MD-PHD Dual Degree Training
Graduates of MD-PhD programs often go on to become faculty members at medical schools, universities and research institutes. Regardless of where they eventually work, MD-PhD candidates are being prepared for careers in which they will spend most of their time doing research, in addition to caring for patients. The MD-PhD dual career is busy, challenging, rewarding, and offers opportunities to do good for many people by advancing knowledge, developing new treatments for diseases, and pushing back the boundaries of the unknown.
Why Pursue an MD-PhD?
- The career of a physician-scientist is unique. There are few comparable careers that allow one to experience the passion of solving a patient’s medical struggles while pursuing research that may define the mechanism of that patient’s disease and may ultimately translate into a clinical cure for the disease.
- MD-PhD trainees are research scientists who solve mechanisms underlying disease, combined with their passion to treat patients in a clinical setting.
- MD-PhD training efficiently integrates the scientific and medical education of the physician-scientist.
- During the PhD training years MD-PhD students take the coursework and formal training in research methodology that are important for the development of the research scientist.
- Most MD-PhD programs provide trainees a stipend and tuition scholarships. This financial support recognizes the time that a student must spend in training for the MD-PhD career. The extent of financial support varies among programs and may only support U.S. citizens and permanent residents.
Areas of Research Interest for MD-PhD Training
- Most MD-PhD candidates earn their PhD in biomedical laboratory disciplines such as cell biology, biochemistry, genetics, immunology, pharmacology, physiology, neuroscience, and biomedical engineering.
- Some MD-PhD Programs also allow trainees to do their graduate work in fields outside of laboratory disciplines, including computational biology, economics, epidemiology, health care policy, anthropology, sociology, or the history of medicine.
- The spectrum of graduate degree programs offered is an important element to consider when applying to specific MD-PhD Programs.
Career Paths for MD-PhD Graduates
According to a study by the National Association of MD-PhD Programs, about 75 percent of U.S. MD-PhD graduates are in academic medicine or pharmaceutical company positions that make use of their interests in both patient care and research.
A MD-PhD physician-scientist is typically a faculty member at an academic medical center who spends 70-80 percent of his or her time conducting research, though this can vary with specialty. Their research may be lab-based, translational, or clinical. The remaining time is often divided between clinical service, teaching, and administrative activities.
Thus, most MD-PhD graduates pursue a career where most of their time is spent on research. This research typically is conducted at academic medical centers, research institutions like NIH, or in the pharmaceutical/biotech industry. With career advancement, many MD-PhD graduates ascend to significant leadership roles in academic medical centers, industry, government and private organizations, reflecting their broad experience in health care and research.
Training Path for the MD-PhD Graduate
The career of each MD-PhD graduate is uniquely based upon research and clinical interests, but follows the general path:
- MD-PhD training: 7-8 years
- Specialty and subspecialty clinical and research training (residency/fellowship): 3-7 Years
Residency and Fellowship Training
Most MD-PhD graduates pursue residency and fellowship training and find that their MD-PhD training makes them particularly attractive to residency programs at top academic institutions. In the past, MD-PhD graduates traditionally entered residency programs in medicine, pediatrics, or pathology. However, the clinical specialty choices of current graduates are more diverse, with many graduates pursuing residency training in neurology, psychiatry, radiology, radiation oncology, and even surgery and surgical specialties.
Research Residency Programs
It is important to note that there are a growing number of “research residency programs” that have been specially developed to foster the career development of physician-scientists.
After completing their specialty clinical training (e.g., in medicine or paediatrics), most physician-scientists pursue subspecialty clinical training (e.g., cardiology or haematology-oncology) and postdoctoral research that typically combines protected research time with intensive clinical training. A number of residency programs around the country offer highly structured programs in which research is fully integrated into the clinical training.
These programs differ in their overall structure, but all offer the following:
- Shortened residency (specialty) training; in general, the integrated programs allow trainees to shorten their residency by one year, depending on the field of specialty
- Integrated research and clinical training; programs usually offer mentoring for trainees to choose a lab early in their training process, so they can embark on their research right away when they start full time in the lab
- Guaranteed subspecialty fellowship position in the trainee’s desired field; this is not offered at all institutions
- Special financial support; a few combined programs also offer support both towards salary and research
The time commitment required to complete the dual degree and subsequent specialty training can be substantial. Thus, you should thoroughly explore whether combining biomedical research and clinical practice is the right path for you. Despite the time commitment, it is important to recognize that professional progress following MD-PhD training can be swift and the years of training truly represent a time of great personal as well as professional growth.
The MD-PhD graduate is unique within medical education, representing about 3 percent of the entire graduating medical school class in the United States. In 2006, there were over 16,000 MD graduates; about 500 of these earned the PhD degree as well.
Education and Training in MD-PhD Programs
- Curricula vary among medical schools, but the formal didactic coursework is often similar among MD-PhD Programs. Students must pass Step I and II of the United States Medical Learning Examination (USMLE). Graduate curricula and research opportunities differ among institutions thus the graduate training obtained during graduate school may vary greatly among MD-PhD Programs.
- In most MD-PhD Programs, the medical and graduate curricula are integrated to show the relationships and connections of science and medicine. Information about research opportunities, curricula, and trainee activities may be found on program websites or by contacting the individual programs.
- Research interests may change over the course of training as new medical- and research topics are encountered during clinical experiences and didactic course work.
In addition to integration of curricula components, most programs engage students in MD-PhD specific activities to enrich their training experience. These activities often include:
- Courses and workshops designed specifically for the MD-PhD trainee
- Research in progress sessions where trainees present their research
- Seminars devoted to research and career development
- MD-PhD orientated student retreats and conferences
Timeline for MD-PhD training is often divided into three stages, termed 2-4-2 based upon the typical number of years required to complete each stage. This general outline may vary with each MD-PhD Programs:
- Two years of medical school when basic science concepts are mastered. Complete STEP 1 examination.
- Graduate coursework and comprehensive exam, directed at developing students into independent investigators are mastered. Conduct dissertation research and dissertation defense. Complete requirement for the PhD Degree.
- Clinical training to prepare student for residency. Complete STEP II examination and requirements for the MD degree.
Most MD-PhD students complete the requirements for the dual degrees within 7 to 8 years. Length of time to degree will vary depending on: Clinical requirements, PhD requirements, progress of the research, and the time needed to develop into an independent investigator (the primary goal of PhD training). While MD-PhD training is a long time commitment, applicants should consider that they are completing academic requirements for two degrees to become a physician-scientist. Since the average time to complete a biomedical PhD in the U.S. is about six years, by integrating the didactic components of training, dual degree training may require less time to complete than if each degree were pursued independently. Skills obtained during PhD training are invaluable and will prepare students for careers as leaders in academic medicine.