are some other personal and compelling reasons, straight PhD programs in biological sciences after perhaps the top 20 are not worth going into. And most of the US students know this already, which is why most of these PhD programs are filled primarily of international students.

While that IS a little extreme, I do agree that cutting funding at the back end (RO1) is ******ed- preference should be to cut funding at the front end (training grants). What is the point of continuing to create scientists, but then eliminating their work? Doesn't it make sense to restrict the number of trainees to reduce the amount of competition for the available funds downstream? I would also restrict who could get RO1/K99s. Look, if people are going to lose their jobs, it shouldn't be the people paying into the system their whole lives.
 
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I disagree that MD/PhD programs in lower tier schools are operating on "prestige". MD/PhD programs even from lower tier schools, for the reasons you've stated, can place into top tier residency programs, which can be a great launching point for a great research or clinical career.

PhD programs from lower tier schools, however, I agree, should be SHUT DOWN completely given the vast overproduction of PhDs in biological sciences we have in the country. PhD training grants should be given out much more sparingly--perhaps altogether eliminated--and researchers should only be allowed to hire time-limited RAs and postdocs. While there are behind the scene incentives that makes this drastic policy change difficult, in terms of advising students and in very general terms, unless there are some other personal and compelling reasons, straight PhD programs in biological sciences after perhaps the top 20 are not worth going into. And most of the US students know this already, which is why most of these PhD programs are filled primarily of international students.

I can't believe you just wrote something so closed-minded.
 
I can't believe you just wrote something so closed-minded.

Well, that's not really closed-minded. In fact, it's the exactly the opposite. It's a pretty radical solution to what is a real problem (greater production of PhDs than there are job spots for them). Closed minded would be saying, "Let's just keep things the same way even though it doesn't really work very well."

Perhaps you meant that it's elitist? In that case, if you do need to drastically reduce the number of PhD students (say by half or more), then how do you do it?
 
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Well, that's not really closed-minded. In fact, it's the exactly the opposite. It's a pretty radical solution to what is a real problem (greater production of PhDs than there are job spots for them). Closed minded would be saying, "Let's just keep things the same way even though it doesn't really work very well."

Perhaps you meant that it's elitist? In that case, if you do need to drastically reduce the number of PhD students (say by half or more), then how do you do it?

Okay, I see your point. I guess "elitest" is a better word, but there's an element of closed-mindedness: he's suggesting that people who obtain PhD's from "lower ranked" institution have very little to contribute -- is that really the case?? Great research is being done at many of these universities. The number of PhD's is deemed excessive only because there is a shortage of funding, which is the real problem. I agree that we should explore radical options, but we should target the heart of the problem, not its symptoms.
 
Okay, I see your point. I guess "elitest" is a better word, but there's an element of closed-mindedness: he's suggesting that people who obtain PhD's from "lower ranked" institution have very little to contribute -- is that really the case?? Great research is being done at many of these universities. The number of PhD's is deemed excessive only because there is a shortage of funding, which is the real problem. I agree that we should explore radical options, but we should target the heart of the problem, not its symptoms.

Is funding shortage really the real problem? Does society really need to churn out thousands of PhDs every year? I know that we, in science, love to complain about funding (and probably rightfully so as of 2014), but the problem of long/infinite-length post-docs didn't just start with sequestration, did it? It's sort of analogous to the glut of people graduating from Podunk State University Polytechnic Institute of Agriculture and Artistic Endeavors. Universities (in both cases) are receiving disproportionate benefit (in the case of PhDs, for basically free labor, and in the BS/BA case exorbitant tuition) for no guarantee, or even hint of a guarantee of job prospects.

Science is awesome, and it's a driver of innovation/technology-based economy, I just wonder if we're saturating the job market, regardless of federal funding. Isn't there also a huge backlog of PhDs in pharma/tech industries as well? If the issue were in fed funding for research, seems like people would still be finding great jobs in related private corporations, but I don't think that that's the case...is it? I honestly don't know, but I was under the impression that pharma has post-docs coming out the ears.
 
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One of my colleagues is in a NIH sponsored MSTP program in Texas right now, and he said he also experienced stereotyping when choosing a research group. I am aware that people do not like to talk about stuff like this in general because it's depressing. However, it does not mean the issue doesn't exist. I am afraid a vast majority of MSTP applicants are probably not aware of this.

People do not like to talk about stuff like this in person because it's a very sensitive, touchy subject, especially for faculty. However, when the budget is tight, tough decisions will be made.

Whoa, WHAT?? I just actually read the beginning of this thread, and being an MD/PhD student at "a NIH-sponsored MSTP program in Texas" (i.e. UTSW), there is absolutely NO stereotyping (in my experience) in choosing a research group. I have been literally RECRUITED by PIs to come join their lab, because the MD/PhDs at this school are highly valued. Of course, I am N = 1, but in my experience this is patently false.

This is a common experience among others at my institution as well, who have been aggressively pursued by very prominent scientists (NAS, HHMI, etc), so I'm sure it's not only me.
 
There are two MSTP funded programs in Texas (BCM and UT-SW) and several MD/PhD programs in Texas have NIH pre-doctoral T32 slots (from Discipline training grants or from the CTSA) as well as NIH sponsored F-30 (individual MD/PhD) training grants.
 
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There are two MSTP funded programs in Texas (BCM and UT-SW) and several MD/PhD programs in Texas have NIH pre-doctoral T32 slots (from Discipline training grants or from the CTSA) as well as NIH sponsored F-30 (individual MD/PhD) training grants.

Yes, I just realized my mistake! :0
 
Is funding shortage really the real problem? Does society really need to churn out thousands of PhDs every year?

The answer is no and no. The funding shortage contributes to the problem, but despite record high funding levels in the early 2000s this was still a problem. There is a problem with the supply chain of PhDs being shaped like a pyramid. There are tons of graduate student positions and many postdoc postions, but relatively few professor positions at academic institutions (with assistant > associate > full professor). There may be 3-5 (or more) PhD graduates for each academic position that is opening up. The rest end up taking positions in industry, consulting, banking, whatever, which then becomes saturated.

It probably needs to be more like medicine, where the number of resident spots, fellow spots, and attending spots (academia + private practice) is much closer to the same.

Anyway, this is pretty far off from the original topic of stereotyping of MD/PhD students, which more and more people are posting doesn't seem to be a problem.
 
[I am just a dad of a MSTP MD/PhD student, and hence, I research, analyze, and follow posts on this forum and on other sites for at least 5 years. I talk to the classmates and as a non-medical academician and a clinical health care provider, I am particularly interested in PhD, MDs and MD/PhD programs.]

I am glad that your persective is thrown into the message board. As a dad of a kid who is finishing a very expensive finance undergraduate degree, I did the same for his field. I was relieved when he landed a "big" job that gives me hope for realistically taking him out of my payroll within a couple of years. Return on investment is an issue that all of us care.
 
You brought some points that are not considered often by applicants. Yes, expenses are an important part of one's calculations - but not always. I was fortunate not to spend much on this MD/PhD kid but spend(ing) even more on the other one. People (even the MD/PhDs) dont think thro everything as they have not walked the complete path yet. From what I have observed on completion and drop-out rates, my (hidden) worries all the time are whether the interest will be sustained throughout the program and how productive the research will be (what is the definition here???), and what lies ahead after the MD/Program. Also, as a dad what about personal life. There are instances (most of the time) that we both differ on PhD length, # and quality of papers (journals-impact index/H-index, etc..), interactions with advisors (or how to pick the "appropriate" one). Unfortunately, the world still lives to some extent by perceptions. One should remember that the MD/PhDs are compared with other MD/PhD graduates after 10 years when it comes to achievement and performance (School, advisor, and PhD problems are therefore very important.) These are all factors that an MD/PhD applicant should consider, and consult with those well informed (and in the field). There is nothing worse than wasting 3 or 4 years of one's life before realizing a big mistake. In my view, it is a financial mistake to do MD/PhD bcz of the free MD (which is the objective of many that I have come across.).

I think I have already said too much for an outsider.
 
OK, back to the topic, I agree with uniquenam that the OP's statement about bias against MSTPs is preposterous and that it's mostly exactly the opposite. We may also come at a discount (for us, the PI eventually picks up the tab once you pass the qualifying exam), but we were the best grad students. There is no need to sugar coat it- we were. MSTPers are like the top 5% of medical school applicants- a very stringent process that rewards those who are very hard working and never make mistakes. You basically only need a pulse to get into a PhD program. OK, that may be unfair but the differences in performance between the two is pretty clear- thus most PIs fight over us. Yes, a PhD-only CAN be very hard working and successful- but usually are relatively lazy and non-productive compared to their MSTP counterparts. I was in lab 12-15 hours a day and in on weekends. While writing my dissertation it was 18 hr days. My PhD-only friends were much more relaxed and often took very long vacations. The time to graduation for MSTPs (for the PhD) was like 4-5 years and over 6 for PhD-only's. That had very little to do with any other factor.
 
Some data: The AAMC data supports a median of 8 years (average was reported yesterday at 8.40 for a cohort from 1997-2003) of training for graduates who were MD/PhD matriculants. My program currently has 7.91 average (7-9 years with ~30% of my students doing their PhD in 3 years; PhD component = 3.91). In contrast, our graduate school has an average of 6 years for their PhD students (5.5 if you add our MD/PhD students). In Texas, our regulanting accrediation agency (THECB), requires a minimum of 72 credits (3 years) for awarding a PhD degree.

It is also clear that, on average, MD/PhD students have considerable higher academic metrics obtained pre-matriculation than PhD students.
 
the statement to abolish all programs at lower-tier institutions is extremely elitist. You're basically saying a PhD from anywhere other than HYPSM is useless.

You (and others) should read what I said more carefully. I chose my words extremely carefully. I did not say that a PhD student from a non-top-20 school is "useless", or that their scientific work is less worthy. What I said is, read again, "in terms of advising students and in very general terms, unless there are some other personal and compelling reasons, straight PhD programs in biological sciences after perhaps the top 20 are not worth going into."

Why? Because your chance of continuing to conduct meaningful research in the long run as an independently funded investigator is very low after graduating from such a program. Perhaps you are 100% okay with that, and you just want to "experience science." Perhaps you have geographical limitations. Perhaps your grades are not good enough for the top 20. There might be "compelling and personal reasons." Nevertheless, these programs will not, generally speaking, provide you with a very solid foundation for a successful career in basic biomedical research. So therefore they are "not worth going into"--i.e. they are not what they are advertised. They are pyramid schemes. If your grades are substandard and there are other issues in your application, and you want a career in research, your best shot is to wait and build up your resume some other way until you can get into a top 20 program.

MD/PhD programs (especially the NIH MSTPs) are a different ball game. If you can get into ANY of them, you have a DECENT chance at building a successful research career, perhaps somewhat slowly and circuitously. You have a fantastic shot at making a lot of money and having a extremely stable career as a pure clinician. Really you are "dually trained" for a job that's basically completely different.

This advice is based on years of observation, personal experience, and intuition. Feel free to disregard it as a personal opinion, but it's not coming out of a place of elitism but one of practicality.
 
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A few points

First, I completely agree with sluox that we have way too many PhDs and way too many people in graduate training. I think this is partly because the PhD, like all other degrees, is becoming devalued. Perhaps it's more like an MS^2? In other words, we've seen the PhD for too long as a track to leadership and intellectual oversight in academia and industry, whereas it may really only mean that you've shown you can perform some experiments successfully, write up a few papers, and present the research to the scientific community? I think the degree to which a student does those things autonomously - and the degree to which his research is a reflection of his own ideas and inspiration rather than that of others - is highly variable. It depends on the PI, and in many labs there's a lot of micromanagement, whether directly from the PI, or from an army of post-docs (in the big labs with PIs that have tons of money and travel constantly).

I mean, I really don't think a PhD means that much. And that's why we find so many people doing long post-docs and multiple post-docs. Much of this grief could be overcome if applicants and graduate students were told from the start that their dream of being a PI was a distant one and an unlikely one, and they should be given advising about other career paths a PhD can open, like teaching in colleges or elite high schools, working for the government, working for industry, etc.

Second, our approach to science is that it can be a large scale industry or enterprise that can be assembly-lined, streamlined, what you will so that we "produce" science. We even bandy about terms like "productivity" - rather than BRILLIANCE or CREATIVITY or INVENTIVENESS. When I think of the great scientists and inventors, I think of Newton and Maxwell, Tesla and Jenner, Pasteur and Pauling (you get the picture). I don't think of them as productive. Prolific maybe, but I think of them as brilliant. I measure their importance through the impact of their work years, decades, even centuries after they lived. Today, instead, we talk about how Professor X is very productive and has published 12 papers this year in PNAS, Nature, Cell, and other top publications. We have allowed the publication and the quantitative aspects surrounding it (i.e. % accepted, how often cited, and the perverse quantity known as "impact factor") to determine the quality of someone's work, rather than letting those who do the work demonstrate its quality by virtue of its internal consistency, testable predictions, utility to humanity, and so forth. And that can only be shown

Third, we cannot and should not democratize science. We keep talking about selling science to the public. Not to be disdainful, but much of science is not comprehensible by the public. We shouldn't dumb it down to sell it, nor should we lie and inflate the promises of science to a credulous population. I think most of us bio PhDs would struggle a lot with understanding quite a few chemistry papers, not to mention physics or mathematics papers (assuming we didn't have training in those fields). Who are we - or Mrs. Smith - to decide what physics problem Dr. Z should study? And, indeed, what exactly has Dr. Z done to merit Mrs. Smith being taxed to fund his research?

Perhaps what we should do instead is facilitate the training of a limited number of very talented and brilliant students (I wouldn't necessarily include myself, just so we get that out of the way) in laboratories of people who have actually *done* stuff (like crystallized insulin or characterized the DNA helix, etc.). These people, once trained, are free to go from lab to lab of other senior scientists until they make their own "break" (much like an actor or a writer). After that, we fund their own lab and set them to doing what intrigues them and to studying something of their own choosing. The questions they ask will be brilliant - no doubt - and the answers they produce will be equally so, and unaffected by pressures of publishing for publishing's sake, pressures of getting tenure and funding via publishing, pressures of conforming to the interests, wishes, and mandates of bureaucrats and grant review committees.

I am certain that the Science made would be just as good, even better, the cost would be less, the broken promises would be fewer, and the garbage that litters the journal articles of today (I am sure half falsified, fabricated, and unreproducible - let's be honest) would be gone.
 
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A few points

First, I completely agree with sluox that we have way too many PhDs and way too many people in graduate training. I think this is partly because the PhD, like all other degrees, is becoming devalued. Perhaps it's more like an MS^2? In other words, we've seen the PhD for too long as a track to leadership and intellectual oversight in academia and industry, whereas it may really only mean that you've shown you can perform some experiments successfully, write up a few papers, and present the research to the scientific community? I think the degree to which a student does those things autonomously - and the degree to which his research is a reflection of his own ideas and inspiration rather than that of others - is highly variable. It depends on the PI, and in many labs there's a lot of micromanagement, whether directly from the PI, or from an army of post-docs (in the big labs with PIs that have tons of money and travel constantly).

I mean, I really don't think a PhD means that much. And that's why we find so many people doing long post-docs and multiple post-docs. Much of this grief could be overcome if applicants and graduate students were told from the start that their dream of being a PI was a distant one and an unlikely one, and they should be given advising about other career paths a PhD can open, like teaching in colleges or elite high schools, working for the government, working for industry, etc.

Second, our approach to science is that it can be a large scale industry or enterprise that can be assembly-lined, streamlined, what you will so that we "produce" science. We even bandy about terms like "productivity" - rather than BRILLIANCE or CREATIVITY or INVENTIVENESS. When I think of the great scientists and inventors, I think of Newton and Maxwell, Tesla and Jenner, Pasteur and Pauling (you get the picture). I don't think of them as productive. Prolific maybe, but I think of them as brilliant. I measure their importance through the impact of their work years, decades, even centuries after they lived. Today, instead, we talk about how Professor X is very productive and has published 12 papers this year in PNAS, Nature, Cell, and other top publications. We have allowed the publication and the quantitative aspects surrounding it (i.e. % accepted, how often cited, and the perverse quantity known as "impact factor") to determine the quality of someone's work, rather than letting those who do the work demonstrate its quality by virtue of its internal consistency, testable predictions, utility to humanity, and so forth. And that can only be shown

Third, we cannot and should not democratize science. We keep talking about selling science to the public. Not to be disdainful, but much of science is not comprehensible by the public. We shouldn't dumb it down to sell it, nor should we lie and inflate the promises of science to a credulous population. I think most of us bio PhDs would struggle a lot with understanding quite a few chemistry papers, not to mention physics or mathematics papers (assuming we didn't have training in those fields). Who are we - or Mrs. Smith - to decide what physics problem Dr. Z should study? And, indeed, what exactly has Dr. Z done to merit Mrs. Smith being taxed to fund his research?

Perhaps what we should do instead is facilitate the training of a limited number of very talented and brilliant students (I wouldn't necessarily include myself, just so we get that out of the way) in laboratories of people who have actually *done* stuff (like crystallized insulin or characterized the DNA helix, etc.). These people, once trained, are free to go from lab to lab of other senior scientists until they make their own "break" (much like an actor or a writer). After that, we fund their own lab and set them to doing what intrigues them and to studying something of their own choosing. The questions they ask will be brilliant - no doubt - and the answers they produce will be equally so, and unaffected by pressures of publishing for publishing's sake, pressures of getting tenure and funding via publishing, pressures of conforming to the interests, wishes, and mandates of bureaucrats and grant review committees.

I am certain that the Science made would be just as good, even better, the cost would be less, the broken promises would be fewer, and the garbage that litters the journal articles of today (I am sure half falsified, fabricated, and unreproducible - let's be honest) would be gone.

Heard of the The Institute for Advanced Study in Princeton, NJ? (http://en.wikipedia.org/wiki/Institute_for_Advanced_Study). They pretty much fund geniuses for life and provide them space for whatever they want to do.
 
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I agree with several of the points you made Mercaptovizadeh, however, I do not agree with the following:

I mean, I really don't think a PhD means that much.

Whoa. I do agree with you that PhD's are becoming devalued, but getting a PhD is 100x harder than getting an MD, in my opinion. MS1, MS2 is a glorified college curriculum where you take some tests at the end of every block. MS3 and MS4, you literally just need to show up. It's cookie cutter and all planned out for you, you just have to get out of bed and follow your schedule. I know I'm describing an average medical student here, not an excellent one. However, navigating a PhD is so much more complicated than that, and takes a mature individual who can think critically and intellectually about the pieces he/she has to find a story, especially if you don't have a micro-managing PI behind you to do the sleuthing for you. It's hard, and I love it. I certainly have more respect for graduate students now than I did before entering this program.

And that's why we find so many people doing long post-docs and multiple post-docs.

Aren't residents in various specialities now doing multiple fellowships as well to become super sub-specialized in their area of interest because this is what the job market requires? Does this mean that an MD is also worthless because you have to work a bit harder to be excellent at what you do?

Perhaps what we should do instead is facilitate the training of a limited number of very talented and brilliant students (I wouldn't necessarily include myself, just so we get that out of the way) in laboratories of people who have actually *done* stuff (like crystallized insulin or characterized the DNA helix, etc.). These people, once trained, are free to go from lab to lab of other senior scientists until they make their own "break" (much like an actor or a writer). After that, we fund their own lab and set them to doing what intrigues them and to studying something of their own choosing. The questions they ask will be brilliant - no doubt - and the answers they produce will be equally so, and unaffected by pressures of publishing for publishing's sake, pressures of getting tenure and funding via publishing, pressures of conforming to the interests, wishes, and mandates of bureaucrats and grant review committees.

This is an interesting thought. However, you can't tell me that every brilliant scientific idea came out of the top labs in the country, so training a limited number of people at a handful of institutions will severely limit the creative flow of ideas in the scientific community. I also completely disagree in only training graduate students in "big wig" labs. These are the labs where the PI is never available, and therefore not mentoring, or the lab is full of Post-docs so the student never gets the opportunity to think for themselves. You reference this exact scenario in your post:
In other words, we've seen the PhD for too long as a track to leadership and intellectual oversight in academia and industry, whereas it may really only mean that you've shown you can perform some experiments successfully, write up a few papers, and present the research to the scientific community? I think the degree to which a student does those things autonomously - and the degree to which his research is a reflection of his own ideas and inspiration rather than that of others - is highly variable. It depends on the PI, and in many labs there's a lot of micromanagement, whether directly from the PI, or from an army of post-docs (in the big labs with PIs that have tons of money and travel constantly).

The questions they ask will be brilliant - no doubt - and the answers they produce will be equally so, and unaffected by pressures of publishing for publishing's sake, pressures of getting tenure and funding via publishing, pressures of conforming to the interests, wishes, and mandates of bureaucrats and grant review committees.

I definitely agree that the scientific process is hindered by these sorts of pressures, but we are a long way away from breaking free of this structure completely. We can't just close the door to those 80% of students who genuinely want to do research.
 
Whoa. I do agree with you that PhD's are becoming devalued, but getting a PhD is 100x harder than getting an MD, in my opinion. MS1, MS2 is a glorified college curriculum where you take some tests at the end of every block. MS3 and MS4, you literally just need to show up. It's cookie cutter and all planned out for you, you just have to get out of bed and follow your schedule. I know I'm describing an average medical student here, not an excellent one. However, navigating a PhD is so much more complicated than that, and takes a mature individual who can think critically and intellectually about the pieces he/she has to find a story, especially if you don't have a micro-managing PI behind you to do the sleuthing for you. It's hard, and I love it. I certainly have more respect for graduate students now than I did before entering this program.

PhDs really don't mean much. Maybe in lay-culture they do, but in academia they are a dime-a-hundred. Acquiring a PhD doesn't set you apart from the 10s of thousands of others who have also acquired one, because the RIGOR of each PhD is extremely variable, even from the same institution/department. I know of one PhD that is set to graduate without publishing a paper! Compare that to another PhD who has published multiple C/N/S papers...but you can't tell the difference, because they both "have a doctorate". A PhD is not proof of a rigorous education, for a variety of reasons.

Aren't residents in various specialities now doing multiple fellowships as well to become super sub-specialized in their area of interest because this is what the job market requires? Does this mean that an MD is also worthless because you have to work a bit harder to be excellent at what you do?

I'm not a resident/attending yet, but I don't think that this is a good analogy for a few reasons. You can practice medicine after a residency, and have a very very high likelihood of acquiring a job; you have a very very low likelihood of acquiring a "real" job after a typical post-doc. Specializations are nice, but they're not required to do what you've been trained to do, whereas it's becoming the norm to have multiple/"extended" post-docs before you can actually set out on your own.

This is an interesting thought. However, you can't tell me that every brilliant scientific idea came out of the top labs in the country, so training a limited number of people at a handful of institutions will severely limit the creative flow of ideas in the scientific community. I also completely disagree in only training graduate students in "big wig" labs. These are the labs where the PI is never available, and therefore not mentoring, or the lab is full of Post-docs so the student never gets the opportunity to think for themselves. You reference this exact scenario in your post:

Actually, you sort of can say that most brilliant scientific ideas come out of the top labs, by way of mentorship trees. Have you ever seen one of those nifty Nobel laureate "family trees"? My point is that there's some strange phenomenon where very smart people are able to generate a lot of successful former students/associates. Of course, this isn't to say that only these labs produce the big breakthroughs, but I don't think that by and large it's a terrible thing to suggest. Also, the characterization that you can't get excellent mentorship from a PI in a huge lab is false. One of my fellow MD/PhD students worked in a humongous lab (like, more than 40 full-time people), and had a semi-normal amount of interaction with the PI. The major difference is that you learn techniques/methods from a post-doc, and only talk the theory of science and maybe a small sliver of logistics with the PI.
 
I'm not a resident/attending yet, but I don't think that this is a good analogy for a few reasons. You can practice medicine after a residency, and have a very very high likelihood of acquiring a job; you have a very very low likelihood of acquiring a "real" job after a typical post-doc. Specializations are nice, but they're not required to do what you've been trained to do, whereas it's becoming the norm to have multiple/"extended" post-docs before you can actually set out on your own.

I think you should take a look at some of the MD specific forums on SDN before you offer up this rebuttal. I don't want to get into this issue here because it would be off-topic, but many residents are also complaining that their fields are becoming saturated with new grads.

Have you ever seen one of those nifty Nobel laureate "family trees"?

Again, Nobel Laureates are not the only ones to contribute to scientific progress seeing as how very few are given out. So you're saying that all of the graduate students in the country should be trained in the handful of Nobel Laureate labs out there? I don't think so.

I know of one PhD that is set to graduate without publishing a paper!

I already addressed this situation earlier in this thread. Except the student set to graduate without publishing was an MD/PhD student, and I know my institution is not the only one to do this. So that would argue against your point that PhD degrees are less rigorous and, therefore, a dime-a-d0zen, when actually, the PhD in a dual degree student's case might be more phony. PhD's are way more valuable (in the biomedical fields) than you all are giving them credit for. I've seen quite a few MD-only PI's at my institution and they would never get any meaningful research done without a team of skilled PhD's. I know I'm playing devil's advocate in arguing many of the points being made, but this entire thread just kind of exudes elitism (even if you don't intend it to). I mean, come on guys.
 
Whoa. I do agree with you that PhD's are becoming devalued, but getting a PhD is 100x harder than getting an MD, in my opinion. MS1, MS2 is a glorified college curriculum where you take some tests at the end of every block. MS3 and MS4, you literally just need to show up. It's cookie cutter and all planned out for you, you just have to get out of bed and follow your schedule. I know I'm describing an average medical student here, not an excellent one. However, navigating a PhD is so much more complicated than that, and takes a mature individual who can think critically and intellectually about the pieces he/she has to find a story, especially if you don't have a micro-managing PI behind you to do the sleuthing for you. It's hard, and I love it. I certainly have more respect for graduate students now than I did before entering this program.

Getting a PhD is not 100X harder than an MD. As someone who is nearly at the end of the MD and already did my PhD (admittedly, I don't very highly of it), I can say the PhD was probably equally hard as the MD. It's frontloaded-hard, while you're mucking about waiting for a break that will let you run with the experiments. The MD is more evenly difficult. And if you want to do well - which everyone should - it is arguably harder than most of the PhD. Then again, I didn't exactly do the 80+ hr workweeks that gbwillner did, so he may think differently.

Again, it's a matter of personality. I much prefer being on my own in the lab, doing my thing. I hate clinical medicine (but will have to do it, of course), which causes me anxiety to no end.

Aren't residents in various specialities now doing multiple fellowships as well to become super sub-specialized in their area of interest because this is what the job market requires? Does this mean that an MD is also worthless because you have to work a bit harder to be excellent at what you do?

They're doing that for better income/opportunities. Even without fellowships they can still be very well paid doing a different sort of career (generalist vs specialist or specialist vs. subspecialist, etc). Once you're done with residency, you should be guaranteed a 100K+ job. You should be competently trained for that job.

There's no such thing with the PhD-scientist track. You could muck through 3 postdocs and still not have a faculty job. You could be a perpetual postdoc. You could end up flying off to industry and working as a cog in the machine. People are doing these multiple postdocs not because they are not specialized and competent enough from just one postdoc. I expect they are doing it because they're basically waiting to accumulate enough papers, develop enough connections, and wait out until enough faculty at the university tier of their choice are retired in order to try to slide into that spot. Most never make it.

This is an interesting thought. However, you can't tell me that every brilliant scientific idea came out of the top labs in the country, so training a limited number of people at a handful of institutions will severely limit the creative flow of ideas in the scientific community. I also completely disagree in only training graduate students in "big wig" labs. These are the labs where the PI is never available, and therefore not mentoring, or the lab is full of Post-docs so the student never gets the opportunity to think for themselves. You reference this exact scenario in your post:

I definitely agree that the scientific process is hindered by these sorts of pressures, but we are a long way away from breaking free of this structure completely. We can't just close the door to those 80% of students who genuinely want to do research.

I agree that every brilliant scientific didn't come out of the top labs in the country, but a great majority do. I don't think we should have so many PhD students in the first place, nor do I think the PhD should be so easy to attain. Perhaps we should go to a more tiered system like they had in Russia. PhD = Kandidat Nauk (Candidate in Science). Getting a Doktor Nauk (Doctorate) requires many years or even decades of excellence in a field of study. Quite simply, we are awarding these honors too easily and too frequently. I will be the first to note that the criteria for my PhD were crap. We had a bunch of journal club BS seminars and a handful of biology courses. We didn't have a rigorous pre-research curriculum taking the biological sciences graduate student through the scope of neurobiology, cell biology, biochemistry, immunobiology, animal/human anatomy and physiology, microbiology and virology, genetics, etc. as well as methods courses in proteomics, genomics, molecular biology, biochemical methods, imaging and microscopy, etc.

Why don't we go back to rigorous graduate school entrance exams, where questions test extensive knowledge in biology (or chemistry, or physics, or whatever the field of choice)? Why don't we go back to open ended exam questions that test hypothesis design and asking students to come up with good scientific questions based on given scenarios, and knowledge of techniques to answer these questions? Instead, we have crappy standards where exams are regurgitative, the graduate student's independence is incredibly variable (between operating at post-doc level early on to plodding along under the PIs/postdoc army micromanagement, etc.).

The "structure" as you put it, was nonexistent as such for centuries. We had gentleman scientists, people who got to university positions as lecturers and researchers through their brilliance (rather than training program this and research program that), people who worked in industry, made some money and opened labs of their own, people who were funded by the benefactors/patronage of the aristocracy and industry.

All these modern academic funding mechanisms have perverted the structure of science. Instead of the university hiring someone and funding him for a time to do the research that he wants to do, we hire them (after multiple postdocs) into some limbo called tenure track, where their excellence is determined by their peers, who will determine what papers they have the right to publish and indeed what research they have the right to conduct; if the research is not interesting to the grant review committees, they get no grant. No grant, no tenure. No tenure, and they're out to work in teaching or as a cog in industry.

This is ideas by democracy. The good ideas are the ones committees and politicians think are good. Those are the ones that will get the money and the support. Who ever said democracy was a good thing for ideas? What scientific theory has come to fruition through a democratic process? If I remember correctly, most theories were invented by one person, by a handful of people, or were cobbled together by different scientists working on different parts of the patchwork (QM being the quintessential example). Theories were fiercely debated amongst competitors. I don't know of any theory that was proposed by a committee. I don't know any that arose out of a consensus of people gathered at a conference. Why would a committee be any better at determining what ideas should be tested? Why would one's competitors (who have a horrific bias) have the right to determine what and where we publish?
 
I think you should take a look at some of the MD specific forums on SDN before you offer up this rebuttal. I don't want to get into this issue here because it would be off-topic, but many residents are also complaining that their fields are becoming saturated with new grads.



Again, Nobel Laureates are not the only ones to contribute to scientific progress seeing as how very few are given out. So you're saying that all of the graduate students in the country should be trained in the handful of Nobel Laureate labs out there? I don't think so.



I already addressed this situation earlier in this thread. Except the student set to graduate without publishing was an MD/PhD student, and I know my institution is not the only one to do this. So that would argue against your point that PhD degrees are less rigorous and, therefore, a dime-a-d0zen, when actually, the PhD in a dual degree student's case might be more phony. PhD's are way more valuable (in the biomedical fields) than you all are giving them credit for. I've seen quite a few MD-only PI's at my institution and they would never get any meaningful research done without a team of skilled PhD's. I know I'm playing devil's advocate in arguing many of the points being made, but this entire thread just kind of exudes elitism (even if you don't intend it to). I mean, come on guys.

By and large, I think we can agree that the MD and residency training is becoming more and more uniform. We're using the same books (Netter's, Robbins and Cotran's, Guyton's, etc.), the same resources (UpToDate, Harrison's, Nelson's, Sabiston's, etc.), and the quality of our training is determined largely by the profile of patients treated at the hospitals and what we as residents put into it (i.e. how much we actually read and prepare). This is a world of difference from the PhD, where the pre-research curriculum is extremely variable, the qualifying/comprehensive exam is highly variable (some have grant applications, others have a series of written exams, some have oral examinations), and the rigors of the research itself are determined by a small committee of faculty. I will right away admit that I tried to get as easy of a committee as I could, because I didn't want some crazy barrier to getting out of PhD land in 4-5 years (you see, MD/PhDs always have these time pressures).

What about the project? Some people have a smattering of hellish/crappy projects which all fail, despite incredible effort. They're allowed to graduate with no/few papers of lower quality. Was their training really inferior, though? Was the troubleshooting they did and the breadth of techniques they acquired in their peripatetic journey from failed project to failed project really so fruitless? And yet we consider them "the bad students" whom we may mention under our breath. Someone else, who got a pre-packaged project based on massive preliminary data from a prior postdoc or graduate student can tie that all up with their own low-hanging fruit research to publish several papers in nice journals. They did a limited set of techniques, maybe even just a few which they repeated over and over, but because of their several papers, they're "the good students." How exactly does that work? How do we evaluate quality?

My own example: my MS research which lasted 1.5 years produced 6 papers, 2 first author and a 3rd co-first author. I used basically 3 techniques, 2 which covered 2 papers (mathematical modeling and animal studies), the third (electrophysiology) which accounted (almost entirely) for the remaining 4 papers. Plug and chug. My PhD work produced 4 papers, 2 first author (one of them just recently published). A large part of my work is still unpublished (hopefully in a third paper before I start residency). The wide variety of techniques I learned during my PhD work (whether biochemistry techniques like BN-PAGE and FPLC and protein purification and ligand binding studies; molecular bio/analytical techniques like WB and qRT-PCR, ELISA, histologic stains, IHC/IF, subcloning and flow cytometry; more specialized microscopy such as confocal, electron microscopy, autoradiographic microscopy; and animals models of disease including BM chimeras, adoptive transfer, live animal physiology experiments, biodistribution and clearance experiments, etc.) went WAY, WAY beyond the scope of my MS. Yet someone just looking at papers produced and impact factors would have very little notion of this. That is part of the problem we have with how we attempt to quantify something that is really much more subtle and qualitative.
 
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By and large, I think we can agree that the MD and residency training is becoming more and more uniform. We're using the same books (Netter's, Robbins and Cotran's, Guyton's, etc.), the same resources (UpToDate, Harrison's, Nelson's, Sabiston's, etc.), and the quality of our training is determined largely by the profile of patients treated at the hospitals and what we as residents put into it (i.e. how much we actually read and prepare). ...

At residency, and particularly at fellowship level, mentoring by a small group of professors (similar to PhD committee) still plays a major role. Not only because of the school of thought of the fellowship/supervising professor. Keep in mind that the actual body of knowledge with high evidence based medicine, once you are deep in the specialty, is quite limited. At MD level, true; at PGY 1-2, ok; at PGY 3-4, maybe; at PGY 5 or higher, no.
 
Getting a PhD is not 100X harder than an MD

Had a long conversation with some people about this recently (I just finished my PhD). I came to this conclusion, would be interested in everyone's insight:

To do 'average' in a PhD program (graduate in 5 years, 1 field-level first author publication) is easier than to do 'average' in medical school (mostly Passes/high passes, 22o step 1). However to do great in a PhD program (graduate in 4yrs or less, multiple first author pubs in prestigious journals, awards, etc) is harder than to do 'average' in medical school. Great in medical school and great in PhD are probably about equally hard but with different qualities required to be great (PhD = 'creativity' and navigating lots of unknowns, MD = studying all the time, quick intellect, good with people).
 
Had a long conversation with some people about this recently (I just finished my PhD). I came to this conclusion, would be interested in everyone's insight:

To do 'average' in a PhD program (graduate in 5 years, 1 field-level first author publication) is easier than to do 'average' in medical school (mostly Passes/high passes, 22o step 1). However to do great in a PhD program (graduate in 4yrs or less, multiple first author pubs in prestigious journals, awards, etc) is harder than to do 'average' in medical school. Great in medical school and great in PhD are probably about equally hard but with different qualities required to be great (PhD = 'creativity' and navigating lots of unknowns, MD = studying all the time, quick intellect, good with people).

Also, for MD the School/Program is important, whereas for a PhD, the Adviser plays a more important role. An accomplished, great Advisor stays adviser for life and helps one to establish and flourish over the next 10 years. Such advisers insist on quality work and publish in reputed Journals (they are careful about protecting their reputation). It takes real hard work and creativity to impress such advisers. Numbers matter, but quality matters even more.
 
Had a long conversation with some people about this recently (I just finished my PhD). I came to this conclusion, would be interested in everyone's insight:

To do 'average' in a PhD program (graduate in 5 years, 1 field-level first author publication) is easier than to do 'average' in medical school (mostly Passes/high passes, 22o step 1). However to do great in a PhD program (graduate in 4yrs or less, multiple first author pubs in prestigious journals, awards, etc) is harder than to do 'average' in medical school. Great in medical school and great in PhD are probably about equally hard but with different qualities required to be great (PhD = 'creativity' and navigating lots of unknowns, MD = studying all the time, quick intellect, good with people).

These kinds of arguments are silly to me since the PhD and MD test different parts of your brain.

MD is more "book smarts" a a PhD is more "street smarts." If you put the time in and are really good at remembering lots and lots of seemingly trivial factoids, you will do well in med school. If you suck at memorizing random facts, med school will be very, very difficult for you. If you find that easy, med school will be a breeze, and the difficulty and time will come in putting it all together in approaching patient care in the 3rd and 4th years.

The PhD requires you to memorize relatively little outside your immediate area of expertise. The difficulty comes in thinking outside the box, approaching problems and tackling them- problems that no one ever before you have solved. MD problems are solved by looking up the answers in a book- there they all are. The PhD difficulty is in technical work and problem solving. If you are more artistic and self-motivated, the PhD can be relatively straight forward and enjoyable. If you need everything to be explained to you the PhD is rigorous and painful.

The SELECTION criteria for the MD, by virtue of it's desirability, is MUCH, MUCH stricter than for the PhD. Thus, in general the average MD student if far more capable than the PhD student. However, this is not universal by any means- there are incredibly brilliant PhD students and incredibly daft MD ones. It is also incredibly variable by institution. I've been fortunate to be around top-tier institutions, and the PhD students there are amazing. I've also seen middle/lower tier programs where the students are basically given a PhD once they put in the time with little regard for quality.
 
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If you put the time in and are really good at remembering lots and lots of seemingly trivial factoids, you will do well in med school.

Performance on clinical rotations appears to be more contingent on certain other "soft" skills, such as being able to show enthusiasm and detail-orientedness.

Performance in PhD (and beyond) is essentially tied to mentors with the most proven past track record of producing high-profile researchers (i.e. pedigree). However, for the MOST part, such track record is either not available or not very good, even though I would say most mentors are still decent. So it becomes more of a guessing game. This is a more of a product of the intrinsic risky nature of PhD training.
 
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