Jim Gorham, MD PhD Director, The MD-PhD Program at the Geisel School of Medicine at Dartmouth

1. Everything you wanted to know about MD-PhD Programs but were afraid to ask Dartmouth College May 14, 2012 Jim Gorham, MD PhD Director, The MD-PhD Program at the Geisel School of Medicine at Dartmouth James.D.Gorham@Dartmouth.edu 603-650-8373

2. Physician-Scientist Career Paths • Preparing your application to MD-PhD Programs • Evaluating MD-PhD Programs

3. Part 1: Physician-Scientist Career PathsMD versus PhD versus MD-PhD

4. MD Course of Training • Preclinical Phase • Clinical Phase • Graduation • Post-Graduate Internships/Residencies • Fellowships (Specialize)

5. PhD Course of Training • First Year • Graduate Coursework • Lab Rotations, Choose Thesis Lab • Second Year • Complete Graduate Coursework • Qualifying Examination • Years 2-5 • Full-Time Bench Research • Thesis Committee Meetings • Teaching Assistantships • Write Papers and Thesis • Thesis Defense

6. MD-PhD Training WHAT IS THE MD-PhD OPTION? Mission: Provide integrated education and training of individuals to become physician-scientists prepared to bridge the gap between laboratory research and clinical medicine. • RESEARCH: • Basic Research • Disease-Oriented Research • Patient-Oriented Research • Population-Oriented Research • TEACHING: • Basic Science • Clinical Disciplines • CLINICAL MEDICINE: • Generalist>Specialist

7. Pathways to become a Physician-Scientist or Clinical Investigator Physician-Scientist MD-PhD ClinicalResearch CollegeStudent MD PhD

8. MD-PhD Training What is special about MD-PhD education and training? MD-PhD vs MD: Structured research training MD-PhD vs PhD: Understanding of human biology (how normal and abnormal function result from complex interactions at many levels of specialization)

9. MD-PhD Training Differing perceptions of MD-PhD trainingand training outcomes Clinicians’ perception of MD-PhD students? They all become basic scientists… Basic scientists’ perception of MD-PhD students? They all become clinicians… Conclusion? We must be doing something right…

10. MD-PhD Training Basic Translational Clinical Epidemiological Industrial R&D RESEARCH CLINICAL MEDICINE Student MD-PhD Training Academic Industry Public Policy ADMINISTRATION

11. MD-PhD Training ADVANTAGES: DISADVANTAGES: FULL FINANCIAL SUPPORT: Broad education in human biology Broad range of career choices Very long education and training Difficult-to-manage conflicting pressures from laboratory, clinical responsibilities, and family Enables careers in academic medicine (but this is not a free lunch)

12. Preclinical Phase – Years 1-2 • Preclinical Coursework • Explore Research Opportunities • Laboratory Rotations • Choice of Thesis Advisor • National Board Exam • Clinical Clerkships

13. Research Phase – Years 3-6 • Graduate Coursework • Bench Research and Publication • Explore Clinical Interests (medical specialties) • -/+ Clinical Experience (limited)

14. Clinical Phase – Years 7-8 • Clinical Clerkships • Residency Application • Graduation

15. Clinical Phase – Years 7-8 • Medicine • Surgery (including subspecialties) • Ob/Gyn • Pediatrics • Neurology • Psychiatry • Primary Care • Medicine Subinternship • Senior Electives • 13-24 Months Total time M3 Year M4 Year

16. MD-PhD vs MSTP • What is a Medical Scientist Training Program? • 109 MD-PhD Programs (42 MSTPs, 67 non-MSTP) • NIH funded MSTP Training Grant

17. Part 2: Preparing your application. Making sure you are the applicant that programs will take a second look at

18. What MD-PhD Programs Seek • Strong academics (of course) • MCAT’s • Plus • Passion for Science • Research Experience • Clinical Experience • Leadership • Commitment to Serving Others

19. The To Do List • Coursework • Research • Clinical Exposure • Community Service • Extras • Recommendations

20. Research - Academic Year Summer Opportunities Post-undergraduate

21. Posters, Oral Presentations & Publications

22. The MD-PhD ApplicationHow to get the coveted offer of acceptance…

23. MD-PhD Application • APPLY EARLY, APPLY EARLY, APPLY EARLY, APPLY EARLY, APPLY EARLY!! • Universal MD-PhD application available on AMCAS. • Personal Statements • Letters of recommendation • GPA and MCAT • Publications help • Secondary forms

24. Personal Statements • Personal Statement – • Individual characteristics, experiences and motivations for choosing a career as an MD/PhD. • Discuss unique life experiences or skills • Why I Want to be an MD/PhD – • Explain rationale for wanting to become an MD/PhD. • Discuss generally how you envision using the combined degree in the future (specifics not necessary). • Research Experience - • Describe any and all research experiences you have had. • Provide clear timelines for each experience • Discuss your role(s) in the research project.

25. The Interview • During the MD/PhD interview: • Try to talk with as many as possible research faculty in your area of interest • Ask lots of questions to the students in the program – • they are the best indicator of whether a program has any major issues • Be prepared to discuss your research in-depth • You should know the big picture as well as the experimental details • Be prepared to discuss your rationale for choosing the MD/PhD track • Be personable • engage both the faculty and students in one-on-one conversation about science and extracurricular activities

26. AAMC - Admissions Data • About 2K MD/PhD applicants nationally • Of these, about one-half (1K) are offered an interview with at least one MD-PhD Program. • Of these, about 2/3rd are offered admission to at least one MD-PhD Program.

27. AAMC – National Statistics • Nationally, there are about: • 4,500 MD-PhD students, of which: • ~12% are underrepresented minority • ~40% are female

28. Part 3: Evaluating anMD-PhD Program In which program will you not only survive but thrive

29. Location Geography – Close to family Housing availability, proximity, affordability Variety of extracurricular activities Proximity to things that matter to you

30. School - Academics Curriculum - Preclinical coursework Clinical requirements (Clerkships/Electives) Patient populations and clinical facilities Flexibility Graduate Programs – Coursework requirements # of required lab rotations Residency Placement of Alumni

31. Faculty Are there sufficient faculty who share your interests? Is there a strong research community? Collaboration Training record (time to degree)

32. Strengths of MD-PhD Program Program Director’s commitment to program Administrative support Support from Dean/Administration Supplemental program opportunities - seminars, lectures, programs, socials

33. Gut Feeling In the end, you will almost certainly make your decision based on a gut feeling, and then find rational arguments to support it. And that is the way it should be.

34. Questions…Concerns?The Complete Guide to theMD/PhD DegreeBen Rosner MD, PhDJayakar Nayak MD/PhDJ&S Publishing