is MD/PhD = MSTP? Costs question

Discussion in 'Physician Scientists' started by Spiderman [RNA Ladder 2003], Sep 2, 2002.

  1. Spiderman [RNA Ladder 2003]

    Spiderman [RNA Ladder 2003] Platinum Member
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    So is it the same? I was also wondering if MSTP is free (something like when you go to grad school people get free tuition sometimes)? Would I have to have exceptional grades or something like that?
     
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  3. CaNEM

    CaNEM Senior Member
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    When someone talks about an MSTP (medical scientist training program), they are commonly referring to an MD/PhD program which is completely or partially funded by the NIH. Not all MD/PhD programs are publically funded - some are completely paid for by the individual schools. However, lately some people and programs have begun to use the term "MSTP" more generically, using it to refer to ANY MD/PhD program (or even a DO/PhD program), whether it receives NIH funding or not.

    MSTP students receive a scholarship which covers tuition and expenses for both the medical and graduate portions of the program. They also receive a living stipend. There are some MSTP institutions that will let you pursue both an MD and PhD even if you are not part of the MSTP. Of course, then you would have to foot the medical school bills.

    Successful MSTP applicants typically have higher GPAs and MCAT scores than the average MD applicant (e.g., 3.7, 35, though there is much variation). Even more important, however, is a dedication to biomedical research and significant research experience.
     
  4. none

    none 1K Member
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    You MUST be a U.S. citizen to receive an MSTP grant. A school may come up with other funds for you, but it will make things more difficult. I definitely don't think MD/PhD is the way to go to fix your difficulty in obtaining loan funds.
     
  5. jot

    jot

    or permenant resident
     
  6. I just wrote a long reply that got erased, so here is a shorter version. Send me a PM if you want to discuss more.

    Citizens and Greencard holders.

    MSTP and MD-PhD are equivalent to many folks, esp at programs that don't have a non-MSTP track. (my opinion: this is semantics but one is "training" and one is an education. I'll take the education over training any day)

    The GPA, scores thing is not as clear as it may seem. You guys are a very self selecting bunch and although the averages may be higher it does not mean the competition is stiffer. Make sense? For one, you guys are goal oriented and know how to work the system and you have as a group taken a traditional path--not too many of you dropping out of college to explore the Amazon etc. So the scores are higher. BUT there are fewer of you competing for spots. Therefore, a score distance from the mean may not mean the same in the MD pool versus the MD-PhD pool. The SD or range of scores taken for a given school will help you decide your chances there. But only the national acceptance rate (regardless of the mean values) will tell you if you'll be in a program at all. In the end, this is all too much of a headache so just do the best you can, apply and see where you end up.

    MSTP started by NIGMS in 60's. Grants go to Programs first. Programs then assign students to "slots" because the money comes in student chuncks. However, the chunks only pay for 6yrs (hello, thesis advisor or other) and the student stipend (NIH student scale) is enough to get you a mini-bench in NYC or SF.

    Almost all "MSTP" students, therefore, get non-MSTP funds to supplement. Also, since Programs and not individuals (this is not an NRSA grant or Howard Hughes fellowship) really get to play with the money, almost all non-MSTP students at MSTP supported programs benefit from the treasury of NIGMS.

    Does this funding class structure make an iota of diff? Yes and no. No to little diff between MSTPers and non-MSTPers at MSTP institutions. Yes diff between those two and MD-PhDers at non MSTP programs. The study done in the late 90's can be found: http://www.nigms.nih.gov/news/reports/mstpstudy/mstpstudy.html.

    So if you want a life in academe with lots of grants doing lots of research, I would shoot for an MSTP funded PROGRAM. If you have other plans, go to the place that has the best food.

    -FB
    CD8, MS4, U Penn
     
  7. axlf1997

    axlf1997 Member
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    Not true. Many private schools <can> have <MSTP> funding for non-us residents e.g. those on an F-1 visa, though it's not well publicized. There's a thread somewhere around here with a listing of those schools that have taken F-1 students in the past.

    Off the top of my head:

    Washington Univ. St. Louis
    Yale
    Johns Hopkins
    Univ. of Chicago
    Duke
    Baylor
    Northwestern
    UT Southwestern (public school with lotsa $$)
     
  8. none

    none 1K Member
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    No one said there was absolutely no money out there...simply that non-citizens are unable to receive MSTP grants.
     
  9. axlf1997

    axlf1997 Member
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    The point I was making was that non-citizens can still be in MSTP programs. It is true that they cannot get money from the NIH MSTP grant, but the MSTP program can sometimes (corrected from "frequently") cover them completely with private funds (whereas US citizens would have a portion covered by private funds and the other portion by the NIGMS MSTP grant). However, this is just what's going on behind the scenes and to the foreign student in the MSTP program it will make no difference.
     
  10. MacGyver

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    axlf,

    you're technically right but keep in mind that funds for foreign MD/PhD students are very very limited. I would imagine that out of the 1000 or so MD/PhD students in the United States, probably only 50 or so are foreign.
     
  11. axlf1997

    axlf1997 Member
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    Macgyver,

    I agree it's difficult. Just pointing out that it is not impossible for foreign students to be in MSTP as the previous post might have suggested. "Where there's a will there will be a way".
     
  12. none

    none 1K Member
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    The OP is a foreign national attempting to go to medical school in the U.S. without having to come up with 200k upfront. An MD/PhD program just isn't the way to do it.
     
  13. axlf1997

    axlf1997 Member
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    none,

    Agreed, definetely not a way to get a free ride. It'll be painful if you're not interested in doing a Ph.D.
     
  14. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur
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    If you're doing the MD-PhD program for JUST THE SCHOLARSHIP, then don't do it. You're just wasting 4 years of potential earnings.

    Your scholarship is really worth the 4 years of medical school, which is about $160,000 total (assuming $40,000 per year for tuition and stipend).

    If you're an average internal medicine doctor, then you'll make ~$150,000. That's $600,000 of potential salary that you're giving up just to take a $160,000 scholarship.

    If you're a surgeon, you'll make on average $225,000. That's $900,000 of potential earnings vs your scholarship for medical school.

    Only do it if you're interested in academic medicine or research. Otherwise, you'll waste your time.
     
  15. sluox

    Physician 10+ Year Member

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    Actually, this analysis is completely oversimplified. If I get paid $40,000, instead of loaning that much money early on, adjusting the interest and the loss of investment, it would be probably a very financially sound decision to do MD/PhD. Earlier on in your career there is no way to make $225,000, but that's when you need your money most to buy cars, houses and stuff for kids when you are in your mid 30s. Who cares if you are making millions in your 50s? The military essentially has the same package for people who are willing to work 3-4 years after medical school.

    Hence, I don't think it's true that MSTP are losing out on the money. If anything, they have a better deal. Personally, I don't think it's a waste of time to do a Ph.D. regardless of whether people want to have a career doing research in the end. PhD in and of itself is a training degree and it exersizes your mind and independence, and I'd imagine that is its purpose rather than preparing you for a particular pathway of career.

     
  16. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur
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    The analysis is not over simplified. You're right that you don't make $225, 000 at the start, but your start up time to make that much is the same number of years whether or not you do a MD or MD-PhD, i.e. it takes about 3-4 years of practice before achieving that level of income. Therefore, by doing a PhD you're simply taking 4 years out of your career where you'll be making that level of income before retirement.

    Interest on student loans have historically been low. The average medical student debt at Hopkins was $150,000. If you pay this over 10 years, it works out to be about $250,000. Financially, you're better off doing an MD program in regards to the total life-time financial reward. You'll still be ahead $500,000 over the life-time of your career. If you're worried about not having money for a car, then borrow up front and pay it back later. You'll still be ahead after you start making money.

    I agree with you that people need more money up front than later on. This is why the military is an outstanding option.

    However, if you're doing a MD-PhD program for JUST THE MONEY, then don't even think about it. You'll have great difficulty completing the PhD program. The PhD program is more difficult than medical school. I've known many MD-PhD candidates, graduates, and professors, and I've also experienced the PhD program first hand. You must love research and want to pursue academics; otherwise, you're going to be miserable for 8 years, particularly when your friends become your attending physicians!

    The point is clear. Go into the MSTP program if you love research and truly want to tackle the rigors of original scientific research. The scholarship is only icing on the cake. This is a mute point because you'll never make it through the 6-8 interviews for the MD-PhD program if you really did not like research. At some programs, you have a committee interview with 5-8 faculty too.

    You're incorrect about the MSTP program being not designed for those who want to specifically enter academic medicine. This program is funded and started by the NIH for that sole purpose. NIH wanted to train medical scientists to bridge the gap between clinical medicine and biomedical research; hence, graduates were expected to enter academic careers. Not all do, but 95% of graduates eventually enter academic careers doing research, teaching, and caring for patients.
     
  17. shamus1

    shamus1 Member
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    You're incorrect about the MSTP program being not designed for those who want to specifically enter academic medicine. This program is funded and started by the NIH for that sole purpose. NIH wanted to train medical scientists to bridge the gap between clinical medicine and biomedical research; hence, graduates were expected to enter academic careers. Not all do, but 95% of graduates eventually enter academic careers doing research, teaching, and caring for patients. [/B][/QUOTE]

    Actually, my understanding is that the number of MD/PhD grads in academia has fallen to ~80% and is continuing to drop. The 95% number, according to Bert Shapiro, head of the MSTP for the NIH (whom I heard speak this past weekend), is the number of MSTP alums who decided to do a residency. According to recent residency data, less than 50% of recent MSTP grads are opting for residencies in pathology, medicine, and pediatrics, vs. >75% a generation ago. While this does not necessarily mean that those who go into specialties such as derm, ophthalmology, radiology, or surgery will forego research for 100% clinical careers, there is a prejudice that this, in fact, will be the case. This trend is not irreversible, and we shouldn't lose sight of the fact that these statistics represent the choices of hundreds of individuals with unique circumstances. Ideally, Adam Smith's invisible hand will eventually work its magic and an oversupply of private practice physicians in lucrative fields such as ophthalmology, derm, etc. will drive down income as a shortage of academic physicians will drive up faculty incomes and force improvements in working condidtions, and the number of MSTP grads in academics will increase. (Unless it doesn't.) Either that, or the NIH will reinstitute payback requirements for MSTP students to ensure that they spend at least some period of time in academics before departing for the promised land of caring for the aging bodies of baby boomers.
     
  18. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur
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    Shamus1,

    Thanks for the input. I'm curious how many of the MD-PhDs who go into derm, ophtho, and surgery will pursue academics. I am in ophtho and plan to stick with academics and research.

    When I started medical school in 1993, NIH dropped the payback requirement because it was hard to enforce and people eventually entered academic careers. There is a lot of potential for research in derm and ophtho so I think these fields are great for the academic research type.

    Dr. Ed Stone is at my program, and he is the first ophthalmologist to achieve status as a Howard Hughes Investigator. He's cloned and studied many genes related to degenerative retinal diseases. He's also a MD-PhD and sees patients once weekly.
     
  19. shamus1

    shamus1 Member
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    I agree that it is ophtho & derm are good choices for MSTPs seeking to go into research, and many of the residency programs are research-oriented. I've heard, however, that the life$tyle differences between 100% patient care and research-intensive careers is so great that many MSTPs find it difficult to stay on the academic path. The National Eye Institute has a ton of money for research, but the income from an academic career is so much less than doing lasik all day long that many find it tough to turn their back on potentially doubling their annual salary just to do research. This is where you have to be deeply committed to research to do stay in academics. Hopefully, your spouse/partner is also committed to your path, as they will be sacrificing something, too. Doing lasik is probably boring compared to doing research, but you can fill the additional free time you have by doing exciting things with the extra cash you've earned.

    Time will only tell how many stay in academics. The NIH report that has been mentioned in other threads only looked at data through 1995, which means that it looked at career choices of those graduating before 1991 (assuming 3 years of residency followed by at least 2 fellowship years). So, it is kinda out of date; new data would be great to have, but Shapiro said that it is highly unlikely that the NIH would undertake another such review at anytime in the foreseeable future.

    It is great that you are committed to acadmics and have a role model like Ed Stone. Hopefully, most of us will continue to have a strong passion for research, numerous examples of physician scientists in our specialties to learn from, and plentiful sources of research funds. Contributors to this forum are great support for those following this pathway & the encouraging messages are very helpful.
     
  20. pathdr2b

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    Shamus 1 and Optho MudPhud:

    Great discussion on the MD/PhD career possibilities. Keep up the good work for MD/PhD wanna be's like me!!
     

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