NonTraditional MD- PhD Training What it is for this session: Public Health Sciences Medical Humani3es Anything that touches on the human condi3on, the humanizing process or the humanist philosophy. It can be History of medicine, bioethics, narra3ve medicine, medicine in literature, crea3ve wri3ng, and various social sciences. Dolan, Brian 2010. "History, Medical Humani>es and Medical Educa>on." Social History of Medicine no. 23 (2):393-405
NonTraditional MD/PhD Program 2015 Survey 70% response rate - 63 total respondents 50 45 40 35 30 25 20 47 Programs 15 10 5 0 Offer Nontradi3onal PhDs 16 Programs Do not Offer Nontradi3onal PhDs
NonTraditional Program Summary 50 45 # P r o g r a m s 40 35 30 25 20 15 10 5 46 42 23 15 0 Total that Offer Nontradi3onal PhDs Public Health PhDs Social Science PhDs Humani3es PhDs
Representation of Disciplines 27 Public Health Disciplines 36 18 3 2 2 4 8 8 Humani4es Disciplines 9 4 Social Sciences Disciplines 17 15 9 Ethics Philosophy History Literature Linguis3cs Religion 1 2 Anthropology Psychology Sociology
Representation of NonTraditional PhD Programs and Combinations Combina3on of Public Health, Social Sciences and Humani3es 13 Public Health Only 21 Combina3on of Public Health & Humani3es 2 Combina3on of Public Health & Social Sciences 6 Humani3es only 0 Social Sciences Only 4
DifDiculties & Barriers Extra 4me educa3ng nontradi3onal graduate programs and faculty on MSTP requirements. More student advisement, mentoring and monitoring Time to degree, lack of course content overlap with medical curriculum Integra4on of coursework within the medical curriculum Dual applica4ons, addi3onal requirements (GRE) Coordina4on of admissions procedures, interviews and revisit Small applicant pools, inconsistent class size, community Separa4on from medical school environment AND
Barriers continued FUNDING!!! Differences in funding structures, reliance on slot alloca3ons or work requirements (TA, RA) Lack of guarantee of support for PhD years Faculty lack the resources to pay high s3pends Less external funding/fellowship op3ons Lower s3pend levels MD/PhD Program must support Lower S3pends affects recruitment, offers and reten3on
BeneDits - Programmatic Assets Students they are mo3vated, resourceful and commieed. Peer Mentorship unique skill set is made available to other students Diversity bring unique perspec3ves and breadth to the en3re program Global healthcare & Importance many of these students work domes3cally and interna3onally, advancing healthcare for the neediest popula3ons Recruitment tool broadly fewer places offer these disciplines Accessibility - their work is ofen more easily understood by general popula3on, including donors.
What makes it work working it out which takes time & effort It's very important to get funding and curriculum details worked out in advance and to have them clearly documented U. Pennsylvania Nego4ate these barriers on an ad hoc basis U Florida Director seeks out alliances and helps crai curricula for the students during mee3ngs with the graduate program directors of the various departments. U Buffalo Directors put substan3al effort into partnering with non- tradi3onal departments U Michigan Coopera4ve leadership Columbia U
Hope Our MSTP had been associated with the public health disciplines of Epidemiology and Biostatistics for decades so we have worked out most of the difficulties. University of Iowa MSTP Support is necessary at all levels. This was cultivated over many years before taking a firm hold. Harvard University
Major Problems by Program Offerings 7 6 46% Number of Programs 5 4 3 24% 31% Funding Time to Degree, Extra Coursework Admissions Procedures 2 15% 1 0 PH (N=21) PH/SS (N=6) SS (N=4) PH/SS/H (N=13) KEY: PH= Programs that offer only Public Health nontradi3onal PhD Tracks PH/SS= Offer Public Health and Social Sciences PhD tracks only SS= Social Science tracks only PH/SS/H= Broad spectrum of Public Health, Social Sciences and Humani3es PhD tracks
Recommendations from My Experience as a Physician-Social Scientist -orwhy I Can t Imagine a More Important Career Seth M. Holmes, MD, PhD Martin Sisters Endowed Chair Assistant Professor Public Health, Medicine, and Medical Anthropology Co-Director, MD/PhD Track in Medical Anthropology Director, Berkeley Center for Social Medicine University of California, Berkeley and San Francisco
Outline 3 Reasons I can t imagine a more important career than medicine and the social sciences and humanities (SSH) 8 Recommendations for MD/PhD program directors and administrators from my experience
Why I Can t Imagine a More Important Career 1: There is overwhelming data that the primary determinants of health and disease are social, economic, political, and cultural My Experience: (1) The mechanisms through which immigration and ethnic hierarchies produce health disparities and disease. (2) The mechanisms through which social and health inequalities come to be understood and responded to as normal and natural in society and in health care.
Why I Can t Imagine a More Important Career 2: SSH MD/PhDs meet goals of training: 100% in research; 78% in academic institutions; 22% in leadership in national and international institutions; majority (66%) are quadruple threats combining research, clinic, teaching and leadership.
Why I Can t Imagine a More Important Career 3: Broad impact on public perception, health care practice, and policy My Experience: Media coverage: NPR, PRI, Huffington Post, Salon, Radio Bilingue, TEDx, Scientific American. Invited briefings for Congress, HRSA, EPA, Department of Labor. Trainings in structural competency.
Recommendations for MD/PhD Programs 1: Consider including strong SSH PhD programs, including multi-institutional arrangements My Experience: UW Biology and Spanish (non-traditional majors) UCSF MSTP in Medical Anthropology (UCSF/B) Support and mentorship from MSTP and from Medical Anthropology on both campuses
Recommendations for MD/PhD Programs 2: Be creative with funding for MD/PhDs in SSH My Experience: *SSH graduate students function as PIs* (different from many basic science fields) Funding from MSTP, SOM, Graduate Division, TA, Private Foundation, UC-Wide Fellowship
Recommendations for MD/PhD Programs 3: Support local and national MD/PhD SSH community and mentorship My Experience: In addition to MSTP journal club UCSF MD/PhD SSH dinner each semester Co-found Society for Social Sciences, Humanities and Medicine ( Shazzam! ) and conference series (leading to PLoS Medicine special issue)
Recommendations for MD/PhD Programs 4: Include SSH MD/PhDs in residency research tracks, post-docs and fellowships My Experience: UPenn Internal Medicine Physician Scientist Pathway provided funding, time, and community Considered Hemi-Doc residency programs RWJ Health & Society Scholars at Columbia U. Considered GIM, ID, NIMH HMS Med Anthro
Recommendations for MD/PhD Programs 5: Support SSH units in medical schools My Experience: Most effective integration of SSH and medicine to respond to today s critical health problems Training in Department of Anthropology, History and Social Medicine in UCSF SOM Teaching in Medical Humanities at UR and Global Health and Social Medicine in HMS
Recommendations for MD/PhD Programs 6: Encourage positions with protected time for research and support for clinical involvement My Experience: Assistant Professor in Public Health (UCB) Negotiated addition of Medical Anthropology (UCB Dept. of Anthropology and UCSF SOM) Separate, UCSF-affiliated clinical practice
Recommendations for MD/PhD Programs 7: Value appropriate SSH publications My Experience: Peer-reviewed articles in medical, public health and social science journals *Book*: Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States (UC Press 2013); broad impact, common book for four universities, multiple national scientific awards
Recommendations for MD/PhD Programs 8: Innovate funding for early career SSH MD/PhDs My Experience: Change culture of traditional funders (NIH, NSF). Support training for grant applicants. Value other possibilities: Foundations (RWJ, WT Grant, Greenwall, Guggenheim); Institutes for Advanced Study.
The Most Important Thing You Can Do to Impact Domestic and Global Health Contribute to addressing the critical social, economic, political and cultural determinants of health by supporting MD/PhDs in SSH. Specifically: Develop academic, funding and moral support for this important minority in training Benefit from their unique scientific contributions and societal impact