Why Pursue an MD-PhD?

What is MD-PhD Training?

MD-PhD programs provide training in both medicine and research. They are specifically designed for those who want to become research physicians, also known as physician-investigators or physician-scientists. Graduates of MD-PhD programs often go on to become faculty members at medical schools, universities and research institutes such as the National Institutes of Health (NIH).

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.

MD-PhD Training from a Historical Perspective

Until about 40 years ago, advances in the science of human health and disease were often made by physicians who became interested in a medical problem and set about solving it. With advancement in the practices of biological science starting in the 1960s and the institutionalization of research by the National Institutes of Health (NIH), the training required to do effective research became more complex. Similarly, medical practice and health care delivery have grown in complexity, with increased training requirements.

Medical school by itself does not provide research training. Thus, while it is still possible to learn how to do research by completing an extended postdoctoral fellowship after a clinical residency, this path has many challenges. The total time is not necessarily shorter, the costs (especially medical school tuition) are likely to be much higher, and the coursework and formal training in research methodology that are part of a good graduate program are missed. If you are ready to make the commitment before starting medical school, MD-PhD programs offer many advantages.

Advantages of Pursuing an MD-PhD

MD-PhD training organizes the experimental and clinical thinking of the physician-scientist. This synergy enables a physician-scientist to recognize new ways that clinical care or the goal of understanding disease mechanisms will benefit from research and to mount the appropriate effort. Likewise, the synergy achieved in dual-degree training enables the physician-scientist to see how the results of research discoveries and insights can be converted into clinically significant outcomes.

Physician-scientists are needed so that the achievements of basic science laboratories and other focused research efforts can be translated into active clinical practice. However, the financial pressures on MD-only graduates are so great that few physicians choose to spend the time necessary to obtain research training after medical school. In order to address this issue, most MD-PhD programs pay candidates a stipend and tuition scholarships during the training years. The financial support for those willing to undertake MD-PhD training recognizes the additional time that a student must spend in training for this career. The extent of this support varies among programs. For example, some programs only support U.S. citizens and permanent residents.

Importantly, in dual degree training, the graduate degree is equivalent to a PhD-only degree. Recent studies have shown that the MD-PhD physician scientist is more successful in developing research programs that are nationally funded than either the PhD or MD scientist, attesting to the quality of students pursuing the dual degree and the training that these students obtain (JAMA. 2007;297:2496-2501).

How Can I Tell if I am Right for an MD-PhD Career?

This is a difficult question to answer in any broadly significant way since individual ambitions and life experience can play important roles. However, one feature that seems common to all committed MD-PhD applicants is a depth of passion for treating today's patients as a physician and tomorrow's patients as a research scientist uncovering the mechanisms underlying disease. The career is inspiring but also filled with challenges and frustrations. Patients don't always get well and experiments don't always succeed. The passion to solve a patient's struggles and to crack the code of a disease's cause carries the physician-scientist through the challenges.

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. The names of departments and graduate programs vary from school to school. At some schools, MD-PhD trainees can also do their graduate work outside of the laboratory disciplines in fields such as computational biology, economics, epidemiology, health care policy, anthropology, sociology, or the history of medicine. Differences as to which graduate degree programs are offered and the quality of these programs are important elements to consider in applying for MD-PhD training.

[Top]