The Doctor of Medicine–Doctor of Philosophy (MD–PhD) is a dual doctoral program for physician–scientists, combining the professional training of the Doctor of Medicine degree with the research program of the Doctor of Philosophy degree.
In the United States, the National Institutes of Health currently provides 50 medical schools with Medical Scientist Training Program grants that support the training of students in MD–PhD programs through tuition and stipend allowances. These programs are often competitive, with some admitting as few as two students per academic year.[1]
The MCAT score and GPA of MD–PhD matriculants are often higher than MD only matriculants.[2][3]
Training programs
In the United States, MD–PhD degrees can be obtained through dual-degree programs offered at some medical schools. The idea for an integrated training program began at Case Western Reserve University School of Medicine in 1956[4] and quickly spread to other research medical schools.
Training structure
When students enter an MD–PhD program, they typically complete the pre-clinical curriculum of medical school (2 years), transition into PhD graduate training, and finally complete clinical rotations (2 years). In the U.S., MD–PhD training during medical school is extensive and lengthy, lasting eight or more years
Traditional PhD training involves combining course content knowledge and research skills to produce original research, culminating in a doctoral dissertation. Typically, PhD-degree completion takes 4–6 years. The MD–PhD physician-scientist workforce is a relatively small group of well-trained professionals with the research skills to address clinical and basic science research questions aimed at improving patient care.[5][6]
Post-doctoral Opportunities for MD–PhD Graduates
Most MD–PhD graduates enter academia, with their primary appointments in clinical departments. Among recent graduates, 95% continued clinical training, while 5% pursued postdoctoral fellowships without clinical training. The most popular residency choice was internal medicine (29%), followed by surgery (11%).[7][8]
Approximately 80% of graduates were employed full-time in academic centers (1,625, or 67%), research institutes such as the NIH (105, or 4%), or in industry (189, or 8%), aligning with the goals of MD–PhD training. The remaining 16% were in private practice.[5]
Attrition rate
Despite variations in attrition rates among different schools, further investigation is needed to understand the underlying causes. For instance, the average attrition rate for students who entered programs between 1998 and 2007 was 10%, comparable to the 12% reported for MSTP-funded trainees who matriculated in the 1980s. However, this rate is considerably lower than the 29% attrition reported in 2008 by Andriole and colleagues. Notably, attrition rates varied significantly among different schools, warranting closer scrutiny to establish cause.[9][10]
According to a 2014 study by Jeffe et al., among those MD–PhD program enrollees who either graduated with MD–PhD degrees or withdrew/were dismissed from medical school, certain factors were associated with attrition. Specifically:
Students who matriculated at non-MSTP-funded medical schools were more likely to withdraw or be dismissed.
Underrepresented minority (URM) race/ethnicity was also associated with higher attrition rates.
Students over 28 years of age at matriculation were more likely to leave the program.
Gender and premedical debt were not independently associated with overall attrition, MD-only graduation, or medical-school withdrawal/dismissal.[11]
Funding and financial compensation
Typically, MD–PhD programs, cover medical school tuition and provide a stipend. MD-PhD programs receive funding from various sources, including institutional grants, individual fellowships, and support from the National Institutes of Health (NIH). NIH funding, including Medical Scientist Training Program (MSTP) grants, has played a crucial role in standardizing training approaches and ensuring program quality. [5]
Christopher Duntsch – Neurosurgeon sentenced to life in prison for intentionally botching 32 surgeries that killed two patients and paralyzed two others[12]
Gregg L. Semenza - Pediatrician and Professor of Genetic Medicine and Nobel Prize Winner in Medicine, subsequently retracted numerous papers.[13]
Joseph Ladapo - Surgeon General of Florida, known for spreading misinformation.[14][15]
Bruce D. Perry - Psychiatrist and researcher in children's mental health and neuroscience, known for developing the Neurosequential Model.
Paul Farmer - Global health physician and medical anthropologist.[16]
^ abcBrass LF, Akabas MH, Burnley LD, Engman DM, Wiley CA, Andersen OS. Are MD-PhD programs meeting their goals? An analysis of career choices made by graduates of 24 MD-PhD programs. Acad Med. 2010 Apr;85(4):692-701. doi: 10.1097/ACM.0b013e3181d3ca17. PMID 20186033; PMCID: PMC4441397.
^Chakraverty D, Jeffe DB, Dabney KP, Tai RH. EXPLORING REASONS THAT U.S. MD-PHD STUDENTS ENTER AND LEAVE THEIR DUAL-DEGREE PROGRAMS. Int J Dr Stud. 2020;15:461-483. doi: 10.28945/4622. PMID 33815015; PMCID: PMC8018685.
^Jeffe, D. B., Andriole, D. A., & Wathington, H. D. (2014). Attrition rates of residents entering US MD–PhD programs in the biomedical sciences. JAMA, 312(20), 2086-2088.
^Andriole, D. A., Whelan, A. J., & Jeffe, D. B. (2008). Characteristics and career intentions of the emerging MD/PhD workforce. JAMA, 300(10), 1165-1173.
^Jeffe DB, Andriole DA, Wathington HD, Tai RH. Educational outcomes for students enrolled in MD-PhD programs at medical school matriculation, 1995-2000: a national cohort study. Acad Med. 2014 Jan;89(1):84-93. doi: 10.1097/ACM.0000000000000071. PMID 24280845; PMCID: PMC3874256.
