Possible future models of academia?

[okemba]

I'm curious to hear your ideas as to what sorts of new MD/PhD career archetypes could be common in 15-30 years. I'm not asking for predictions as much as an enumeration of possibilities. Its the consensus here that 80/20 or 50/50 TT professorship roles are not available in large enough numbers to support the majority of MD/PhD grads.

So what are the other sorts of positions or roles that may crop up in the future by which physicians continue to do basic science research? Will it become more common for MD/PhDs to begin working in part-clinical part-research positions with protected time but without their own space in other PI's labs for their "real" career? Currently this seems a rare choice.

Curious to hear your thoughts.

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[solitude]

I'm curious to hear your ideas as to what sorts of new MD/PhD career archetypes could be common in 15-30 years. I'm not asking for predictions as much as an enumeration of possibilities. Its the consensus here that 80/20 or 50/50 TT professorship roles are not available in large enough numbers to support the majority of MD/PhD grads.

So what are the other sorts of positions or roles that may crop up in the future by which physicians continue to do basic science research? Will it become more common for MD/PhDs to begin working in part-clinical part-research positions with protected time but without their own space in other PI's labs for their "real" career? Currently this seems a rare choice.

Curious to hear your thoughts.

Assuming the research budget continues to shrink, expect a decline in the number of slots, or possibly abolition of federal MSTP funding. As clinical revenue shrinks concomitantly, people will end up bifurcating into either 100% research or 100% clinical, though many of the latter will be "academic" positions in the Clinical Professor mold. I predict many, many more will go into private practice as even the Clinical Professor track doesn't have that much to offer these days vs. a university-affiliated community hospital where you can still teach but don't have to do crappy chart reviews on nights and weekends. 80-20 or 50-50 is already essentially dead for our generation of trainees. It is still possible to take a pay-cut in order to have 70-30 clinical-research or 80-20 clinical-research, but with that little time you can't do any basic science of value, so it is all collaboration, translational, or clinical. Basically, in my opinion, things are only going to get worse.

 

[okemba]

As clinical revenue shrinks concomitantly, people will end up bifurcating into either 100% research or 100% clinical, though many of the latter will be "academic" positions in the Clinical Professor mold.

That's interesting. I have trouble figuring out where the money would come from to pay the 100% research MD/PhD. Right now we have people trying to decide between unstable TT positions at ~90-130k+clinical salary and 100% clinical. A 100% research position that isn't a professorship would be offering like...a post-doc or research scientist salary, vs. a 100% clinical salary, which is a far starker difference.

 

[ValentinNarcisse]

The money for the 100% research MD/PhD would be the same as their PhD only TT faculty counterparts. I am finding that a substantial portion of faculty that pursue this route, are often from affluent backgrounds or have a high earning spouse. Otherwise, I do not know how they accept such a low salary after 16+ years of training.

 

[okemba]

The money for the 100% research MD/PhD would be the same as their PhD only TT faculty counterparts. I am finding that a substantial portion of faculty that pursue this route, are often from affluent backgrounds or have a high earning spouse. Otherwise, I do not know how they accept such a low salary after 16+ years of training.

I think solitude was discussing a world where we have NON-tenure track, NON-professor MD/PhDs doing full-time research.

 

[Traumweber]

How about part time industry supported research coupled with clinicals? May not work out for basic science, but translational could be a possibility.

 

[TeddyMeddy]

.

 

[ValentinNarcisse]

There is a surplus of highly qualified PhDs willing to accept lower salaries and do research 110% of their time.

 

[TeddyMeddy]

.

 

[gutonc]

Pre-meds are so cute sometimes.

 

[TeddyMeddy]

.

 

[gutonc]

Fine, medical schools will always need people to sell a lie to young impressionable people looking for a career

Nice. You catch on quickly.

 

[uniqenam]

Fine, medical schools will always need people to sell a lie to young impressionable people looking for a career

LOL! From senior year undergrad to PSTP resident in one sentence...impressive!

There's a wealth of literature in this forum that people should look for if they're interested in a broad perspective, I think it was called "the problem with MSTP" or something similar...a lot of attending/fellow/PD perspectives on what is going or needs to happen.

I think the glut of PhDs is a problem, as well as the glut of MD/PhDs that aren't going on to do the goal of NIH funded programs, which is to produce physician scientists. I sometimes wonder if we're not better, as a whole, to make MSTP funding contingent on continuing down the PS pathway in some form (however NIH wants to define it). I guess I'm sort of concerned by looking at the classes above me, and finding that maybe 1 in 5 are still "true believers" in finishing the MD/PhD and defining a research/clinic mix down the road. It just seems a huge waste of funding for the NIH (and us as US tax payers) to be training MD/PhDs only to lose them to plastic surgery, derm, and rad. I mean, what's the cost in training an MD/PhD student from the NIH's perspective? It seems to me that NIH would be much better served in cutting 20% of MD/PhD slots across the board, and increasing RO1s awarded per year by a commensurate amount.

 

[TeddyMeddy]

.

 

[ValentinNarcisse]

It just seems a huge waste of funding for the NIH (and us as US tax payers) to be training MD/PhDs only to lose them to plastic surgery, derm, and rad. I mean, what's the cost in training an MD/PhD student from the NIH's perspective? It seems to me that NIH would be much better served in cutting 20% of MD/PhD slots across the board, and increasing RO1s awarded per year by a commensurate amount.

This is another issue. Why keep pushing MD/PhDs into Medicine, Peds, Path, Neuro, and Psych? Do you not think other disciplines do not have exciting research areas? The current grant mechanisms are not friendly to surgical specialties that require a substantial amount of clinical practice to maintain technical proficiency. As long as we keep paying MD/PhD faculty significantly less than their clinic only counterparts, make it difficult for them to secure R01 level grant funding, we cannot be surprised when they shift to clinic only positions.

 

[dl2dp2]

You should read the "how to fix MSTP" thread. I wrote in there that I don't know if you want a system where it's really really extremely difficult to get into MSTP, but then once you are in it you have to commit the rest of your life to medical research, even if funding is guaranteed...that would be more like a Soviet system.

 

[ValentinNarcisse]

You should read the "how to fix MSTP" thread. I wrote in there that I don't know if you want a system where it's really really extremely difficult to get into MSTP, but then once you are in it you have to commit the rest of your life to medical research, even if funding is guaranteed...that would be more like a Soviet system.

I cannot imagine it getting much more difficult to get into MSTPs than now. Aside from the GPA/MCAT, Its becoming increasingly common for competitive applicants to take additional years after undergrad to gain greater research experience/publications. This has been a shift since I went through the process when overwhelming majority were straight out of college.

 

[solitude]

You should read the "how to fix MSTP" thread. I wrote in there that I don't know if you want a system where it's really really extremely difficult to get into MSTP, but then once you are in it you have to commit the rest of your life to medical research, even if funding is guaranteed...that would be more like a Soviet system.

as I have maintained previously, the solution is to abolish MSTP. Take all that money and plow it into K99R00 awards that provide attending level salaries and graduated loan repayment to fellowship-trained MDs that commit to basic research. The problem is that government programs, once enacted, are virtually impossible to revoke.

 

[tr]

I guess I'm sort of concerned by looking at the classes above me, and finding that maybe 1 in 5 are still "true believers" in finishing the MD/PhD and defining a research/clinic mix down the road.

My impression as I update myself on the activities of my fellow grads (I finished MSTP in 2007) is that most people are actively trying to pursue research on some level. The issue is not (IMO) that most MSTP grads actively choose to leave research, but that funding is just very tight and they get pushed out just like the straight PhDs, most of whom end up in industry or other nonacademic positions as well, because the common denominator is that there are not enough faculty slots to go around. Perhaps there is somewhat more attrition of MSTPs due to the relatively greater appeal of their available alternatives, but I don't think this is the main issue. It's the tight funding that's the issue.

It seems to me that NIH would be much better served in cutting 20% of MD/PhD slots across the board, and increasing RO1s awarded per year by a commensurate amount.

Meaning you see no value in having people who are dually trained?

As long as we keep paying MD/PhD faculty significantly less than their clinic only counterparts, make it difficult for them to secure R01 level grant funding, we cannot be surprised when they shift to clinic only positions.

I don't understand what you're asking for here. You are saying that MD/PhDs who work in research should be given higher salaries than PhDs for doing the same thing? This makes no sense. Clinical work is something for which there is a market. Research has pretty much no immediate market, thus is supported by the government, companies and foundations that see it as a good. Funding is limited and so researchers don't make much money. This seems logical and I can't imagine why you would expect the system to be rigged heavily in favor of people with certain degrees. I think it's a nice perk that as an MD you can get clinical work to augment your salary above that of the straight PhDs. I don't know why you would expect the time you spend doing what they do to be reimbursed at a higher level.

I think the NIH recognizes that it's not feasible to pay off med school loans on a researcher's salary, but they do see value in having MD-trained researchers, hence the MSTP (and loan repayment programs for straight MDs) which removes the loan burden. Financially I'm in much the same place as a straight PhD, though perhaps a few years older due to residency time. I can supplement my researcher's salary with clinical work which reimburses at a higher rate, which is a bonus. I don't think it's logical or realistic to expect a salary bump for my research time that would put me on par with a full-time clinician.

as I have maintained previously, the solution is to abolish MSTP. Take all that money and plow it into K99R00 awards that provide attending level salaries and graduated loan repayment to fellowship-trained MDs that commit to basic research.

You don't think you learned anything of value in your PhD? You feel you would be equally well equipped to do your research without it?

I think the problem is basically unsolvable. The problem is that there are too many people who want to do research (even more now after the large increase in PhD funding in the early 2000s) who are competing for a very limited pool of research money. That's it, it's not changing, fooling around with the allocation is not going to fix it. I don't think it's a terrible idea to reduce MSTP slots somewhat and fund more R01s instead, but you'd have to cut three MSTP slots to fund one additional R01 so it would be a drop in the bucket given there are only about 300 MSTP slots funded by the NIH per year, compared to ~5000 R01s.

 

[tr]

And back on the OP'S topic:

I'm curious to hear your ideas as to what sorts of new MD/PhD career archetypes could be common in 15-30 years. I'm not asking for predictions as much as an enumeration of possibilities. Its the consensus here that 80/20 or 50/50 TT professorship roles are not available in large enough numbers to support the majority of MD/PhD grads.

So what are the other sorts of positions or roles that may crop up in the future by which physicians continue to do basic science research? Will it become more common for MD/PhDs to begin working in part-clinical part-research positions with protected time but without their own space in other PI's labs for their "real" career? Currently this seems a rare choice.

Actually I think this is a great choice and I'm hoping I will be able to pull it off. I have no interest in dealing with the headache of running a lab myself. Right now I have a great collaborator/co-mentor who lets me use his lab for my stuff. I think in the future it would be fantastic if I could team up with a number of other clinician-researchers who don't need large amounts of lab time, and share a lab. This could work in academia but even also outside of it - people on Kickstarter are funding publicly accessible labs, and I heard a talk last year from a researcher who couldn't get NIH funding but managed to get enough private funding to start a lab on his own, totally outside the academic system, and he was planning to basically lease space/time to other researchers to keep it going.

A lot of what I do could actually be done (albeit for a heck of a lot more money) by the core facility, which is another option, but that would be much more limiting.

How about part time industry supported research coupled with clinicals? May not work out for basic science, but translational could be a possibility.

This is not new at all, many people have supported their academic careers by grants from pharmaceutical companies and not from the government. These grants tend to be very targeted though, from what I've seen they almost always want you to have a very specific drug option in mind that is pretty much ready to go into human trials. It would be pretty limiting to base your entire career on this. But who knows, it's possible this could change. Companies do seem to think more innovatively these days than they have in the past, and the speed with which new technologies are developing may make it less of a time investment to fund earlier stages of discovery for novel therapeutics.

 

[ValentinNarcisse]

My impression as I update myself on the activities of my fellow grads (I finished MSTP in 2007) is that most people are actively trying to pursue research on some level. The issue is not (IMO) that most MSTP grads actively choose to leave research, but that funding is just very tight and they get pushed out just like the straight PhDs, most of whom end up in industry or other nonacademic positions as well, because the common denominator is that there are not enough faculty slots to go around. Perhaps there is somewhat more attrition of MSTPs due to the relatively greater appeal of their available alternatives, but I don't think this is the main issue. It's the tight funding that's the issue.


Meaning you see no value in having people who are dually trained?


I don't understand what you're asking for here. You are saying that MD/PhDs who work in research should be given higher salaries than PhDs for doing the same thing? This makes no sense. Clinical work is something for which there is a market. Research has pretty much no immediate market, thus is supported by the government, companies and foundations that see it as a good. Funding is limited and so researchers don't make much money. This seems logical and I can't imagine why you would expect the system to be rigged heavily in favor of people with certain degrees. I think it's a nice perk that as an MD you can get clinical work to augment your salary above that of the straight PhDs. I don't know why you would expect the time you spend doing what they do to be reimbursed at a higher level.

I think the NIH recognizes that it's not feasible to pay off med school loans on a researcher's salary, but they do see value in having MD-trained researchers, hence the MSTP (and loan repayment programs for straight MDs) which removes the loan burden. Financially I'm in much the same place as a straight PhD, though perhaps a few years older due to residency time. I can supplement my researcher's salary with clinical work which reimburses at a higher rate, which is a bonus. I don't think it's logical or realistic to expect a salary bump for my research time that would put me on par with a full-

It's all about the intangible benefits of having MD/PhDs doing innovative research in a particular field. They bring fame, prominence, and increase the ranking of their home department. The clinical revenue of the department should bridge the gap between NIH funding (which maxes out at 187K) and the average academic salary in that particular market.

 

[tr]

It's all about the intangible benefits of having MD/PhDs doing innovative research in a particular field. They bring fame, prominence, and increase the ranking of their home department. The clinical revenue of the department should bridge the gap between NIH funding (which maxes out at 187K) and the average academic salary in that particular market.

You are vastly overestimating your value here. Fame, prominence, and rankings are determined by research output, grant funding, and (on another axis) reputation for clinical care, not by the degrees held by the faculty. And you want the clinicians, who work hard to provide a service that happens to create revenue, to fork over their earnings to subsidize you to spend your time doing research, which is a revenue sink? That's a pipe dream and frankly I'd be pretty insulted if I were a clinician colleague of yours.

 

[Traumweber]

This is not new at all, many people have supported their academic careers by grants from pharmaceutical companies and not from the government. These grants tend to be very targeted though, from what I've seen they almost always want you to have a very specific drug option in mind that is pretty much ready to go into human trials. It would be pretty limiting to base your entire career on this. But who knows, it's possible this could change. Companies do seem to think more innovatively these days than they have in the past, and the speed with which new technologies are developing may make it less of a time investment to fund earlier stages of discovery for novel therapeutics.

Ofcourse it isn't new. In my current position in the Industry, I personally fund university professors to do research that would reap economic dividends to my company. Any accidental contributions to basic science is a happy coincidence and not the main goal. More than 50% of all funding to academics in my non-medical area come from the industry. On the flip side a friend of mine who finished his PhD in a different field and currently works in academia, completely relies on federal dollars and gets no Industrial funds.
So "limiting" would definitely apply to his field and not my current field. I would guess the same applies to medical research as well. However regulations and competition would definitely affect how open or closed companies would be. Things always are in flux, and it would be wise for researchers to aim to diversify where their dollars come from.

 

[ValentinNarcisse]

You are vastly overestimating your value here. Fame, prominence, and rankings are determined by research output, grant funding, and (on another axis) reputation for clinical care, not by the degrees held by the faculty. And you want the clinicians, who work hard to provide a service that happens to create revenue, to fork over their earnings to subsidize you to spend your time doing research, which is a revenue sink? That's a pipe dream and frankly I'd be pretty insulted if I were a clinician colleague of yours.

This already happens in academic departments between divisions all the time. For example, in Medicine departments, GI and Cards subsidize the Rheumatologists and Endocrinologists which are a net sink in terms of revenue. However, these divisions house some of the biggest researchers that bring prominence to the overall department.

 

[Fencer]

Earlier someone quoted slightly incorrect numbers.

There are 932 NIH supported MSTP slots every year (typically used for years 1-3) and 434 NIH F30 grants that were active in 2014 (there are 30 additional F30s from Dental Institute for DDS/PhDs). The overall number of MD/PhD students who were matriculants in 2013 was 5,124 students.

see: http://acd.od.nih.gov/reports/PSW_Report_ACD_06042014.pdf for MSTP slots
see: NIH Reporter for F30 grants - http://projectreporter.nih.gov/reporter.cfm
see: table 37 for total MD/PhD enrollment - https://www.aamc.org/download/321556/data/2013factstable37.pdf​

Regarding fame, reputation, etc., your publications and grants will speak for you. In the end, the question is how big and lasting is your contribution to your field.

 

[gbwillner]

I think the problem is basically unsolvable. The problem is that there are too many people who want to do research (even more now after the large increase in PhD funding in the early 2000s) who are competing for a very limited pool of research money. That's it, it's not changing, fooling around with the allocation is not going to fix it. I don't think it's a terrible idea to reduce MSTP slots somewhat and fund more R01s instead, but you'd have to cut three MSTP slots to fund one additional R01 so it would be a drop in the bucket given there are only about 300 MSTP slots funded by the NIH per year, compared to ~5000 R01s.

I definitely concur with the first sentence, given realistic constraints. The key issues:

1. Too many people go into science (PhDs), but there is not enough funding for them or their MSTP counterparts
2. It takes too long to get through training- by the end your priorities shift and money becomes a bigger concern. As a researcher, you will make less of it
3. There is little to no security in a science career right now
4. It is too difficult (or there is little incentive) for administrators to accurately predict which applicants will ultimately continue a research career
5. Too much lifestyle discrepancy between clinical and science careers
6. Reimbursement climate forcing young physician-scientists to commit to full-time clinical practice, even if it is not desired

I am a big proponent of cutting MSTP spots drastically to reflect the monies available on the back end (addressing #1). This will force medical schools to be more selective as to who enters their programs (addressing #4). The money generated from this cost-cutting measure should go to support MSTP graduates, with guaranteed monies for their start-up and salary support out of fellowship (addressing #3, #5 and #6).

I am not sure about today's numbers, but when I matriculated I got a letter telling me the total compensation of my training- it was ~$300K. This was in 1999, I bet it is a lot more today. A $500K payout to graduates for start-up out of fellowship would do the following:
1. Make them more likely to stay because they already have funds to work with
2. Make their departments more willing to give them protected time and be productive because they are paying for their own research time or reagents
3. Potentially allow MSTP grads to bypass the dreaded post-doc or even instructorship and go right into asst. Prof with a much more viable salary.

 

[Fencer]

The cost of your training was ~$300K, which is about $500K now. Would you like to have $500K in student debt to allow you to have $500K in research funds?

 

[gbwillner]

The cost of your training was ~$300K, which is about $500K now. Would you like to have $500K in student debt to allow you to have $500K in research funds?

No, I would not. Not sure why you asked this. The money would be saved from cutting ~1/2, not all, MSTP spots. The money would be used for those that successfully complete the training. So they would likewise NOT have to pay student loan debt.

 

[Fencer]

The problem with funding was created by explosion of PhD graduates and post-docs from the late 90's and early 00's. The double of the NIH budget got universities to build (an unsustainable outlook) too much capacity in research buildings and programs, and even leveraging their future based on indirect research costs. If you examine the contribution of the increased number of MD/PhD graduates to this mess, is almost negligible in size. However, as the clinical margins also shrunk, institutions no longer are able to transfer those funds and they have to pay mortgage for the excesses caused by the NIH doubling. If you are going to cut training, you must reduce PhD classes, make them more competitive, and grossly smaller in size. One way that NIH is thinking to address this is by not allowing to charge training to R-01's but only to Training grants. In that way, they can control capacity. The other aspect is to increase the number of grants for a pathway to independence, which is what you are trying to address with those 500K.

 

[gbwillner]

The problem with funding was created by explosion of PhD graduates and post-docs from the late 90's and early 00's. The double of the NIH budget got universities to build (an unsustainable outlook) too much capacity in research buildings and programs, and even leveraging their future based on indirect research costs. If you examine the contribution of the increased number of MD/PhD graduates to this mess, is almost negligible in size. However, as the clinical margins also shrunk, institutions no longer are able to transfer those funds and they have to pay mortgage for the excesses caused by the NIH doubling. If you are going to cut training, you must reduce PhD classes, make them more competitive, and grossly smaller in size. One way that NIH is thinking to address this is by not allowing to charge training to R-01's but only to Training grants. In that way, they can control capacity. The other aspect is to increase the number of grants for a pathway to independence, which is what you are trying to address with those 500K.

Yes, I agree with everything you state here. I way only focusing on our own specific issues internal to our training programs and budgets. But I totally agree that PhD training grants and classes need to be significantly trimmed to reflect market opportunities for graduates. Extra money there can likewise be used to supplement K99s and other bridge funding to support those already invested in the game.

 

[tr]

I agree with the overall thought that training spots need to be cut in favor of more support for those transitioning to independence. I really like the idea of restricting training costs to specific training grants, this would be fantastic. This would not only help with the PhD glut, but it would do something to disrupt the excessive power imbalance between PIs and their graduate students, and the resulting rampant exploitative behavior by PIs. This is a huge problem that leads to a lot of mental health morbidity on the student side (as I well know from my own experiences in graduate school as well as having treated many struggling biology graduate students through our university's student mental health service).

However I do think it's naive to imagine that program directors can effectively predict which applicants to MSTPs are likely to remain in science. It might be easier at the end of MSTP, because it's been shown that PhD success is a major predictor of successful transition to faculty. But I'd be very surprised if you could effectively pick out the people who remain in research when they are 22-25 years old. On the other hand, I don't think this is the crux of the problem anyway. My impression is that most MSTPs would remain in science if the incentive structure were just a little less horribly skewed towards clinical practice, and improving the junior faculty funding situation would go a long way there.

 

[Traumweber]

I am guessing there is going to be another big surplus of PhDs graduating pretty soon, considering the downturn of 2008-2012, and severly reduced employment opportunities for graduating seniors.
Cutting M.D/PhD slots has huge risks as well. I would think there are few people willing to stay committed to research while leaving behind a lucrative clinical career. Why risk reducing that pool even more?
Coming back to the OP's question, as an example, In the energy sector, there is sufficient funding from DoD(and all its various tentacles), DoE, NSF, DoT, EPA. But to be succesful in winning research dollars, Academics need to collaborate in a vast interdiscplinary team with the involvement of the Industry (who may chip in with matching dollars, and possible rights to licensing technology). This yields a bigger bang for the buck because the chances of meaningful impact to society are maximized. I don't know if NIH has a similar mechanism.
Atleast for translational research, Instead of running individual labs and playing a zero-sum game, M.D-PhDs could play the role of "system integrators" who are crucial to large projects because they understand all facets equally well.

 

[dl2dp2]

tr said almost everything I wanted to say in this thread. I just want to echo the "OpenScience" model. I was actually thinking that if my K doesn't work out I might just go start a non-profit and apply for my grants, while doing private practice on the side.

I don't think cutting MD/PhD is a good idea, simply because if we compare the PhD vs. MDPhD students side by side, MDPhD students win hands-down. PhDs should be definitely be more shut down (i.e. more regulated as said above) first.

Also keep in mind MD/PhD programs are already much more regulated than both PhD programs and postdoc positions, as they are limited by the NIGMS MSTP grants to individual institutions, and these grants are competitively renewed. I think PhD programs should eventually become more like MD programs, where there is a "LCME" of some sort, a "match" process, and some baseline salary protection, instead of this winner-takes-all soft money "American" system.

Btw, they do this in PhD in economics. Match system. Self regulation of size/market by the guild. The whole nine yards. So it's definitely possible.

The main problem with our current dysfunctional system is a lack of transparency. Not everyone can/should/want to be a PI. Just like not everyone can be a neurosurgeon or dermatologist. Not everyone can be a major league baseball player. You need to draw a line somewhere and kill the hope so people can MOVE ON. This in itself is not where the "fix" could or should happen. Instead, currently in biomedical research we have this ever shifting, soft money supported line that just keeps going longer and longer and mirkier and mirkier. People need to be able to say, okay, I didn't match into one of the 5 open tenure track positions. I have 1 more try. Then this is IT. Instead of having it drag on and on and on until they develop "mental health" issues as per above.

 

[tr]

tr said almost everything I wanted to say in this thread. I just want to echo the "OpenScience" model. I was actually thinking that if my K doesn't work out I might just go start a non-profit and apply for my grants, while doing private practice on the side.

You let me know if that works out and I'll come join you. My impression right now is that most large funding agencies won't look at your proposal unless you're backed by a major academic institution or research foundation. Maybe this will change as open-source, DIY culture slowly diffuses into the fusty corners of the research-industrial complex. Might take a while though.

I don't think cutting MD/PhD is a good idea, simply because if we compare the PhD vs. MDPhD students side by side, MDPhD students win hands-down.

In what sense do you mean this? My impression is that the PhD group is just much larger and more heterogeneous than the MD/PhD group. MD/PhDs have a very specific profile.

Also keep in mind MD/PhD programs are already much more regulated than both PhD programs and postdoc positions, as they are limited by the NIGMS MSTP grants to individual institutions, and these grants are competitively renewed. I think PhD programs should eventually become more like MD programs, where there is a "LCME" of some sort, a "match" process, and some baseline salary protection, instead of this winner-takes-all soft money "American" system.

I absolutely think this is a good idea as I said above. I think the MSTP model (competitive funding that accrues to the individual and does not depend on the PI) could work just fine for the PhD alone and would really improve both the quality of the research force and the quality of life for the students themselves.

But, it should be noted, this would require a total overhaul of the way science is done today. The biomedical research enterprise currently depends on the labors of this poorly paid, poorly protected army of graduate students and postdoctoral fellows. If you drastically reduce the population of this indentured workforce, we'd have to either greatly reduce our expectations for research output or accept that maintaining current output levels would become enormously more expensive, because underpaid overworked graduate students/postdocs would have to be replaced with paid research scientists who actually had reasonable salaries and viable health insurance.
Another way to deal with it, as someone else suggested, would be to figure out how to massively reduce the competition-based inefficiencies in the system by getting rid of the feudal inter-lab competition and moving everything to huge research consortia that share data freely. Perhaps this might reduce the overall labor need sufficiently to compensate for the loss of manpower.

But any way you slice it it would require the grayhead PIs who make these kinds of funding decisions, who are all already successful under the current system, to initiate a radical change in a direction that would not be to their benefit. How many of them are going to be really excited to exchange their flock of young, hungry, underpaid minions for two or three skilled, experienced scientists who would have to be paid commensurately more? Hm. So yeah, I'm a little skeptical that this could ever happen, at least in the short to medium term.

 

[dl2dp2]

poorly paid, poorly protected army of graduate students and postdoctoral fellows...How many of them are going to be really excited to exchange their flock of young, hungry, underpaid minions for two or three skilled, experienced scientists who would have to be paid commensurately more? Hm. So yeah, I'm a little skeptical that this could ever happen, at least in the short to medium term.

I agree. What we can do right now is to use SDN and similar forums to make people AWARE of this.

As I said, given the fact that very little can be done systematically, the first step is transparency. People need to be aware of all of this stuff. Be aware how much PIs get paid (i.e. assistant professor, $80-100k, associate $120-140k) . Be aware what the odds are of funding an R01 (10%). Be aware of the ratio of postdocs who end up in a tenure track position by the end of 5 years (~15%). Mean age of first R01 ~ 43. There's nothing wrong with taking risks in life. You just need to know your odds and make an informed decision.

Full time physician salaries for different specialties are discussed in various other forums.

 

[dl2dp2]

Oh and

http://www.pipredictor.com/