Advanced Residency Training

[Narmerguy]

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I was looking at programs for residency training:

http://med.stanford.edu/arts/overview.html

Like that website. Apparently it's designed for MD graduates who want to get a PhD in clinical research or something like that? I know Yale and UCLA have similar programs as well:

http://www.info.med.yale.edu/invmed/

http://www.star.med.ucla.edu/

What's the merit of programs like these and why would they expect someone to do this over an MDPhD? Is this basically separate from your residency training (as in, it would still take 3-4 years longer to become an attending)?

Thanks.

 

[wholeheartedly]

Some people might realize their interest too late to do an MD PhD.

It might also have something to do with getting paid a residents salary for those years as opposed to a grad. students? It seems like it would make more financial sense to not put off that income for 4 years, plus you could probably moonlight.

"Stipends, (up to PGY III maximum), health benefits, and full tuition costs are provided throughout the graduate research years, which is typically 4 – 5 years. However, if the fellow is able to obtain additional funding through scholarships or fellowships, or if their clinical department is able to provide supplemental funding then the fellow can be paid according to their PGY level (up to PGY VI maximum). This will be decided on a case-by-case basis. "

 

[Narmerguy]

Some people might realize their interest too late to do an MD PhD.

It might also have something to do with getting paid a residents salary for those years as opposed to a grad. students? It seems like it would make more financial sense to not put off that income for 4 years, plus you could probably moonlight.

"Stipends, (up to PGY III maximum), health benefits, and full tuition costs are provided throughout the graduate research years, which is typically 4 – 5 years. However, if the fellow is able to obtain additional funding through scholarships or fellowships, or if their clinical department is able to provide supplemental funding then the fellow can be paid according to their PGY level (up to PGY VI maximum). This will be decided on a case-by-case basis. "

So this still takes an additional 4-5 years on top of whatever 4+ years of residency?

 

[Narmerguy]

No other thoughts?

 

[Charles_Carmichael]

I haven't had a chance to really scrutinize the information in the links you provided so I apologize if I'm completely wrong here. But it seems like these are essentially post-doc positions that result in you getting a PhD. If that's the case, they should be several years long after residency.

If this is the case (ie. the post-doc after residency), I would think that an MD/PhD would be a better approach because it offers you protected research time. In my experience, post-docs are expected to write grants and be able to fund themselves within 6-12 months and thus, there's high expectations there. If an MD/DO with no prior research experience gets a post-doc position, I would imagine it to be a pretty stressful situation to be in.

In my opinion, if you know right now that research is absolutely a significant professional goal of yours, an MD/PhD makes a lot more sense than and MD + post-doc (that might result in a PhD). Just my 2 cents.

 

[Charles_Carmichael]

To be honest, I don't know if a research residency geared towards providing you a PhD is that good of an idea. If you're pursuing a PhD during residency, there's no way you're getting the same amount of clinical training as a pure MD/DO. And I don't think that you're getting the same PhD level of training as someone pursuing a pure PhD because part of your time is devoted to clinical duties.

Like I said previously, in my opinion, if you know for sure that you want a research-heavy career, it might be better to pursue an MD/PhD. Not only would you get protected research time, but you'll also (most likely) graduate without any debt.

 

[StIGMA]

What's the merit of programs like these and why would they expect someone to do this over an MDPhD? Is this basically separate from your residency training (as in, it would still take 3-4 years longer to become an attending)?

These programs are for people who want to combine research and medical training, so yes it does take longer to become an attending... because you are also beginning a research program.

People who do these programs will already have significant research experience in medical school and decide during this time that they want to work in academics running a lab in addition to patient care (or else they would not need to do the residency).

The advantage to these programs over an MD/PhD program is that with these programs, you bridge your "PhD" research during residency, which would better be called a post-doc, with your applications to academic jobs as you finish residency. Ie: You are able to BUILD a research program during this time that will be the basis for your grants and initial lab work in your first assistant professorship. This is hard because you are combining research training and building a mature program at the same time, which most people cannot do. You will be expected to win startup award grants as you are applying to positions, so there is a lot of pressure to perform. There is likely a higher training:future research career rate in these programs than MD/PhD programs (relatively low % become primary researchers), although I am not sure of the numbers.

Whereas MD/PhD student still has to build their research program during/after residency to bring into a new position (Will still take 1-2 years). The advantage is that they are already trained. MD/PhD students also have slightly higher R01 grant funding success rates than MD researchers, and the startup grant success rates are probably higher as well.