What is an MD-PhD Program?
MD-Programs are designed to train physician scientists that can potentially perform medically related research while maintaining a clinical practice. Training programs come in several varieties but they are all designed to grant graduates a PhD as well as an MD degree. The MD-PhD pathway is a long one, but many programs provide funding for students to make the time more bearable. There are several other perks to these programs, including the ability of graduates to explore a variety of career paths. While many MD's do research it is easier to get a faculty position and funding in today's climate if you have both degrees. MD-PhD's can translate scientific research to real clinical advances. However, not all work in the lab. Some run clinical trials, others work in government to set medical policy, still others are hospital administrators or professors.
To begin an MD-PhD training program you must have completed a four four year undergraduate degree. While it is not necessary to start college knowing you will follow this career path there are certain courses you must take. These are the same prerequisites that all premed students must take. You do not need to major in a science, but it certainly does not hurt.
Once finished with college most MD-PhD trainees enter dual degree programs specially designed to facilitate the awarding of both degrees. While some people obtain the two degrees separately, this is usually because they were unaware they wanted both degrees. Many programs run on a 2-4-2 schedule: First two years of medical school, graduate school research for about 4 years, followed by a return to medical school for two years of clinical training. The aim is to graduate in 7-9 years. Some students take more time, some students take less.
After graduation, MD-PhD's are faced with a choice. Many enter residency to ensure they can practice medicine later. Others opt to pursue postdoctorate training and never practice medicine.
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Yet Another Acronym to Learn
The nomenclature a program uses is actually significant. MSTP, standing for Medical Scientist Training Program, means that a program receives funding from the NIH. These programs are bound by certain rules, the most important of which are about student funding. MSTP programs guarantee their students full tuition and a stipend for all their years of schooling. Should a student drop out they are not required to pay back the tuition or the stipend.
Other MD-PhD programs that are not MSTP's have varying funding policies. Several require you to pay back tuition should you drop the program. Several do not provide funding for the first two years of medical school. Others require students to pay for the first two years of medical and say they will reimburse this cost upon completion of the PhD.
Still other programs combine a mixture of both funding types. Some school will designate certain students as "MSTP funded" while other students are funded from other sources or not funded at all. Such schools inform applicants of which funding source (if any at all) they will be listed under when they are extend acceptance offers.
How to Get Your Foot in the Door
Applying to MD-PhD programs is similar to applying to medical school, with a few more hurdles to jump through. Your first step is filling out a primary application on a service called AMCAS. This application will be similar to that for an MD applicant, requiring a personal statement, transcripts, MCAT scores, letters of recommendation free text options about your activities and the ability to select which schools you would like to apply to. Applying MD-PhD will prompt AMCAS to ask you for two additional essays. One will be about why you selected the MD-PhD option and one will be about your research experiences and career goals. Many schools require a letter from each researcher you have worked for. Try and give your writers ample time to write you a supportive, personal letter.
Once they receive your primary application schools can opt to send you a secondary application. These vary widely by school. Some will have additional essays and questions, others will not. All will have a processing fee. Try to get these applications back to each school in a timely fashion. Selection of candidates for interview gets more competitive as more applications roll in. This step requires serious organization. Make sure you stay on top of your requirements to complete your application at each school. This will ensure you do not miss vital deadlines that are often earlier than those for MD applicants.
School who remain interested in you will invite you to come for an interview. The school will usually provide you with overnight accommodation and travel reimbursement. Usually there are social events with current students. This is a good time to evaluate the school and ask questions you may have. There will be a tour of the school and several interviews with faculty. Most schools have three formal interviews in which you are being evaluated and several informal interviews where you meet with researchers you have expressed interest in. Be prepared to discuss and defend your research.
Once you have completed your interview you must sit back and wait. If something major changes about your application you can update schools, but do not go overboard. They will respond to you with an acceptance, rejection or a waitlist spot. If waitlisted express your continued interest in the school and any other updates you may have. If you are lucky enough to receive multiple acceptances remember your fellow applicants and inform schools as soon s you have made your decision. This frees spots for other students.
Because most MD-PhD programs provide funding they are extremely competitive. Having a solid GPA (3.5 and up) combined with an above average MCAT score (35 and up) can help you gt an interview. However, students with lower scores sometimes do better than students with perfect scores. Why? Because they have outstanding research experience and letters of recommendation from research supervisors. Programs shell out a large amount of cash per student and they want to make sure you will complete your training and do well. Their best indicator for this is your research experience. If you have done good research in the past, it is likely you will continue to do so. Therefore it is vital to get laboratory experience while you are an undergraduate. Some students even take a year off between graduation and applications to focus on research.
Having a publication will set you apart from the bulk of applicants who do not but it is not a guarantee of admission. Nor is it a requirement. Do not let lack of publication stop you from applying.
Learn More About MD-PhD Programs
Pros and Cons
for the sake of full disclosure
Many students think MD-PhD programs are a great way to get a free MD. Well, there's no such thing as a free lunch. You dedicate 4 or more extra years of your life to getting that PhD. That's not a decision to be made lightly.
Is the MD-PhD stipend livable? At most schools and locations, yes. However you will not be living in the lap of luxury. One person can live comfortably on their stipend. However, if that person wanted to have a child they would likely need a spouse with a much better paying job, a loan or a family member willing to provide free daycare. Eight years is a long time to be living on a student salary. Your friends will likely be paying off their loans and making a nice salary by the time you graduate. Which brings me to the next downside: It is very hard to watch your friends move on without you.
You will begin your program with a great group of MD classmates. These classmates will graduate just as you are finishing your second year of research (often a tough research year for students). You will still have a while to go. Heck, some of them may be your attending when you get back to the wards. Can you handle that psychological toll?
Spending four years in the lab before you hit the wards means you will forget a lot of your clinical knowledge. You will need to bone up on things that have likely changed since you last studied them and you will be competing with a bunch of students who just took the USMLE and are at the top of their game. Plus you are going from finishing your PhD and feeling great to being the low man on the medical totem poll. It's a roller coaster. There are ways to ease these transitions, but you should be aware that they exist and can be very tough on students.
Think long and hard before committing. There are a million reasons to do the MD-PhD and there are a million reasons not to. In the end you need to decide if it is right for you.
Resources to Learn More
- Ace the MCAT
Tips for studying for the MCAT.
- AAMC MD-PhD Website
Developed by seasoned MD-PhD directors and administrators is an ideal tool for pre-health advisors, MD-PhD students and applicants (including potential applicants). It is the official website of the MD-PhD Section of the AAMC.
- Jewish Alliance for Women in Science
A place for women interested in Science careers to learn about various career pathways.
- MD-PhD Panel Podcast
on 6/30/09 this podcast outlines the goals of an MD-PhD program and includes a discussion on careers, training and admissions.
Physician Scientist Association is dedicated to career development and community building among physician-scientists in training. The website is a wonderful resource for students pursuing the MD-PhD or DO-PhD careers.