MD/Ph.D Students

[iowaboy]

I am a MD/PH.D student at Iowa and I am currently in my second year of my PhD work. I was wondering from other students who have graduated from graduate school and have gotten back into the clinical years...how was the transition back into med school?? I am beginning to feel rusty in even basic things like anatomy and physiology. And thus I am starting to worry that I will have forgotten a lot by the time I get back into clinicals. Any thoughts???

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[mrp]

After 4 years working on my phd, I managed to return to med school last july. I was actually surprised--remembering everything really hasn't been a problem. I think there are a few reasons for this:

-Everyone else forgets things.
-The stuff you learned, while maybe not at instant recall currently, is somewhere in your head. I keep surprising myself by pulling random facts out of my a** that I learned 4-5 years ago. Once you get in the ward environment and start thinking about medicine, things come back.
-The things you learn on the wards are pretty different than what you learn in class. For instance, in surgery, you might anticipate that a thorough knowledge of anatomy is mandatory. Actually, for the shelf exam, you don't need to know any anatomy at all. The only reason you might need anatomy is for pimping during cases, which you can easily review before the surgery.

Anyway, don't stress about it--it will all be okay. I freaked out about this, and was quite pleasantly surprised at how I've stacked up with the other med students.

BTW, say hi to eric epping for me.

-mike peterson

 

[Hopkins2010]

I have to admit that as an entering MD/PhD student in 2002 the problem stated at the top of this thread is my one (and only) worry about the combined degree program.

I'm probably going to try to review some before I go back to the wards. I wont be able to review everything, but hopefully some of hte finer details will come back to me by associative learning with other related material.

 

[mrp]

I would suggest that rather than not remembering things when you return to the wards, the number one thing you should worry about is limiting the number of years in grad school. If you don't purposefully push towards graduating in a reasonable amount of time, grad school can stretch on and on and on. Careful selection of your lab and mentor can help greatly in this area.

It's a really, really long program.

-mrp

 

[bubster9]

what if you want to do MD/Ph.D but want to due something very clinically orientated. Do any MD/Ph.D'ers spend lots of time actually on the wards during research years thus they're not rusty. Also, what types of research keeps you very clinically orientated. I may want to do MD/Ph.D but want to not be in a lab constantly, I want to see, help, and heal patients but also research at the same time such as conducting clinical studies.

 

[mrp]

Hmmm...can't say that I know alot about this. It is pretty rare for people to do really clinically oriented research for the PhD portion, I think. As you probably know, the vast majority of people do bench work. But, depending on where you go to school, most programs are fairly flexible. Where I go, UCSD, the program is noted for its extreme flexibility. You can pretty much do anything you want here, so if you want to do clinically oriented research, the administration will support you as much as they can. The real trick is to find a good, supportive mentor and to work on a project that is important, original, and can be completed in a reasonable amount of time.

One thing to keep in mind is that (i think) clinially oriented projects can take quite a bit longer to complete than typical bench research, what with human subjects committees, and large amounts of data collection.

-mrp

 

[AnnK]

Hey -
Im a 3rd year returned from my Phd this summer. I will agree with the comments already made about not worrying too much about the transition. I have found it to be much easier than I thought and I had no time to review before I started. It is really a whole new set of information and skills for everyone. I might bring out the path or pharm book a little more often than my regular med school peers but thats about it.

Also, in regards to the questions about an interest in clinically oriented research... I had some of the same thoughts. I worked for an MD to do my PhD for that reason. I wound up doing a very basic science project with a advisor that wasn't as dedicated to basic science as a PhD. He also didn't understnad my qualifiers and dissertaion requirements. So, I dont think that this was a very good approach. I would say that the MD/PhD programs is really designed for people that want to do basic science lab work in addition to practice medicine. Unless you can find a school with a different approach, I think that you would be better off doing the MD with research honors or something like that. You could get very frustrated spending 3-6 years doing basic science otherwise.

Ann

 

[JJ4]

I agree with Ann. On another note, clinically oriented research (i.e. clinical trials and the sort) don't have much in the way of "thesis material" to work with. A thesis typically concerns elucidating a problem from the bottom up. By the time bench work begins getting translated to tractable therapies all the mechanisms have usually already been worked out. Then it's just a matter of testing efficacy and the like.

 

[Vader]

At several schools such as UCSF (where I'm attending), MSTP students can do a longitudinal clinical clerkship, for which they'll receive credit, during their Ph.D. years. This is usually arranged by the student in conjunction with a preceptor of interest. One setup would be to attend a weekly clinic. This enables the student to stay in contact with clinical medicine, while requiring only a minimal time committment.

Most MD/PhD students do laboratory benchwork during their thesis. Some students enter "dry labs." Few actually do clinical research. The idea of MD/PhD programs is to generate physician-scientists who will conduct basic biomedical research and help translate their discoveries into potential targets for therapy.

Of note, clinical research (i.e. measuring the efficacy of a drug versus another drug or placebo), often takes place without a precise knowledge of the underlying mechanisms. There are many drugs available for which the mechanism of action is not really known. In clinical research, elucidating the exact mechanism is not the primary goal--it is to determine efficacy, dosage, side effects, and other information.

In order to elucidate the mechanisms of drug action and hence pathways affected by disease, basic research is needed. A clinical study may raise interesting questions that can then be investigated at a more basic level, and thus we can learn more about pathogenic mechanisms and identify additional targets for treatment.

Just my 2 cents... well, maybe a nickel...

 

[gt5045b]

I have been doing semi-clinical research for my MD/PhD thesis work. Entering into the field of bioengineering will probably get you a little closer to patient and private buisness interactions. However, this type of work is not clinical trials and you'll probably have to wade through several more advanced math and engineering classes which will lengthen your stay in the PhD years.

 

[Hopkins2010]

Originally posted by gt5045b:
•I have been doing semi-clinical research for my MD/PhD thesis work. Entering into the field of bioengineering will probably get you a little closer to patient and private buisness interactions. However, this type of work is not clinical trials and you'll probably have to wade through several more advanced math and engineering classes which will lengthen your stay in the PhD years.•••

Most of the MD/PhD programs I've interviewed at do indeed have more course requirements for bioengineering graduate programs than for the others. You would probalby have to take a few advanced engineering electives like digital signal processing and biomedical instrumentation. On the other hand, I've also heard a lot of anecdotal stories from both bioengineering MD/PhDs and non bioengineering MD/PhDs that in bioengineering, once you get into your thesis lab you can possibly progress and finish your thesis faster than the average non-BME grad student, due primarily to the different nature of experiments and research that BME grad students tend to do.