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The National Institues of Health (NIH) funds Medical Scientist Training Programs (MSTPs) also known as MD/PhD programs to create a group of researchers whose work more rapidly effects medical practice. For example, they would help to develop new diagnostic tools, drugs, or surgical procedures.

It sounds good, but how many of the students actually pursue this track? Does anyone know of data about the NIH's return on investment besides the somewhat dated data about three New York programs?

Thanks for your time, Mike

  • Also, this comment probably also applies to DVM/PhD programs (still NIH funded, but also sometimes NIFA (National Institute of Food and Agriculture). – OldTroll Feb 14 '12 at 21:08
  • @OldTroll: You're completely right. I didn't think of them, so thanks for catching that. – mac389 Feb 14 '12 at 21:23
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I have no idea how you'd find hard data on the program itself and its results, but as an idle musing I checked how many full time faculty members in the Johns Hopkins School of Public Health's Dept. of Epidemiology held an MD/PhD or DrPH. The department was chosen as a very good department in a very good school with a strong medical school that I'm not affiliated with.

Ten of the 94 listed faculty members were MD/PhD or DrPH's. Little under 11% of the faculty. And that's not including other possible "physician scientists" like MD/MPH degree holders...if you do that the number rises to 23 faculty members with an MD degree in a related, but non-clinical research department. Nearly a quarter of the faculty total.

Of course, this is only a very crude proxy for how many physician-scientists pursue academic tracks, and even the representation of clinician-scientists in research departments will likely vary wildly by said department. That being said, I've met a considerable number of them in my graduate school career, either entirely in academic settings, or balancing research with practice. It's absolutely a viable path, though not an easy one.

As another data point, here is the list of alumni for the UNC School of Medicine's MD/PhD program: http://www.med.unc.edu/mdphd/fps/alumni-1 . That should give you a decent glimpse at where those particular graduates go - it looks like a fair number ended up in research or hybrid positions.

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I'm a student enrolled in a MD/PhD program in Canada. I don't know about NIH very well, but our experience here is that it is very difficult to continue research. I agree with eykanal: it takes a lot to be a great clinician (and being a mediocre clinician is very hard on one's conscience). 50%+ of students rethink their decision during their first year of medicine and do not begin the PhD portion of the program. Only those who begin 80/20 in terms of devolution (80 research, 20 clinician) seem to be able to continue the research path, with considerable sacrifice of their clinical skills (fewer clinical elective during both medical school and residency), as well as many more years of education.

Once done, however, the career path in academic medicine is relatively good. The PhD really helps with those jobs and their attendant excitement and opportunities, although they often pay significantly lower than a pure clinican job.

I know that in the States, the culture of MD/PhD's is more pronounced than in Canada, since there's a massive amount of NIH funds. I heard that nearly a quarter of the class in U of Pennsylvania at least begin as MD/PhD's (don't quote me). Dropping out of the PhD is harder, because you have to give up your funding. I expect that many of them are able to complete the program, but few manage to continue in the research path.

Many of the professors who are MD and PhD's often complete their PhD separately from the MD - they either had it before the MD or got it afterwards. Materially, it's a more difficult path, with less funding and guarantees, but there's less room to regret and it's easier to cut one's losses, since it's 2 big decisions, not 1.

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I don't know where you'll find hard data on this, but from experience working at a hospital/university center (University of Pittsburgh, a subset of which is the University of Pittsburgh Medical Center), very few MD/PhDs end up doing full-time, or even half-time, research. Being a clinician is very demanding on one's time, and doing meaningful research requires a significant time commitment. Many of the MD/PhDs I know ended up dropping their research work due to a combined lack of progress and time.

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