MD/PhD --> MD (dropped out PhD)

[drcushing]

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Hi, I'm a current MD/PhD student at a small-medium size school. I was just wondering what is the typical PhD attrition rate in MD/PhD programs are since these data are not easily attainable. For the MD/PhD students/graduates out there, please provide a rough estimate in your school..

My school had about 23 students and 5 dropped out the PhD program and went back to complete MD.

 

[gstrub]

Well for us, if you drop the PhD part, you have to repay all stipend/tuition wavier money, so there is a lot of motivation NOT do drop.

That being said, since I have been in the program (5yrs), 1 student has voluntarily withdrawn, 2 students failed to make grades, and one student was dismissed from school for a non-academic offense. There are approximately 50 students in our MD/PhD program.

 

[Neuronix]

so there is a lot of motivation NOT do drop.

It is unlikely the courts will enforce this sort of contract, so it is more a threat than it is a reality. Still, only non-MSTPs are allowed to have students sign contracts to this effect. The NIGMS's official position is that this sort of coersion to stay in graduate school is wrong. It is partially for this reason I always recommend applicants strongly favor NIGMS MSTPs (the programs receiving federal funding). You never know how you might get screwed by graduate school for things that aren't your fault. You also never know what might happen to you in life that might make you want to leave graduate school.

In my 5th year class only 1 student has dropped so far. The attrition rate is highly variable from class to class. My guess is that it is on the order of 10-20% (1-5 per recent class of 20+). It was much more when not everyone was fully-funded, but we have been all funded for almost 10 years now here. I know the dropout rate is higher for straight PhD students, but I wonder how much higher.

 

[drcushing]

You raised a good point about whether your particular school requires you to pay back first 2 years' tuition. That certainly would discourage students to drop the PhD program.

As for PhD attrition rate for a PhD straight program, I also think that it is higher than MD/PhD's. For sure this sort of things vary greatly among programs/schools, I know several PhD programs have about 30 to 50% drop out rate. Percentages are higher for programs that have an intermediate Masters --> PhD transition.

 

[Maebea]

Attrition rates are one things that programs do not talk much about. The NIH has said that 15% is acceptable for attrition. Neuronix is correct, it does seem to go in spurts. beyond the intraprogram attrition is the attrition from the physician-scientist career after graduation. Another 15% or so decide not to do any research (the proportion has been growing in the last decade). So, of an entering class of 20, maybe 13 or 14 will end up completing both degrees and do at least some research in their career. Some at the NIH, FASEB, & AAMC feel that this proportion is really too high, given the $150,000,000+ that is spent nationwide each year training MD-PhD students.

 

[Neuronix]

Another 15% or so decide not to do any research (the proportion has been growing in the last decade).

I wonder how this was measured. I remember seeing one paper that claimed ~90% of MD/PhD graduates were in "academic positions". The truth is that a vast number of academic positions are primarily RVU generating positions (including residency) with little to no research involved.

Is there any way to measure what proportion of MD/PhDs are bringing in their own grants? My guess is that if this was used as a benchmark, the estimates of percentage of MD/PhD graduates past residency/fellowship doing meaningful research (defined as bringing in research grants within the past 5 years with them as the PI) would be much much lower.

Some at the NIH, FASEB, & AAMC feel that this proportion is really too high, given the $150,000,000+ that is spent nationwide each year training MD-PhD students.

Not to argue with you, but to point out to the MD/PhD newbies an important viewpoint shared by many; this probably wouldn't happen if we didn't graduate into a world that rewarded clinical work better than research work in pretty much every possible way you can think of. I'm sure this is becoming more and more of an issue as R01s get harder and harder to get.

 

[Ariodant]

I do see such conditions as repay on the website of some non-MSTP dual degree programs. I guess since they pay 100% out their own pocket, they want to be sure it's not "wasted".

 

[computerdorkdan]

I'm sure this is becoming more and more of an issue as R01s get harder and harder to get.

What's an R01?

 

[Neuronix]

NIH grants get a code that are one letter and two numbers. An R01 grant is a large single project grant with a PI. I've heard them called "career-defining" because due to their size and individual nature most institutions use them to make decisions like tenure and promotions. To get one nowadays you have to be better than 90% of the other grants--i.e. they are extremely competitive to get. As a new PI looking for tenure, at least where I'm at, you'll need at least 2 of these within 7 years to get tenure. That is no easy feat at all, especially when you have clinical duties on top of that. I could talk about some of the crap deals "research tracks" get (50% research time for 3 years and expect an R01 to continue? Suuurrrreeeee).

Also, they tend to last on the order of 5 years, so PIs constantly have to fight for these. With the current setbacks I've seen numerous labs run out of money and have to fire people or even leave. The funding situation is no joke, and my guess is that it's the main reason for any MD/PhD shift to clinical work besides the fact that research has always paid less, had worse hours, less job stability, etc etc etc

 

[malchik]

As a new PI looking for tenure, at least where I'm at, you'll need at least 2 of these within 7 years to get tenure.

You sure about this? I find this hard to believe.

 

[Neuronix]

You sure about this? I find this hard to believe.

I've heard the 2 R01s to tenure idea from a lot of professors who would know such things. There is no official policy. If you asked the department head/dean you'd probably get the "blah blah blah I'm beating around the bush and not answering your question oh look at the time I have to go" answer. If you are in a clinical department and had some clinical duties, they may extend your tenure clock to 9 years, as opposed to the 7 years for basic science only people.

In basic science they also have the maternity leave extends the tenure clock policy. I assume this is true for the 9 year program as well?

Even getting a tenure track spot here is extremely competitive. Out of that, a publication that surveyed several big name research institutions put that figure at around 50%.

 

[computerdorkdan]

An R01 grant is a large single project grant with a PI.

To continue my "what does this mean" questions...what's a PI?

 

[Neuronix]

PI = Principal Investigator, the person who is responsible for the grant and usually wrote it. A big part of the grant as well is evaluating the PI's record, experience, and resources available to address the questions posed by the PI.

 

[Leforte]

First of all - tenure means little in most academic medicine departments. Tenure is important for PhD's, since it allows for job security when funding is low. As an MD/PhD, if you do clinical medicine and not 100% lab, you will always have a job. Your clinical income will support you if the NIH well starts to run dry. In fact, many academic medical centers have clinical and tenure tracts now. A person on a clinical tract still gets promoted based on teaching, service, etc and can become Assoc Prof or even Prof - just not tenured (a title of Clinical Associate Professor for example). Also, in academics, moving from one institution to another is quite common - when this happens, just because you were tenured at place A doesn't mean you'll be tenured at place B. It goes through the promotions committee just like internal candidates. You may be able to use tenureship for negotiating your contract - but there is no guarantee. Because of this, at my institution, many people enter the clinical tract.

I am finishing my residency soon, and as an MD/PhD surgeon, have accepted an academic position. I am not concerned about tenure, nor do I think that most MD/PhDs should. There is little that comes with a title in the clinical realm - people just care that you're a good physician or surgeon and if so, they will send patients to you. On the bench side, the basic scientist are often into their own thing, and yes, they do hold you to their standards when it comes to grant success, publications, etc when it comes time for promotion in a tenure tract.

Personally, just do good medicine and science, get along with everyone and you'll be fine.

 

[tr]

During my 7 years of MD-PhD I saw two students drop out. It's possible there were more that I wasn't aware of though. We had about 70 people in the program.

 

[Gfunk6]

The NIGMS's official position is that this sort of coersion to stay in graduate school is wrong. It is partially for this reason I always recommend applicants strongly favor NIGMS MSTPs (the programs receiving federal funding). You never know how you might get screwed by graduate school for things that aren't your fault. You also never know what might happen to you in life that might make you want to leave graduate school.

This is a very important point and bears repeating. In my own class of eight students, two students dropped out (one for family reasons and the other transferred to another MSTP to follow his spouse). I myself often reached points in grad school when I seriously considered throwing in the towel. In those cases I'm glad I didn't have to deal with the additional stress of impending debt hanging over my head.

 

[Foghorn]

Also, they tend to last on the order of 5 years, so PIs constantly have to fight for these. With the current setbacks I've seen numerous labs run out of money and have to fire people or even leave. The funding situation is no joke, and my guess is that it's the main reason for any MD/PhD shift to clinical work besides the fact that research has always paid less, had worse hours, less job stability, etc etc etc

Yes, I've seen this happen. I did an internship a couple years ago and my PI/supervisor was telling me about another PI (Ph.D. only) who had been in the institution 25+ years and had to close down his lab because he couldn't get funding anymore

I felt so sad for him. The time I was there, it was only the PI in his lab and no one else. But he kept plugging away, arriving in the wee hours of the morning to set up his experiments.

I think my PI, the lab I'm currently in, is up for tenure review in a couple of years. I sure hope she gets it 'cause I'm seriously considering doing my graduate work in her lab when it's time for me to apply.

 

[DeadCactus]

Maybe a silly question, but is there any sort of stigma associate with dropping the program that might follow someone around throughout their career?

 

[pseudoknot]

Maybe a silly question, but is there any sort of stigma associate with dropping the program that might follow someone around throughout their career?

I'd say no, since if you're dropping out of half of the program, presumably you will be pursuing a solely clinical or scientific career and you will have the same training as everyone else.

Despite what some people here say, there's not a single, straight path to each career destination that must be followed...people start programs, drop out, switch residencies, and do just fine. A stigma that follows you around forever would be something like scientific fraud or carving your initials into a patient's uterus.