Everything you wanted to know about MD-PhD Programs but were afraid to ask

Jim Gorham, MD PhDDirector, The MD-PhD Program at the Geisel School of Medicine at DartmouthJames.D.Gorham@Dartmouth.edu603-650-8373

Dartmouth CollegeMay 14, 2012

1. Physician-Scientist Career Paths

2. Preparing your application to MD-PhD Programs

3. Evaluating MD-PhD Programs

Part 1: Physician-Scientist Career PathsMD versus PhD versus MD-PhD

• Preclinical Phase• Clinical Phase• Graduation• Post-Graduate Internships/Residencies• Fellowships (Specialize)

MD Course of Training

PhD Course of Training• First Year

• Graduate Coursework• Lab Rotations, Choose Thesis Lab

• Second Year• Complete Graduate Coursework• Qualifying Examination

• Years 2-5• Full-Time Bench Research• Thesis Committee Meetings• Teaching Assistantships• Write Papers and Thesis• Thesis Defense

Mission: Provide integrated education and training of individuals to become physician-scientists

prepared to bridge the gap between laboratory research and clinical medicine.

RESEARCH:• Basic Research• Disease-Oriented Research• Patient-Oriented Research• Population-Oriented Research

TEACHING:• Basic Science• Clinical Disciplines

CLINICAL MEDICINE:• Generalist

>Specialist

MD-PhD Training

WHAT IS THE MD-PhD OPTION?

CollegeStudent

Physician-Scientist

MD-PhD

MD

PhD

Pathways to become a Physician-Scientist or Clinical Investigator

ClinicalResearch

MD-PhD vs MD: Structured research training

What is special about MD-PhD education and training?

MD-PhD Training

MD-PhD vs PhD: Understanding of human biology(how normal and abnormal function result from complex interactions at many levels of specialization)

Clinicians’ perception of MD-PhD students?They all become basic scientists…

MD-PhD Training

Basic scientists’ perception of MD-PhD students?They all become clinicians…

Conclusion?We must be doing something right…

Differing perceptions of MD-PhD trainingand training outcomes

RESEARCH

CLINICAL MEDICINE

ADMINISTRATION

Student MD-PhD Training

BasicTranslational

ClinicalEpidemiologicalIndustrial R&D

AcademicIndustry

Public Policy

MD-PhD Training

ADVANTAGES:

DISADVANTAGES:

FULL FINANCIAL SUPPORT:

MD-PhD Training

Broad education in human biologyBroad range of career choices

Very long education and training Difficult-to-manage conflicting pressures from laboratory, clinical responsibilities, and family

Enables careers in academic medicine(but this is not a free lunch)

• Preclinical Coursework• Explore Research Opportunities• Laboratory Rotations• Choice of Thesis Advisor• National Board Exam• Clinical Clerkships

Preclinical Phase – Years 1-2

• Graduate Coursework

• Bench Research and Publication

• Explore Clinical Interests (medical specialties)

• -/+ Clinical Experience (limited)

Research Phase – Years 3-6

• Clinical Clerkships

• Residency Application

• Graduation

Clinical Phase – Years 7-8

• Medicine• Surgery (including subspecialties)• Ob/Gyn• Pediatrics• Neurology• Psychiatry• Primary Care

• Medicine Subinternship• Senior Electives

13-24 Months Total time

M3

Year

M4

Year

Clinical Phase – Years 7-8

MD-PhD vs MSTP• What is a Medical Scientist Training Program?

• 109 MD-PhD Programs (42 MSTPs, 67 non-MSTP)• NIH funded MSTP Training Grant

Part 2: Preparing your application. Making sure you are the applicant that programs will take a second look at

What MD-PhD Programs Seek•Strong academics (of course) •MCAT’s

Plus•Passion for Science•Research Experience•Clinical Experience•Leadership •Commitment to Serving Others

The To Do List

• Coursework• Research• Clinical Exposure• Community Service• Extras • Recommendations

Research - Academic Year Summer Opportunities Post-undergraduate

Posters, Oral Presentations & Publications

The MD-PhD ApplicationHow to get the coveted offer of acceptance…

MD-PhD Application• APPLY EARLY, APPLY EARLY, APPLY EARLY,

APPLY EARLY, APPLY EARLY!!• Universal MD-PhD application available on

AMCAS.• Personal Statements• Letters of recommendation• GPA and MCAT• Publications help• Secondary forms

Personal Statements Personal Statement –

• Individual characteristics, experiences and motivations for choosing a career as an MD/PhD. • Discuss unique life experiences or skills

Why I Want to be an MD/PhD – • Explain rationale for wanting to become an MD/PhD. • Discuss generally how you envision using the combined degree in the future (specifics not necessary).

Research Experience - • Describe any and all research experiences you have had.• Provide clear timelines for each experience• Discuss your role(s) in the research project.

The InterviewDuring the MD/PhD interview:• Try to talk with as many as possible research faculty in

your area of interest• Ask lots of questions to the students in the program –

they are the best indicator of whether a program has any major issues

• Be prepared to discuss your research in-depth You should know the big picture as well as the

experimental details• Be prepared to discuss your rationale for choosing the

MD/PhD track• Be personable

engage both the faculty and students in one-on-one conversation about science and extracurricular activities

AAMC - Admissions Data• About 2K MD/PhD applicants nationally

• Of these, about one-half (1K) are offered an interview with at least one MD-PhD Program.

• Of these, about 2/3rd are offered admission to at least one MD-PhD Program.

AAMC – National Statistics• Nationally, there are about:• 4,500 MD-PhD students, of which:

~12% are underrepresented minority ~40% are female

Part 3: Evaluating anMD-PhD ProgramIn which program will you not only survive but thrive

Location• Geography –

Close to family Housing availability, proximity,

affordability Variety of extracurricular activities Proximity to things that matter to you

School - Academics• Curriculum -

Preclinical coursework Clinical requirements (Clerkships/Electives)

• Patient populations and clinical facilities• Flexibility • Graduate Programs –

Coursework requirements # of required lab rotations

• Residency Placement of Alumni

Faculty• Are there sufficient faculty who share your

interests? • Is there a strong research community?• Collaboration• Training record (time to degree)

Strengths of MD-PhD Program• Program Director’s commitment to program• Administrative support• Support from Dean/Administration• Supplemental program opportunities -

seminars, lectures, programs, socials

Gut Feeling

In the end, you will almost certainly make your decision based on a gut feeling, and then find rational arguments to support it. And that is the way it should be.

Questions…Concerns?

The Complete Guide to theMD/PhD DegreeBen Rosner MD, PhDJayakar Nayak MD/PhDJ&S Publishing