6 year long MD/PhD vs. 7/8 yrs

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karbouzie

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Some schools say students can get their MD/PhD in 6 yrs cuz 4th year of med school can be omitted and its optional. How would this affect the student' s clinical work? what does the student miss from 4th yr? How different will I be as a physician from other students who completed their 4th yr? and what negative impact will this have on my residency?

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A common criticism is that the "MD/PhD is not a real PhD", yet nobody ever says it's not a "real MD". This is strange because only the MD is abbreviated here, not the PhD.

Anyways, I don't look at it as missing essential clinical training rather than missing time to relax and electives in what you want you want to do. While as an MD/PhD you're still going to be a top pick for many residencies, you may not get time to do an away rotation which could hurt you in more competitive things. You also need to know for sure what you want to do residency in as soon as you're done your clinical rotations. You don't get a few rotations to decide, as many MD students do, and you may never get exposed to a number of specialties you don't get in your core clerkships that you might be interested in. I think time pressure to decide and lack of exposure to other things may be reasons so many grads go into IM or peds from MD/PhD programs, but I digress. The joke in medical school is that you never see the fourth years because they're out partying or travelling the world. While that's exaggerated, the fourth year of med school, unless you take alot of hardcore electives, tends to be the easiest year since you are doing what you want to do, not studying for shelf exams, and MDs often take time out for research that's not exactly PhD caliber. Many view that fourth year as time to have a child (I know at least one student at my school who's doing that), get married, or do things you've always wanted to do before residency. What are you missing as far as training goes? Probably nothing you're not going to make up in residency, unless you were looking for some broad based learning in other specialties that you think you might use someday.

At Penn the 4th year of medical school is essentially omitted, making medical school for most 3 years and 2 months. Yet, very few students graduate in 6 years total. Most take 7, and more than 50% in the last few years are taking 8. I wonder often why this is, and I think it boils down to that you're getting the "real PhD". In most graduate groups you have to take alot of classes and you're held to the same standards for theses as the PhD students. It boils down to a 3 year MD and 4-5 years of grad school. The thing is, I don't think this is specific to Penn. 6 year program graduates are rare anywhere, and while certain schools like to say "We want to move you through in 6" (Pitt is notorious for this), it still very rarely happens and you should expect to spend 7-8 no matter where you go as the average at most schools should be around 7.5 (if it's much higher than that, worry). When you hear about these so-called 6 year programs, ask them their real average time to graduation and don't let them dodge the question. As said many times in other threads by lots of people, the individual time to graduation does not depend on how hard you work--instead it depends on alot of other factors like luck (will it work and continue to work? Will you get scooped?), how time consuming your project is, and in many cases the lab and graduate program's requirements if they're not uniform for the PhDs in the MD/PhD program.
 
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Neuronix said:
You don't get a few rotations to decide, as many MD students do, and you may never get exposed to a number of specialties you don't get in your core clerkships that you might be interested in
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Thanks Neuronix. So i guess a student in a "6 yr MD/PhD" most likely will end up finishing in 7.5 yrs avergae either way, so might as well do the 4th yrs and be exposed to more specialties. Well, my other question is, will a student in "6yr program" be allowed to chose what specialties u wana be exposed to in 3rd yr? im not a med student so I dont know how it works... or can i in my 3rd yr med school chose to try all specialties but spend half the time instead?
 
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For me, cutting out the fourth year of med school was something I was highly critical of. Often, not even sure there are exceptions to this, what they cut out is all the elective time one normally has in fourth year. All you are left with are the core rotations that normally take place in third year, and maybe one or two electives. I thought that this arrangement would make it very difficult to chose a specialty if you had only seen the core clerkships and had never even been exposed to some fields that you might have interest in.

One other thing to keep in mind is that most places wont try to kick you out the door if you want to stay around for that fourth year.

Good luck.
 
Mitro said:
One other thing to keep in mind is that most places wont try to kick you out the door if you want to stay around for that fourth year.

Agreed there. Flexibility is key. You can certainly take more time in fourth year at most schools if you want to. A big part is scheduling and a big part is the individual desires. I'd say most 7th or 8th years just want to graduate and move on, but some spend a little more time...
 
As an MD/PhD who just went through 4th year, the thing that would have been most difficult about not doing 4th year would have been have things lined up to apply to residencies.

4th year is the way it is because you have to apply for the match during that time. Like applying to medical school, the timeline is quite inflexible. Your application materials have to be in by Nov 1 (usually), but should be in by September 15. The electives are pretty flexible about letting you travel to interviews; none of my 3rd year clerkships would have been so.

And there's another problem with applying as a 3rd year: you'd start interviewing after only a couple of months of real clinical experience, which would have been difficult. It'd be hard to know how to approach interviews, what they were looking for. It'd be hard to have developed the clinical contacts in your own school. It would be hard to convince them that you were clinically competent.

4th year isn't arduous, but it does serve two purposes: get you ready to be an intern, and get you the next job. It'd be hard to cram that into the same year as the clinical rotations.
 
Is it me, or does it feel like sometimes combined degree programs take the timing of the education like Name That Tune?

"... I can graduate that mudphud in seven years."

"...well I can graduate that mudphud in *6* years."

"Well, graduate that mudphud!"

Ahem. I digress.

It seems like a year is all the difference between a so-so thesis/residency and/or a great thesis/residency. Why are they trying to push you out the door in spite of good science and the acquiring of a great graduate education taking time? Is it us as applicants upping the grad time ante, or is it them trying to push us through the process in order to get more of their potential graduates out in the academic world? Just curious...
 
scooter31 said:
It seems like a year is all the difference between a so-so thesis/residency and/or a great thesis/residency. Why are they trying to push you out the door in spite of good science and the acquiring of a great graduate education taking time? Is it us as applicants upping the grad time ante, or is it them trying to push us through the process in order to get more of their potential graduates out in the academic world? Just curious...
Because we are pricey little mofos. The sooner you graduate, the sooner a bright-eyed, bushy-tailed, yet-to-be-jaded applicant can have your funding.
 
In the grand scheme of things, a year isn't really that much longer. I mean, we've already been in school for 20 something years, what's a few more months?

I'm a 4th year med student now, and loving it. Our program actually requires that we mudphuds do a little research project during our 4th year, and gives us anywhere from 4-20 weeks protected time to do it. Most use it to get their feet wet in more clinical type research. I'm using my time to hop onto an existing fMRI project - a field I knew nothing about but decided I wanted to learn. But I digress...

I agree with the comments above about the 4th year and applying for residency. I was gone at least 80% of the month of December for interviews. Hard to imagine doing that, studying for boards, and doing my third year electives all at once. Do you take Step 2 before you've finished your clerkships? If so, I would think that would put you at a disadvantage. And I can't imagine what I would do if I was one of the many med students (including MD/PhDs) who aren't sure what specialty they want to go into until near the end of their 3rd year clerkships. (Even if you think you're sure... lots of people surprise themselves and change their minds.)

so... looking at it from a cost-benefit point of view, I think being a year older when I graduate is worth what I've gotten out of the 4th year.
 
thnx everyone for the feedback!
 
Hurricane said:
I'm a 4th year med student now, and loving it. Our program actually requires that we mudphuds do a little research project during our 4th year, and gives us anywhere from 4-20 weeks protected time to do it. Most use it to get their feet wet in more clinical type research. I'm using my time to hop onto an existing fMRI project - a field I knew nothing about but decided I wanted to learn. But I digress...

To give the opposing viewpoint, I would be pretty upset if after a full 4-5 years of doing research they made me do the 4th year research project. At Penn, MD/PhDs are exempt from that requirement and alot of schools don't have that requirement at all. If you care about these sorts of things, look into these things when you're applying to med schools. Some of the schools still have some 6 month rural medicine requirement for MD/PhDs. Seems kind of silly considering extremely few MD/PhDs end up doing that sort of thing.

In my opinion, It's simply the old mindset that MD/PhDs should be getting the FULL MD and PhD and not trying to integrate. It's also that MD/PhD programs often times don't want to step on anyone's toes, so everyone takes that attitude: what's another 6 months for these extra requirements? We don't want to make the med school or the grad school angry, so what's 8 years matter vs. 7 years in the grand scheme of things? You definately see it in the students here when they're faced with something they don't like. We're powerless to change it (not true), it'll look bad if we say anything, so we'll just make the best of it and if any applicants ask us we'll just put on a smiley face and spin some nonsense we don't believe.

Hurricane, I don't know where you go to school, but my impression is that you pretty much have to take a full 4th year. I'm willing to bet the average graduation time is more like 8 years (or more?) there. In the end, my message here isn't to say "My way is better than your way", but rather to encourage applicants to make up their own minds about integration. Do you want to spend 8-9 years getting the "full" MD and PhD experience (as one MD/PhD director explained to me) or do you want to spend 7-8 years with with some requirements taken out? There's always that argument, "some students take longer for personal reasons" or "some students work harder than others" or "luck" and all that crap. Yes, that all comes out in the wash. It's why some programs have average graduation times around 7.3 years, and some are up in the 8.5 range. Decide for yourself.
 
I agree with Neuronix--I would also be very upset about any additional research requirement. The med school just started this "Area of Concentration" thing at my program, which is akin to a major. I have already asked whether this will be required of MSTPs and the answer is no, it won't because the PhD is ACTUALLY worth something! ;)

As for a "full" MD and PhD-- I think it is shortsighted to suggest that one need spend as long as regular med and grad students to garner the same level of training. MD/PhD students can streamline things by finishing the lab rotations and most graduate coursework during the first two years of medical school, taking the qualifying exam no later than a year into the graduate school phase, and having regular, frequent thesis committee meetings. Moreover, you should choose a PI that is supportive of your goal of finishing in a timely fashion and will help you plan a project that is in accord with this goal. Doing these things will drastically enhance your chances of reducing the graduate school phase to 3-4 years.

About 4th year requirements--these really vary considerably depending on the program and have much to do with state licensure requirements. The state of California has a relatively large number of required weeks of clinical training for licensure, so it would probably be impossible to eliminate 4th year as a result.

IMO, the clinical years already tend to be fairly streamlined for MD/PhD students at most programs. There isn't much to be gained by further compacting 4th year, while there is much lost. The places really in need of streamlining are the front (1st years of med school and grad school) and back (i.e. residency and fellowship)-ends of MD/PhD training.
 
Neuronix said:
It's why some programs have average graduation times around 7.3 years, and some are up in the 8.5 range.

Does anyone have up-to-date data on the range? How about follow-up? Does length of training have an impact on any aspects of alumni career development or program development? This stuff always splashes around, but I don't think I've ever seen real data from the MSTPs.
 
Neuronix said:
To give the opposing viewpoint, I would be pretty upset if after a full 4-5 years of doing research they made me do the 4th year research project. At Penn, MD/PhDs are exempt from that requirement and alot of schools don't have that requirement at all. If you care about these sorts of things, look into these things when you're applying to med schools. Some of the schools still have some 6 month rural medicine requirement for MD/PhDs. Seems kind of silly considering extremely few MD/PhDs end up doing that sort of thing.

In my opinion, It's simply the old mindset that MD/PhDs should be getting the FULL MD and PhD and not trying to integrate. It's also that MD/PhD programs often times don't want to step on anyone's toes, so everyone takes that attitude: what's another 6 months for these extra requirements? We don't want to make the med school or the grad school angry, so what's 8 years matter vs. 7 years in the grand scheme of things? You definately see it in the students here when they're faced with something they don't like. We're powerless to change it (not true), it'll look bad if we say anything, so we'll just make the best of it and if any applicants ask us we'll just put on a smiley face and spin some nonsense we don't believe.

Hurricane, I don't know where you go to school, but my impression is that you pretty much have to take a full 4th year. I'm willing to bet the average graduation time is more like 8 years (or more?) there. In the end, my message here isn't to say "My way is better than your way", but rather to encourage applicants to make up their own minds about integration. Do you want to spend 8-9 years getting the "full" MD and PhD experience (as one MD/PhD director explained to me) or do you want to spend 7-8 years with with some requirements taken out? There's always that argument, "some students take longer for personal reasons" or "some students work harder than others" or "luck" and all that crap. Yes, that all comes out in the wash. It's why some programs have average graduation times around 7.3 years, and some are up in the 8.5 range. Decide for yourself.

I guess I wasn't being totally clear. The 4th year research project is a special requirement of the MD/PhD program, not the regular medical school. (This is at University of Cincinanti.) Yes, we do the entire 4th year. And we do get out of some 4th year requirements, like rural medicine, to make time for the research project. The idea being that most of us do a basic science project for our PhD, and this gives us the opportunity to get our feet wet in more clinical or translational projects. And it is a rather lax requirement. You can do pretty much whatever you want to do for as little as 1 month or as much as 5 months. My project is technically 4 months, but I spent most of last month and a large chunk of this month away on interviews, so I've mostly been reading, and I can hit the ground running in the lab. And I have gotten a favorable response when I talk about it on residency interviews.

As far as which is "best" there is no answer to that. All I can say is that I am quite happy this year, and glad that I don't have to stress about fitting in the traveling for my zillion interviews during core clincial rotations. I really underestimated the toll all of this intervew travel would take. And maybe I'll come off as a slacker for saying this, but I appreciate having time in between the the hectic 3rd year and intern year to relax and pursue electives and research that I enjoy. I won't have time like this again until my PGY3 or 4 year. Other people might see the free time in 4th year as a waste of time, and the research project as just another hoop to jump through, which is a valid viewpoint too. Sort of like how some people think undergrad is a waste of time and go to 6 year med programs. So if you're of that mindset, pick a program that doesn't require you to do a full 4th year. Viva la difference. :)
 
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