MSTP Boulevard part 01

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hey shogun,
i feel your pain/confusion/whatever. after several md/phd interviews, i got my first rejection w/o interview from a school i had applied to only md. huh? maybe they found out about the other applications?
 
Hey Rondo it's good to "see" you. I'm sorry about the rejection. I'm sure it's inferiority complex on their part cause they know you're too good for them. I really hope you come to Duke. My crazy and unpredictable self just decided an hour ago that I'll go to Duke. I called them up for the 2nd time today and asked them to send me all the paper work and stuff. Hey definitely keep in touch. I hope to see you at 2nd look.
 
Hey Everyone!

I got two letters in the mail today, both good and bad news:

First, I got rejected from the WashU MSTP. I guess they gave my application a second look and still didn't like it. I'm kind of bummed b/c they have a really robust program. Since I've gotten into UCSF, I'm going to withdraw my app from the regular MD program there. But...

I got an MSTP interview invite from the Big H! I'm still pretty shocked about it...but it looks like I'll be visiting on January 29th. I'm really excited to check out the school, Boston, and my friends in the area.

MapK

P.S. ORIGINAL: I also think it's a good sign that Harvard contacted your references...thanks for the heads up b/c I might warn my letter writers.
 
hey guys,

original, congratulations on your decision. are you sure you ain't gonna change your mind a million more times? 🙂 btw, i know durham is quiet, but if you think st. louis is a happening town, you gots another thing coming.

mr. mapk, congratulations on your interview! you must be one happy dude!
 
Mapk,

Congrats on your Harvard interview, thats awesome. I looked at their website and according to it, there are only 4 interview dates and the last one is on Jan 29th. So needless to say, if I dont get the interview letter then at least I wont have to wait to hear from them anymore.

Did your interview letter give a deadline for responding? I wont be able to check my mailbox until 2 weeks from now. Its very inprobable that I got an interview letter anyways, but on the slim chance that I did get one it would really suck to not respond to it in time. Did the invite come only via snail mail or did they email you also?
 
Hi Baylor and Rondo,

Thanks! I'm certainly happy and excited! Baylor, I follow your logic on ruling yourself out of an interview...but with this year's AMCAS, perhaps Harvard will offer more dates or postponed earlier dates until later in the Spring. I'm going to call the admissions people tommorrow to confirm my interview and I'll try to ask them about the dates.

So my letter did not give a deadline for responding...it just asked me to (1) schedule an interview with the New Pathway or HST people on the preceeding or following day, and (2) call to confirm that I will be going to the interview ASAP. BTW, I applied only for the New Pathway and I only got the invite by snail mail.

MapK
 
Map,
Congrats of the BIG H! Would you go there over Cornell if everything worked out?

Baylor: I agree with MAP. It is too early to consider yourself out of the running at Harvard. With all your interviews you have gotten, I would have to think Harvard will take a serious look at you.

This is a question to all of you who might know. Has anyone gotten a sense of how many people are applying for MD/PhD this year? I know that it is a small minority amongst the total applicant pool, but I was wondering how small(or big for that matter)it really is. At one of my interviews, the Dean told our interview group that there is a real shortage of people applying to do medicine/research. I should have asked him whether he was implying MD/PhD or not.
 
Hey EVERYONE!

So I called Harvard today and the MD/PhD coordinator says that they have opened up TWO NEW DATES for interviews after January 29th. I seems like they are trying to speed things up with interview invites...the regular MD people told me that the MD/PhD committee has started inviting people before checking with them!

BAYLOR: Check your PM.

SHOGUN: Harvard vs. Cornell? First I'll have to get in...then I'll see how my visit feels. I'm pretty big on feeling out the city and surrounding environment...

MapK
 
*bump*

And a question to the MSTP applicants out there: What would you do with your MD/PhD once you get it? Out of the following:

1) Practice only
2) Research only
3) Teach only
4) Teach + Research
5) Practice + Research
6) Teach + Practice
7) Do all three, you superwoman you
8) Hell if I know
9) Investment banking
 
Hey MAP! Congrats on the big H. must be nice 🙂 . Few things a friend hinted me prior to my interview there:

If there's a relatively good chance that you'll go there if accepted, then definitely let them know. Better yet, if it's your #1 choice then you certainly must tell your interviewers (I'll let you do the math on that one).

Also tell them where you've gotten accepted/interviewed and the like.

Then much more so than anywhere else is that you have to know your research and the rest of your application STONE COLD.

Be enthusiastic and show it; dont "curb your enthusiasm" It's Harvard but you'll be surprised how many applicants tell them straight up that they ain't all that.

I didn't even get an MD/PhD interview there, but it's the same set of peeps in and on HST that are in and on MD/PhD class/adcom/whatever.

Good luck buddy. Go knock em out real quick.
 
DerisiveWords:

8/9 : Hell if I knew/IB

More seriously: Research and Practice at least for the first half of my career.
 
derisivewords,

I'd probably frame my MD/PhD first. Then I'd take a short vacation in Maui, train for the Ironman like another famous MD/PhD we know, and spend about 6 months with the usual vices: women and alcohol.

Then I'd probably do clincal care and research.

peace.
 
ORIGINAL,

Thanks for the tips! I'm definitely going to have to brush up on all the details of my research. My last interview was back in November with Cornell!

MapK
 
DERISIVEWORDS,

What's up? Ideally I want to be superwoman and do a little teaching, some clinical work and mostly basic research.

I'm going to shoot for that but realistically, much of it depends on how well my clinical and research training goes. I'm going to have 7-9 years to figure out which doors to close...

MapK
 
Hey all you MSTP folks,

Please keep posting!
Jalbrekt wants to have the longest post in the SDN history. Let's not let that happen. Let's keep our MSTP Boulevard ROLLING!!!!!!!

Orignial, you've been very active, so keep up the good work. MapK has also been doing his job.

Baylor21 and Rumit, what happen to you guys? I have not heard anything from you.

Let's do it you guys 🙂 😀
 
Well...it's kinda hard to keep posting on here when you have no new interviews coming up and you're just waiting to hear from schools. I guess, I could post a daily update, something like..."Still no news." 🙂 🙂

On another note...has anyone heard from Stanford since the vacation?

Later,

Adam
 
Rumit,

I have not heard anything from Stanford and at this point I don't really care... I am just having a hard time trying to decide where to go.

Have you decided yet? 🙂

Baylor21:
Have you decided where you're going to go next year?
 
academic,

No I havent decided yet. Its going to come down to 5 possible schools for me: Harvard, Hopkins, Yale, WashU, or Penn.

Of course Harvard is a longshot because I havent gotten an interview there yet and dont really expect to anyways. And both Yale/Penn dont say anything about acceptance until March. I looked at the Yale website and it says acceptance letters are typically mailed by March 31st. Does that mean that they might send you a notice in the beginning of March or that you absolutely wont hear anything from them until the end of March/beginning of April? Does Penn use an exact date for notices or are they somewhat vague like Yale?

I got accepted to Hopkins already but havent heard anything about funding status yet. Anybody else who got accepted to Hopkins heard about funding?

At this point, I'd say theres probably an 80% chance that I will be going to WashU.

Is WashU still your top choice academic or are you looking at other schools?
 
Hi,

i haven't really read most of this thread, and am not a current applicant. I'm still doing my pre-med studies.

But, i do know I want to go into academic medicine. whether I want to do an MD/PhD program is another thing. okay, i've talked to a lot of professors/research/admission people. basically, to do academic medicine you need a post doc like position experience. And that can come just as easily from an MDPhD as from several years of research as a fellow after you become an MD.

Just for you guys to cogitate (sp?) what is the advantage of MDPhD (compared to doing fellowship) other than no tuition to pay?
benefits of doing post doc, is that you're doing your research once you have more experience. also, you're more decided about your interests, both in academic field and in overal how much your career is spent on research vs. practice.

so, for the next few years, my brain will spin on whether I want to do MD PhD.
 
Sonya,

Vader could probably answer this question more eloquently than me, but I think the MD/PhD gives you better training for basic science research than just the MD+postdoc.

If all you want to do is clinical research with no emphasis on basic bench research, then I would go with the MD + postdoc route. However, if you are seriously consdering basic science research, I think the MD/PhD is advantageous.

If you do MD/PhD, you really dont need a postdoc to go into academic medicine; you are pretty much ready to jump into it immediately after graduating with the MD/PhD.

You might want to search the archives for old threads about this subject, its been discussed at length and would probably help you get a much better idea about the "triple threat"
 
A couple q's:

What exactly is 'academic medicine', how is it usually defined? Does it only encompass medical doctors who are affiliated with an university and do all the usual professorial stuffs, or does it also include medical doctors who conduct basic science research, say at a hospital?

The thing is, I want to mainly practice, and do some research "on the side", but I'm not sure if an MD/PhD is worth what I want to do. I don't have any desire to be a professor who teaches (I'd much rather teach high school actually). However I've heard that to get into the best residency programs an MD/PhD has an extra edge. Say I want to do radiology or neurology and do some research, with practicing being the primary focus. Should I even bother with MSTP?

HELP!!!!111!1L!Jlk!@Iuo!JO!J@OJ2io1jjOI!Jo!!!!
 
Just from what my perception is from what you told me, I'd say you might be unhappy in an MD/PhD program.

Whilte it is true that MD/PhDs do tend to match better than regular MDs, any small boost in matching ability is not justification enough for pursuing the combined degree.

This is my opinion, but I really think the MD/PhD is designed for those who want to have a MAJOR role in research, definitely not just a side aspect of their career.

If all you want is to do some research on the side, then an MD only is good enough.
 
One of my professors, who's also an MD/PhD, had some pretty nasty things to say about the MSTP program -- and I think he raises some good points. First and foremost, because there is so much new information, new data, new discoveries etc coming out, and since it's highly likely that this trend will only continue, it is extremely difficult for someone to read all the literature that is pertinant to his/her research, and that makes the life of a simple PhD professor rather hellish. Mind you, this professor I'm referring to is crazy ass brilliant, and even he can't keep up with all the new information. Also, as things become more and more specialized, collaboration and teamwork will become more and more the norm, people being experts in their specialized tasks and working together rather than a few MD/PhD super(wo)men doing everything. That being said, apparently there are whispers in academic circles saying that the NIH's original vision of what types of scientists the MD/PhD program is intended to create has failed, and that these super-scientist-doctors don't really exist because no one person has the time to do significant research, and apply the research to their practice. The NIH would never ever admit this of course 🙂

Anyway, for those future MSTPers, any rebuttal? 😛
 
Baylor21:
Right now WashU is pretty much my top choice. In my opinion WashU has THE BEST MD/PhD program in the nation. Their research is outstanding and their clinical training is superior. The only school that might offer you a better MD/PhD training would probably be Harvard.
WashU is #1 in student selectivity and I think that says a lot.
I do admit that St. Louis is not a really fun and exciting place to live in, and many would prefer to live in SD, LA, SF and NY, but honestly what counts more: the place you live in or the training which you will receive as a future physician-scietist?
 
Hey DERISIVE!

Because many MD/PhD graduates from the MSTP choose not to pursue the "triple threat" (as BAYLOR calls it), it can be interpreted that the NIH's goal of nurturing more "superwomen" physician-scientists has not succeeded.

Is this the fault of MSTP? I don't know...after finishing the MSTP, isn't the graduate ready to tackle either clinical work, research, or teaching?

Maybe it's because after students graduate from the MSTP, the support for MD/PhD (in residency or postdoc) is pretty much nonexistent. Sure, there are fast-track residencies...but do they adequately (and quickily) prepare MD/PhD to become multifunctional physician-scientists?

My two cents...
MapK
 
Originally posted by derisivewords:
•One of my professors, who's also an MD/PhD, had some pretty nasty things to say about the MSTP program -- and I think he raises some good points. First and foremost, because there is so much new information, new data, new discoveries etc coming out, and since it's highly likely that this trend will only continue, it is extremely difficult for someone to read all the literature that is pertinant to his/her research, and that makes the life of a simple PhD professor rather hellish. Mind you, this professor I'm referring to is crazy ass brilliant, and even he can't keep up with all the new information. Also, as things become more and more specialized, collaboration and teamwork will become more and more the norm, people being experts in their specialized tasks and working together rather than a few MD/PhD super(wo)men doing everything. That being said, apparently there are whispers in academic circles saying that the NIH's original vision of what types of scientists the MD/PhD program is intended to create has failed, and that these super-scientist-doctors don't really exist because no one person has the time to do significant research, and apply the research to their practice. The NIH would never ever admit this of course 🙂

Anyway, for those future MSTPers, any rebuttal? 😛 •••


It sounds like your professor got the wrong idea about what MSTP is supposed to be about. Perhaps when he obtained his degrees they misled him, but I think that what he is talking about was never a stated goal of MD/PhD programs.

First off, it is true that there is so much new data and literature coming out that its hard to stay on top of it all. I would ask you this: Would it be easier to keep track of it with only an MD degree, which generally gets very little training in scientific research, or with both degrees, in which you get significant exposure to both clinical training and scientific research? I dont think anybody at the NIH ever said that if you had both degrees that you would be able to single handedly stay on top of every bit of research going on.

It sounds like your prof seems obsessively compelled to know absolutely everything about his field. Of course, this is a futile goal, no matter how many degrees you have. In med school, he probably got depressed if he got a single question wrong on his exams. It sounds to me like he is holding up MD/PhDs up to an extreme; more than anything the NIH claimed would be obtained from the dual degree programs.

I also dont think the stated goal of MD/PhD programs is to produce physician-scientists who HAVE to work independently. Clearly, collaboration is likely to increase as research becomes more complex and interdisciplinary. There is no rule stated in the MD/PhD programs that you are expected to stay locked up in your own little lab with no collaboration with others. Again, when your prof went thru med school, maybe things were different. I think the potential for collaboration with an MD/PhD program is there... if you want to take advantage of it. For example, since you will probably be working in a lab with other students there (med students, grad students, postdocs) the environment is rich for collaboration between research projects. You will likely have access to others who are NOT working on the same degree and thus have different career goals. In addition, you are very likely to have contact with people who look at their research in different ways. I dont understand why your prof seems to think that such an environment is unsupportive of collaborative efforts.

As for combining research and practice, I agree it is difficult. But I disagree that its not obtainable. I've met many doctor/scientists at my interviews who do both; their research is not lacking or subpar either. Do you have to work hard to get to that status? Absolutely, but thats also true for MDs who are trying to do research; thats not a problem thats unique ONLY to MD/PhDs.

Just from how you have described this particular prof, it sounds as if he was expecting an MD/PhD program to give him absolute knowledge of his field and the ability to do it all with no sacrifice in any of the areas he chose to pursue. I dont know where he got that idea, but thats not part of the ideology of the MD/PhD anymore - perhaps it was in the past. Clearly, thats not reality. Compromise is a part of a career as an MD/PhD, just as it is for any medical career.
 
I'm not saying that he's saying that MD/PhD's should not collaborate -- that's simply ridiculous that the NIH would want MD/PhD's to be completely independent. Nor am I saying that he wants to keep tabs on all the literature out there. The point he's making, I think, is that research is already a long and time-consuming job, and that it's only going to get longer and more time-consuming. I think he's making a prediction for the future state of medicine and science, based on what he observes in the present. Yes, there are some people who are able to balance practice and research now, but their jobs are only going to get more difficult as time goes on. Therefore it will become more and more advantageous for a MD/PhD to focus on one or the other aspect (either practice or teaching/research for instance) in the future, and build strong collaboration and cooperation networks. For instance, he gave me an example of a paper in which he was a co-author with 15 others. Each of the people there had an essential role, but they needed to be specialized to do it. Once those networks are built, then what precisely is the advantage of an MD/PhD over an MD or PhD? Is it really necessary? Perhaps to serve as a "bridge" betweeen the language and methodology of medical practice and the language and methodology of research, but I think this could be circumvented if people had a chance to experience a little of each. (i.e. a medical school that encourages students to do some research)

Anyway, that's just my 02
 
The way I look at it, the situation is similar to what happened to the state of medicine in the 20th century. In the past you could make do with a general practitioner, but as more and more medical information came out it became necessary to specialize. I wouldn't trust a cardiologist to administer me anesthesia, for example. Since it seems that medicine is becoming more cooperative and integrative (in the sense that different fields of science are participating), with biochemists etc etc and now biomedical engineers participating in it, further specialization may be necessary. What this portends for the MD/PhD in the next 20-30 years, I don't know. But if you can hear this and successfully convince yourself that the MD/PhD is right for you, then more power to you, you've "passed the test" so to speak. But it's something worth considering, whether it actually comes true or not.
 
The fundamental objective of the MSTP is collaboration. So MD/PhDs are best positioned to take advantage of the evolution of research/medicine into a collaborative network. What I'm saying is that the changing face of medical research is nothing but good news for MD/PhDs. Most MSTP programs actually put alot of energy into emphasizing how collaborative they are.

Today most MD/PhDs do about 70% research and 30% patient care. Those that want more than 30% patientcare usually have to switch to 100% patientcare. This limitation is well known and expected; and like Baylor21 said, it's not specific to MD/PhD but to anything in life. It's simply basic economics of limited resources (time in this case).
 
Well maybe I'm mistaken in this assumption, but from my experience, getting a PhD is a far cry from simply doing medical research on the side in med school.

We could debate all day about how much the PhD really helps you... in the end its all subjective anyways. For my career goals, I think the MD/PhD is beneficial, but for others it may not be.

With research constantly changing, I think having both degrees makes it easier to switch back and forth between clinical practice and basic research than having just the MD degree.

Certainly having the MD/PhD is not a bane to any career goals someone may have, whether its all clinical, all research, administration, teaching, or a mix of all of them. While it IS true that is possible to do all of those things with only an MD, that doesnt necessarily mean that having both degrees is worthless. Ultimately it comes down to your individual situation, and is based almost entirely on subjective, not objective reasoning.

Exactly how do you measure how effective the MD/PhD degree is? Theres no quantitative comparison or even very much of a qualitative comparison you can run between MD only and the combined degrees.
 
Originally posted by baylor21:

With research constantly changing, I think having both degrees makes it easier to switch back and forth between clinical practice and basic research than having just the MD degree.
•••

I don't know what your career goals are, baylor, but I think you may be in for a rude awakening. Once you choose your particular path, it will be next to impossible to switch to another, and even harder to go back to the original if you try to do that later. Going from a clinical to a research focus will not be that hard, but it will be much more difficult to go the opposite way. I have yet to meet an MD or an MD/PhD who went from a clinical focus to a research focus and was able to go back. At the rate of advancement today, you will not be able to keep up with the most current treatments, etc, because your focus will be so specific in your research. If you choose to do strictly clinical research, you will be able to see patients while doing research, but you will not be able to go "back and forth" from one or the other. As I said, once you have locked yourself into something, it is hard to change. Also, if your interest is in clinical research, I have been told by both MDs, PhDs and MD/PhDs (at Baylor, UT-Houston, UTMB and UT-Southwestern)that the PhD portion really isn't that necessary. That is why I decided against the MD/PhD program; I couldn't justify the extra time for what I wanted to do with my life, and I plan on doing academic (clinical) medicine.

I know you are ultra gung-ho about MTSPs, but I hope you are not putting blinders on to the way it really is.
 
Socialist,

I agree if all you want to do is solely clinical research then there is probably no benefit gained with an MD/PhD. But it certainly wont hurt you. If time is something that is very important to a person, then they SHOULD NOT got for the combined degree.

However, I think in the future its going to become increasingly difficult to sharply delineate between "clinical" and "basic science" research. The line between them is starting to fade away. Having the MD/PhD gives you a better opportunity at the transitional research relating clinical to basic science than just the MD degree by itself in my opinion.

A lot of people keep saying "you can do research with an MD only." Although that is correct, its not a very helpful comparison. I think the quality and research focus matters too. Of course its very hard to measure this quantitatively, but MD/PhDs in general are more successful at getting research grants, research publications, and also hold an advantage in academic titles/positions over regular MDs. The NIH has just recently started keeping track of these statistics, so its hard to say if this will remain true in the future.

Of course, statistics have limited relevance, and we could argue all day that perhaps thats not the best judge of how much of an advantage the combined degree gives. Thats why I said in my post above that any arguments around this issue are almost totally subjective.

In the end, all medical career paths are open to you after getting the MD/PhD degree. Are they completely closed for MD onlys? No, but the degree of "openness" to doing all of these things in some portion is reduced in my opinion. For some people, there is no benefit gained out of the combined degree.

You say that going from clinical to research is easier than going the opposite direction. Depends about what level of research you are talking about. If you are talking about top flight publications, and becoming an expert in that field, then I would disagree with you. Besides, the choice is more complex than that. Most MD/PhDs strike some balance between the two. So its not like they are going from 100% research to 100% clinical or vice versa. If you keep some foothold in clinical medicine while devoting time to research, I would say the transition is similar to the opposite direction. After all, if you are going solely clinical work, its very hard to stay on top of the research progress being made on the basic science/transitional level, which would mean you would have to spend some amount of time on background material before you could really make an impact on the research front. That part of the problem cuts both ways, whether you are going from clinical to research or research to clinical.
 
I think one breakdown (perhaps the worst case scenario for MSTP) is as follows:

Clinical medicine: Even
Clinical research: Even
Basic science research: Advantage MD/PhD
Cost: Advantage MD/PhD
Time length: Advantage MD


Even if you disagree about the basic science advantage, from a purely objective viewpoint it comes down to time vs money.

I doubt that most MDs are able to pay off their loans in only 4 years (generally the extra time commitment required for MD/PhD) whereas MSTPs are debt free. So in my subjective opinion, the time vs cost is an advantage for MD/PhD. But then again, if you consider those 4 years as crucial years lost, then your perspective may be different. Of course, if you are fairly well off before attending med school, debt load is not a problem either.

Playing devils advocate against the MSTP, according to the criteria above it comes down to a wash. That is, at WORST the MSTP person will end up in the same position as the MD graduate.

There are other criteria that also fall in the favor of MD/PhD, such as match rates. Out of the 5 MSTP programs that I have interviewed with, the match rate for MSTP was significantly better than the regular MD class at every school. Of course, that could be considered subjective criteria so I did not include it in the list above.

For my research and clinical goals, MD/PhD makes the most sense. Nobody ever said that the MD/PHD is ALWAYS the right choice if you want to do research. It depends on what kind of research and what extent you want to pursue it.
 
Hey baylor,

I'm curious as to what you mean by basic science and clinical research lines becoming more blurred in the future.
 
Originally posted by academic:
•Baylor21:
Right now WashU is pretty much my top choice. In my opinion WashU has THE BEST MD/PhD program in the nation. Their research is outstanding and their clinical training is superior. The only school that might offer you a better MD/PhD training would probably be Harvard.
WashU is #1 in student selectivity and I think that says a lot.
I do admit that St. Louis is not a really fun and exciting place to live in, and many would prefer to live in SD, LA, SF and NY, but honestly what counts more: the place you live in or the training which you will receive as a future physician-scietist?•••

Congratulations on being admitted to WashU and it is certainly a great school and probably the best organized MD/PhD program.

However, I would dispute your contention that "The only school that might offer you a better MD/PhD training would probably be Harvard." How "good" your training is depends on many factors, not the least of which are your goals and the type of research you want to do. You will receive excellent training at any MSTP you attend. Location is an extremely important factor in deciding where to attend for most people. After all, you're going to be there 7-8 years. I sure would want to be happy wherever I ended up, as it would allow me to be the most productive. It could be different for you though.
 
Originally posted by baylor21:

For my research and clinical goals, MD/PhD makes the most sense. Nobody ever said that the MD/PHD is ALWAYS the right choice if you want to do research. It depends on what kind of research and what extent you want to pursue it.•••

As I said, I do not follow your posts to know exactly what your career goals are, but I think that if you believe you can go back and forth from clinical medicine to basic science research then you are in for a rude awakening. If you are more interested in clinical research and you are going MD/PhD for the cost/time benefit, more power to you. My thing is clinical research. To me, having that extra 3-7 years outweighs any debt I will have because I have paid for school on loans rather than having the MSTP scholarship. I figure I have known living with no money for so much of my life, doing it during my residency while I pay back my loans will not be a big deal, and once I finish my residency my student loans will be a thing of the past and I will already have the autonomy to do what I want to do in terms of my research. As I said, to each his/her own.
 
I think baylor made some excellent points. Couldn't have said it any better myself. Unfortunately, I think there will always be those people who cannot appreciate what MD/PhD is all about.

The goal for you and me (and all the rest of these brilliant folks) is to act as a bridge between MDs and PhDs to facilitate collaboration, come up with innovative ideas, and hover over the blurred boundary between clinical medicine and basic research.

People who say you can't do both medicine and research simply don't know what they are talking about. It is not easy, but not impossible either. The point is that having both degrees and the associated experiences of the medical and graduate programs gives you excellent preparation for anything you want to do later on.

Sorry, but having an MD + postdoctoral fellowship is not the same thing as the combined MD/PhD training. I'm frankly getting tired of repeating myself every few posts. If you want to read arguments on both sides, you have only to go back and search through previous posts. For those who are vehement in knocking MD/PhD programs, I would encourage you to do your homework first and then come to the table to discuss. You do raise some valid concerns, but most of these have been addressed previously.

It is my sincere hope that my MD colleagues will be able to at least appreciate the value of doing both the MD and PhD, regardless of their own goals and ambitions.
 
Originally posted by SocialistMD:

As I said, I do not follow your posts to know exactly what your career goals are, but I think that if you believe you can go back and forth from clinical medicine to basic science research then you are in for a rude awakening. If you are more interested in clinical research and you are going MD/PhD for the cost/time benefit, more power to you. My thing is clinical research. To me, having that extra 3-7 years outweighs any debt I will have because I have paid for school on loans rather than having the MSTP scholarship. I figure I have known living with no money for so much of my life, doing it during my residency while I pay back my loans will not be a big deal, and once I finish my residency my student loans will be a thing of the past and I will already have the autonomy to do what I want to do in terms of my research. As I said, to each his/her own.•••

The MSTP is not designed to created physicians who do clinical research. It is primarily for people who wish to conduct BASIC research and connect the results with clinical medicine. With your goals, you obviously shouldn't be in an MSTP program and no one is denying that. However, the MD/PhD does give you more flexibility than an MD alone and does give you much better insight about the interface between medicine and science.
 
Hi,

it's all quite an interesting discussion.

I'll read through the previous posts, vader, and see what's said when I get the time.

Last summer I talked to a LOT (i'm guessing around 10) of different professors (usually PhDs or MD PhD), and asked them about the advanatages of PhD. That's where I got the impression in the end it can come out equal to have post doc vs. MD PhD. Of course, PhD is better than post doc. but anyway, that was my impression, and that's my basis.

anyway, another thing I learned was, as a previos post mentioned, it is around 30/70 split. (i would say 20/80, but you get the idea). Whether you have PhD or not, if you want to do both, it is usually focusing on one - either practice or research. and if you have a PhD, it'll probably be research.

If you're good at getting grants, you can focus on research. otherwise, there you are likely to be pushed into practice b/c that brings the hospital $$. So, i would not be so positive that it is hard to switch from research to practice.

In terms of MD PhD being financially better off, keep in mind you are loosing 4 years of a physicians salary by doing the PhD...

Vader, mind I ask (sorry if you've mentioned this earlier, i haven't read the 36 pages yet), what's your backgroun. I mean what level are you at (doctor, student, med student, resident...)

I guess, for me, i have to know how much I want to do research. and i'm still not sure about that. My research so far i think has given me a good feel of what research will be about. So, i guess my question is now, how much i want to do practice. and shadowing, volunteering, all that, hasn't (YET) given me the perspective...

Sonya
 
Originally posted by Vader:


The MSTP is not designed to created physicians who do clinical research. It is primarily for people who wish to conduct BASIC research and connect the results with clinical medicine.•••

Yes, but in connecting the results with clinical medicine, you usually are not the one who applies it to patients. I am not knocking the MD/PhD program, but I think many people who go into it have some unrealistic expectations as to exactly what they will be able to do, not what avenues are open to them. Being able to do basic science research and then directly applying that to patients yourself is not a very realistic goal. As I said, I have yet to meet an MD/PhD who has done it. If you choose to do basic science research, your MD will give you a better background to see how your discoveries apply to the entire body, but you will not go into clinics and apply your work; that will be done by someone else.

If you know of MD/PhDs who actually do this, then I will stand corrected. However, out of the 30 or so I know, roughly half of them are strictly basic science researchers with no patient interaction and the other half does clinical research with no basic science research at all.
 
Originally posted by SocialistMD:

Being able to do basic science research and then directly applying that to patients yourself is not a very realistic goal. As I said, I have yet to meet an MD/PhD who has done it. If you choose to do basic science research, your MD will give you a better background to see how your discoveries apply to the entire body, but you will not go into clinics and apply your work; that will be done by someone else.
•••

I worked in the lab of an MD/PhD who did both basic research and clinical medicine (80%/20%, respectively). He had a weekly specialty clinic a half day per week and was an attending a month out of every year. The rest of his time was spent doing research stuff: writing grants and papers, overseeing his laboratory, attending conferences, presenting results, etc. He manages to do it successfully because he is 1) able to multitask, 2) has incredible energy, and 3) has subspecialized his practice and integrated it with laboratory investigation. Many of the patients he sees have genetic disorders. If there is a strong family history, he can gather blood samples and begin to do genetic analysis to look for genes. This is just one way he has managed to integrate things.

I agree, however, that it is rare to find someone who can successfully integrate both the medical and research aspects of one's career. Especially when the research is at a very basic science level, as opposed to more disease-oriented research.

However, even basic discoveries have an uncanny way of finding their way into the realm of applicability to patients. For example, there have been recent attempts to find additional molecular targets of the HMG-CoA reductase inhibitors that would better explain their therapeutic effect. For example, certain drugs of that class have anti-inflammatory properties. The structure of at least one receptor has recently been solved using X-ray crystallography and the binding site determined. This opens up the possibility for the rational design of new compounds that could more specifically inhibit the molecular target.

Another example is Stan Prusiner's recent discovery that a couple of known drugs have anti-prion properties that could be used in the treatment of Creutzfeld-Jakob disease. Clinical trials have already been fast-tracked because of the therapeutic potential.

I think most of the people who apply for and are successful in gaining admission to MD/PhD programs have some idea of what they are getting into. They don't make us go through an insane number of interviews, giving us the third-degree on our research for nothing! 🙂

I agree completely that anyone who wants to apply MD/PhD should absolutely know what they are getting themselves into. It is definitely not for everyone. However, those people interested in a career in basic biomedical research and clinical medicine should consider applying. There is a great need for physician-scientists who can make basic discoveries that can ultimately be translated into targets for therapy.
 
Baylor21:

I'll be skeptical about assuming that Harvard MD/PhD is better than WashU's program. Harvard's program is certainly not as student-oriented, and it takes an average of 3 yrs longer. Believe it or not, the average finishing time at Harvard is 9-10 yrs, while it's 7 yrs at WashU. The extra time at Harvard is due to disorganization as opposed to better and more rigorous training. In addition, during med and grad school you'll have 2ce the spending power of Harvard muddphudds. That is important. These are some of the reasons why I already decided that I'll be going to Duke before I even heard squat back after my HST interview. But then again I might just be saying this cause I didn't get into their MSTP 😉 .
 
Hey MAP! Ignore the above post.
 
Socialist,

Although I do not have a specific research area in mind yet, I am considering doing something with diagnostic radiology; for example perhaps usign new MRI techniques for diagnostic cardiac imaging.

The basic science part of this is the biophysics behind MRI. You have to study pulse programming, gradient trims, advanced mathematics and computer engineering. Of course you also need to know how biological tissues and molecules respond to these stimuli.

The clinical part of it occurs once you are done with the pulse programming and MRI sequence design. You can then go into clinic and test your sequences on patients with different cardiac disorders to quantify its usefulness in diagnosing certain conditions. You do NOT have to simply hand off the results of your basic science research to an MD to accomplish this.

So, its not that hard after to integrate basic science research and clinical in my area. For other areas that are more molecular-based, I'm sure the case is different. But for me, MD/PhD is the best approach, and I'm confident that I can integrate both basic and clinical research together.

So I disagree with you that it is necessarily always difficult to integrate the two.
Again, it depends on your specific case and your specific interests.

Thats why I said its so hard to generalize between MD and MD/PhD because you have to look at it from an individual's perspective.

Perhaps the people you cited are not as interested in clinical correlation. If they are interested and insist that its not possible for them to do it, I would question their motivation to do so. Is it easy, NO. But definitely attainable from what I've seen.
 
I havent thought a whole lot about which program is the best yet. I know WashU is right there with the other top programs. I guess I'm still waiting to hear from other schools so I will know EXACTLY what offers are on the table.

Then I plan to methodically go through and compare/contrast the schools. Thats where things will get tough, since they all seem like great programs.

Good luck at Duke Original. I might still give you a sales pitch for WashU if I see you at the 2nd look, but you cant go wrong with Duke either. By the way, have you received any info from WashU yet about the 2nd look?
 
Baylor21:

That would be nice. I'm definitely planning to be at 2nd look. I'm actually looking forward to it. A slight problem I have is that I am yet to send in my $100 which was due last week. I'll put it in the mail tomorrow after I confirm that my file hasn't yet been trashed. When I asked Brian about 2nd look he told me that we can show up anytime we want, but that the main weekend will be sometime in March. I'll ask him again tomorrow when I call to see if I'm still in.
 
I found this FAQ on the Medical College of Georgia website. I think it does a better job at expressing some of the possible benefits of the MD/PhD, while also addressing some of the most commonly cast "stones" against the program.


What are the advantages/disadvantages of the MD/PhD program versus research post-doctoral fellowships after medical school and residency?

This is probably the most commonly asked question from students considering research or academic medicine careers. The answers are fraught with opinion and rhetoric. Nevertheless, the comparison can be simplified into a comparison of two different training environments. The MD/PhD programs attempts to provide a relatively efficient scenario for training of students with broad expertise in both medicine and basic sciences. The PhD degree provides a complete training in research through both course work and thesis activities. Thus, in general, dual degree recipients tend to have a broader scientific knowledge base. The PhD degree for these students is a training degree, just as the MD degree is, and prepares them for advanced training. In addition, the dual degree is often seen as attractive by residency programs looking for mature housestaff with investigative interests. This has been especially true in Neurology, Psychiatry, Surgery, Therapeutic Radiology and Internal Medicine subspecialties. Furthermore, since the majority of residency and fellowship programs have substantial research components (e.g. 1-2 years in general surgery), MD/PhD students have an opportunity to use this time to complete further training that launch their faculty research careers. It is during these residency/fellowship research years that most MD/PhD's can find the completely protected time to develop research initiatives that can be carried into faculty positions. Increasingly, this type of transition has become a requirement for a smooth transition in academic medicine.

All this being said, there are significant stated benefits to the post-doctoral fellowship tract. The most common stated benefit is that research training is initiated at a point when the trainee has largely determined their area of interest. This certainly is an advantage for some, especially for those who do not have the clear commitment to research during medical school. On the other hand, the two year duration of most post-doctoral fellowships (e.g. NIH NRSA fellowships) means that the fellow must remain incredibly focused to assure productivity. In addition, there is further pressure since the fellowship will be the only formal research training before faculty status. Now it must be noted that many fine academic physicians have been "bred" through the postdoctoral fellowship route, so there is no doubt that success is possible. Nevertheless, the many of those who have been successful in the past, often will state that they would have gone the MD/PhD route if they had it to do over again.

The major point of evaluation for these two pathways is to look at success rates for dual MD/PhD programs and NIH NRSA Postdoctoral fellowships in creating academic physicians. A recent review from NIH looked at dual degree program graduates from 1975 to 1990. The statistics show that an amazing 85% of graduates are still practicing in an academic setting. In contrast, NIH Postdoctoral Fellowships have had a much poorer track record with most programs showing only a 15-20% success rate of physicians maintaining academic medical careers. Several reasons have been stated to explain this difference. First of all, dual degree candidates may be more motivated at baseline, since they decide early in their training to pursue an academic career. Therefore, the results may represent self-selection. Second, some have stated that, in subspecialty fields such as gastroenterology, the lure of financial reward in private practice has eroded the impetus to carry on academic careers. Third, others have cited the different investment of mentors in graduate student and postdoctoral fellow success. Thus, since the success of a graduate student requires a thesis defense, the advisor is tightly and publicly committed to the success of that student. In contrast, the postdoctoral fellow is more invisible, and while a lack of success by fellows may be recognized by NIH review sections, it will seldom be registered by an academic faculty. Finally, still others have felt that the 2 year postdoctoral fellowship, in many cases, is not sufficient scientific training for the high level of competition for research funding. In this manner, advanced research training is seen as much a requirement for a successful academic career as specialty clinical training is for patient care.


Can you do both research and medicine well?

Never listen to anyone who tells you that you CAN'T do something. They are clearly talking about themselves. Indeed, you CAN do anything you want to if you have the determination and talent. You are in charge of your own life, and a major advantage of the MD/PhD program is that it provides complete training in both science and medicine. This gives the graduate extensive flexibility to arrange his/her life as seen fit. How one chooses an admixture of research and clinical medicine is up to the individual. There is no perfect or correct pathway, and the format that you choose will depend on how you structure your own life.


Do MD/PhD's make good physicians?

A brief perusal of the top residency training programs around the country will demonstrate the large number of clinically excellent MD/PhD physicians. MD/PhD student success in obtaining residency positions also testifies to the inaccuracy of this statement. MD/PhD students returning to the wards often stand out because of their increased maturity and organization. The process of the PhD degree requires that a student learn to justify their thought process at every turn. More importantly, the thought process behind hypothesis-driven science, which is at the heart of research training, is identical to that for differential diagnosis as a physician. This means that MD/PhD students have a significant advantage in the intellectual skills required of excellent physicians.


Do MD/PhD's do good research?

Figures from NIH indicate that MD/PhD graduates from dual degree programs are marginally more successful at obtaining funding. As time goes by and competition becomes stiffer, this advantage may increase, but time will tell. In any case, it is clear that MD/PhD graduates perform research at as high a level as their PhD counterparts.


Do you get a real PhD when you are an MD/PhD student?

Absolutely. At the Medical College of Georgia, and at most MD/PhD programs, students must complete all of the requirements of a regular PhD candidate including written and oral comprehensive qualifying exams and completion and defense of a PhD dissertation. In addition, the belief that the "time" for degree is shortened is also fallacious. Many of the first and second year medical school courses, including biochemistry, cell biology, physiology, neurosciences, pharmacology and microbiology also count for graduate credit. Thus, MD/PhD students actually complete far more credit hours of advanced coursework than the average graduate students. In addition, the students usually perform 2.5 to 3.5 years of research in a 6-7 year program. This is the same amount of time that is recommended in most PhD programs. Thus, the MD/PhD spends 4.5 to 5.5 years in PhD-associated work. Perhaps a counter question should be leveled as to why a PhD degree takes over 5 years in many programs.
 
Vader:

Did you go to a UC undergrad school? I think I know who you are 😉

Cheers,
 
baylor-

My point in posting here was not to put you on the defensive, but just to make sure you and others (mainly others) realize what you are getting into. A couple of my really good friends are mudphuds and I know they will be great at whatever they decide to do.

The only reason I post this (which will be my last on this thread) is because your UGa article illustrates the point I am trying to make; the advantages are based on opinion. Just as you say the MD/PhD has all of these doors open, your article shows that MDs have the exact same opportunities, it is what one chooses to make of his/her opportunities that determines how far s/he will go (just as in anything else).

Again, I am not trying to discourage you. If you can justify going MD/PhD to yourself then that is all that matters. I don't care one way or another what you do with your life. I just think other people may take your word as gospel (because of how much you glorify MSTPs) and not realize it isn't for them until it is too late. Generally speaking, you already have to have research experience to even apply. That should indicate that people who have done it before know if it is something they would be able to do for the rest of their lives or not. That fact honestly makes me wonder why so many people ask questions about MD/PhD programs, but that is a discussion for another day...
 
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