How important is the MD/PhD program you attend for long term career goals?

[cellsignaling]

As I look ahead to having to make an important decision in the coming months, I am curious how far ahead in my career I should be looking at when deciding on an MD/PhD program.
I know how hard it is to establish a lab of your own and be successful in academia, even as a physician scientist. How important of a role does your MD/PHD training play in career success down the line? Is successful and productive residency/ postdoctoral training more important in securing a faculty position?

Should one consider an institutions ranking in the decision making process or focus more on happiness and fit?

Would greatly appreciate any advice or thoughts on how to pick an MD/PhD program, especially from people a few years out or finishing their MD/PhD

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[CaliforniaAsian]

As I look ahead to having to make an important decision in the coming months, I am curious how far ahead in my career I should be looking at when deciding on an MD/PhD program.
I know how hard it is to establish a lab of your own and be successful in academia, even as a physician scientist. How important of a role does your MD/PHD training play in career success down the line? Is successful and productive residency/ postdoctoral training more important in securing a faculty position?

Should one consider an institutions ranking in the decision making process or focus more on happiness and fit?

Would greatly appreciate any advice or thoughts on how to pick an MD/PhD program, especially from people a few years out or finishing their MD/PhD

Just my $0.02, my limit on delayed gratification is a few years. 8-10 years of MD/PhD is too long to spend at a place where you would be less than happy if you have the option to avoid it.

 

[cellsignaling]

Good point, I agree with that. I guess I want to take every step possible that will bring me closer to my career goals, but the reality is that I have to enjoy the ride

 

[dl2dp2]

Frankly, I think below a certain threshold "happiness and fit" doesn't really matter, so the answer should be more specific to the question.

Let me be more explicit. If you do an MD PhD at a school that's roughly below the top 40 NIH funded institution, your chance of eventually run your own lab is <10%. So you should know that going in. I.e. what are you doing here? You are [mostly] trying to do a free MD and you have some interest in science so you can play around for 3-4 years. MAYBE in a best set of circumstances, you match into a top residency/postdoc and you can press the reset button, but that's unlikely. If this is what you want to do with your life, then yes, it doesn't matter.

Let's say within the top 40-ish schools, does it matter if you are going to top 10 vs. the rest? Well, does it matter if you do your PhD with a Nobel laureate vs. no-name at top 10? You need to figure it out for yourself if you want to be in the big leagues or you'd rather be happy playing junior varsity.

 

[SoberPony]

@sluox respectfully, I disagree that top 10 is the big leagues and anything less than that amounts to something less substantial. although I guess maybe I’m just not understanding the vague Varsity or JV metaphor because in general people who are serious about training go JV—> Varsity.

 

[dl2dp2]

@sluox respectfully, I disagree that top 10 is the big leagues and anything less than that amounts to something less substantial. although I guess maybe I’m just not understanding the vague Varsity for JV metaphor because in general people who are serious about training go JV—> Varsity.

This is exactly the right analogy. People who are serious about training go from non-top 10 to top 10. I don't mean USNews ranking. I mean the overall "level of science", whether it would be broadly considered "world class", or not.

It's actually much more malignant than the top 10 [schools] by USNews. I would argue that most people at Harvard [as an example] are "less substantial", and are very poorly equipped to train you to actually succeed at science--statistically maybe 25%, 30% at best, of Harvard's MSTP grad eventually become fully independent physician scientists. Yes you can obviously go to a non-top 10 school and thrive there, but the point of all this is that the environment right now is such that every step of the way you are judged 1000 times and scrutinized for every possible weakness in your application throughout your career. So, if you have an opportunity to do something that will seem to sound good on your biosketch, and if you truly care about your career more than everything else in your life, then it's clear how your decision needs to happen.

Grants get trashed routinely by people at non-top 10 [USNews] schools but run "top 10 labs" saying that the candidate who is at a top 10 school did not publish in prestigious enough journals or their collaborative teams don't have the right "expertise". If you want to do X, you need to go to the best place for X, and kiss up to the right people for X. Statistically the best places are at top 10 USNews. They could still be at top 40 NIH, but you gotta know what you are doing.

That is the question, right? Read the thread title again.


To add on to this: I have almost NEVER met someone who decided to go top 10 school, when faced with a choice of going to a top 40/below school decided to go with top 10, and later regretted it, in terms of their career development. Plenty of people regret dumping their girlfriend or moving to Boston/SF. People make choices, and choices have consequences.

 

[tr]

Grad school success is hugely important to future success, but unfortunately there is no way to guarantee or even really predict how to achieve that. Success in grad school (measured by research productivity, i.e. number of publications and impact factor) is an extremely powerful predictor of future success as an independent investigator. But how can you know as an applicant which institution/lab can best help you achieve that? I think it's very difficult. A USNews ranking is definitely not going to do it. Unfortunately I'm not sure there is any real way to anticipate this. The whole thing is too tied up in micro-specific factors related to your project, timing, and the people you are working with.

 

[dl2dp2]

A USNews ranking is definitely not going to do it.

The statement that USNews being not predictive is that high ranking has low positive predictive value. But that's because the overall prevalence is so low. Low USNews ranking has excellent negative predictive value--if you go somewhere below ~ 50, your chance of getting an R01 at some point in your life is virtually zero.

 

[tr]

The statement that USNews being not predictive is that high ranking has low positive predictive value. But that's because the overall prevalence is so low. Low USNews ranking has excellent negative predictive value--if you go somewhere below ~ 50, your chance of getting an R01 at some point in your life is virtually zero.

Do you have any evidence to cite for that statement?

I've never seen specific data to address this institutional prestige question, but anecdotally I would say that prestige of individual lab mentor is much more important than institutional prestige - not because of the halo effect of the prestige but because hotshot PIs do better at getting their students' stuff into hotshot journals - and there are hotshot PIs at all kinds of different institutions.

I would suspect institutional prestige is a non factor when separated from PI prestige and applicant selection, though I can't adduce any formal evidence one way or another.

 

[dl2dp2]

I would suspect institutional prestige is a non factor when separated from PI prestige and applicant selection, though I can't adduce any formal evidence one way or another.

Sure. But these are confounded covariates. It's also much harder for an MD/PhD applicant to figure out which PI is considered prestigious. On the first point, see this: the top 50 gets 60% of $. You can use this number to calculate the relative posterior probabilities...and they ain't good for the >50.

The Rich and the Rest: NIH R01 Grant Distribution by Institution

The R01 is of indisputable importance to supporting medical research. Statistics from the NIH data book report that $14.9 billion dollars were awarded to R01 type research project grants in 2013. R01 grants support virtually all costs associated with medically relevant research projects that...

grantome.com

 

[EvoMed]

if you truly care about your career more than everything else in your life, then it's clear how your decision needs to happen.

There are many ways to define success in a career

see this: the top 50 gets 60% of $

The Rich and the Rest: NIH R01 Grant Distribution by Institution

The R01 is of indisputable importance to supporting medical research. Statistics from the NIH data book report that $14.9 billion dollars were awarded to R01 type research project grants in 2013. R01 grants support virtually all costs associated with medically relevant research projects that...

grantome.com

So, >50 still gets 40%

 

[tr]

So, >50 still gets 40%

But that's like 250 institutions (or 2450 if you count that last 7%). Sluox is right that those numbers don't look good for the >50.

However I'm kind of doubting that most of them have MSTPs anyway. There are 50 MSTPs in the US and I'd bet they are coextensive with that blue/orange slice of the pie.

(I'd also point out that the linked pie chart ranks institutions by their R01 dollars, not their US News factor. So it's not an argument for letting a rank list be your guide, it's an argument for looking up the NIH funding record for your institution and PI of choice. Which is absolutely a smart move and one I'd recommend as well.)

 

[inode]

My two cents: yes, it's important but it's not the end-all-be-all (there are other factors at play and it's not black/white).

If you get into Stony Brook's mstp (not a top 50), and do research with an amazing mentor at Cold Springs Harbor and have great research productivity, I don't see why that would be any less preferable to a top 10 (aside from your medical degree being from a less prestigious med school, which might make a difference in residency apps but that's honestly about it).