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Wednesday, 22 October 2014
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Here are some questions frequently asked by MSTP applicants.

Where can I find general information about MD-PhD training programs and physician-scientist careers?

Information is available at the Association of American Medical Colleges AAMC MD-PhD Dual Degree Training and at the NIH NIGMS websites.

Are all MD-PhD programs the same and what is an MSTP program?

No. There are many flavors of MD-PhD programs. They can differ in their funding, admissions process and degree of clinical vs. basic science integrated-ness. The Medical Scientist Training Program (MSTP) is an NIH-funded training program for physician-scientists. There are also schools that have non-MSTP MD-PhD programs as well as schools who have a bit of both.

What are the key differences between programs?

Besides the obvious in terms of location, student satisfaction and graduate success, there are a number of important differences between MD-PhD programs, and even within the group of MSTP programs that will impact on your experience as a student. So ask questions before you apply and during your application process.

Funding: A very important question. This will directly impact your peace of mind throughout the long period of training. Funding includes both a stipend as well as tuition waivers and any other benefits. Depending on their relative importance to you, you’ll need to know the relative amounts in each category. Some programs provide a stipend during all years in the program, others only during the graduate school years. In programs that provide a stipend in all years, the amount may be the same in all years or it may be lower during the medical school years. Some programs waive tuition in all years, others only in the graduate school years. Within a single school there may be several different small programs, each with a different funding philosophy. In addition, one also needs to ask, upon entering the graduate years, whether your lab PI is required to fund you. If so, this might impact the number and breadth of labs you could choose from. Schools also vary in the benefits they provide (remember this impacts how much disposable cash you would have too) such as medical benefits, eye and dental coverage etc.

At Einstein there is only one class of MSTP students. All MSTP students receive the same benefits during all years in the program. These include a stipend, currently $31,300 per year, complete tuition waiver, and health insurance.

Integration of Medical and Graduate School Coursework: MD-PhD students must complete coursework for both medical and graduate school. There are several different models for organizing this didactic coursework. In most programs students first completes all of the first and second year medical school courses and then beginning in the third year they take the required graduate school courses. Alternatively, the coursework may be integrated to expedite the student’s progress through the program.

At Einstein we have developed an integrated first year curriculum that allows MD-PhD students to learn the necessary first year medical school material and simultaneously complete most of their required graduate school coursework. The first year of medical school is designed to take all students whether they were Biochemistry majors or Art History majors and bring them to a common level providing them with the language and knowledge necessary to take the pathophysiology courses in the second year of medical school. MSTP students enter the program with very strong science backgrounds. Therefore at Einstein first year MSTP students take graduate school Biochemistry and Molecular Biology and Molecular Genetics in place of the corresponding medical school courses. The students learn the material necessary for medical school but delve deeper into the scientific and research aspects. Students with strong backgrounds in Biochemistry can place out of the course and take other graduate school courses instead. In addition, we have organized four MSTP-specific courses in Histology & Cell Biology, Physiology, Anatomy, and Disease Mechanisms. As with the graduate school courses, these courses cover the necessary medical school material but at the level of a graduate school class. Finally, students take one or two graduate school elective courses each semester so that by the end of the first year most students have complete three to four of the five required graduate school courses and they are ready to enter the second year of medical school. This allows Einstein MSTP students to focus on their PhD thesis research as soon as they start the third year.

Basic Science and Clinical Integration: The truth is, medical and graduate training have very different aims and philosophies. As an MD-PhD student, you can sometimes feel like there is little connection between the two schools. Sometimes courses will overlap. Programs differ in whether they have programs or courses that help bridge the gap between MD and PhD. This can include, medically relevant graduate courses, waived medical school courses, MSTP-tailored medical courses, clinical refresher courses during the PhD years, seminars to expose you to various medical subspecialties, a clinical skills program that extends through the PhD years etc.

At Einstein we have several programs during the PhD thesis research years to strengthen and build the students clinical skills. The Continuity Clinic is and MSTP run outpatient clinic that meets once a week. Patients are seen by MSTP students with supervision provided by a group of dedicated physicians and physician-scientists. This allows MSTP students to obtain experience in long term outpatient care while honing their skills in physical diagnosis and treatment. A monthly Clinical-Pathological Conference provides students the opportunity to discuss a case with a clinical expert and get a free breakfast as well. Finally, many MSTP students volunteer on Saturdays in the student run ECHO clinic that provides free health care to underserved populations in the South Bronx. All of these activities help the students develop their clinical competence so they are better prepared to return to the wards following the completion of their PhD thesis.

Where to apply and how many programs?

The NIH provides a list of MSTPs in the country. This a starting point. other non-MSTP MD-PhD programs can be found through the medical or graduate schools they are associated with.

I got an interview! How do I prepare? What should I be prepared to discuss?

Congratulations! The interview process varies from school to school, from marathon 12-person panel interviews over several days to a few one-on-one interviews in one afternoon.

At Einstein, you will be asked to submit names of faculty whose research interests you. On your interview day, you will have half a dozen meetings, two will be formal interviews by members of the MSTP Admissions Committee and the rest will be with some of the faculty that you selected. Most students did not find the process unduly stressful but rather quite laid-back.

Be prepared to discuss what you have submitted in your application, in particular your research experiences. You will be asked questions about the science so it might be a good idea to review what you have done.

I'm not a permanent resident or US citizen. Is there an MSTP program out there for me?

International students are not eligible for NIH-funded training grants, which can comprise the bulk of the funding for many MD-PhD programs. It is important to find out before you apply and send in your application check, whether the program has spots for international students, whether those spots are funded in the same way as regular students, and any other restrictions you might experience should you attend that institution.

The rules vary from school to school. And it is not necessarily true that the larger the program, the more spots there are for international students. Perhaps the best way to get information about such rules is to ask how many international students are currently in the program, and if you could be put in contact with one of them.

At Einstein we encourage applications from international students and we typically accept international students each year. As with all applicants, in order to be eligible to apply, foreign students must have completed at least three years of study toward a baccalaureate degree from an accredited college or university in the U.S. or Canada. All students whether US citizens, permanent residents or international receive the same support as described above in the funding section.


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