Why MD/PhD?

Med school is SO long - why spend another few years getting a PhD?  I've gotten this question a lot since I started med school.  Like applying to straight MD programs - there are plenty of good BS reasons to apply to MD PhD programs.  [The REAL reason I want to go to med school]

MD/PhD - the rough outline by year

Sidenote - if you're wondering what MD/PhD programs are - see image on right - they are essentially med school (MD) and school for scientists (PhD) so we combine medical and scientist training.  We exchange spending a few extra years in school with free tuition.  

Here on sidenote, we give the people what they want.  Once we pare away all the BS of med school admissions, there are 3 reasons why I chose to pursue two doctorates, when I would have been equally as useful with an MD.  

1- The incredible tution bill of med school.  The average 2010 med school graduate left with $160,000 in debt.  15% of all med school graduates left with a quarter million dollars of loan money.  And when you graduate med school you're still a resident which means you make in the neighborhood of $50,000, not quite doctor money.  And don't forget that loan money is definitely not interest protected.  It keeps growing and growing and..  

As an MD/PhD student, the government pays my medical school tuition bill.  Thanks tax dollars!  

running gels gets a bad rap.. but I love science

During my admissions year I kept hearing that the financial incentive to pursue an MD/PhD wasn't worth it, but it still seems smart to me.  Spend 3-4 years working in a lab, which I love, and come out with a free MD, which my wife loves.  Everyone wins.

2- I needed a backup plan.  One day, I really want to be a scientist and run a mega lab to the tune of 20+ scientists, Cell papers by the month, and grant money flowing in like Brandon Roy's bank account.  The point is - I only want to be a scientist if I can be a good one.  

If you've ever worked in a lab you know the 40 year old burned out postdoc that's bitter at the research world for screwing over his opportunities to publish in Science/Nature/Cell and get independent grants.  You also know that guy questions his life on a daily basis - should he quit and go into advertising?  teaching?  

great book

I didn't want that to be me, but frankly it's only so much in my hands.  Science is a volatile career, and a high impact publication is usually the result of right-place-right-time phenomenon.  (See Malcolm Gladwell's Outliers).  

I really want to have a family some day - preferably sooner rather than later - so I wanted to make sure I had a viable backup plan before I tried to launch a risky career in science/academia.  At the end of the day I want to do science so I can use my brain to help people, so I figured being a doctor would be a good alternative - still intellectual and still helps people.

3- I believe I do things right and other people don't.  Don't hate me for it. I despise med school because all we're doing right now is learning the status quo and how medicine has been done for years.  I know we have to learn this because we need to pass boards.. but it is BORING.  Sidenote - when I run academic medicine we will be done with standardized tests and memorizing rote BS. Instead med students will learn, you know, actual medicine.  

I'm a cynical med student, and I know in 6 yrs I won't be the kind of intern that's going to see the medical world and accept it at face value.  I know I'll be a pissed off resident, and a pissed off attending.  There's a lot to be cynical about in science, but at least science is trying to come up with new solutions.  I wanted to be part of a world that asked, what if we could come up with a better way to do this?

Overall conclusions.. perks to the MD/PhD - it saves $ and you get to do science.

See you on the other side,

from ken

Iyer/Noguchi on med school admissions: Virtual Coffee Date pt 2

ken and amulya

Here with Amulya Iyer, current med school applicant.  A continuation of last week's post, analyzing and critiquing med school admissions. 

Ken: Another half-baked idea to build on the intangibles: in the NBA, teams send scouts out to check out top college players.  Why don’t med school do the same?  Send some faculty out to the local colleges, observe students in class, chat with other students, read the school newspaper, get the pulse of the school. 

At this school, which students matter? 

If you’re a school like Stanford – intentionally trying to recruit the future leaders of medicine – wouldn’t you want the students that matter?  Can you tell that from a resume, where everyone looks the same?  Nah.  Can you tell that by going to a school and talking to the dean, the department chairs, a handful of students?  For sure. 

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Amulya: Love this. It sounds difficult logistically, but I doubt that it really is. Let’s get some stats in here courtesy of University of Michigan. Thus far in the application process they have made 117 interview offers: 54% of these interviews were made to students from just 9 undergraduate institutions.

A school like Michigan could benefit enormously from sending an ‘MD scout’ to each of those 9 schools for a week or two and seeing the students in action in the classroom or with their friends. If it works for the NBA, why not use it in medicine? When a player retires from the NBA, they become a scout. When a doctor retires from practicing medicine, he should become a scout.

--

md scout home base

Ken: True.  Wouldn’t retired doctors love this?  This blows golfing out of the water. 

If you’re an MD scout, what are you looking for?

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Amulya: Hmmm, tough question. Just off the top of my head, if I was a scout chilling in the back of a classroom discussion I'd look for:

1.) Works well with others and functions well in a group setting.

2.) Shows intellectual curiosity.

3.) Respected by peers and teachers.

Just like I don't think it's fair to judge an MD applicant based on their paper application alone, they shouldn't be judged just on the MD scout. Instead, the scout should serve to single out candidates that wouldn't necessarily be noticed otherwise. I imagine the scout sitting in the classroom, meeting with Dean's and professors, going to sports practices, etc. with a list of pre-med students and then flagging some of those students as 'studs'. And it could also serve the opposite purpose - if someone is clearly selfish, then those tags can work against them.

--

If I was MD scouting at Kenyon in 2012 here is what I would look for.  

#1 - I would survey every science major to name the best student.  I'm a huge huge fan of respect by peers.  If someone's a beast, who better to know than the people always around them?

#2 - I would go to watch honors thesis presentations and pick out the students with the best presence. People with good stage presence are good with people - thus they'd be good doctors.  

people who go big, will keep going big.
true or false?

#3 - I would figure out who won these three awards: Anderson Cup, MLK Award, and the Humanitarian Award.  Basically, this tells you who mattered at Kenyon that year.  If they mattered at Kenyon, they'll probably keep mattering in med school.  

#4 - I would ask the athletic director to pick the top 10 athletes.  There should be more points for athletics in the admissions process.  If you have an average premed student that spends a ton of time training to be D3 Nationals caliber swimmer, what does he do when he's done with competitive swimming?  Probably training to be an excellent doctor.

If there's any top athletes with any of #1, 2, or 3 I would offer them admission on the spot. 

Anyways, we’re getting long we’ll cut it off here.  Let me know if you have any ideas to make the med school admissions process any better.

See you on the other side,

from amulya and ken