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MD/PhD in Epi/other public health discipline

ltrain

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Jul 9, 2004
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    Hi guys,

    Sorry if this has been addressed previously...the google search didn't pull up anything for me.

    I'm thinking about applying MD/PhD with the PhD in epidemiology or perhaps health policy/decision science. Is there anyone out there doing a program like this? I've looked at the programs at all the MSTP schools and it seems like only a small portion of them would accomodate such a program. So I'd love to hear first-hand:

    1. Where are you going to school and what is the specific focus of your program?
    2. How have you been able to integrate your medical training with a public health discipline? What are you working on for your thesis/dissertation?
    3. Do you feel there is added benefit to getting a PhD to eventually do integrated academic research (as opposed to MD alone or MD/MPH)?

    Feel free to PM me if you don't want to share in the forum.
    Thanks!
    -L
     

    mendel121

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      I know that there have been students at U. Michigan that have done the PhD in Epi in the MSTP. I can't comment on the inner workings of the MSTP at UM with regards to the Epi PhD.

      I did my PhD in Epi, and I'm doing the MD at a different school. I really don't think that intergrating the two is a problem. Epi is very relevant to the learning and practice of Medicine.

      My dissertation was a genetic epi one - with gene mapping and mutation detection for a simple mendelian disease - my med school experience has helped me as I continue the work as I understand the anatomy and physiology of the disease I worked on much better - and I think that the PhD has helped me to look at med school from a more practical standpoint than I may have without the PhD

      I know others that did their dissertation work in more traditional epi contexts, and I know that a detailed knowlege of the path, anatomy and physiology of the disease they are working on would give them a huge lift in designing studies and asking the right questions.

      I guess that's a long winded way of saying that I think that an MD/PhD with the PhD in Epid is very useful and IMO is one of the more relevant pairings for the two degrees
       
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      fantasty

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        1. Where are you going to school and what is the specific focus of your program?
        University of Iowa. You can definitely do epidemiology, biostatistics, and probably environmental health. A few people have asked about community & behavioral health, or health management & policy, but I'm not sure that this would be viewed as favorably as epi/biostats. There are multiple areas that one could directly focus on within epidemiology - Infectious diseases; Genetic Epi, Pharmacoepidemiology; Chronic Disease Epidemiology (Cancer / cardiovascular disease); Injury prevention & Trauma; Perinatal / Reproductive Epidemiology (or birth defects); Nutritional Epi; Neuroepi; Epidemiology of Aging; Psychiatric epi; Clinical preventive services, or just general clinical epidemiology or basic population-based causal epidemiology (I'm sure I'm forgetting options, but these are the major focus areas in our dept). There is also a PhD program within the college of public health in Public Health Genetics, and also a Substance Abuse track.

        2. How have you been able to integrate your medical training with a public health discipline? What are you working on for your thesis/dissertation?
        I use medicine all the time in my research. I had to learn a lot of detailed pathology for each disease outcome that I've worked on (and to a lesser extent, pharmacology and other diagnostic or surgerical treatment options). I also have done studies that would be considered physiologic outcomes, and I'm working on a biomarker study of diet. My dissertation is in pharmacoepi, though (using existing data for a secondary analysis). (AND, I'll also add that having more public health coursework really helps with my confidence in clinical encounters - I've reinforced some of the basic pathology since I've learned more about the causes of diseases as well as the populations that they affect, and the MPH core-type requirements of health care systems and health behavior/health education are things that I feel most medical students do not get enough information about).

        3. Do you feel there is added benefit to getting a PhD to eventually do integrated academic research (as opposed to MD alone or MD/MPH)?
        I think that one CAN do competant clinical research with either of these combinations. Most med students can find opportunities (Doris Duke fellowships, NIH, Fogarty Fellowships) to do clinical research with a good mentor. The MPH by itself is not a research degree - it's an applied or professional degree. But, some places offer a MPH in clinical investigation (although one could mold a good biostats or epi MPH into an appropriate foundation for clinical research). In my program, however, I think that the PhD has improved my abilities to contribute to epidemiology as a field (aside from whatever clinical discipline I'll be in). That is, epidemiologic methods are evolving beyond your basic options and (IMHO) you need to take a rigorous sequence of both epi & biostats methods to appropriately design and analyze these newer, advanced study designs.
         

        ltrain

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        Jul 9, 2004
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          thanks for all the responses.

          another question i have is if it usually takes longer to finish an epi phd (since there is less overlapping coursework than with basic science phds). is it still reasonable to finish in 7 or 8 yrs?

          i know that a phd in epi is rare in the md/phd programs, but is there anyone else out there thinking about applying to these programs?
           

          Crazy Canuck

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            ltrain said:
            thanks for all the responses.

            another question i have is if it usually takes longer to finish an epi phd (since there is less overlapping coursework than with basic science phds). is it still reasonable to finish in 7 or 8 yrs?

            i know that a phd in epi is rare in the md/phd programs, but is there anyone else out there thinking about applying to these programs?

            I'm interested in taking the MD/PhD program in epi. I am working on my MSc in epi right now, and I think I would like to go the MD/PhD route so that I can get a better clinical understanding of disease causation, thus allowing me to do more detailed research in the future. I'm torn though. I'm not sure if I should just stick with an MSc, go with the MD/PhD or just do a PhD by itself. Any thoughts/experiences from others would be greatly appreciated!!
             

            uptoolate

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              Hopkins and PittMed both have Epi as an option in their MSTP program. I did a PhD in Epi before med school-at a different grad school than where I am currently attending medical school. I also have an MPH-but whoever said that the MPH is not really a research degree is right on.
               

              Doctor&Geek

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                ltrain said:
                another question i have is if it usually takes longer to finish an epi phd (since there is less overlapping coursework than with basic science phds). is it still reasonable to finish in 7 or 8 yrs?
                That is a valid concern. The School of Public Health here requires another year's worth of classes only on top of the first two years before starting dissertation research. However, students graduating from Public Health still finish the program in 8 years or less, and in one case, in 6 years.
                 

                fantasty

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                  ltrain said:
                  thanks for all the responses.

                  another question i have is if it usually takes longer to finish an epi phd (since there is less overlapping coursework than with basic science phds). is it still reasonable to finish in 7 or 8 yrs?

                  i know that a phd in epi is rare in the md/phd programs, but is there anyone else out there thinking about applying to these programs?
                  Good point, and I'll agree with both Crazy Canuck and JPaikman's comments. In our case, I had signficantly more coursework than my MSTP colleagues (although if you have a master's coming in, you might shave off some of this time). My MD coursework did not waive much (just pathology and physiology, although some of my previous stats and epi from before helped me skip a few intro courses).

                  In our MSTP, I'd say 4 years in graduate training is the average for everyone (that would be 7 overall, as we shuffle our clinical requirements to a little over 1 year). Most basic science folks take roughly 1 year of courses and then 3 years of lab work (varies by department of course). I had 3 years of coursework and (hopefully) only one year of post-comps dissertation only work. I didn't mind that, because I felt that most of the coursework was worth it, and I was still actively doing research as a 50% time grad RA. I do think it would be conceivable for a student with a master's already to finish in 3 years (6 overall).

                  The only program that I personally know epi folks at is UAB, and they've taken a little longer to finish (I'd say 8+). I've heard rumors of a biostats student at Northwestern only needing a few months for the dissertation because their work was mostly a mathematical theorum, but I'd guess they had a similar amount of coursework required as we do in epi.

                  It is important to start working on research early in graduate school, and JPaikman's comment is true here, too. Normally, incoming epi students have a hard time finding a grad RA position because the dept wants more experienced students in the research position. But, if you have a research background, it's not hard to jockey into a position. And, since MSTP students have to find mentors who are committed to supporting them, I had no problem finding a PI to work with who was also willing to start me on some really good projects as soon as I hit grad school.
                   
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