are md/phd admissions fair?

Pre-Med & Medical School Pre-Med Topics
1

<p>i have a great interest in the mathematical and physical sciences, and i'm working to apply my knowledge to biology. i've been doing a lot of research and have two first author publications in my name. i also go to a quality undergraduate institution etc. etc.</p>

<p>my lab advisors have told me that they have seen several outstanding students (researchers) rejected from the top medical schools (MD only) in the country because, for whatever reason, they were deemed unfit for becoming doctors. some said they failed to display the utmost passion for the practice of medicine in their interviews/personal statements.</p>

<p>i know a grad student (undergrad at MIT, phd, great experience across the board) who recently applied to medical school. he had a 3.6 gpa as an undergrad and he told me that during his medical school interviews, he was often questioned about his "low" gpa and lack of volunteer experience. as a result, he was rejected by the top schools he applied to. i asked him what i could learn from his experience, and he basically told me that i had to "play the game." whether you like it or not, it seems like you have to BS your way through the admissions process in order to have a chance to get in to a top med school.</p>

<p>why is this the case? i'm genuinely interested in science but i don't want to have to fake enthusiasm during an interview when the truth is i have enough interest in becoming a doctor. i feel like i'm forced to apply to md/phd programs because of their inherently meritocratic nature. my question is, are md/phd programs "more fair" in evaluating their applicants? in other words, are they more objective? does the phd admissions committee have a greater say in whether a candidate should be accepted than the md committee?</p>

2

<p>It is true that MD/PhD applicants are not held to the same standards when it comes to enthusiasm for the practice of medicine.</p>

<p>Of course, it hardly seems "unfair" to ask prospective physicians to demonstrate enthusiasm for the practice of medicine.</p>

3

<p>it depends on the md/phd program. Some schools have a separate admissions track for the md/phd kids, and some schools you need to get into the md part first before they will consider you for the md/phd. The first set you would probably have better luck with, while the second the lack of volunteering could really hurt you.</p>

4

<p>if anything, I'd say the MD/PhD admissions track is MORE likely to be 'unfair.' Grad school admissions outside of professional schools are notoriously politics-driven, and who your PI knows could play a real role in getting you into a program.</p>

<p>That said, two first author pubs would give you a much bigger boost in the MD/PhD route than MD only, assuming the papers are not in some totally irrelevant journal (a point I would argue makes the process even more 'unfair,' as undergrads have very little say if their research gets published or what their authorship position will be).</p>

<p>Most importantly though, you need to consider if you WANT to go the MD/PhD route more than the MD-only route, as it is a significantly longer process and inherently pushes you down a different career path than MD-only programs.</p>

5

<p>On this issue, I feel that there is a significant need to demonstrate an interest in the practice of medicine. Medicine is not just science. Having an interest in science is not sufficient. </p>

<p>On a near daily basis, even as a measly third year student, I ask people some of the personal questions imaginable having known them for less than 5 minutes. I poke and prod them, violate their personal space, and cause them pain or discomfort. It absolutely requires a certain make-up that not everyone has. I think it is entirely appropriate for medical schools to be looking for great doctors, not simply great students. Certainly there is a spectrum of clinical skills/tact/empathy, and there are people in my class who make me cringe whenever they start talking to patients, but they're orders of magnitude more capable than some of the kids I saw in the Kaplan classes I taught. </p>

<p>This isn't fluff either. There's plenty of research out there that shows time and time again, patients care much more about how their physician communicates with them rather than how much they know. There are certainly occasions when a patient really just wants a diagnosis, but a caring attitude and being personable can buy you a significant period of time and ineptitude a great majority of the time. It also saves you from lawsuits...</p>

<p>I really think you need to examine what your career goals are, how your skills, your likes/dislikes, and what really makes happy all fit together. If you really prefer science, might you be happier as a researcher to begin with? What is really drawing to medicine?</p>

6

<p>well i have an interest in medicine but i feel that my level of interest is not overwhelming in comparison to students that apply for md only programs. i feel that i'm prepared to make the career change that is required of md/phd's -- my interests don't lie in clinical practice. i'd much rather pursue innovative scientific research and see the results through to novel drug design. anyways, that's just me...</p>

<p>i disagree with the claim that graduate school admissions are 'unfair' according to philly. if anything, that's how an admissions process should work -- if you're good enough to work with a well-known advisor and to be placed with enough responsibility to conduct research/contribute in a significant manner to a scientific publication then you deserve to be accepted into a good graduate program. in a sense, i'd much rather be accepted in that fashion as opposed to having to unnecessarily feign interest in being in clinical practice and wanting to "help people" for the rest of my career.</p>

7

<p>
[quote]
i'd much rather be accepted in that fashion as opposed to having to unnecessarily feign interest in being in clinical practice and wanting to "help people" for the rest of my career.

[/quote]
</p>

<p>Yeah. That WOULD be unneccessary wouldn't it? That whole "helping others" thing - I mean, how could a doctor need that? I don't think you should feign it either. Show them the right path. Stand up for what you believe in. Lead with it on the app, I'd say. It will separate you from the pack, so to speak.</p>

8

<p>if that is your thought process, then I don't see why you are even applying MD/PhD, clearly grad school only seems the road for you, as you won't have to feign interest in taking care of patients at all.</p>

<p>My point was not that the admissions process is truly unfair, as you claim it to be (you'll note the quotation marks in my previous post), merely that it is just as if not more subjective than the MD only process. The two are looking for different things, this does not make one more fair than the other. You are confusing fairness with being compatible with your strengths.</p>

<p>Additionally, working with a big-time PI and getting your name on pubs has far less to do with how good you are at research and more to do with luck, and I say this as someone who works in the lab of a department chair at a major university and has a couple pubs to my credit. You are not in control of your own research when you are in the lab, whether you publish or not is entirely at the discretion of the PI, and your experiments are largely influenced by whatever postdoc you're working with. If you're totally on your own, which I find difficult to believe, then good for you, but the fact that you wound up in such a good lab situation has more to do with the benevolence of the PI than it does with your talents in getting into the lab. Yes, you had to work hard and be talented to make the most of that situation, but you did not land in the situation on merit.</p>

9

<p>look, there are ways to "help people" without wanting to actually take care of patients. if i'm not mistaken, that's what make science such a noble profession. i think that, and the reasons i stated in my earlier post, is a perfectly acceptable answer to "why do you want to be a physician-scientist." however, i don't want to have to beat the "i want to help people" answer to death as i would probably have to in the md only admissions process. if you want to take offense to that, curmudgeon, then suit yourself. just realize that there are plenty of other pre-meds, mudphuds in training, and physician-scientists that feel the same way.</p>

<p>i think i have been fortunate enough to be given a great amount of responsibility and control of the research i conduct in my lab. i have my own project admittedly after a brief period of acclimatization to the work in my field. the decision on whether to publish my data, for example at the end of this summer, will be based on my input as well as my PI's. of course the project was the brainchild of my PI and now i'm in control of it, however, i did have to land the situation on a combination of my own merit and my PI's "benevolence." i'm treated like a grad student/postdoc, and at least where i currently study, i know several motivated undergrads in the same exact position.</p>

10

<p>
[quote]
well i have an interest in medicine but i feel that my level of interest is not overwhelming in comparison to students that apply for md only programs. i feel that i'm prepared to make the career change that is required of md/phd's -- my interests don't lie in clinical practice. i'd much rather pursue innovative scientific research and see the results through to novel drug design. anyways, that's just me...

[/quote]
</p>

<p>If this is what you want to do, then why even bother with the MD to begin with? You can be a PhD and do this. It seems like having to actually take care of patients would be a bother to you. Nothing you've said so far leads me to believe you'd find anything redeeming from all the clinical training you'd receive, beginning with third and fourth years, and then residency. If you want to do research, then do research.</p>

11

<p>well the whole point of doing an md/phd is to obtain a clinical angle that isn't available in a graduate program in order to solve problems in research with potential clinical applications. even if i do decide to make the jump into clinical practice down the line, i'd be a better doctor than those without research training (although this will undoubtedly be a point of contention on this board). however, i'd much rather be an academic basic scientist and from a funding perspective and md/phd would definitely be of more value than a phd.</p>

12

<p>There are PLENTY of opportunities to get a PhD with a "clinical angle." Medical schools have tons of research labs associated with them, and likewise tons of graduate students (PhD-only) who are doing clinically-oriented work. At this very moment, I'm across the hall from a lab that does research in bone growth, and one that does research in cardiac electrophysiology. Both are run by PhDs, who are on "X Medical School" faculty.</p>

13

<p>that's all well and good, but an md/phd program allows you conduct research with the benefit of having clinical training to solve problems from a different angle.</p>

14

<p>
[quote]
i know a grad student (undergrad at MIT, phd, great experience across the board) who recently applied to medical school. he had a 3.6 gpa as an undergrad and he told me that during his medical school interviews, he was often questioned about his "low" gpa and lack of volunteer experience. as a result, he was rejected by the top schools he applied to. i asked him what i could learn from his experience, and he basically told me that i had to "play the game." whether you like it or not, it seems like you have to BS your way through the admissions process in order to have a chance to get in to a top med school.

[/quote]
</p>

<p>I think your last sentence gave it away, as I would argue that the MD admissions process, and in fact, the entire physician's career track, is probably more fair than that of a researcher/academic, in the following sense. Sure, that MIT guy that you mentioned may not get into a top med-school, but the fact is, he'll probably get in somewhere and getting into a top med school is of only minor benefit relative to getting into an average med school, a point that has been discussed numerous times here on CC. </p>

<p>On the other hand, if you want to be a researcher, especially in academia, then where you get your PhD really does matter a lot, not just in terms of the general prestige of your school, but also the eminence of your advisor. </p>

<p>I tend to agree with phillySASer08 that your publication success is not as based on the quality of your research as people seem to think. However, I agree with him that it's largely a matter of luck either. The truth of the matter is, whether we like it or not, much of the success of your publication rate is based on prestige and social networks. For example, the Peters & Ceci (1982) paper that studied the academic peer review process took articles that had been written by famous authors from famous universities and that had already been published and resubmitted them back to the same journals that had previously published those papers, but with the authors' names and university affiliations changed to low status, and while some of the papers were detected as resubmissions, most were not, and of those, most were rejected as being 'unworthy'. Remember, these papers had originally been accepted by those very same journals. Along the same lines, being affiliated with a high prestige and well connected department will give you a far greater chance of gaining personal contact with editors and referees of top journals, and some of those editors and referees may even be in your department. For example, I know one Harvard grad student who coauthored a paper for which one of her referees actually turned out to be none other than her boyfriend. I guess it worked out well: the paper was successfully published and the two later got married.</p>

<p>The bottom line is, I would argue that while neither career track is perfectly fair, the physician career track is probably more 'fair' as a whole, as you can still have a highly successful career as a physician even if you went to a no-name med school. As a reseacher/academic, not so much, as it really does matter whether you went to a top PhD program vs. a no-name program. Whether we like it or not, academia/research is one of the most prestige-conscious of careers.</p>

15

<p>In terms of academia, for MD/PhD does the undergrad need to have a lot of prestige in order to be viable for a top med school? Of course it helps being from a top undergrad, but then again MD/PhD programs can take a max of 1 person each yr from each school b/c they have so few spots. So in that case, by going to a lesser prestigious undergrad, you would have a greater chance of being looked at and possibly selected. Plus less ppl apply from less prestigious undergrads than from more prestigious ones. Am I not correct in that sense?</p>

16

<p>well fine sakky, but you'd better get into a top md/phd program to have a chance at a notable research career...</p>

17

<p>
[quote]
well fine sakky, but you'd better get into a top md/phd program to have a chance at a notable research career...

[/quote]
</p>

<p>Uh, yeah, that is precisely my point. On the other hand, you don't really need to get into a top MD program to have a fine career as a physician.</p>

18

<p>I think the definition of "notable" is open to a lot of interpretation...</p>

19

<p>what i meant was that in order to get a phd from a top program (as an md/phd applicant) you're going to have to be at a top medical school as well (in most cases). </p>

<p>brm, i know you're an anti-prestige kind of person, but in science it matters as sakky has demonstrated. if i were faced with the prospect of earning a phd from a no-name school, i'd rather not get a phd.</p>

20

<p>I'm not saying that it doesn't, and I've been through this discussion with sakky before. I simply believes he overstates it (and time and time again, despite my asking for it, he stringently avoids putting any sort of quantifying label on the effect), and I think it's a touch ludicrous to avoid following your interests/passions based on prestige. But again, what you define as notable can vary a lot - so much of research is so extraordinarily specific these days that you find world renowned experts in all sorts of topics coming from all sorts of schools. And of course, creative, well designed research with significant findings and application will find it's way to publication and widespread use. There's certainly a difference between elucidating the effect of chromosomal microdeletions in the treatment of extramammary Paget's Disease vs. demonstrating the effectiveness of combination therapy in the relief of rheumatoid arthritis symptoms.</p>