Journal of Clinical Investigation article about medical admissions

Mansamusa

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I wouldn't call your threads pro-science....

1) How do you tell the difference between someone really into research and someone who isn't? More students now come into med school with research than in the past. Med school committees might think they are admitting people who want to do research and the people professing to want to do research in past med school classes might not have even known what doing research is like before they went into medicine

2) We are getting more specialized in all careers. What if people instead of doing MD/PhDs are just getting PhDs in order to do medical research? There are a lot of costs in adding that MD and many people may not see benefit in that.

3) The percentage of MD/PhD students isn't decreasing, so who is to say that we are producing less physician-scientists? Just because more people professed to liking research in older classes doesn't indicate that more people actually ended up doing research. Academic institutions aren't at a loss for employees

4) the author admitted that debt is a big reason for people to not go into research. The research environment is disfavorable for many other reasons. Without addressing these issues, why is there any reason to believe more people will go into research just because more research loving people are admitted?

5) Why would it be more valuable to admit a MD student who is more interested in research than clinical care when PhDs exist? (There are some potential benefits, but do you think these benefits outweigh the fact that we do need our doctors to perform their clinical duties?) Especially when it costs a lot to train a dr

Just some things to think about because there are always more ways to look at things
 
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Officer Farva

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I wouldn't call your threads pro-science....

1) How do you tell the difference between someone really into research and someone who isn't? More students now come into med school with research than in the past. Med school committees might think they are admitting people who want to do research and the people professing to want to do research in past med school classes might not have even known what doing research is like before they went into medicine

2) We are getting more specialized in all careers. What if people instead of doing MD/PhDs are just getting PhDs in order to do medical research? There are a lot of costs in adding that MD and many people may not see benefit in that.

3) The percentage of MD/PhD students isn't decreasing, so who is to say that we are producing less physician-scientists? Just because more people professed to liking research in older classes doesn't indicate that more people actually ended up doing research. Academic institutions aren't at a loss for employees

4) the author admitted that debt is a big reason for people to not go into research. The research environment is disfavorable for many other reasons. Without addressing these issues, why is there any reason to believe more people will go into research just because more research loving people are admitted?

5) Why would it be more valuable to admit a MD student who is more interested in research than clinical care when PhDs exist? (There are some potential benefits, but do you think these benefits outweigh the fact that we do need our doctors to perform their clinical duties?) Especially when it costs a lot to train a dr

Just some things to think about because there are always more ways to look at things
All very interesting and valid points!

After talking to my PI, an MD/PHD who never did residency, she believes that pure MD's are beneficial for understanding implications of research, and PhDs are better at understanding the purely theoretical. You get rid of the MD-researchers, you are not translating laboratory research into clinical practice. You get rid of the PhDs, you don't have any new innovative ideas and medical research is stunted.

You need both MD's and PhD's working together, without one or the other, our system for research will fail.

Outside of MD/PhDs, we need pure MDs who at least want to contribute to the research process.
 
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Officer Farva

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Hey I see you are an MD/PhD. Don't worry, clinical MDs are not making enough to justify a lot of administrative headache as they used to. I would rather make 10-20% of what I would make as a purely clinical MD in research than deal with the headaches nowadays for a bit more money.

WE NEED RESEARCHERS.
 

justadream

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The key is to sort out who ACTUALLY wants to do research as a career.

This issue will be a problem for research-heavy institutions because it's somewhat difficult to tell who truly wants to do research.

After all, the politically correct answer when interviewing at any research-heavy institution is to proclaim your vast and unyielding love for research (but also have an answer ready for the "well then why not MD/PhD" question).
 

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The key is to sort out who ACTUALLY wants to do research as a career.

This issue will be a problem for research-heavy institutions because it's somewhat difficult to tell who truly wants to do research.

After all, the politically correct answer when interviewing at any research-heavy institution is to proclaim your vast and unyielding love for research (but also have an answer ready for the "well then why not MD/PhD" question).
My experience interviewing at research-heavy schools is that they want researchers who are somewhat research-oriented, but not too research oriented.

Very wishy-washy about research.
 

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Hey I see you are an MD/PhD. Don't worry, clinical MDs are not making enough to justify a lot of administrative headache as they used to. I would rather make 10-20% of what I would make as a purely clinical MD in research than deal with the headaches nowadays for a bit more money.

WE NEED RESEARCHERS.
Lol if you think pursuing a research career especially as a physician scientist has less headaches than clinical medicine.
 

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I am curious if the author's views have evolved in the intervening 13 years.

Wondering why there aren't more physician-scientists is like wondering why someone would choose a pile of money over a tightrope walk that culminates in the retrieval of a ham sandwich.
This is great, making this my new profile blurb lol
 

darkjedi

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MD/PhDs are an integral part of medical research. For grant writing, that MD on top of the PhD carries an enormous amount of weight. The truth of the matter is that there are probably a surplus of PhDs being graduated into an already relatively saturated field. In comparison, the are a very limited number of MD/PhDs, and even less who continue onto purely research.

I wouldn't call your threads pro-science....

1) How do you tell the difference between someone really into research and someone who isn't? More students now come into med school with research than in the past. Med school committees might think they are admitting people who want to do research and the people professing to want to do research in past med school classes might not have even known what doing research is like before they went into medicine

2) We are getting more specialized in all careers. What if people instead of doing MD/PhDs are just getting PhDs in order to do medical research? There are a lot of costs in adding that MD and many people may not see benefit in that.

3) The percentage of MD/PhD students isn't decreasing, so who is to say that we are producing less physician-scientists? Just because more people professed to liking research in older classes doesn't indicate that more people actually ended up doing research. Academic institutions aren't at a loss for employees

4) the author admitted that debt is a big reason for people to not go into research. The research environment is disfavorable for many other reasons. Without addressing these issues, why is there any reason to believe more people will go into research just because more research loving people are admitted?

5) Why would it be more valuable to admit a MD student who is more interested in research than clinical care when PhDs exist? (There are some potential benefits, but do you think these benefits outweigh the fact that we do need our doctors to perform their clinical duties?) Especially when it costs a lot to train a dr

Just some things to think about because there are always more ways to look at things
 

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Wondering why there aren't more physician-scientists is like wondering why someone would choose a pile of money over a tightrope walk that culminates in the retrieval of a ham sandwich.
 
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I'm not really interested in an MD/Ph.D but Thomas Südof, MD, is one of many reasons I have for wanting to make room for a research component to my career. Look at that face! Just look at that happy bassoonist!

View attachment 200289

Staying interested in life is happiness.
My favorite MD role models in life are researchers, in terms of career and personality. I guess I fit in more with the research geeks ;)
 

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Undergraduate research seems to have become another 'check box' for med school applicants to check off prior to applying. Of course more med students have it...
No way.

I was certain that sophomore who did southern blots and cleaned glassware 3 days a week for a summer was REALLY interested in studying novel approaches to regenerating pancreatic tissue in Type I diabetics. At least, that's what he said in his interview.
 
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Officer Farva

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No way.

I was certain that sophomore who did southern blots and cleaned glassware 3 days a week for a summer was REALLY interested in studying novel approaches to regenerating pancreatic tissue to cure diabetes. At least, that's what he said in his interview.
Maybe he was really interested.....
 

mistafab

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I love research.

With my GPA and MCAT, I did not make the minimum bar for MSTP.

With the 300k dollars of debt I will incur during my medical training, my love of research will be slowly beaten out of me.

Tis sad, but I do not see myself venturing into academic medicine until mid-career. I will continue to do research on the side but I will not be able to focus on it like I want to until I can live comfortably and have my debt paid off.
 

URHere

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Wondering why there aren't more physician-scientists is like wondering why someone would choose a pile of money over a tightrope walk that culminates in the retrieval of a ham sandwich.
Personally, I would pay money for the chance to walk a tightrope. Or swing on a trapeze. If there's a snack waiting at the other side, that's just a nice meaty bonus.

But...I understand your analogy. Oh well, there are always hostels, public buses, and places willing to buy my belongings when I end up utterly broke.
 
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Officer Farva

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Personally, I would pay money for the chance to walk a tightrope. Or swing on a trapeze. If there's a snack waiting at the other side, that's just a nice meaty bonus.

But...I understand your analogy. Oh well, there are always hostels, public buses, and places willing to buy my belongings when I end up utterly broke.
From what I heard from MD/PhD labmates and PIs, there is not enough MD/PhDs out there to fulfill the demand for physician-scientists. Unless a lot of PhDs feel like going back to school that is. I think MD-only physician-scientists would be quite useful.

However, tell that to the last school I visited, who is more interested in finding the next Shakira or Van Gogh for their medical student class over the next Shinya Yamanaka or Jonas Salk.
 

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From what I heard from MD/PhD labmates and PIs, there is not enough MD/PhDs out there to fulfill the demand for physician-scientists. Unless a lot of PhDs feel like going back to school that is. I think MD-only physician-scientists would be quite useful.

However, tell that to the last school I visited, who is more interested in finding the next Shakira or Van Gogh for their medical student class over the next Shinya Yamanaka or Jonas Salk.
Honestly, the rate limiting factor here is funding. For my lab's last grant application cycle, paylines were below 4% (meaning that the top 4% of applicants got money and the rest were SOL). Sure, you can apply again, but you need new ideas or data if you want to submit more than twice, and there are only so many cycles before your existing grants run out.

The point is that most people with back-up plans aren't taking risks like this, and I doubt MD-only scientists are the answer. If MD/PhDs struggle with funding, someone with $300k in medical school debt would struggle even more, especially when you consider that they have to hunt out their research training during residency and many fail to secure grants that will allow them to continue in research.

The answer is better funding. This country needs to support research in a way that offers some sort of job security to scientists. If not, the physician scientist path is doomed, at least for those of us in basic science research.
 
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Officer Farva

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Honestly, the rate limiting factor here is funding. For my lab's last grant application cycle, paylines were below 4% (meaning that the top 4% of applicants got money and the rest were SOL). Sure, you can apply again, but you need new ideas or data if you want to submit more than twice, and there are only so many cycles before your existing grants run out.

The point is that most people with back-up plans aren't taking risks like this, and I doubt MD-only scientists are the answer. If MD/PhDs struggle with funding, someone with $300k in medical school debt would struggle even more, especially when you consider that they have to hunt out their research training during residency and many fail to secure grants that will allow them to continue in research.

The answer is better funding. This country needs to support research in a way that offers some sort of job security to scientists. If not, the physician scientist path is doomed, at least for those of us in basic science research.
I would love better funding. Its a shame that this country is heading in a direction that emphasizes cost cutting and prevention above treatment research. Sure, prevention is effective, but you can't prevent all diseases by diet, exercise, and annual checkups! That's where researchers like you come into play.
 

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WE NEED RESEARCHERS.
As @URHere stated, the root of the problem is primarily funding. It's not like NIH has a bunch of unclaimed grant money lying around in perpetuity. If you doubled the number of researchers the net result would be a halving of the existing payline, which would not serve anyone.

That said, the system has other serious problems (worse, even, than admissions committees). Length of training, which has crept up steadily since the 1980's, is a big one. Here are a couple of more recent articles from The Journal of Clinical Investigation that discuss this issue in more detail:

Rescuing the physician-scientist workforce: the time for action is now
Challenges and opportunities for reinvigorating the physician-scientist pipeline
 

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JustAPhD

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Without an increase in funding the problem will only get worse, unfortunately. As @URHere said, less than 10% of grants get funded. That means PIs are devoting a large percentage of their time to grant writing. Tack that onto any teaching responsibilities and the time left for actual science is quite small. Less time for science = less publications, and in the current "publish or perish" culture this means a lot of institutions are becoming revolving doors for scientists. not exactly an attractive situation to say the least.
 

eteshoe

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Honestly, the rate limiting factor here is funding. For my lab's last grant application cycle, paylines were below 4% (meaning that the top 4% of applicants got money and the rest were SOL). Sure, you can apply again, but you need new ideas or data if you want to submit more than twice, and there are only so many cycles before your existing grants run out.

The point is that most people with back-up plans aren't taking risks like this, and I doubt MD-only scientists are the answer. If MD/PhDs struggle with funding, someone with $300k in medical school debt would struggle even more, especially when you consider that they have to hunt out their research training during residency and many fail to secure grants that will allow them to continue in research.

The answer is better funding. This country needs to support research in a way that offers some sort of job security to scientists. If not, the physician scientist path is doomed, at least for those of us in basic science research.
Finally, was wondering when someone would bring this up. In the US, the problem could be alleviated by a 5-10% cut in the defense funding going to science research
 
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I knew Dr Sudhof when I was in grad school. He never looked that happy, and neither did his post docs . He did smile if he saw them work in in the lab at 11 PM.



I'm not really interested in an MD/Ph.D but Thomas Südof, MD, is one of many reasons I have for wanting to make room for a research component to my career. Look at that face! Just look at that happy bassoonist!

View attachment 200289

Staying interested in life is happiness.
 

Lucca

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I would love better funding. Its a shame that this country is heading in a direction that emphasizes cost cutting and prevention above treatment research. Sure, prevention is effective, but you can't prevent all diseases by diet, exercise, and annual checkups! That's where researchers like you come into play.
I'm interested in the basic sciences myself but American healthcare is riddled with systemic problems that require a different kind of approach (and not just that of a physician's, but of a whole slew of experts and researchers and professionals) than basic science. This kind of statement is laughable in a world where quality improvement is the name of the game not because it's a buzzword but because it should have been 50 years ago and now it's QI or Die. Personally, I hope more economists and systems engineers lend their talents and minds to tackling healthcare system problems.

I think the main pushback against your posts is due to the fact that most of us on SDN don't see it as "clinic or soft stuff vs sciences and hard stuff". Rather, we see it as "all of the stuff". Research across the board should be a bigger priority of the American government. You would think that "learning how to spend taxpayer money more effectively" would be an easy sell to people because both types of research can work towards that goal, but Congress is this evening's entertainment and they aim to surprise.

I don't think it's possible to spend a significant amount of time around American healthcare without acquiring an acute sense of desperation regarding the variety and magnitude of problems there are to solve. It's one of the exciting things about wanting to participate, especially in academe but it's also terrifying. Now is not the time for belittling serious disciplines who have something to contribute.
 

Goro

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Jeeze, Farva, you've really outdone yourself. This is why I recommend the software job over a medical career.


I would love better funding. Its a shame that this country is heading in a direction that emphasizes cost cutting and prevention above treatment research. Sure, prevention is effective, but you can't prevent all diseases by diet, exercise, and annual checkups! That's where researchers like you come into play.
 

URHere

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I would love better funding. Its a shame that this country is heading in a direction that emphasizes cost cutting and prevention above treatment research. Sure, prevention is effective, but you can't prevent all diseases by diet, exercise, and annual checkups! That's where researchers like you come into play.
Two things:

1) Clinically, it's always better, cheaper, and easier to prevent something than to treat it once it develops. Prevention should be a huge focus of medicine.

2) Not all research is focused on treatment. Many scientists study the links between environmental/behavioral factors and disease to see exactly how diseases can be prevented. Still others will look at the efficacy of screening techniques so that we can catch problems early without wasting a ton of money or exposing patients to unnecessary radiation or invasive tests. Drug development, epidemiology, genetics, clinical studies, case reviews...all of these are important components of medical research. We need to fund and support all of them if we want the best for the medical field and society.