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I though everyone might be interested in three articles in the current issue of Nature Medicine:

1. Article deals with whether PhDs can make significant contributions to the Field of medicine. Highlights the Harvard-MIT HST program

2. Article deals with the decline in MD-PhDs, the training and possible ways to obtain more MD-PhDs

3. Article asking about the decline of female applicants/matriculants/graduates of MD-PhD programs. Written by Nancy Andrews of Harvard.

I would have put in a link to the articles, but I got them off the internet from a digital library account our lab has.

Enjoy
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brandonite

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Sounds like a good article. If only my library subscribed to Nature Medicine... I will have to make an effort to find it elsewhere.
 

xanthines

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would you mind posting the issue/vol #'s for the lazy?

:)

-X
 
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Does anyone know how hard it is to publish an article in Nature medicine?

People say that Nature medicine is a lot better than Nature. True?
 

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Nature Medicine is not that great...all the Nature spin-offs cannot possibly compare to Nature in terms of prestige. In the field of general medicine, JAMA or New England Journal are both much better than Nature Medicine.
 

brandonite

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All of the articles can be found at:

<a href="http://www.nature.com/cgi-taf/dynapage.taf?file=/nm/journal/v8/n5/index.html" target="_blank">http://www.nature.com/cgi-taf/dynapage.taf?file=/nm/journal/v8/n5/index.html</a>

It is an interesting read - you might want to take a look at them...
 

xanthines

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I don't think the impact factor necessarily means better. I takes into account the number of subscribers which could be very high if it is freely given to members of an organization, like AMA and JAMA (which is a pretty good journal, I agree, but you get the idea). I don't remember exactly how they calculate impact factors, but I think it is possible to be a mediocre journal (by scientific standards) and still have a high impact factor. I guess the impact factor is just that: the impact factor. Not how "good" a journal may be. Does this make sense to anyone else or am I just babbling? Sorry. Rainy day here.

-X

</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by kk:
<strong>Nature Medicine is actually BETTER than Nature according to the journal impact factor list.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">
 

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<a href="http://dukenews.duke.edu/med/hogan.HTM" target="_blank">http://dukenews.duke.edu/med/hogan.HTM</a>

I stumbled across this profile a few days ago. It was kinda disturbing that there had never before now been a female basic science department chair at Duke med. Though I'm sure the problem is not peculiar to Duke.
 

brandonite

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Yes, it is pretty sad... I guess that female MSTP's are reasonably rare. It sounds like men outnumber women 2:1, which is quite out of balance. The theories they put forward make some sense to me, but I can't quite believe that women would avoid going into a competitive atmosphere because they feel that they need to be better than the men in order to be perceived as their equals. RNAgirl, sar520, any thoughts on this?

What do people think about the deficit of MD/PhD's the article talks about? What is the solution to that issue? I like the idea of more funding spaces they talk about... But I really think what should be worked on, and has been worked on already, is making sure that MSTP's graduate within around 7 years. I think that time factor is still scaring quite a few potential researchers off...
 

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I read Nancy Andrew's article, and was annoyed by one of her comments.

She says something to the effect of, 'women are better team players, less aggressive to the detriment of others'

I understand that men and women are different, but she seems to be one of those who try to argue not only that women are equals, but that they are superior to men in several regards.

I'm sure there is some bias against women in the academic environment, but Nancy Andrews seems to take the extremist position, implying that ALL the obstacles to women are those that are set up by men. I think self-selection has something to do with it too.
 

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I neither think she implied women are superior to men; nor did she imply that ALL obstacles facing women in medical research are caused by men. What she emphasized was that women are different from men, and that these inherent traits that women typically have are no less useful for doing Science than are male traits (agressiveness, competitiveness blah blah ..).

Her point was that the existing academic culture was cultivated during the era when women were not allowed to participate. As a result, the current mode1 selects for the typical male traits; and consequently against the typical female traits. However, this mode1 of doing science is independent of Science itself. Her article was advocating a revision of the current mode1. A revision that will make life easier for females as well as for males saddled with the responsibilities of raising a family.
 

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I've talked to alot of different pre-meds, male and female, and the #1 reason given for not going MD/PhD for those thinking about it is the time involved. For most women, the time involved would prevent them from having children and starting a family. I don't want to make myself sound sexist, but I've never met a female MSTP wannabe cept RNAgirl, and the #1 reason cited is later family concerns given the strenuous and lengthy training.

Do women have to have kids? No. But, do most want to have kids and raise them well anyways? Yes. I don't want to hear this "The husband can do it" crap, cause women want to give their children a good start in life, and whether or not it's politically correct, they usually do bear the brunt of the child-rearing activities. My g/f is an anthropology major and a feminist, and we get into arguments in this almost weekly :)

I know many females who work in research labs in and around my University. In fact, I know more, and I think there are more female undergrads working in labs than males. But when I talk to them they're all considering MD OR PhD. Again, because of family concerns.

I really don't think there's some sort of underlying discrimination. Especially not with the numbers of oppertunities available around here for anyone of either gender. In fact, every once and awhile I'll get an e-mail from my Biology advisor giving research or pre-MD/PhD oppertunities that are minority or female only. Sometimes, when I was looking for a lab job, they would get me so mad I considered asking her not to send them to me anymore, since I'm a white male. To make a long story short, I just kept knocking on doors and found what I was looking for.

I think this comprises the largest reasons why you don't see many women in certain specialties also. Sure it's true that some women would only want (and reasonably so) to see pediatricians and OB/GYNs that are female. But, the sheer number of female pre-meds and med students that I've met that talk about their love for children and that as motivation for being a doctor makes me think that women really are looking to have kids and work with kids.

Please don't think I'm saying that men and women are unequal. To me, this is all COMPLETELY cultural. In America we put the baby doll in the little girl's hands and the race car in the little boy's hands and they grow up the way we've produced them. Then they do the same thing to their kids. It's not easy to fix. Women are equally capable of CHOOSING and PERFORMING in their chosen path. My new boss is a female MD/PhD, I'll have to ask her opinion on the subject.
 

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i just wanted to comment on one aspect of your post: as a female entering an mstp next year, i have personal reasons for hoping that it is possible, with the right partner, to have and successfully care for a child while either while completing an MD/PhD (for example, in the PhD years) or afterwards. i have met several female mstp still completing their programs who either have children or are planning to do so, and i feel that if it is planned correctly, it can be done and done well. however, i think that females aren't usually provided with these models. instead, i think that many women told by others that it's simply not a good idea. there also might be something to the idea that a lot of females i know that are going into medicine are REALLY into the nurturing side of it all rather than the research side. whether this effect is mediated through genetic or environment (and personally, i think it's both), it might just mean that fewer women are interested in academic medicine.

just a personal opinion!

s
 
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There's some very good banter going on here. I thought I would add my thoughts. First, I work with a female MD/PhD who is a mom to two year old Gabrielle. One reason she chose to become a MD/PhD was because of the time flexibility. Think about what an MD/PhD's responsibilities are: 90% research, 10% clinical. Before anyone gets upset, I use this numbers as an "average", not the final true nature of the job. Back to Gabrielle's mom: She is doing a post-doc and had her daughter after she was done with her residency. Now, doing bench research, she can come in around 9:30 or 10 AM after dropping off her child at daycare and work until 5- a typical day for any other profession, really. Her husband is also an MD/PhD, and they chose this timing for their baby- now, that they are post-docs with their own funding (K grants) they have the luxury of a diminished patient responsibility (just one morning a week for each of them) and flexible working hours. Gabrielle's mom said she likely will look to try to even the balance of her time once Gabrielle is older.

Next point.
I really wonder if guaranteeing a shorter time to degree(s) would increase the number of MSTP applicants. Again, consider what an MD/PhD does. The theory is that the combined begree allows a person to foster a love for the basic sciences in order to advance understanding of disease and physiology, right? Now consider the facts: MD/PhDs are generally paid less, face more time doing fellowships, post-docs and residencies (should they choose to specialize). Now, even if a program could guarantee that you're done in seven years, look at what lays ahead of you. I think that a person desiring to become an MD/PhD considers this and accepts it.
Many people who want to go into medicine do so for a large salary, flexibility, prestige in the lifestyle: the "country club lifestyle", if you will. Md/PhDs are more of scientists than the "stereotypical" (well, generalist at least)physicians and don't fit that mold. Many people simply want to treat patients and don't have the drive to leave the clinic and start asking the questions that need to be asked in order to understand disease states.

Next Point.
A point of the first two articles is stating that there is a shortage of physician- scientists (ps for brevity) doing CLINICAL research. They are all in the lab and the article asks, how can we get p-s's to bridge the gap from bench to bedside? It is an interesting question, as most (of the p-s's I know) seem to undertake study on a disease state without thoughts of therapy.

Whew, that was tiring. I hope it wasn't too rambling or incoherent and I hope I didn't offend or stereotype any one or any group.

M
 
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one more thing about the time issue:

I graduated from college in 2000. I will be starting a PhD program at Wash U this summer. Once there, I will try to transfer into the MSTP program. If Wash U won't allow it, I'll apply to medical schools. In my case I am looking at possibly being done with schooling in 10 years. This doesn't bother me at all. The be a physician, scientist or both, a person needs a love for the field to foster their dedication. While shortening the time to graduation maybe be one idea, the integrity of the dual degree program should be maintained. Otherwise, a MD/PhD might not be more than some one who worked for a couple years as a tech and then went to medical school.

Sorry for all the typos in my last post. I can't spell so good.

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</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Original:
<strong>I think MAPKinKster was at the La Jolla conference.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Yeah I was! Varki and Rosenberg essentially summarize the forum in their article.

Surprisingly, a majority of the MSTP students who attended were female. During one of the dinners, we discussed the issue of raising a family: should it be done during the MD/PhD? when is the best time? what kind of disadvantage does it create? Interestingly, the opinions of the students seemed to reflect their directors' approach toward the issue. One program's director tells the students flat out that they can't have kids. Another director totally encourages it.

For my rotation this summer, I'm going to be working with an MD/PhD post-doc who just recently returned from maternity leave. Other members of the lab are either almost expecting or planning to have children. They seem to be pretty open with the PI about it. So for fellow MSTPers who are considering kids, checking out the "pregnancy record" might be just as important as the publication record.

-MapK
 
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Journals

Clinical clinical wish list (less arguable):
NEJM, no doubt
Lancet
JAMA, falls off a bit

Clinical science wish list (more arguable):
Scinece/Nature
NEJM, good luck at only 4 original articles per issue
Nature Medicine
Nature Genetics (somewhat specialized but huge, find a gene for a neurologic or immunologic disease? publish it here...if you can)
JCI (journal of clinical investigation; official pub of ASCI, an honor society for young mediciney folks)/PNAS, honor society for old mostly mediciney folks

Whoever feels that the nature spin-offs (especially the two above) are to be brushed aside should think again. (Don?t get too worried or impressed by impact factor; much of the equation is arbitrary and reflects factors such as field(s) predominantly represented (ie everyone loves genes), number of review articles, types of articles (mechanistic, random controlled clinical trials), prestige etc). Many investigators spend their whole careers as PIs without a single senior/first author pub in one of these (my two lists above including the two spin-offs) journals. A section chief or chair of medicine would be good to have a handful (this I know for fact). If you get one as a student, jump for joy. More than one? Lucky bastard or genius.
 

Sm00th13

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</font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by brandonite:
<strong>All of the articles can be found at:

<a href="http://www.nature.com/cgi-taf/dynapage.taf?file=/nm/journal/v8/n5/index.html" target="_blank">http://www.nature.com/cgi-taf/dynapage.taf?file=/nm/journal/v8/n5/index.html</a>

It is an interesting read - you might want to take a look at them...</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Hey Brandonite,

Good looking out!!! I would usually have to get to sloan kettering to get access to nature medicine, the articles came out well on print. Thanks alot for the hookup!!!! :cool: :cool:
 
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