I recently sat in on a luncheon with a few other current MD/PhD students as we chatted with, and fielded questions from, half a dozen applicants to our program. This brought back a multitude of memories from my own admissions season five years ago. I’ve also had plenty of experiences in the past few years interacting with talented undergraduates who are considering applying to MD/PhD programs, so I’d like to share some reflections on my process, and offer some semi-qualified advice to current and future applicants.
Reasons you should apply to MD/PhD programs vs. traditional MD or PhD programs
The goal of pursuing a dual MD/PhD degree, in my opinion, is to situate oneself to become a knowledgeable, capable leader in the field of academic medicine and biomedical science. While it is true that some MD/PhD graduates go on to pursue a career only in medicine or only in research (often with tremendous success), the MD/PhD training path is ideal for those of us who seek to do both. In short, you will learn to approach medicine thinking like a scientist, and to approach science thinking like a physician, which is an extremely valuable skill set to possess.
Reasons you should not apply to MD/PhD programs
No matter where you matriculate, completing an MD/PhD program is a major investment of close to a decade of your life (more than that if you count residency training and postdoctoral training). If the thought of still pursuing your degrees and formal education while the majority of your friends and school colleagues are finished with their schooling is disconcerting, you should think long and hard about where you want to be in 10, 20, 30 or 40 years into the future and figure out if the MD/PhD path will enable you to achieve your future plans.
If you know you are committed to a career in medicine but unsure of whether to apply to traditional MD programs or combined MD/PhD programs, think about whether devoting 50 to 60 hours each week for three to six years of your life to working in a research lab sounds exciting, tedious, or somewhere in between. One stark contrast between medical school and graduate school is the work-to-reward ratio. In medical school, being studious, focused, and hardworking will help you perform well academically, and your progress through coursework is largely well delineated. By contrast, in graduate school, you can be the most studious, most focused, most hardworking student in your research laboratory, but you may be unwittingly working on a futile research product, limited by a dwindling research budget, or scooped on a publication you’ve been working on for years by a different research group. Thus, in graduate school, you often do not attain the output corresponding to your input.
For applicants who are interested in research, but not enough to spend three to six years of your medical school years pursuing it, there are still plenty of awesome opportunities to get hands-on experience being a scientist. For instance, many traditional medical students here do summer research programs following their M1 year, and some pursue a six-week research elective clerkship during their M3 or M4 years. After medical school, there is also the possibility of pursuing a research residency (which includes a few years of research time) or a research-focused fellowship training.
In my opinion, MD/PhD programs are most suited to individuals who want to devote several years to solely learning the nitty-gritty process of becoming an independent researcher and scientist and to who want to do this before the rest of their training and before the siren call of the clinic.
How to best prepare yourself for a successful application season
Achieving admission to MD/PhD programs is a very competitive feat. As you prepare your application package, think of it as preparing two different packages: you as an aspiring physician and you as a budding scientist. Your “physician package” should include a strong MCAT score, strong grades in your pre-medical coursework, and evidence of your commitment to medicine, leadership, and serving others. Your “scientist package” should include evidence of a strong and prolonged interest in research. When I applied to MD/PhD programs my senior year of college, I didn’t have any research publications, but I had worked in research labs for four years. Many other MD/PhD matriculants in my cohort had taken one or more years after graduating from college to pursue research full-time. A few had additional postgraduate degrees.
Another piece of advice, especially if you are applying to MD/PhD programs directly following your undergraduate years, is to apply broadly. Many MD/PhD programs have only a handful of spots available each admission season, and you are up against a large pool of applicants who probably have more medical and scientific experience and credentials than you in the most competitive programs. Find trusted mentors who are willing to look over your application materials and your CV to give you honest feedback about your strengths and weaknesses as a candidate.
Finally, just as in medical school and residency interviews, approach the interview with enthusiasm and self-confidence. Since MD/PhD programs are a longer time commitment than MD or PhD programs, take the time to talk to current students about their experiences and explore the community surrounding the campus to figure out if it is somewhere that you would be comfortable living for seven to 10 years. Good luck!
This column explores the MD/PhD career track from a current trainee’s perspective, including the benefits and challenges of pursuing two doctoral degrees simultaneously, time management and life balance, and post-graduation training and career opportunities.