so how exactly does this md/phd thing work?

Perhaps this whole MD/PhD thing deserves some explanation. Or perhaps I just don’t really have anything else to write about and am using this topic as a filler post. You be the judge.

Let’s not go into why I chose to torture myself so just yet. Let’s just focus on what’s involved in this torture.

The Medical Scientist Training Program (MSTP) was established in 1964 by the National Institute of General Medical Sciences (NIGMS) to address the need for investigators who are well trained in both basic science and clinical research. According to the NIGMS, there are 40 participating programs and 75 medical schools that offer combined MD/PhD degrees without funding from the NIGMS.

So what exactly is involved? At my school, the combined degrees are expected to take seven years to complete. We start out in medical school, finishing the first two years of medical school (the basic science part) and passing our USMLE Step 1 before leaving medical school to start our graduate work in our area of interest. During the first summer of medical school (which is the closest that we get to the summer vacations we’ve been used to), we don’t get to kick back and relax or travel to exotic places or even catch our breath. Instead, we are required to rotate through a number of labs in our area of interest to try to find the lab that we want to do our thesis work in. As I mentioned earlier, instead of going on to the wards during our third year of the program, we start our grad school work. Depending on the field we are going into, graduate courses need to be taken to fulfill the PhD degree requirements. A field closely related to medicine, such as physiology, will have a lot of overlap with the medical school curriculum, leading to fewer courses needing to be taken (or so they claim). In contrast, a field such as biomedical engineering, which isn’t so related to medicine, requires more coursework to be taken. Simultaneously with the coursework, we are expected to be working in the lab (either rotating through labs if we haven’t yet chosen one or in our chosen lab). Graduate programs tend to be a little more flexible with MD/PhD students as well—how this so-called flexibility manifests really depends on the specific graduate program. After completing our required graduate coursework, we must go through the torture that is the qualifying exam just as in a PhD-only program. Then we are free to complete our research, all of which should take a mere three years. Once we’ve completed our thesis work to the satisfaction of the powers-that-be, we’re released back into medical school, where we complete our last two years of medical school. There is supposedly some flexibility in the curriculum for us during the last two years of med school as well, since we usually don’t start right on time to begin “third” year with the rest of our MD-only classmates—however, I’ve heard that they’re becoming less and less flexible (which means I’ll really be screwed by the time I return).

And that brings the grand total to seven years, if we’re lucky. If we don’t complete our thesis work in three years, we just keep going until we do (but the funding just might not, depending on the school and the program).

So where am I in this whole grand scheme? I’m just going over the hump that is the middle. I have one year left before going back to med school IF I stop conveniently sabotaging my own experiments. It wouldn’t be so bad if I knew for a fact that all I have left is this one year. But I don’t. So it’s just sheer torture.

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  1. an open letter to the director of the md/phd programDear Mr. Head Honcho Who Has No Clue What His MD/PhD Students Are Suffering Because He's Too Kooky Himself: Before it comes to your attention that I am not making satisfactory progress in your program and thereby hurting your chance of receiving NIH funding for it, I would like to make clear the failures in your program that have led to the waste of my valuable potential, which five years ago, you thought would blossom through your program. First off, we need more guidance. Even those of us who were very much involved in research before coming to medical school do not know how graduate school works. We assume that someone will tell us and guide us through the process since it is in your best interest that we finish in a reasonable amount of time. I waited and waited for this guidance and it never materialized. I even tried seeking it out through your required semiannual meetings with my appointed advisor. The last time I met with my advisor, I told him of my concerns with my major professor's mood swings and unwillingness to be open to my ideas and outright unprofessional behavior towards me. I also told him that I was not making the progress I would have liked to make by that time and that I feared that I would not finish my PhD any time soon because of my major professor's failure to be a good mentor to me. He sent you a report of my...
  2. the dreaded phd qualifying exam*I’ve put it off way longer than I should have. And it’s not my fault. Well, not 100% my fault. When I first started grad school still high from that adrenaline that pumps non-stop during those hectic first two years of med school, I wanted to take my quals as soon as possible so that I could finish my PhD as soon as possible. Then in stepped my major professor, who told me that I’d be committing suicide by doing so and that I should take the quals at the last possible minute to ensure that I would have enough time to study for it. Adding to his argument was the fact that one of the classes I wanted to take was only offered in alternate years and not that particular year. So I really had no choice but to wait until this fall to take my quals. So I putted along with my grad school classes (none of which could even come close to matching the difficulty of a single med school class, by the way) and dutifully met with my advisor at the end of the year. I had listed out the courses I still needed to take before being done with the required coursework, including the I-put-off-my-quals-to-wait-for-this-class one. When he saw this course listed, he told me that it had not been offered for awhile and that he didn’t think that it was ever going to be offered again and to confirm with the professor. I emailed...
  3. sometimes i REALLY wonder why i’m doing this md/phd thingNote the emphasis on "really." Because I wonder why I'm doing this every day. No. Every waking moment of everyday. No. Even in my sleep. I want to be done with this so badly that I dream about being on rotations and how great that is (which it isn't, or so I hear). I kid you not. And nothing reminds me more of why I hate this whole PhD thing than having to give a talk about all of the progress that I failed to make since the last time we all got together (which led to this brilliant post about my lack of progress) to rub our fellow MD/PhDers' faces in just how much more brilliant we are than them. I'm sure I'm such an easy target now that it's not even any fun anymore. I'd love to talk about something besides my experiments not working. In fact, I'd even settle for something I actually believed in even if it doesn't work. Because back during my un-jaded days as an undergrad in my major professor's lab, I actually believed in his work. I don't today. The only thing I've learned from him is how not to do research and how not to be a mentor. I guess I've also learned how to bluff and pretend that I've done a lot more work than I really have. How else do you explain the fact that I haven't yet been reprimanded by the powers-that-be for my complete and utter lack of...

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