Often MD/PhD students begin a program, only to withdraw from the PhD portion later in the program. Does anyone have ideas for how to screen applicants in order to accomplish lower attrition rates? In other words, what questions might you ask that would help give you a better sense of whether or not applicant X will finish the entire program? Interested to hear your thoughts.
MSTP applicant screening questions
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So, tell me about your research?
The prior 2 questions dealing with talking about research and guessing what you'll be doing in 10-15 yrs are unfortunately quite common and don't really contribute much towards predicting an applicant's likelihood to remain in a program. I'm looking for more creative questions that haven't necessarily been asked before. For example, "tell me about an experience in which you bit off more than you could chew" or "tell me about an interpersonal conflict you have had with a colleague over the past year and how you resolved it". The 2nd question was asked of me on a residency interview.
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I do not like gimmick questions. Talking to an applicant about his research for a half hour or so is enough to assess the following: 1) does he know what he is talking about? 2) did he do any of the thinking for his research? and 3) does he know what he is getting into? The final point is the one in which you seem most interested. Graduate school is open-ended and many (most?) experiments fail. Students who do not realize these points may be in for a shock.
Dropping out in the middle of grad school is rare at my program; people usually tough it out and then swear off research (after residency interviews of course 😉. Students either fail out of the program in MS year 1 or 2, or drop out after MS2. MCAT score is the best predictor for the former case, but I know of none for the latter (often it involves a life change that could not be predicted prior to med school).
Dropping out in the middle of grad school is rare at my program; people usually tough it out and then swear off research (after residency interviews of course 😉. Students either fail out of the program in MS year 1 or 2, or drop out after MS2. MCAT score is the best predictor for the former case, but I know of none for the latter (often it involves a life change that could not be predicted prior to med school).
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Frankly, I don't think there is a way to predict which applicants are going to become researchers. If they have an interest in research, experience doing it, and a clear vision of what an MD/PhD does, how are you to say they aren't going to go do it?
I think MD/PhDs who fall off the wagon have experiences that lead them to do so. Maybe they have family and kids and they can't justify to them that they're making peanuts when they could be out there making 200k+. Maybe they had a horrible lab experience due to a bad mentor, getting scooped, or just because their experiments never did work, and they've had enough of research. Who knows?
Besides, do you really expect pre-meds to know really what MD/PhD is going to be like for them? Sure, they can have MD/PhD role models, but how do they know what they're going to think in training and in the real world? Maybe they just won't like it? Some people propose that we should go back to forcing MD/PhDs to do some amount of research.
Maybe there are some amount of pre-meds who really are just ignorant and don't know what they're getting themselves into. I've heard stories from physician-scientists about these types when they're speaking of themselves. Then again, I've seen people who have always known the MD/PhD life (maybe they even had parents who are MD/PhDs) and who have always wanted it, who had to decide it wasn't for them for one reason or another. I see both types (clued and unclued) in my program. Is it possible to predict which will become the researchers? I don't think so.
I think MD/PhDs who fall off the wagon have experiences that lead them to do so. Maybe they have family and kids and they can't justify to them that they're making peanuts when they could be out there making 200k+. Maybe they had a horrible lab experience due to a bad mentor, getting scooped, or just because their experiments never did work, and they've had enough of research. Who knows?
Besides, do you really expect pre-meds to know really what MD/PhD is going to be like for them? Sure, they can have MD/PhD role models, but how do they know what they're going to think in training and in the real world? Maybe they just won't like it? Some people propose that we should go back to forcing MD/PhDs to do some amount of research.
Maybe there are some amount of pre-meds who really are just ignorant and don't know what they're getting themselves into. I've heard stories from physician-scientists about these types when they're speaking of themselves. Then again, I've seen people who have always known the MD/PhD life (maybe they even had parents who are MD/PhDs) and who have always wanted it, who had to decide it wasn't for them for one reason or another. I see both types (clued and unclued) in my program. Is it possible to predict which will become the researchers? I don't think so.
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I think the questions need to get at:
1) Motivation to enter the MSTP/MDPhD training. If somehow it sounds like financial reward is a significant part of it, chances are this person will forgo 3 years of tuition for a quicker (and larger) pay check by finishing MD sooner.
2) Other life plans: for people who want families or who do have families already, how do they incorporate their medical training into their life plans AND vice versa? I have seen a few women drop out because they want to have a family instead of a career.
3) Motivation to enter medicine. If it is to PROVE a point, that he/she of a certain background can also "make it", then the applicant is a somewhat risky candidate to me. It has nothing to do with his or her background, but rather the motivation is wrong. Soon the motivation to PROVE anything will wear out, and they'll settle for the easiest thing to prove.
4) This question is asked all the time, but there aren't that many good answers: why both MD and PhD instead of MD only? Another way to ask this would be, if you could ONLY choose between MD and PhD, which would you choose?
5) Prior exposure to combined training and what they see as disadvantages of such training. I am at times surprised at how many people who decide to drop out of combined training are actually people who have done extensive amount of research as an undergrad at the particular institution where they have enrolled as MSTP students. I think the reason is that faculty actively encourage these bright and talented students to apply for the MSTP/MD-PhD training and the students sign on the dotted line based only on faculty advice without careful consideration only to regret it later.
6) Don't admit anyone into MSTP programs who otherwise would not have gotten into MD-only programs. Some people DO use the MSTP route as a backdoor to med school.
1) Motivation to enter the MSTP/MDPhD training. If somehow it sounds like financial reward is a significant part of it, chances are this person will forgo 3 years of tuition for a quicker (and larger) pay check by finishing MD sooner.
2) Other life plans: for people who want families or who do have families already, how do they incorporate their medical training into their life plans AND vice versa? I have seen a few women drop out because they want to have a family instead of a career.
3) Motivation to enter medicine. If it is to PROVE a point, that he/she of a certain background can also "make it", then the applicant is a somewhat risky candidate to me. It has nothing to do with his or her background, but rather the motivation is wrong. Soon the motivation to PROVE anything will wear out, and they'll settle for the easiest thing to prove.
4) This question is asked all the time, but there aren't that many good answers: why both MD and PhD instead of MD only? Another way to ask this would be, if you could ONLY choose between MD and PhD, which would you choose?
5) Prior exposure to combined training and what they see as disadvantages of such training. I am at times surprised at how many people who decide to drop out of combined training are actually people who have done extensive amount of research as an undergrad at the particular institution where they have enrolled as MSTP students. I think the reason is that faculty actively encourage these bright and talented students to apply for the MSTP/MD-PhD training and the students sign on the dotted line based only on faculty advice without careful consideration only to regret it later.
6) Don't admit anyone into MSTP programs who otherwise would not have gotten into MD-only programs. Some people DO use the MSTP route as a backdoor to med school.
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pathdr2b said:
Well that would have ruled me out. I wonder if all the slots could be filled under such strict criteria.
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the citizen said:
Maybe all slots could not have been filled with this criteria but should the goal be to fill the slots or be reasonably sure these programs are in fact producing physician/scientist. Of the people I know in MD/PhD programs or that have finished them, they ALL had one and usually both of these criteria going in. And they are ALL still doing research.
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Neuronix said:
that almost necessitates taking a year+ after ugrad.
i think there's a fine balance between having graduates who do research as a majority of their time (obviously important) and recruiting qualified people who are willing to do so--people change. IMHO, it's also not much good for people to still be doing research if their research has no impact on the community (scientific and otherwise). the problem for adcoms is that they will never know a priori who will be the next watson.mullis.etc and whom will (to put it rather crudely) fail miserably. yet another factor is simply immeasurable; i don't think anybody here would deny that plain luck can make and/or break a career.
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I am not a fan of taking MSTP students ONLY from those who have done post-bacs (be it one year or twenty years). There are plenty of driven and talented college grads who have only done 1-2 years of research that have demonstrated more progress and determination than years and years of research and publication. You can achieve the latter easily as a life-time lab tech, but they are not leaders of medicine or science.
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I know that in my current lab, the person that essentially "runs" the lab only has a master's degree and is considered just the "tech" but if you ask anyone in our research group if any of us could do without her the answer would be unequvically no way! And the proof in her value is that she has more publications that ALL of the MD/PhD's I know and she hasn't been in the system 100 years either.
So far as I know, no one became a great scientist without the help of the lowly lab tech. Just like great doctors NEED a great support staff to be great.
Perhaps, what MSTP's need to be looking for in their applicants are people that understand that science and medicine works because we all are memebers of a TEAM, with no on person having a more important role than anyone else based on the number of letters behind your name.
Yeah, I think a humility test for MD/PhD interviews could go a long, long, way....
So far as I know, no one became a great scientist without the help of the lowly lab tech. Just like great doctors NEED a great support staff to be great.
Perhaps, what MSTP's need to be looking for in their applicants are people that understand that science and medicine works because we all are memebers of a TEAM, with no on person having a more important role than anyone else based on the number of letters behind your name.
Yeah, I think a humility test for MD/PhD interviews could go a long, long, way....
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pathdr2b said:
Every lab has one of those. There is no denying her abilities to do science under someone's direction, but there is also no point in equating her to the PI because she is not. I think everyone else on this board appreciates the fact that every lab needs a lead tech and other techs to function, but not many would not make them the majority of MSTP applicant pool similar to how you don't get most MD students from nurses. Once again, training and the money that goes towards training at this level is for people who have enough producive years LEFT to contribute and for people who have tons more potential than a lifetime of products they help complete under others' guidance.
Or an intelligence test for that matter. In your lifelong pursuit of respect from others for your disadvantaged background, perhaps YOU are missing the big picture.
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While I was applying a couple of years ago for a position in this program at my school that would pay me for doing research I was asked if I preferred driving a Porsche or maybe winning the Nobel prize. I know it sounds kind of far-fecthed but I know they wanted me to realize that most probably as a researcher I won't ever own a Porsche 996 and that even though I would prefer the Noberl prize over a car (who wouldn't) I had to like research enough so that even if I never win the Nobel prize I would still like what I am doing sans le Porsche.
I would ask students if they have faced hardships while working in research, this will let you know if they know that research does not always work out, that maybe someday they will be faced with an experiment that does not work, or a mentor that is just making you work for their own interests and forgets about your goals and purpose in the lab. If they haven't faced hardships then I would postulate an imaginary scenario where things do not work out and are not as "peaches and cream" as the student maybe imagines it. Maybe asking the student not what he/she will be doing in 10 yrs but how does he imagine the coming up ten yrs will be, it might show how realistic the student is about research.
I would ask students if they have faced hardships while working in research, this will let you know if they know that research does not always work out, that maybe someday they will be faced with an experiment that does not work, or a mentor that is just making you work for their own interests and forgets about your goals and purpose in the lab. If they haven't faced hardships then I would postulate an imaginary scenario where things do not work out and are not as "peaches and cream" as the student maybe imagines it. Maybe asking the student not what he/she will be doing in 10 yrs but how does he imagine the coming up ten yrs will be, it might show how realistic the student is about research.
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Great point !!! Unfortunately what I've come to realize is that this profession is filled with ego maniacs!jeonsied said:
jeonsied said:
This is a great idea!!! 👍 But if the applicant already had say 3-4 years of solidresearch experience they would have a real story to tell about "hardships" in the lab. I know I have plenty!
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pathdr2b said:
We could also make it a requirement that the applicant has to be at least 35 years of age, born in the US, and has held political office in local government...
Why should a talented high school or college basketball player have to play in the European league for 20 years before being considered for the NBA?
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If an applicant has four years in the lab and some 1st author papers under his belt, he likely does not need any more PhD training. Certainly he could polish his skills during a fellowship.
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the citizen said:
Sure, but how do you explain the fact the when it comes to competition for grants, ect, that MD/PhD's have the advantage? Unfortunately in this life, somethings ARE about the letters behind your name. This is about "career advantage".
Another point is that over the years, I've seen plenty people with numerous publications and bachelor's degrees regret not going for their PhD's. Why live your life in regret? If there's something you want to achieve, then I say just do it!!! 👍
Then of course for me personally, it's about "finishing the job" and surely you guys can relate to that, right? You know finish what you start.......
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pathdr2b said:
Well, there are two options:
1) Study sections look for MD/PhDs and rate their work higher a priori; or
2) In general, the MD/PhD is better trained for research than the MD and thus writes better grants and does better research.
I would explain the overall MD/PhD advantage with #2 not #1. However, at the individual level this advantage may not exist. Surely you know of many straight MDs who do very strong research.
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the citizen said:
I agree with you about option #2 especially when it comes to translational research and yes I do know many MD's AND PhD's that do very strong research. However, being around pathology, urology, and radiology residents over the past year or so has clearly illustrated to me that when it comes to evaluating problems, even highly clinical ones, the MD/PhD's draw circles around everyone else at the same residency training level. Does this mean that everyone else is incompetent, of course not, but I'm talking again about a training advantage here.
