Pursuing a medical degree is challenging and requires great familiarity and comfort with biomedical science. For those inclined to delve deeper into biomedical research, dual M.D.-Ph.D. programs offer an intriguing and unique pathway and should be carefully considered.
How Are M.D. and M.D.-Ph.D. Programs Different?
M.D.-Ph.D. programs differ from M.D.-only programs in several ways, including time, expense and purpose.
Time Commitment
While M.D. programs typically take four years to complete, M.D.-Ph.D. programs integrate heavy research training and last an average of four years longer than traditional medical school. This significant time commitment allows you to complete the requirements for a Ph.D. in a biological science, typically doing lab rotations before and during the first and second years of med school, followed by full-time lab work between the second and third years and culminating in thesis defense and awarding of the Ph.D. degree.
These joint programs typically are accelerated. Some medical students complete the Ph.D. requirements in three years, but most need four to five years. With the Ph.D. work done, the M.D. is earned upon completion of the third and fourth years of med school.
Cost Considerations
The average cost of medical school alone in the U.S. is $230,296, according to the Education Data Initiative, although it can range depending on the school and the student’s state of residency.
Generally, M.D.-Ph.D. programs cost more because of the additional degree. However, the National Institutes of Health’s dual M.D.-Ph.D. programs are divided into those that receive NIH Medical Scientist Training Program funding via a T32 research training grant for their students, and programs that don’t. All MSTPs and many non-MSTPs waive med school tuition and provide stipends for M.D.-Ph.D. students.
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Thus, many M.D.-Ph.D. students don’t need to take out additional loans, which can be a significant advantage.
Purpose
M.D. degree recipients tend to go into some field of medical practice, while M.D.-Ph.D. graduates veer more toward medical research and academia.
Typically for M.D.-Ph.D. studies, MSTP programs are better organized and more productive than their non-MSTP counterparts, and more effectively prepare students to compete for independent faculty positions at academic medical centers.
The career goal of becoming a physician scientist who practices medicine and runs an NIH-funded research laboratory drives M.D.-Ph.D. students through a long and difficult training period, which is the primary purpose of such programs.
What Is the M.D.-Ph.D. Application Process?
Applying to M.D.-Ph.D. programs, similar to M.D.-only programs, can be done through the American Medical College Application Service, known as AMCAS. The same application materials are required, plus two additional essays: an M.D.-Ph.D. essay detailing your motivation to apply and an essay describing your individual research experiences and accomplishments.
Throughout your application, your thoughtful consideration of the M.D.-Ph.D. pathway and a genuine passion for research must be evident. This is commonly the No. 1 component that admissions committees look for — does this applicant truly love biomedical research and demonstrate the commitment to science that will keep them motivated and on track during the arduous training process?
Passion and commitment can be communicated through the essays, work and activities section, personal statement, interviews and, critically, letters of recommendation — hopefully from accomplished faculty in biomedical sciences.
[READ: Everything You Need to Know About Medical School Interviews.]
Significant research background is expected for M.D.-Ph.D. applicants, and it is extremely important to demonstrate high familiarity with research throughout the application.
A minimum of two years in a lab is generally considered significant research experience, and many applicants take one or more gap years to expand their research background and acquire further recommendation letters from scientists or doctors who can speak to both clinical and research potential. These recommendations take on added importance in the smaller biomedical research community.
What About an M.D. With Research vs. an M.D.-Ph.D.?
So, you’ve joined a lab as a premed and are enjoying research — at least more than you expected to. That’s great! At the very least, clinical medicine needs physicians with a strong background in scientific research.
But how do you know whether you should pursue an M.D.-Ph.D. program, with the goal of a lifelong career in research after graduation? Many med students, residents and attending physicians without a Ph.D. lead successful research endeavors, so pursuing an M.D. with research is feasible.
If you’re weighing such a choice, ask yourself if science brings out enough passion in you to sustain a lengthy training period. If the thought of watching your peers graduate and rise in their professions while you remain in training is outweighed by the thrill of scientific discovery, an M.D.-Ph.D. program may be a wise decision.
The benefits of a Ph.D. through a combined M.D.-Ph.D. program, compared to pursuing research later in your career as an M.D., are:
— Elevated familiarity with the methodology of basic science.
— More in-depth experience in carrying out experiments, compiling data, writing and publishing high-impact papers.
— Networking opportunities and the valuable connections they can create.
The protected research time of a Ph.D. is a rare and valuable commodity. Never in your career as a doctor will you have an opportunity to delve as deeply into a scientific subject as you will during Ph.D. studies.
Although exceptions abound, researchers without a Ph.D. are frequently limited to clinical or translational science, and often do not feel comfortable enough with basic science methodologies to run a laboratory built around such techniques. With fewer publications and experience, the transition to an independently funded scientific career is typically harder.
Traditionally, this transition is accompanied by a K08 clinical investigator award, which provides funding for supervised research development as a final step before full independence, for example running a NIH R01-funded laboratory. K08 grants and other early-career funding opportunities are competitive, so it’s a great benefit to have more publications and research experience.
Should I Apply to Traditional M.D. Programs as a Backup?
M.D.-Ph.D. programs are highly competitive, as you must demonstrate to a medical school that you are worth significant time and financial investment. Admissions committees must feel that you are a worthwhile investment and will contribute significantly to biomedical research as a future alumnus.
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After deciding to apply to M.D.-Ph.D. programs, should you apply to traditional M.D.-only programs as a backup option? If you feel you have enough clinical experience to be competitive for M.D.-only programs and don’t want to take a gap year, this is a realistic backup pathway. You can still pursue a meaningful research direction as an M.D., particularly if you dedicate several years to a postdoctoral position to learn research techniques.
A cautionary word of advice: Honestly self-reflect and try to understand and maintain focus on your primary interest.
If you are more excited to practice clinical medicine than research, you should heavily consider applying only to traditional M.D. programs. You can still pursue collaborations with basic science researchers and participate in clinical trials without a Ph.D., with a flexible level of involvement in basic science.
To make the right decision, consider your personal aspirations, long-term career goals and genuine level of commitment to biomedical research. Carefully evaluate these factors, as well as your qualifications.
Seek out mentorship from M.D.s and M.D.-Ph.D.s who know you and your application, and ask them whether you will be competitive for such programs. It can help to ask M.D.-Ph.D.s how they knew they wanted to apply, if they would make the same decision again and whether they can see you being fulfilled in a career using that degree.
Premed students commonly describe their affinity for medicine with a variation of the words, “I can’t imagine a fulfilling career outside of medicine.” The decision-making process for an M.D.-Ph.D. versus a traditional M.D. can often be broken down similarly: Can you imagine a fulfilling career without scientific research?
If the answer is yes, an M.D.-Ph.D. probably doesn’t align with your career goals. If the answer is no, this long but rewarding training path may indeed be for you.
As you embark on this application journey, know that regardless of the path you choose, you have likely already developed an appreciation for the importance of scientific discovery in furthering advancements in clinical care. Successful completion of either program will allow you to make valuable contributions to biomedical science, and it is a privilege to have the opportunity to advance understanding of medicine in such a unique and meaningful way.
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How to Decide Between an M.D. and M.D.-Ph.D. originally appeared on usnews.com
