1. What is the purpose of pursuing a physician-scientist training pathway? ↶
Physician-scientist training programs provide training in both medicine and research, and are specifically designed for people who want to become research physicians. Graduates of these programs often go on to become faculty members at medical schools, universities and research institutes, or may enter the pharmaceutical/biotech industry. Regardless of where they eventually end up, trainees are being prepared for careers in which they will spend much of their time doing research, not just taking care of patients. It is a busy, challenging and hugely rewarding career that offers opportunities to do good for many people by advancing knowledge, developing new treatments for diseases and pushing back the boundaries of the unknown. A study of what has happened to MD-PhD program graduates from 24 schools appeared in Academic Medicine in 2010 (Brass, et al. Acad. Med. 85:692, 2010).
1b. How do physician-scientists make the world a better place? ↶
Dr. Sanaz Memarzadeh speaks about her research on LabTV:
Students typically begin with two years of medical school, switch to graduate school in the third year of the program, then return to finish medical school after completing (and defending) the thesis research project. At a growing number of schools there has been an increasing emphasis on integrating the medical and graduate parts of the training with graduate school courses during years 1 and 2 and clinical experiences during graduate school, where appropriate. Be sure to ask how things are organized at schools that you are considering. In programs leading to a PhD in laboratory science, physician-scientist trainees usually spend the summer between the first and second years of medical school working in the laboratory of the faculty member that they are considering as a potential thesis adviser. Some programs ask students to do “lab rotations” in the summer before starting medical school classes as well. When fulltime clinical training begins varies among programs. Depending on the particular school, trainees may have anything from casual clinical experiences during the first two years of medical school, to extensive fulltime clinical rotations lasting six months or more. Depending on the number of clinical months completed before starting the thesis research, students returning to medical school will need 1 to 2 years to finish their training and meet the requirements for medical licensure. The goal is to complete your program in 7 or 8 years. Numbers from across the country show that some students finish in 6 years, while others take 10 years (or more). However, the average currently is 8 years (see Brass, et al. Acad. Med. 85:692, 2010).
Yes! In fact, it is becoming more common for non-traditional students to pursue medical training from a post-bacc, in general. A caveat for physician-scientist training, specifically, is in getting the appropriate research experience necessary to succeed in one of these intensive programs. Generally, it is expected that an applicant to a MD/DO-PhD have at least two years of research experience under their belt, preferably in the same lab (publications are a major plus).
4. What is the difference between all of these combined degree programs I see? ↶
Programs designed to train physician-scientists go by all of these names. For the most part, the terms are interchangeable, although at some schools “combined degree” programs also refer to a medical degree pairing with a JD or Master’s degree. The NIH uses the term “MSTP,” which stands for Medical Scientist Training Program, to refer to schools that have been specifically awarded special funds to help train dual degree candidates, though most schools provide funding mechanisms of their own.
Medical school by itself does not provide training in how to do research. At some point, you will need that piece of your education if you intend to become a physician investigator. If you are ready to make the commitment before starting medical school, physician-scientist training programs offer many advantages, and will help you develop the skill-set necessary in order to eventually gain independence as a clinical or scientific investigator.
6. Do I have to go to a University with an MSTP program to become a physician-scientist? ↶
Not at all! MSTP programs are a great choice for people who decide early-on that that they want to train to become physician-scientists. Not everyone does this, however: some don’t learn about the option early enough, or decide in time to apply; others have academic records (including MCAT scores) that present obstacles, or insufficient research experience. Not finding out early enough turns out to be a common problem. Pre-health advisors at many institutions tend to know much less about physician-scientist training than conventional medical training - not surprisingly since a small percentage of medical school applicants in the U.S. every year apply for physician-scientist training. As a result, some people choose (or are obliged) to approach training in series, rather than parallel – finishing one degree and then starting the other. The disadvantages of this approach include the longer time to finish training, and the likely need to cover the cost of medical school on your own. Some schools will consider you for transfer into their physician-scientist training program after you have completed a year or two of medical school or graduate school at the same university. Although it is very rare that a program will consider accepting a medical or graduate student from a different school, it does occasionally happen when faculty move from one institution to another and want to bring their students with them. The rules and requirements vary from school to school.
Another option is to complete medical school and residency training before doing an extended period of supervised research. This used to be the main pathway for preparing physician-scientists, but with the increasing number of schools offering training options, most people who make the decision to become physician-scientists while still in college elect to pursue these programs.
7. Are physician-scientist training programs limited to those interested in laboratory research? ↶
Not all schools offer PhD programs in all disciplines and medical schools may limit the disciplines that can be combined with your medical training. The vast majority of students receive their PhD in biomedical laboratory disciplines such as cell biology, biochemistry, genetics, immunology, pharmacology, neuroscience, and biomedical engineering.
At some schools, trainees do their graduate work outside of the laboratory disciplines in fields such as economics, epidemiology, public policy, sociology, medical anthropology, and etcetera. You should check before you apply to see what is actually offered at any particular school.
8. How do career physician-scientists spend their time? ↶
The answer to this varies depending on what type of career they have chosen. A physician-investigator who is a faculty member at an academic medical center will typically spend 75-80% (or more) of his or her time doing research. The remainder may be split between clinical service, teaching and administration.
9. I want to go to the annual meeting but I really can’t afford it .. ↶
We understand that traveling long distances can be expensive, particularly for undergraduate students. To help support students interested in attending our annual meeting we award travel stipends each year to undergraduates.
Corny as this may sound, the process is never really finished. Your education will continue throughout your career. A more pragmatic answer is that the process began in college (or sooner) and will extend beyond medical school and graduate school as you complete your post graduate education.
Here are some typical numbers:
Typical physician scientist training program 7-8 years
Residency 3 years
Post-doctoral fellowship 3-4 years
For most people the “postdoctoral fellowship” includes another year or two of clinical training, followed by a return to research for 2 or more years. So the total before you get your first job can be 13 or more years beyond college. You’ll be in your 30’s! That means that you have to be sure that this is what you want to do and you have to be able to enjoy the process as it unfolds.
11. How can I participate in interactive conference calls? ↶
Each interactive conference call is announced on the main page of our website, and additionally, a monthly email digest is sent to members. To join the call all you need is a phone or computer, and the provided access code. Check out some of our previous sessions here!
Institutional Representatives from universities across the country are appointed to serve as liaisons between the student population and the APSA executive council, voicing the needs specific to their individual institutions. Interested in serving as an IR? Look [HERE] for more information!
The process varies from school to school. Some schools have a separate admissions committee that will screen your application and coordinate the interview and admission process. Other schools consider applicants only after a decision has been made about medical school admissions. Finally, some schools consider students only after they have completed a year or more of medical school. Be sure to familiarize yourself with the specific processes used at the schools you may be applying to.
Some applicants have decided that they want to work in a particular field or with a particular faculty member. For them, choosing where to apply is defined by where that faculty member works or where the field is best represented. Most applicants have only a general idea of what they might want to work on in the future and know that their interests are likely to evolve as they are exposed to new things. For them choice will be defined by issues such as the reputation of the school (hopefully not based solely on US News and World Report!), the success of the graduates of the program (be sure to ask!), and geography. Schools range in terms of the difficulty of gaining admission. The directors and non-faculty administrators of physician-scientist training programs nationwide are a large pool of resources that you can tap. Most of us get e-mail from future applicants all of the time. Take advantage of our willingness to talk with you. Ask questions about the things that are important to you.
Most people apply after finishing their junior year in college, but a growing number of applicants finish college and work for a year or more before applying. Some people use the time after college to take courses needed for medical school admission (if they’ve not had them already) or to gain more laboratory research experience. Some people simply weren’t ready to make a decision about their future career and postponed choosing beyond the finish of college.
The answer to this question clearly varies from school to school, but some basic principles apply. In general the admissions committees will look for the following four things: evidence of academic success, relevant research experience, letters of recommendation from people who know you well and your plans for the future.
1) Evidence of academic success using criteria that will include your GPA and
MCAT scores, but not be limited to them. They will undoubtedly consider where you went to college and what types of courses you took. They will not necessarily be dismayed if you got off to a slow start, as long as you did well later. They will place the greatest emphasis on courses that are relevant to your chosen area of graduate school training. I have not encountered anyone who seriously believes that the MCAT tests your ability to be a physician-scientist, but programs use MCAT scores in a variety of ways, including seeing how you compare to the national pool of applicants and predicting how you will do on the numerous standardized tests that all of us have to take in medical school and in the process of maintaining our medical licenses.
2) Relevant research experience. If you plan to get a PhD in one of the laboratory sciences, then prior laboratory experience counts heavily, particularly if you spent a year or more in the same laboratory. Summer laboratory experience can be helpful, but summers are short. Whenever possible you should try to do research during the academic year or at least spend multiple summers in the same lab. For those of you planning a PhD outside of the laboratory sciences, seek equivalent experiences. The idea is to be sure you like it and to create a track record upon which your past performance can be judged and your future success predicted.
3) Letters of recommendation. The most important letter(s) are from the faculty member or other senior investigator with whom you worked. The letter should comment on your talents, skills, and potential for success as an independent investigator. Admissions committees are usually most interested in your talent and ability as a scientist.
4) Your plans for the future. Since training to be a physician-investigator is so costly in terms of your time and the school’s resources, your career goals should be compatible with the training. Becoming a full time practitioner is a laudable goal, but doesn’t require a PhD in addition to your medical degree. Your goal as a trained physician-investigator should be to spend a significant portion of your time on research. You do not need to know the specific problem you want to work on at this point (many don’t and it is likely to change), or with whom you would like to train, but your commitment to becoming an investigator should be clearly communicated and you should have given thought to what will be required.
7.How important it is for prospective medical students to shadow a physician in a clinical setting? ↶
Shadowing is important for determining whether or not you are interested in becoming a doctor, but research experience should be the primary focus. The skills that you pick up in the lab: precision, perseverance, patience, etc. are invaluable to a developing student, and it takes time to carve out your niche in research. You can also "do" more in a research lab than you can shadowing, and so it provides a better qualitative metric for admissions directors in dual degree programs, such as abstracts or papers. It is necessary though to get enough shadowing in to make sure that you want to be a physician. By doing a few hours every month, you can demonstrate to yourself and to medical admission committees that you are convinced you want to be a physician.
Information about the contributors to this FAQ
Lawrence “Skip” Brass (L.B.) has had considerable relevant experience as a former MD-PhD student, physician-scientist, professor of medicine, MSTP director at the University of Pennsylvania, and colleague of numerous other MD-PhD program directors.