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Foot Fetish

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So, I attend a medical school associated with a Top 10 business school. I never really thought I'd go for an MBA, but the opportunity to attend such a well ranked program is making me consider it now. Since I have no business experience, I would have had zero chance at getting accepted into this MBA program if I had applied to it via regular admission, but this MD/MBA route is like a backdoor that waives the experience requirement and makes it very straightforward to get in....it has really piqued my interest....

Should I pursue this opportunity? I've always had an entrepreneurial spirit. I have dabbled in trading stock, and I had some small, profitable ventures back in college...back when I used to follow stocks, I was always fascinated by the biotech companies, namely the massive moves they would make when a drug was approved/rejected. I'd love to get into the financial side of that industry....would this top 10 MD/MBA program be a good way to do that?

...or should I stick with the original plan of just becoming a radiologist (not as exciting but safer, I guess)
 

doc05

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really depends on your career goals. Practicing medicine has become increasingly challenging in recent years. That includes radiology. If you want to be a business person, sounds like a good opportunity.
 

Merely

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Who says the top 10 MBA would even accept you?
 

Foot Fetish

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Who says the top 10 MBA would even accept you?

I never said it's a guarantee, but it's much more probable than getting into the straight MBA. There will be like 6-10 people from the MD program competing for ~6 MD/MBA spots. In previous years, 100% of those who applied got accepted. All I'm saying is that it's a super opportunity. I'm just trying to decide whether or not I should go for it at this point.
 

MDviaMBB

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Congrats on your medical school acceptance being at a university with a strong business school. I was going to apply to MD/MBA programs last year, and if I didn't get in somewhere linked with a top 10 business school, I'd planned on taking a scholarly leave of absence between M2/3 & M3/4 to attend one. Like you, I don't have any formal financial experience and want to more or less do what you're referring to (e.g. working somewhere between pharmaceutical companies, investment banks, and private equity firms).

However, after researching MD/MBA programs over the last year while pursuing an MSc in clinical research/pharmaceutical development, I've decided not to apply to any based on my career goals, below reasons, and perhaps more so after receiving internship offers from known brokerage and investment firms within the last few weeks via my current degree. I'm still planning to go to medical school, and of course not trying to dissuade you from pursuing an MBA; I'm sure that you can do what you're asking about after completing one. Although, I'd simply like to describe what worked for me in order to provide perspective for you and others since I haven't seen this topic discussed here, before.

So, if you have a few minutes, feel free to read the following broad outline of the pharmaceutical side of finance and fill in the blanks regarding where someone with medical training would fit in. I'm in the process of editing it, too, so please don't quote me or analyze it too closely. First, biotech/pharmaceutical companies tend to interact with and/or are mostly affected by investment banking (IB), trading (brokerage), private equity (PE) & venture capital (VC), and equity research financial services in addition to hedge funds; each one of these fields is based on economics and business principles that not only require significant amounts of studying and quantitative abilities to comprehend, but relevant degrees, internships, networking, tailored ECs, and several years of 80-100 hour weeks as entry level analysts in some cases (e.g. for ibankers, including those that transition to private equity) to perform well at the associate level. I'm not saying that you can't learn the above and do one of those jobs competently, but wanting to work for an investment bank or a hedge fund after a medical residency is like saying that you want to leave your career as a professional soccer player to be a helicopter pilot. To see what I mean, google the term glossary for investment banking, private equity, etc to gain an understanding of what it is that they do, and even check out the prep material for the series 7 and 63/66 that brokers have to take. If they're in the healthcare industry, their fields are pharmaceutical-related on the surface, but still really far removed from medicine.

For reference and continuing, early startups with pre-clinical and clinical trial drug candidates, devices, and/or technologies aren't traded publicly on a securities exchange (the stock market), but are instead invested in by grants, loans, and/or VC firms +/- private investors that in return gain a stake in the company and receive modest or larger returns. Hypothetically, companies with a decently marketable or even a blockbuster candidate that passed phase I studies evidencing safety are valued at ~ 50 million and may have PE investors, but aren't publicly traded; those that successfully demonstrate their compound's efficacy through a phase II or sometimes Ib clinical trial jump in worth significantly (e.g. ~ $100-200 million) en route to/by going public through an initial public offering (IPO) coordinated by an investment bank, which values and establishes a market for ("underwrites") their equity securities (stock) amongst other services related to debt and assets, after which they're publicly traded on the NYSE or Nasdaq. At that point, the company may be acquired by a bigger pharmaceutical company through a merger/acquisition (M&A). And if their compound successfully completes a phase III clinical trial demonstrating efficacy and safety in a large patient population and then gains FDA approval, the company can reach really high valuations (e.g. >$1 billion). For instance, Denali Therapeutics -- a CNS-oriented pharmaceutical company -- raised the largest VC investment in history (~$220 million) by taking a biomarker-based approach to drug development, which not only lets them predict which therapies are likely to be effective, but enroll patients (the "small subpopulation" mentioned below) into clinical trials whom are most likely to have a measurable, positive response as described in Forbes "... promising early clinical results, even in a small subpopulation, an IPO and a multi-billion-dollar valuation may not be far behind" http://www.forbes.com/sites/stevedi...round-not-just-because-it-could/#1f6e09292d0a

People with medical degrees aren't needed in strictly financial roles within the above processes since their input, while useful in terms of predicting which drugs will become approved, isn't valuable enough to offset the cost of financial services they don't provide (which isn't to say that they can't granted that they have relevant degrees and experience). That is why most MDs in the pharmaceutical industry (ref. the http://forums.studentdoctor.net/threads/physicians-in-the-pharmaceutical-industry.243278/ thread, here) are most often on the medical end of biotech companies in medical affairs types of roles acting as liaisons, publishing, presenting at conferences, and otherwise doing clinical research or at consultancies, such as McKinsey, Bain, etc. Reference any biotech company's website e.g. http://audentestx.com/company/ to see the distribution of degrees by sector, where there are usually no MDs in management but quite a few on the Board of Directors and acting as scientific/clinical advisors.

If you're curious how I was able to receive offers for several internships, my research is in an area (shared with Denali) that directly and indirectly relates to evaluating and, yes, predicting drug's efficacy. As you described, huge jumps in stock prices following positive clinical trial results are exciting to me, too, and I tailored my research & ECs accordingly, although bringing medications to patients sooner is what compelled me to do so; along the way, I found out that improving both the development speed and approval likelihood of a drug by 10% reduces its $2.6 billion development cost by $634 million, and realized that accusations against "big pharma" regarding price hikes etc can be traced to their need for recovering prior R&D expenditures (88% of drugs entered into clinical trials do not gain FDA approval). And as a caveat, my research isn't confidential or insider information, per se, but I've been able to gain familiarity with how drugs in several high demand classes as well as emerging technologies (nanotechnology, precision medicine, targeted therapy; these are huge in oncology) and devices are evaluated and ultimately approved via my MSc at a "target" University (a.k.a. where the financial industry recruits students), as well as to perform my research remotely with pharmaceutical companies. Over the Summer, I not only cold called and networked with brokerages, but studied both finance through the "Breaking Into Wall Street" online tutorial and for the series 7 whilst researching the business and capital structures of companies I worked and didn't work with. I was also able to align my coursework, based on the structure and function of clinical trials, with the commercial and regulatory aspects of pharmaceutical development -- topics Forbes publishes on regularly -- and network with business students through related and even start my own student interest group(s) at my University. Lastly, there's significant unmet demand for people that can work between finance and clinical development per the following quote from a Cornell spinout "We are always interested in speaking with investors who wish to share in the success of this innovation and with pharmaceutical development companies that may be interested in working with us to develop this discovery for market" http://www.adispell.com/Home/ContactUs
 
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DrCommonSense

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Congrats on your medical school acceptance being at a university with a strong business school. I was going to apply to MD/MBA programs last year, and if I didn't get in somewhere linked with a top 10 business school, I'd planned on taking a scholarly leave of absence between M2/3 & M3/4 to attend one. Like you, I don't have any formal financial experience and want to more or less do what you're referring to (e.g. working somewhere between pharmaceutical companies, investment banks, and private equity firms).

However, after researching MD/MBA programs over the last year while pursuing an MSc in clinical research/pharmaceutical development, I've decided not to apply to any based on my career goals, below reasons, and perhaps more so after receiving internship offers from known brokerage and investment firms within the last few weeks via my current degree. I'm still planning to go to medical school, and of course not trying to dissuade you from pursuing an MBA; I'm sure that you can do what you're asking about after completing one. Although, I'd simply like to describe what worked for me in order to provide perspective for you and others since I haven't seen this topic discussed here, before.

So, if you have a few minutes, feel free to read the following broad outline of the pharmaceutical side of finance and fill in the blanks regarding where someone with medical training would fit in. I'm in the process of editing it, too, so please don't quote me or analyze it too closely. First, biotech/pharmaceutical companies tend to interact with and/or are mostly affected by investment banking (IB), trading (brokerage), private equity (PE) & venture capital (VC), and equity research financial services in addition to hedge funds; each one of these fields is based on economics and business principles that not only require significant amounts of studying and quantitative abilities to comprehend, but relevant degrees, internships, networking, tailored ECs, and several years of 80-100 hour weeks as entry level analysts in some cases (e.g. for ibankers, including those that transition to private equity) to perform well at the associate level. I'm not saying that you can't learn the above and do one of those jobs competently, but wanting to work for an investment bank or a hedge fund after a medical residency is like saying that you want to leave your career as a professional soccer player to be a helicopter pilot. To see what I mean, google the term glossary for investment banking, private equity, etc to gain an understanding of what it is that they do, and even check out the prep material for the series 7 and 63/66 that brokers have to take. If they're in the healthcare industry, their fields are pharmaceutical-related on the surface, but still really far removed from medicine.

For reference and continuing, early startups with pre-clinical and clinical trial drug candidates, devices, and/or technologies aren't traded publicly on a securities exchange (the stock market), but are instead invested in by grants, loans, and/or VC firms +/- private investors that in return gain a stake in the company and receive modest or larger returns. Hypothetically, companies with a decently marketable or even a blockbuster candidate that passed phase I studies evidencing safety are valued at ~ 50 million and may have PE investors, but aren't publicly traded; those that successfully demonstrate their compound's efficacy through a phase II or sometimes Ib clinical trial jump in worth significantly (e.g. ~ $100-200 million) en route to/by going public through an initial public offering (IPO) coordinated by an investment bank, which values and establishes a market for ("underwrites") their equity securities (stock) amongst other services related to debt and assets, after which they're publicly traded on the NYSE or Nasdaq. At that point, the company may be acquired by a bigger pharmaceutical company through a merger/acquisition (M&A). And if their compound successfully completes a phase III clinical trial demonstrating efficacy and safety in a large patient population and then gains FDA approval, the company can reach really high valuations (e.g. >$1 billion). For instance, Denali Therapeutics -- a CNS-oriented pharmaceutical company -- raised the largest VC investment in history (~$220 million) by taking a biomarker-based approach to drug development, which not only lets them predict which therapies are likely to be effective, but enroll patients (the "small subpopulation" mentioned below) into clinical trials whom are most likely to have a measurable, positive response as described in Forbes "... promising early clinical results, even in a small subpopulation, an IPO and a multi-billion-dollar valuation may not be far behind" http://www.forbes.com/sites/stevedi...round-not-just-because-it-could/#1f6e09292d0a

People with medical degrees aren't needed in strictly financial roles within the above processes since their input, while useful in terms of predicting which drugs will become approved, isn't valuable enough to offset the cost of financial services they don't provide (which isn't to say that they can't granted that they have relevant degrees and experience). That is why most MDs in the pharmaceutical industry (ref. the http://forums.studentdoctor.net/threads/physicians-in-the-pharmaceutical-industry.243278/ thread, here) are most often on the medical end of biotech companies in medical affairs types of roles acting as liaisons, publishing, presenting at conferences, and otherwise doing clinical research or at consultancies, such as McKinsey, Bain, etc. Reference any biotech company's website e.g. http://audentestx.com/company/ to see the distribution of degrees by sector, where there are usually no MDs in management but quite a few on the Board of Directors and acting as scientific/clinical advisors.

If you're curious how I was able to receive offers for several internships, my research is in an area (shared with Denali) that directly and indirectly relates to evaluating and, yes, predicting drug's efficacy. As you described, huge jumps in stock prices following positive clinical trial results are exciting to me, too, and I tailored my research & ECs accordingly, although bringing medications to patients sooner is what compelled me to do so; along the way, I found out that improving both the development speed and approval likelihood of a drug by 10% reduces its $2.6 billion development cost by $634 million, and realized that accusations against "big pharma" regarding price hikes etc can be traced to their need for recovering prior R&D expenditures (88% of drugs entered into clinical trials do not gain FDA approval). And as a caveat, my research isn't confidential or insider information, per se, but I've been able to gain familiarity with how drugs in several high demand classes as well as emerging technologies (nanotechnology, precision medicine, targeted therapy; these are huge in oncology) and devices are evaluated and ultimately approved via my MSc at a "target" University (a.k.a. where the financial industry recruits students), as well as to perform my research remotely with pharmaceutical companies. Over the Summer, I not only cold called and networked with brokerages, but studied both finance through the "Breaking Into Wall Street" online tutorial and for the series 7 whilst researching the business and capital structures of companies I worked and didn't work with. I was also able to align my coursework, based on the structure and function of clinical trials, with the commercial and regulatory aspects of pharmaceutical development -- topics Forbes publishes on regularly -- and network with business students through related and even start my own student interest group(s) at my University. Lastly, there's significant unmet demand for people that can work between finance and clinical development per the following quote from a Cornell spinout "We are always interested in speaking with investors who wish to share in the success of this innovation and with pharmaceutical development companies that may be interested in working with us to develop this discovery for market" http://www.adispell.com/Home/ContactUs


That makes sense that one can't transition immediate into a VC/PE role after obtaining an MD/MBA (even with residency training plus board certification) due to lack of experience in the field.

However, there would be significant opportunities that should open up in healthcare consulting (considering the MBA is from a top school) that would allow years of experience at increasing salaries. This would afford the physician lateral options later into PE/VC or insurance/big pharm positions at a management/VP level.

With the future of medicine being quite uncertain (think Obamacare cutting salaries) with continued risk of malpractice, I am would still think the MD/MBA route is beneficial. If the physician completed a residency, he/she can return to clinical medicine if consulting appeared to not work out well. The MBA could subsequently used to attempt to gain hospital leadership positions.
 

justadream

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That makes sense that one can't transition immediate into a VC/PE role after obtaining an MD/MBA (even with residency training plus board certification) due to lack of experience in the field.

However, there would be significant opportunities that should open up in healthcare consulting (considering the MBA is from a top school) that would allow years of experience at increasing salaries. This would afford the physician lateral options later into PE/VC or insurance/big pharm positions at a management/VP level.

With the future of medicine being quite uncertain (think Obamacare cutting salaries) with continued risk of malpractice, I am would still think the MD/MBA route is beneficial. If the physician completed a residency, he/she can return to clinical medicine if consulting appeared to not work out well. The MBA could subsequently used to attempt to gain hospital leadership positions.

Assuming you want to be a board-certified physician, is this even that easy/possible? Say you are a ENT and have been out of practice for 2-3 years doing consulting. Is coming back that easy? I've heard that you need to do physician-reentry type programs (could very well be wrong about this)? I also doubt medical boards would look fondly upon extended (like 1 year+) leaves of absence from practicing medicine.
 

DrCommonSense

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Assuming you want to be a board-certified physician, is this even that easy/possible? Say you are a ENT and have been out of practice for 2-3 years doing consulting. Is coming back that easy? I've heard that you need to do physician-reentry type programs (could very well be wrong about this)? I also doubt medical boards would look fondly upon extended (like 1 year+) leaves of absence from practicing medicine.

I actually don't know the answer for this in all fields. I'd figure procedural fields might need a more extensive reintegration plan than just taking a test again.

The guy from Bain who is a pediatric cardiologist appears to believe he can get back without a problem if his consulting falls through.

http://hackyourwealth.com/tarun-mahajan-boston-consulting-group
 

zeloc

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Should I pursue this opportunity? I've always had an entrepreneurial spirit. I have dabbled in trading stock, and I had some small, profitable ventures back in college...back when I used to follow stocks, I was always fascinated by the biotech companies, namely the massive moves they would make when a drug was approved/rejected. I'd love to get into the financial side of that industry....would this top 10 MD/MBA program be a good way to do that?

The misconception here is that there is a strong relationship between investing and having an MBA, when there isn't. You specifically mention the pharmaceutical/biotech space. It is normal for the price to fluctuate rapidly when a drug is approved/rejected. The price reflects the new information that is available based on the drug. But that is not predictable and it is the domain of quants, not MBAs. If you are interested in business, eg, starting or running a company, or even in healthcare management, then I would consider an MBA for that reason, and that reason only. I know several MD/MBAs and they largely work in healthcare management positions, +- clinical work.
 
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