duke md/phd information session...duke md/phd information session christopher d. kontos, m.d...
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Duke MD/PhD Information Session
Christopher D. Kontos, M.D. Associate Professor of Medicine,
Pharmacology, and Cancer Biology Director, Duke MSTP September 20, 2012
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Duke Medical Scientist Training ProgramDuke University School of Medicine
• Before: What do MD/PhD programs offer, and how do I get in?
• During: What will I do in an an MD/PhD program, and how do I get through it?
• After: What can I do with the dual degree?
Overview
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Before: What do MD/PhD programs offer, and how do I get in?
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Duke Medical Scientist Training ProgramDuke University School of Medicine
What is the purpose of MD/PhD programs? • To train future physician-scientists
• To teach trainees to bridge clinical medicine and biomedical research
• To ensure that the scientific workforce is maintained with highly qualified trainees
• To limit the financial obligation of trainees so they stay in research
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Why consider an MD/PhD?
• You love science
• You want to be a doctor and like the idea of taking care of patients
• You love doing research
• You’re excited about research to understand the mechanisms of disease
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Research and Clinical Medicine are both puzzles
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Research Questions
Missing Data
Experiments
New Insights
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Clinical Questions
Missing Data
History, Physical Lab tests
Residual questions
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Reasons not to consider MD/PhD
• It’s prestigious • It will look good on my CV • It’s the hardest thing to do, and I’ve always chosen
the hardest curriculum • I’m not sure which path is right for me, so I’ll do both
and figure it out later
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Duke Medical Scientist Training ProgramDuke University School of Medicine
• 138 accredited US medical schools • 82 offer dual MD/PhD degree (59%) • 45 funded by NIH “training grants” (T32) – Medical
Scientist Training Programs (MSTP) • Remainder (37) are non-MST programs • Duke’s program is the 4th oldest MSTP in the
country – started in 1966
MD-PhD programs
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Duke Medical Scientist Training ProgramDuke University School of Medicine
MSTP vs. non-MSTP
• MSTPs are typically the top programs • MSTPs provide full funding throughout training for
both degrees: – Tuition – Fees – Stipend (Duke: ~$28,000/year) – Value: $70,000/year, >$500,000 total
• Most non-MSTPs provide similar funding (varies by program)
• All will provide full funding/stipend during PhD years
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Duke Medical Scientist Training ProgramDuke University School of Medicine
• ~600 matriculants each year into MD-PhD programs (vs. 17,000 MD matriculants); 3.5% are MD/PhD
• About 5,000 total MD/PhD students nationally • Duke ~10 per yr; 68 total as of fall 2012; goal is 80-90 at
steady-state
How many MD-PhD students are there?
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Duke Medical Scientist Training ProgramDuke University School of Medicine
• Short-term: students complete the program
• Long-term: trainees do research life-long
• High cost of training – need to ensure students complete training
Demonstrating MD/PhD program success
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Duke Medical Scientist Training ProgramDuke University School of Medicine
What are programs looking for? • Longitudinal research experience and a demonstrated
commitment to a research career • Clear understanding of how (and why) research will be
combined with clinical training • Great grades • Great MCATs • Perseverance • Intellectual curiosity • Enthusiasm for and dedication to scientific investigation • Publications? • Diversity
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Differences from MD-only programs
• Less emphasis on volunteering • Shadowing is necessary to inform the dual degree • Both items are secondary to the research
experience • MD admission committees have varying degrees of
say in MD/PhD admissions
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Interview questions
• Tell me about your research
• How will you combine both degrees?
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Duke Medical Scientist Training ProgramDuke University School of Medicine
How selective are MSTPs? • National: 1,813 applicants, 633 matriculants in 2011
(35% success)
• Duke: 400 applicants for 10-12 slots (3%)
• National: GPA=3.8, MCAT=36 • Duke: GPA=3.9, MCAT=36.8
• Of interviewees at Duke, ~50% are accepted
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Duke Medical Scientist Training ProgramDuke University School of Medicine
During: What will I do in an an MD/PhD program, and how do I get through it?
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Duke Medical Scientist Training ProgramDuke University School of Medicine
MD curriculum • Typical MD curriculum:
– MS1: normal physiology, anatomy, histology – MS2: pathology, pathophysiology – MS3: core clinical clerkships (medicine, surgery, pediatrics,
OB/Gyn, psychiatry, neurology, family medicine) – MS4: clinical electives, sub-internship, interviews for
residency
• Duke MD curriculum: – MS1: normal body; body and disease – MS2: core clinical clerkships – MS3: research – MS4: clinical electives, sub-internship, interviews for
residency
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Duke Medical Scientist Training ProgramDuke University School of Medicine
MD/PhD Curriculum • Most programs are 2-4-2:
– 2 years of didactic basic science education, mostly in the classroom
– 4-5 year PhD – Clinical medical education: 3rd year: core clinical rotations;
4th year: clinical electives
• Duke curriculum is unique, 2-5-1: – First 2 basic science years are combined into 1 – 2nd year: core clinical rotations – 4-5 year PhD – 4th year: clinical electives
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Duke Medical Scientist Training ProgramDuke University School of Medicine
The PhD training • Learn to “think like a scientist” – ask good questions,
design experiments to answer them • Complete a scholarly body of work • Build a foundation for your future career • Time to degree: 4-5 years (ideal) • Ensure that the PhD is not short-changed despite
time pressures • Completed in any department that offers the PhD
– Most in basic biomedical sciences – Increasing interest in social sciences (health policy or
economics, sociology) and humanities (philosophy, ethics)
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Duke Medical Scientist Training ProgramDuke University School of Medicine
MD/PhD programs seek to integrate scientific and clinical training • Exposure to great research during the MD
• Opportunities for clinical experiences during the PhD
• Opportunities to obtain clinical samples for basic science research (“translational research”)
• Ongoing curricular events to integrate the two career paths
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Advantages of the Duke program
• The only MD/PhD program that provides complete clinical training prior to the PhD
• The clinical experience informs the research experience – may determine its direction
• Shorter MD helps ensure that neither degree is short-changed
• May shorten the time to both degrees • Only a few other programs offer partial clinical
training prior to the PhD: Yale, Iowa, Vanderbilt, etc.
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Duke Medical Scientist Training ProgramDuke University School of Medicine
What does an MD/PhD program do for you? • MSTPs are judged every 5 years on their trainees’
success and program structure • Provide programming to ensure trainees are well
prepared: – Scientific guidance (with grad program) – Career guidance – Exposure to excellent scientists – Build a strong student community – Events: weekly lunches, monthly science dinners, annual
retreat and symposium, social events
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Duke MSTP Retreat 2012
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Duke Medical Scientist Training ProgramDuke University School of Medicine
After: What can I do with the dual degree?
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Combining research and clinical training
• After graduation most graduates (~95%) enter residency (post-graduate clinical training)
• Residency (specialty) and fellowship (subspecialty) generally last 3-7 years (some exceptions)
• Most graduates seek residencies in research-focused programs
• Long-term goal: a career with 80% time dedicated to research, 20% clinical
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Program Choices for Duke MSTP Grads
1966-2010
2001-2010
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Residency program choices of Duke MSTP grads
1966-2010
2001-2010
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Duke Medical Scientist Training ProgramDuke University School of Medicine
The next steps
• Transition to independence requires additional research time
• Usually during a fellowship (during or after residency)
• Establish new research directions • Apply for career development (K) awards from NIH • Obtain mentored faculty position for 2-3 years • Start independent lab
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Typical career development timeline
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Common career options with an MD/PhD
• Academic physician-scientist – 80/20 research/clinical – 100% research, usually in basic science dept.
• Research institute – NIH, etc. • Pharmaceutical industry
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Career choices of MD-PhD alumni
Private Practice
16%
Industry 8%
Res. Institute
4%
Unknown 5%
Academia 67%
Brass et al., Acad. Med. 85:692 (2010)
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Long-term goal
• Obtain a faculty position at an academic medical center
• Start your own lab • Obtain independent funding, ideally from the NIH
(R01 grant) • Merge your own particular scientific and clinical
interests and have fun!
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Additional resources • Duke MSTP:
– http://mstp.duke.edu/ – [email protected]
• AAMC MD/PhD Information: – https://www.aamc.org/students/research/mdphd/
• AAMC Podcast: “Joint MD/Ph.D. Degrees Combine the Best of Science and Medicine”: – https://www.aamc.org/podcasts/aspiringdocs/271476/md-
phd.html
• MD/PhD: Is it right for me? (PDF): – https://www.aamc.org/students/download/121086/data/
mdphd_isitrightforme.pdf
• Summary of MD/PhD Programs and Policies: – https://www.aamc.org/students/download/62760/data/
faqtable.pdf
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Duke Medical Scientist Training ProgramDuke University School of Medicine
Thanks • Duke Undergraduate Research Society
– Chirag Vasavda
• Research Scholars Program – Rui Dai
• Duke Genome Research and Education Society – Akash Shah
• Office of Health Professions Advising – Dr. Dan Scheirer
• Undergraduate Research Support Office – Dr. Ron Grunwald
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Duke Medical Scientist Training ProgramDuke University School of Medicine