What makes a good MD/PhD Program?

[Fencer]

I strongly agree with these two statements:

• Graduate program - look for a T32 training grant in that discipline, it is another marker that good training in that discipline happens there.
• Strong MD/PhD administration - a strong PD is able to protect, mentor, and solve problems for you

The post above was my answer to the OP. I believe that the quality of the PhD and the strength of the MD/PhD administration are the two most important issues.

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[mercaptovizadeh]

Dear gbwillner,

I hear and feel the same pain as you do. In Neurology, CMS also cut 30% rates for EMGs for 2013 (announced in Nov '12) and threaten to do the same for EEGs in 2014. Our professional societies heavily lobbied against these cuts and we were able to show the impact to practices and academic centers. I was on the Hill, talked to CMS people, had email campaigns, and engaged people involved in the process during 2013. The final rules for 2014 were dramatically better and most of the 2013 cuts were reversed. The impact of the ACA to academic centers is significant, and diminishing their ability to use strategic funds to invest in research. As we hear often in administrative meetings, research doesn't pay. The institution ends up paying about 20-40% additional costs to the total award (direct+indirect). Having said that, I am also have to be involved in the development (i.e.: endowments) side of the institutions. See this story: http://chronicle.com/article/Gifts-to-Colleges-Hit/144707/
Think about the population dynamics in the country, the baby boomers (I am at the tail end) are getting to retirement with the mindset of doing legacy projects. Honestly, the negative spiral is not rational. Many institutions are undergoing restructuring and sustainability studies. The overall research structure at many institutions is clearly changing. However, a need will remain (fact), and the marketplace will figure out a model to fulfill the need. It is that plain, and it is not delusional... I still believe that the people best positioned to make the most out of this opportunity are those who do a MD/PhD training (opinion).

Fencer

I don't really understand this reasoning. If we consider the funding mechanisms (government, private donations, citizens, etc.), it is not so much the need as you understand it that matters, or even the need in the absolute sense (perhaps they are the same?), but the need as it is perceived by the payers. Medicine has in most societies had a high profile because people value their health highly. But how much do they really value researchers? I would say, not so much. I mean, much of the research is inscrutable to the general public and even other scientists, much of it will never amount to anything, and much of the high quality work that will end up mattering is years if not decades away from becoming clinically relevant. The NIH is recognizing this in that grant applications are increasingly requiring clinical data - not clinical implications or proposed experiments - but substantial preliminary data in humans strongly implying that mechanistic animal studies will have near and even immediate clinical applicability. Researchers have somewhat discredited themselves with absurdly optimistic statements a la "may help in the treatment of cancer" and the like, and the public and the funders will be increasingly dismissive of this kind of palaver which was unfortunately abused so that yeast geneticists could get their extremely basic cell cycle research done using funds allocated with the intent of reducing morbidity and mortality of cancer in humans. I'm sorry, but I just don't see that the perceived need is strong enough to mandate limited funds being allocated to research. Nobody really cares whether the next bunch of drugs/treatments are developed in the US or Israel or Japan or Germany.

 

[gutonc]

Maybe the OP was asking the wrong question.

 

[oxfordian]

Well on the bright side, us just starting the program will probably have a completely different job market, hopefully worked out the kinks of Obamacare, in ya know, the 10-15 years it takes us to train.

 

[bd4727]

Um hold on. I thought a med school's "reputation" is just how extensive their research facilities are and the strength of their faculty. How can this be separated from the quality of mentors and productivity of research done at the school (ie the PhD part)?

Besides, I thought everyone considered the preclinical med school curricula to be basically equivalent in terms of what you learn. And as far as clinical rotations are concerned, I haven't found a reliable way to compare them between institutions. So what should I be looking for, as an MD/PhD applicant?

I am not saying go by US News, etc or even that medical schools are necessarily easy to differentiate between (they probably aren't). I am saying that IMO if you are at a decent sized research institution, you will be able to find a good lab to work in no problem. Then it's basically up to you (again IMO, many will disagree) as to how 'good' your PhD will be. Yet I feel like the majority (many?) applicants are very focused on finding a school with PIs working on one specific field of research, and count this way too heavily in their decision relative to the importance it plays both in the quality of PhD one receives and in the long-term outcomes such as residency, grants, etc.

 

[Fencer]

I suggested to look for PhD discipline T32 funding because at least a NIH study section thought there were "enough numbers of training quality investigators" (i.e.: quality PhD mentors) and there were also a few PIs who were thoughtful about training to put together a T32 training grant. Any T32 training grant (including MSTP) justifies to NIH study sections the long-term outcomes of their graduates.

 

[scneuro]

As a current graduating MSTP student, I think it's important that you find the program that "feels like home" to you. You are making a big commitment and you need to be in a program that is supportive, nurturing and yet challenging at the same time. You should not choose a program solely to work with one specific investigator, because that PI can and may leave during your time in medical or graduate school. Be prepared to work hard and don't worry too much about how fast you'll finish your PhD. There are going to be days, weeks and maybe months when nothing is going right, so you need to be in a place and program where you'll thrive throughout the hard times - so if that means being close to family- then make sure it's right for you. You want your PhD to be successful- publications, NRSAs, etc.- but you also want a program director who will go to bat for you if you need help with re-entry to third year or helping you choosing a lab, finding funding, etc.

Best of luck.