Duke MSTP or the pros/cons of only 1 yr preclinical and 1 yr clinical before PhD

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I am trying to decide on an MSTP program by May 2. I really liked because the Duke program because MD training is only 3 years and because one year of clinical training (what would be the traditional 3rd year on the wards) happens before the PhD. The benefits to this program are shorter time to graduation and perhaps a better chosen PhD project because of the year of clinical experience. While the Duke students were very happy with their curriculum, students from other MSTP were skeptical of the efficacy of a 1 year pre-clinical curriculum. My biggest concern was that some students also thought that having the multi-year PhD gap between most of the core 3rd year rotations and residency would cause a severe disadvantage during residency. Does anyone have any thoughts about the Duke curriculum specifically for MSTP'ers? Does anyone have opinions on the quality of Duke-MSTP'ers during their residencies?

 

[Neuronix]

It's all about step 1 score in the long run, and step 1 is almost enitrely based on second year and step 1 prep. So I bet the Duke crowd does just fine in life.

As for clinical disadvantages, what matters is those clinical grades. If you come back to clerkships off-cycle and/or have to take a lot of rotations after Dean's letter goes out--that's the real disadvantage at other programs. If anything you have fourth year to catch up, which is awesome because the grades stop being important and you can focus on learning. My point is there's pros and cons to every arrangement. The pros here are that you can really know what specialty you want to do during your PhD. That's very helpful for many specialties.

In the long run keep in mind everyone likes what they know/have (if they don't they won't tell you in an admissions setting) and everyone is skeptical of what they don't know/have. You will see this over and over again in the future.

 

[solitude]

I know this will offend people, but I personally think the Duke curriculum is a terrible idea. Doing 1 yr clinical before the PhD is fine, although I think it's dangerous because people will lose a lot of clinical competence during the PhD phase. The second reason that I think it is a bad idea is that you are sacrificing an entire year of pre-clinical information. You can argue that the pre-clinical years are worthless, that you forget everything anyway, etc., but this is just false. Talk to any MD-PhD who is in their PhD years, and compare their medical knowledge to a straight PhD student--the difference is staggering.

Perhaps a better question is: do Duke MD-PhD students know as much as an MD-PhD student from another school with a 2-year pre-clinical curriculum? I don't know the answer. I'm sure Duke's Step I scores are great because Step I does not, in my opinion, very accurately assess one's knowledge base or clinical competence. Plus Duke selects for good MCAT scores, which are the number 1 predictor of Step I scores.

If I put myself in the chair of a residency director, why would I take somebody from Duke? Fundamentally, I'm worried. They spent one less pre-clinical year, and they did their key clinical clerkships four or five years ago. Sure, they may have a great Step I, good clinical grades, and prestige, but I have a ton of applicants like that.

These are my two cents. FWIW, I knew a lot of MSTP students at Duke. I did not apply to their program.

 

[bd4727]

If you come back to clerkships off-cycle...

Just curious what you are arguing is the disadvantage to this, as it is broadly applicable to many MD-PhD programs that will let you decide when to come back (ie mine). Do you mean that you would try to set it up so that you are starting a rotation with 3rd years on their first rotation, therefore you look just as new? Or do you mean that you will have trouble scheduling all of your cores and therefore have trouble doing aways, getting good letters, etc before applying?

 

[Neuronix]

Do you mean that you would try to set it up so that you are starting a rotation with 3rd years on their first rotation, therefore you look just as new?

Yes. I came back with the 3rd years on their last rotations and looked like an idiot by comparsion. I tried to explain my situation to no avail.

Or do you mean that you will have trouble scheduling all of your cores and therefore have trouble doing aways, getting good letters, etc before applying?

This can also be an issue depending on when you come back and how much time your program gives you.

 

[bd4727]

Yes. I came back with the 3rd years on their last rotations and looked like an idiot by comparsion. I tried to explain my situation to no avail.



This can also be an issue depending on when you come back and how much time your program gives you.

Good point. I never really thought about it. I will definitely keep this in mind toward the end of my PhD years.