How much does your PhD research benefit from M1 & M2 coursework?

[microTAS]

I know the answer to this question will be subjective depending on what line of work people do, but I am still curious what various post PhD phase people think about the relation of med basic coursework to their research (please mention your field). Did something you learn the first two years help you find a direction or make a connection that would have been otherwise absent? Or is it that, in practice, there is little overlap?

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[b&ierstiefel]

Well, it's hard to remember exactly what I learned during M1 and M2 year since that was quite some time ago. In general, I thought there were some factoids and concepts I learned during those two years that may have helped spark ideas during the graduate phase of training.

I'll start off by saying that my graduate phase research involved working on a very basic science project. Our research focused, in very broad terms, on examining protein complexes that we found were crucial for tight junction formation and apico-basal polarization in epithelial cells. Now, these processes are important in virtually any organ system that contains epithelia.

I will think out loud here and list the courses I took and whether I found them useful for my graduate school research:

M1 year:
Anatomy - somewhat useless
Histology - very useful...helped me become well versed with the structure and function of epithelia in general. Also, some of our proteins we worked on is important in retinitis pigmentosa so being familiar with the structure of the retina and photoreceptors also helped.
Pathology - general pathology was somewhat useless but the histopathology sequences during 2nd year were of some use.
Embryology - somewhat useless
Physiology - renal physiology was useful in a sense. we believe that some of our proteins are important in the polarization of podocytes (i.e., how do they know where to form the slit diaphragm, which is in essence a cell-cell junction like structure). Understanding glomerular physiology was quite useful in this respect. Also, learning about the various glomerular disorders helped me appreciate the significance of looking at our proteins in this particular context.
Pharmacology - essentially useless.
Microbiology - essentially useless.
Molecular and Cellular Biology - it was pretty much a review for me and I didn't learn too much new stuff here since I was a biology major in college and learned a ton of this stuff in undergrad. So, essentially useless.

M2 year:
Infectious Diseases - somewhat useless.
Heme/Onc - essentially useless.
Cardiovascular - essentially useless.
Respiratory - essentially useless.
Renal - quite useful (see above)
Dermatology - skin is epithelia. how exciting. next...
Neuroscience - somewhat useless.
GI - somewhat useless
Endocrine - essentially useless.
Reproductive - essentially useless.
Musculoskeletal - completely useless.

So as I review my thought process above, I can say that the stuff I learned during M1 and M2 year helped me appreciate the background behind my project and the big picture in terms of normal physiology as well as deranged physiology (i.e., pathophysiology). However, when it comes down to the specifics of my research, most of the insight came during graduate school when I read the primary literature. Nonetheless, I think the one advantage that MD/PhD's have is the ability to do a couple of things:

(a) Have an easier time gaining an appreciation of the big picture and the physiological context in which the significance of your project lies.
(b) Look at the commonalities between different organ and physiological systems which is important if you are working on a project investigating a very basic fundamental process.

Hope this helps.

 

[ears]

So as I review my thought process above, I can say that the stuff I learned during M1 and M2 year helped me appreciate the big picture better in terms of normal physiology as well as deranged physiology (i.e., pathophysiology). However, when it comes down to the specifics of my research, most of the insight came during graduate school when I read the primary literature.

I think how much it varies depends on how clinically oriented your grad school research is. My research was pretty non-clinical, so most of the grad school stuff wasn't directly relevant.

But there was a lot that was indirectly relevant. Look, a grad school education is a specialist's education: you learn more and more about less and less until you know everything about nothing. Whereas med school (and especially the first two years) is the opposite. And those two approaches complement each other quite well.

In particular, because you've been through M1 & M2, and understand a lot of issues, you have a good basis for at least starting discussions with almost anyone. And since more and more projects are multi-disciplinary, if you can bring ideas from many areas to your research, that can be an advantage.

I don't think there's anything sacrosanct about doing the 2-X-2 approach to an MD/PhD, but I found that there were advantages to it.

 

[Vader]

I found that having the broad background of knowledge M1 & M2 provide has helped me think about my research projects in a slightly different, more clinical context. It also has helped me think across disciplines (i.e. the relatively well-understood cellular/molecular interactions of the immune system has provided a nice context for thinking about developing nervous system cellular and molecular interactions).

A good knowledge of neuroanatomy, some of which was gained during medical school, has been essential to understanding my project (i.e. 3-dimensional relationships in the brain through embryology and into adulthood).

There has also been some pharmacology that has been/will be potentially useful in my research (i.e. psychotropic drugs).

 

[microTAS]

Thanks Andy, ears, and Vader. Your comments were definitely helpful and encouraging. It's a relief to know that the first 2 med years are well spent in relation to the other degree. It seems like even for a basic science researcher, there are nuggets of gold in the coursework. But since I don't know where they're buried, looks like I'll have to mine the whole area anyways.

Do you think the clinical rotations add on as much substance to the research? Have there been moments in the clinic when you stumbled onto an idea related to your thesis in a basic science area?

 

[b&ierstiefel]

Do you think the clinical rotations add on as much substance to the research? Have there been moments in the clinic when you stumbled onto an idea related to your thesis in a basic science area?

To be honest...not really. But that was because my research was basic science and not clinically oriented whatsoever. One of the MSTPs who will be graduating this year like myself has coined the term "MSTP sweetspot" or something to that effect. He did research on Diamond-Blackfan anemia. Then during his peds rotation, he admitted a patient with that same condition. The attending thought that he could stump him and make him feel dumb by asking him a tough question on Diamond-Blackfan anemia in front of an audience. He got the questions right and shut that attending up good. I have not experienced anything remotely close to this though

 

[BDavis]

One of the MSTPs who will be graduating this year like myself has coined the term "MSTP sweetspot" or something to that effect. He did research on Diamond-Blackfan anemia.

I remember a MSTP student who did their thesis on a genetic disease and one of their papers was reviewed for a journal club by an attending during clinics. The attending mis-interpreted some of the results/discussion and the student tried to propose an alternative explanation. I think the attending tried to embarass the student and finally the student said, "I don't think that is what the authors were trying to convey because I was the first author and wrote the paper".

 

[b&ierstiefel]

I remember a MSTP student who did their thesis on a genetic disease and one of their papers was reviewed for a journal club by an attending during clinics. The attending mis-interpreted some of the results/discussion and the student tried to propose an alternative explanation. I think the attending tried to embarass the student and finally the student said, "I don't think that is what the authors were trying to convey because I was the first author and wrote the paper".

Nice. There was a story just like that here. One of our recent graduates wrote the Nature paper on ADAMTS and TTP. Similar thing happened with her when the medicine folks were presenting her paper at grand rounds.

 

[BDavis]

Nice. There was a story just like that here. One of our recent graduates wrote the Nature paper on ADAMTS and TTP. Similar thing happened with her when the medicine folks were presenting her paper at grand rounds.

Sounds like the same person. That student did their MSTP elsewhere and came to Baylor for the combined Peds-Genetics program.

 

[b&ierstiefel]

Male or female MSTP?

The person I was talking about, as far as I know, went to Stanford for Internal Medicine. But things could have changed.

 

[BDavis]

Male or female MSTP?

The person I was talking about, as far as I know, went to Stanford for Internal Medicine. But things could have changed.

Male; maybe this happens a lot more than I thought.

 

[b&ierstiefel]

But there was a lot that was indirectly relevant. Look, a grad school education is a specialist's education: you learn more and more about less and less until you know everything about nothing. Whereas med school (and especially the first two years) is the opposite. And those two approaches complement each other quite well.

In particular, because you've been through M1 & M2, and understand a lot of issues, you have a good basis for at least starting discussions with almost anyone. And since more and more projects are multi-disciplinary, if you can bring ideas from many areas to your research, that can be an advantage.

I don't think there's anything sacrosanct about doing the 2-X-2 approach to an MD/PhD, but I found that there were advantages to it.

I very much agree with that assessment. The knowledge we have gained in medical school really sets up well to inspire ideas and look at things from a unique perspective.

The 2-X-2 thing...I would have prefered 1-X-3, that way I wouldn't feel like a complete ******* when going back to M3 year. Let's face it. M1 year is not as crucial for M2 year as M2 year is for M3 year. Unless your school has some kind of new organ system based curriculum that spans both M1 and M2 year (like our program after the recent curriculum change).

 

[fyli260]

The 2-X-2 thing...I would have prefered 1-X-3, that way I wouldn't feel like a complete ******* when going back to M3 year. Let's face it. M1 year is not as crucial for M2 year as M2 year is for M3 year. Unless your school has some kind of new organ system based curriculum that spans both M1 and M2 year (like our program after the recent curriculum change).

Wouldn't you be screwed for Step 1 boards then under this scheme?

 

[b&ierstiefel]

Wouldn't you be screwed for Step 1 boards then under this scheme?

well before the recent curriculum change here at Michigan, we covered normal anatomy and physiology, normal histology, all normal normal normal stuff during 1st year. 2nd year we covered all the pathophysiology. under that system, M1 year stuff is almost completely useless for Step 1. The far majority of stuff I learned to do well on boards was covered during 2nd year. so under that scheme, i don't think i would be too screwed for step 1.