outcome analysis of the Swiss MD-PhD program

[aag]

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...and here comes the outcome analysis of the Swiss program, courtesy of our great national coordinator, Kathrin Kuehnle (formerly a postdoc in my Institute, I am proud to report!).

Any feedback and comments shall be highly welcome!

 

[schrizto]

I'm a little confused here... what's the difference between an MD/PhD program in Switzerland versus one in the US other than the fact that they are in different countries? I haven't read the whole article so maybe it's answered there.

 

[aag]

the most visible difference is that our students go first through the entire medical education and then go on to do a PhD. I understand that in the USA most programs squeeze the PhD education in the middle, hence medical school must be resumed after finishing the PhD.

There are people also here who favor the US curriculum. I am the program director for the Zurich MD-PhD program, and I am currently resisting these tendency. It would appear to me that it is in the students' best interest to first get one graduation and then do the other, sequentially. This way the risk of dropping out from both programs (and finding oneself without any professional qualification) is minimized.

 

[Neuronix]

the most visible difference is that our students go first through the entire medical education and then go on to do a PhD. I understand that in the USA most programs squeeze the PhD education in the middle, hence medical school must be resumed after finishing the PhD.

Main differences I can see:
Dropout rate of 8% seems similar to here, perhaps a bit lower, but I don't have hard data.

Only 23% females in your system!!! That is very low.

Average duration of 4.2 years is similar to duration of a PhD within a MD/PhD program here.

When surveyed, the vast majority of students at completion of a MD/PhD program here will also say they are planning to persue a research oriented career. I'm trying to remember which study had ~90% also.

Some unpublished MD/PhD data out of the US argues that ~50% of MD/PhDs post-training are doing <50% research and ~50% are doing >50% research in their careers. Your data is quite similar in that regard as well.

This way the risk of dropping out from both programs (and finding oneself without any professional qualification) is minimized.

This is extremely rare in the US system. The vast majority of dropouts are dropping the PhD, not the MD. Very few students don't finish either.

I'm not arguing that either system is more correct. Both have their advantages and drawbacks. I could go into it, but I'm low on time right now.

 

[aag]

This is extremely rare in the US system. The vast majority of dropouts are dropping the PhD, not the MD. Very few students don't finish either.

Good point. Maybe I am just paranoid about this issue. I just try to avoid by all means that, despite our best intentions, we may end up bungling some of our students' careers...

 

[dl2dp2]

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[aag]

Well... I have certainly great respect for US science. A significant part of my scientific training took place in the US. Also, I spent my sabbatical in the Bay Area in 2007. Furthermore, I travel 5-6x/year to the US for scientific purposes.

Conversely, Swiss MD-PhD isn't bad either. One of the first Swiss MD-PhD graduates, Rolf Zinkernagel, has become a Nobel Prize winner. I am entirely convinced that training in the best Swiss labs (including mine🙂) is equivalent to that offered by Scripps, the Whitehead, or the NIH (all places that I know very well).

Still, I deeply admire US scientists, and have even more admiration for the US system of fostering excellence. I advise every young Swiss scientist to spend at least some time at a US research institutions.

 

[hardy]

Good point. Maybe I am just paranoid about this issue. I just try to avoid by all means that, despite our best intentions, we may end up bungling some of our students' careers...

If you drop out of both programs in Switzerland you have nothing but a high school degree. If you were to drop out of both in the US, you still have a bachelor's degree and depending on your field quite good career opportunities. Hardly comparable. In addition, just a handful of people who start medical school in the US do not finish, whereas in Switzerland 10% do not make it to third year and some more people drop out after that. They are simply two very different systems and comparing them is not as easy as sending out a survey.

Also, the survey response rate was only 63.5%. I wonder what happened to the rest...

 

[alacast]

If you drop out of both programs in Switzerland you have nothing but a high school degree. If you were to drop out of both in the US, you still have a bachelor's degree and depending on your field quite good career opportunities. Hardly comparable. In addition, just a handful of people who start medical school in the US do not finish, whereas in Switzerland 10% do not make it to third year and some more people drop out after that. They are simply two very different systems and comparing them is not as easy as sending out a survey.

Also, the survey response rate was only 63.5%. I wonder what happened to the rest...

In the world of surveys, a 10% response rate is dandy. >60% is absurdly good.

 

[Neuronix]

Also, the survey response rate was only 63.5%. I wonder what happened to the rest...

This is something to keep in mind when reviewing MD/PhD student outcome data. The students that went into private practice or other 100% clinical positions are theoretically more likely to be lost to follow-up or not respond.

 

[schrizto]

This is something to keep in mind when reviewing MD/PhD student outcome data. The students that went into private practice or other 100% clinical positions are theoretically more likely to be lost to follow-up or not respond.

why would anyone go through an MD/PhD program and then be 100% clinical practice... that just doesn't make sense to me.

 

[xanthines]

Since tuition for medical school is approaching astronomic levels, this approach would be a spectacular failure in the US (in my opinion). There would be a flood of applicants gunning for free medical school and then dropping out after finishing the MD. Making students pay back the money would also discourage genuine applicants who know that sometimes getting a PhD doesn't work out (projects fail, mentors move/die/lose funding, family issues/death, etc).

Schools with free tuition in the US, such as the Cleveland Clinic program at Case and I forget where the other one is, saw a HUGE increase in applications when word got out they were free.... much to the chagrin of my PhD mentor who is also on the med school admissions committee. He finds it annoying to not only argue with other adcom members, but now he has to figure out which applicants are in it for the free tuition as opposed to supporting the school's mission.

-X

the most visible difference is that our students go first through the entire medical education and then go on to do a PhD. I understand that in the USA most programs squeeze the PhD education in the middle, hence medical school must be resumed after finishing the PhD.

 

[Neuronix]

why would anyone go through an MD/PhD program and then be 100% clinical practice... that just doesn't make sense to me.

Nobody goes into it thinking they wanna do 100% clinical practice. Then they get beat up by research enough and decide they want a lower-stress, higher-paying life.

 

[aag]

Since tuition for medical school is approaching astronomic levels, this approach would be a spectacular failure in the US (in my opinion). There would be a flood of applicants gunning for free medical school and then dropping out after finishing the MD.

-X

Ahhh... but we have a different system over here! We do not believe that selecting medical school applicants according to the financial power of their parents is the best thinkable criterion (irony emoticon here). Our cantons pay for medical schools through taxes.

There are fees for studying at any Swiss universities, but they are extremely low and most importantly they are the same for everybody independently of their courses. Hence there is no financial incentive upfront in studying one thing rather than the other (of course there still is a long-term financial incentive in becoming a radiologist rather than a molecular biologist...)

 

[xanthines]

I apologize for the confusion. I meant to say I actually knew a little bit about the financial circumstances for Swiss students. My point was, the structuring the curriculum in the US to mimic the Swiss version just would not work for reasons outlined above. I'd actually be in favor of a system like yours. At least, I think I do, anyway! 🙂

-X