All About MD PhD Programs: Who, What, Where, When, Why?



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All About MD PhD Programs: Who, What, Where, When, Why? From Let s Go (ft. Lil Jon and Twista): I want answers [about MD PhD programs] now: who, what, where, when, why!? Peter Kundert Joe Cannova

Outline 1. What does an MD PhD degree entail? What can I do with it? 2. What are the pros and cons of doing an MD PhD? 3. How does the application process work? Where should I apply?

Outline 1. What does an MD PhD degree entail? What can I do with it? 2. What are the pros and cons of doing an MD PhD? 3. How does the application process work? Where should I apply?

What is the structure of an MD PhD degree? or where are the remainder of my 20 s about to go?

What is the structure of an MD PhD degree? 1. First 2 years of medical school* Mostly lecture based, basic and clinical science End with USMLE Step 1 (read: MCAT on crack) Laboratory rotations? Graduate courses? 2. ~4 years of graduate school Early: laboratory rotations, courses, preliminary exam Interminably: thesis research, writing, defense 3. Final 2 years of medical school Clinical rotations Residency/Post doc applications** *Some schools (Penn, Baylor, others) now have an 18 mo. basic science curriculum, then 6 mo. clinical rotations, then Step 1 exam, then PhD phase. **Many schools are now offering research residency programs tailored to physician scientists, which provide advanced clinical and research training in ~5 years, as opposed to 3+ year residency then 3 4 years post doc/fellowship before finally securing a faculty position.

Pictorial example

What are some general features of MD PhD programs? Avg. size: 90 trainees total (~11 trainees/yr) Male/female: 63/37 (variable between programs) Avg. time to completion: 8.0 ±0.4 yrs Avg. attrition rate: 10% Lawrence F. Brass, MD, PhD, Myles H. Akabas, MD, PhD, Linda D. Burnley, David M. Engman, MD, PhD, Clayton A. Wiley, MD, PhD, and Olaf S. Andersen, MD. Are MD PhD Programs Meeting Their Goals? An Analysis of Career Choices Made by Graduates of 24 MD PhD Programs. Acad Med. 2010; 85:692 701.

What areas do MD PhD s pursue for thesis work? Biomedical sciences: 86% e.g. genetics, immunology, molecular/cell biology, microbiology, neuroscience, biochemistry, etc. Engineering: 9% Primarily biomedical Other disciplines: 5% health policy, epidemiology, public health, anthropology, sociology, chemistry, mathematics, philosophy, marine biology, population health, psychology, history and sociology of science Lawrence F. Brass, MD, PhD, Myles H. Akabas, MD, PhD, Linda D. Burnley, David M. Engman, MD, PhD, Clayton A. Wiley, MD, PhD, and Olaf S. Andersen, MD. Are MD PhD Programs Meeting Their Goals? An Analysis of Career Choices Made by Graduates of 24 MD PhD Programs. Acad Med. 2010; 85:692 701.

Where do MD PhD graduates end up? Anywhere they want in medicine! Academic medical centers: 67% Industry: 8% Research institutes: 4% e.g. NIH Private practice (boo! ): 16% wait, that only adds up to 95%. What happened to the other 5%? Lawrence F. Brass, MD, PhD, Myles H. Akabas, MD, PhD, Linda D. Burnley, David M. Engman, MD, PhD, Clayton A. Wiley, MD, PhD, and Olaf S. Andersen, MD. Are MD PhD Programs Meeting Their Goals? An Analysis of Career Choices Made by Graduates of 24 MD PhD Programs. Acad Med. 2010; 85:692 701.

They just sort of wandered off

What do MD PhD grads do in academic medicine? Internal med + peds + path + neuro = 60% 88% with primary clinical appointments Many with secondary basic science appointments Lawrence F. Brass, MD, PhD, Myles H. Akabas, MD, PhD, Linda D. Burnley, David M. Engman, MD, PhD, Clayton A. Wiley, MD, PhD, and Olaf S. Andersen, MD. Are MD PhD Programs Meeting Their Goals? An Analysis of Career Choices Made by Graduates of 24 MD PhD Programs. Acad Med. 2010; 85:692 701.

What do MD PhD grads do in academic medicine? 82% doing research Between 61% and 73% in academia have funding Avg. age of first R01 grant acceptance is the same for MD s and MD PhD s (43 y.o.) Lawrence F. Brass, MD, PhD, Myles H. Akabas, MD, PhD, Linda D. Burnley, David M. Engman, MD, PhD, Clayton A. Wiley, MD, PhD, and Olaf S. Andersen, MD. Are MD PhD Programs Meeting Their Goals? An Analysis of Career Choices Made by Graduates of 24 MD PhD Programs. Acad Med. 2010; 85:692 701.

Outline 1. What does an MD PhD degree entail? What can I do with it? 2. What are the pros and cons of doing an MD PhD? 3. How does the application process work? Where should I apply?

Why should you do an MD PhD? You want to live the academic medical ideal. Take scientific discoveries from the bench to the bedside; conduct translational research e.g. human trials Run your own lab at an academic medical center, perhaps while seeing patients and teaching

Why should you do an MD PhD? You want the skills to ball so hard in industry. MD PhD s generally start higher and ascend quicker than MD s and PhD s.

Why should you do an MD PhD? You want options. take the time to experience all realms of medicine so you can find the best fit for you in terms of subject material and clinical/research balance.

Why should you do an MD PhD? You want the best medical education in the world fo free!!

Why should you do an MD PhD? You want a better shot at your residency of choice.

Why should you do an MD PhD? You want a better shot at research funding.

Why should you do an MD PhD? You want clout.

Why shouldn t you do an MD PhD? It s loooooong:8 years then residency and/or post doc and/or fellowship (13+ yrs total) Delayed gratification: no degree awarded until 6+ years in.

Why shouldn t you do an MD PhD? The transitions are liable to suck. Year 3: into the lab, year ~6: into the clinic

Why shouldn t you do an MD PhD? The long hours can easily be rough on your personal life. Difficult to start a family, but certainly possible

Why shouldn t you do an MD PhD? Disjointed friendships: your med school friends will move onto residency without you and not infrequently drop out of your life.

Why shouldn t you do an MD PhD? You ll be different. You will sometimes fall through the cracks between worlds, a condition that neither administrators nor fellow students will always understand. Ben Rosner, M.D., Ph.D. and author of The Complete Guide to the MD/PhD Degree

Why shouldn t you do an MD PhD? Chimera doesn t necessarily mean master in both arenas.

Ultimately, what are your goals in life? Are you a sprinter or a steady marathon runner? Are medicine and research really your passions? Imagine 15 years from now w/out MD PhD. Could you still be doing what you want to do? If you have a strong desire to be in both the clinic and the lab, are you comfortable with likely being less clinically astute and less productive in lab than your peers?

Outline 1. What does an MD PhD degree entail? What can I do with it? 2. What are the pros and cons of doing an MD PhD? 3. How does the application process work? Where should I apply?

What characterizes a successful MD PhD applicant? (S)he is a sextuple threat who has 1+ academic years and summers of research experience Stellar letters of recommedation An undergrad. GPA above 3.6 An MCAT score above 34 Significant leadership experience in 1+ extracurricular activities Well composed personal statements

How do I get into a lab at ND? Take Drs. Whaley and Gursky s Introduction to Undergrad. Research course next spring. 1 credit, pass fail Small group, independent research projects in ND labs guided by research faculty Take Dr. Whaley s 2 credit Cell Bio lab next spring Alternatively, email potential mentors directly

What should I do in research at ND once I m in a lab? Present your findings at the College of Science Joint Annual Meeting (COS JAM). Stay for the summer. After 1 academic year in your lab, apply for the $4,500 College of Science Summer Undergrad. Research Fellowship (COS SURF). If you don t yet have a year under your belt, the Career Center provides other sources of summer funding (Eli Lilly Indiana Careers Grant, etc.).

What should I do in research beyond ND? Seek out off campus summer REU opportunities with the Career Center, the Pre Professional Office, the Biology Department, etc. Take advantage of the Center for Undergraduate Scholarly Engagement (CUSE) and the College of Science Undergrad. Research Travel Grants for off campus research and/or presentations.

What makes a good recommendation? Letter(s) from your primary research mentor(s) is/are the most important. Should comment on your talents, skills, and potential for success as an independent investigator For best results make an effort to get to know your research mentor personally frequently go A&B the COD in lab. For all recommenders, be sure to ask if they can write you strong letters.

What do a high GPA and MCAT score really do for me? Contrary to popular belief, they aren t everything. In isolation, they ll often get you into the interview room, but they won t often take you beyond it. Your personal skills, informed by the insights and maturity you gain through extracurriculars and hobbies, will usually be what seals the deal.

What is a good activity? http://www.youtube.com/watch?v=e4lgldoxp 6A&feature=player_embedded#! 3:27 4:27

For real now, what about extra curriculars? Clinical experience is imperative... Shadowing docs through the Tom Dooley Society, personal contacts, and/or the Career Center s ND Job Shadow Program Volunteering at a local clinic Reflecting on these experiences otherwise, anything goes. Pursue your passions and, just like in lab, go A&B the COD Take at least one leadership role.

What is different about MD PhD personal statements? There are 3 of them, as opposed to 1 for MD only. 1. Why MD? (5,300 character limit) 2. Why MD PhD? (3,000 character limit) 3. Comment on your research. (10,000 character limit)* For #1, see Fr. Foster s advice in Preparing Health Professions class For #2, answer why you need both degrees; why you want to be a chimera. For #3, focus on your contributions (esp. intellectual) in the lab(s) in which you ve worked. Email Joe and I for examples before May: pkundert@nd.edu, jcannova@nd.edu *All character limits include spaces.

What about the interviews? MD PhD interviews Some will be with faculty who you select. Do your homework on who they are, recent developments in their professional lives, recent publications, etc. Show enthusiasm and a deep understanding of your own research. At a minimum, appear interested in their research and follow along with their description of it so you can ask pertinent questions about it. Know what you want to know from this person before you step into the room and extract that info without going about it pushily.

What about the interviews? MD interviews Sometimes, your interviewers won t know you re applying for the MD PhD program. Make them aware of this. If it comes up, discuss your research even here. Follow Fr. Foster s advice and don t fret. Some examples of what they re trying to figure out: Why medicine? Do you engage intellectually outside of the classroom? Do you have solid leadership skills? Are you culturally and emotionally sensitive? Are you willing to evaluate touchy issues from others perspectives? (Fr. Foster s clinical ethics course is great for this). Can you think creatively on your feet? Do you have a basic knowledge of the healthcare system? (Dr. Navari s Introduction to the American Healthcare System course is great for this).

When does all of this need to happen? Freshman and sophomore year Get involved in extra curriculars. Get into a lab. Shadowing, clinical volunteering Summer before junior year Start research if you haven t already. Write up your curriculum vitae, resumé. Start to research MD PhD programs to find those that interest you.

When does all of this need to happen? Fall junior year Enroll in an MCAT prep course or begin studying on your own, register for MCAT. Volunteering Spring junior year COS JAM Letters of recommendation MCAT studying in high gear Draft personal statements.

When does all of this need to happen? Summer before senior year Submit AMCAS, preferably before July 1 st Latest July 15 th Secondaries Senior year More secondaries Interview prep

What are some factors I should consider when choosing where to apply? Research infrastructure Presence of role models Training support (NIH Medical Scientist Training Program [MSTP] vs. MD PhD) Curriculum integration Presence and strength of your PhD area(s) of interest Reach schools to safety schools Location Program size Community Outcomes Prestige

What are some factors that should NOT influence my decision? The program that accepts you first Size of the stipend Time to degree The presence of a certain individual faculty member

Who should I contact with questions? For anything about MD PhD (before May!): Us: pkundert@nd.edu, jcannova@nd.edu For finding a lab: Drs. Whaley and Gursky: Michelle.A.Whaley.3@nd.edu, Susan.K.Gursky.2@nd.edu For research funding: Dr. Dom Chaloner (College of Science): dchalone@nd.edu Career Center: ndcps@nd.edu Robyn Centilli: robyn.o.centilli.1@nd.edu Laura Flynn: lflynn@nd.edu For all things pre professional and application based Fr. Foster: foster.34@nd.edu

What are some good general resources? The Complete Guide to the MD/PhD Degree by Ben Rosner and Jayakar Nayak. ISBN: 1 888308 16 8 A little dated, but very comprehensive Anything by Dr. Skip Brass http://sciencecareers.sciencemag.org/career_mag azine/previous_issues/articles/2009_10_16/caredi t.a0900124 www.med.upenn.edu/mstp/applicantfaq.pdf http://biology.nd.edu/undergraduateprogram/research/mdphd resources/ studentdoctor.net