Let’s Talk MD-PhD. Here’s What You Need to Know Before You Apply.

MD-PhD programs are competitive. Let's get some numbers out of the way: The 122 U.S. programs that grant an MD-PhD dual degree had a collective 2,091 applicants and 750 matriculants in the 2021 cycle. That means approximately 36% of applicants got into a program. (There are also 13 Canadian schools and the NIH MD-PhD Partnership Program to consider.)

Who should be interested in an MD-PhD?

If you're passionate about research but also want to work with patients in a clinical setting, the physician-scientist path might be right for you. A strong applicant should have a research background already. "Most MD-PhD candidates earn their PhD in biomedical laboratory disciplines such as cell biology, biochemistry, genetics, immunology, pharmacology, physiology, neuroscience, and biomedical engineering," according to the AAMC. But there are some programs that allow you to pursue non-laboratory interests as well (epidemiology, healthcare policy, etc.).

How can I improve my odds of acceptance?

There are fantastic MD-PhD-focused summer research programs for undergraduates that will amp up your resume and Work and Activities entries. The AAMC provides a helpful list of such programs. 

If you're an underrepresented applicant, The Gateways to the Laboratory Program of the Tri-Institutional MD-PhD Program focuses on helping underrepresented students prepare for MD-PhD programs. That program is open to freshman and sophomores only, but Tri-I offers other research opportunity programs for undergrads further along in their studies.

Wait, it's HOW long?!

On average, an MD-PhD program lasts eight years. Schools have different ways of covering both bases, but you might attend medical school classes for two years and then switch gears to a PhD program, and then post-thesis switch back to an MD-focus and do clinical rounds.

The National Institutes of Health (NIH) MD-PhD Partnership Training Program provides an accelerated track for recent college graduates, current medical students, and NIH Graduate Partnerships Program (GPP) students that can be completed in approximately four years.

Can I apply to both MD and MD-PhD programs simultaneously?

Yes. And it's a good idea since MD-PhD programs are so competitive. You can always apply to an MD-PhD program again after you have a year of medical school under your belt. The first year of an MD-PhD program is basically the same thing. If you're rejected by one school's MD-PhD program, they'll still consider you for their med school.

When should I apply?

At the same time as you would (or will) apply to MD programs. Ideally, you would have your application in decent shape by April. AMCAS opens in May for a sneak peek at the application requirements (you should already be familiar with those). You can submit your application in June. Your program will start the following year sometime between June and August.

Who quits MD-PhD programs?

A 2020 study on MD-PhD dropouts found that students who left programs either lost a passion for research, felt isolated or had a "lack of social integration" during training, had poor experiences with PhD-advisement, or had "unforeseen obstacles to completing PhD research requirements, such as loss of funding." A separate study found that a lot of post-docs suffer from imposter syndrome, which is the inability to believe one’s success is deserved. We know this information is disheartening, but it's good to know before you walk in, the reasons why you might consider walking out. Preparing yourself for these possibilities could prevent your early exit from a program.

Amidst Tech Turmoil, Physicians and Medical Students Use Social Media as a Platform for Medical Education and Combating Misinformation

In the summer of 2021, Surgeon General Vivek Murthy issued a report calling the distribution of medical misinformation through social media an “urgent threat to public health.” And this week, amidst a turbulent period for tech companies marked by extensive layoffs, a New York Times article identified a trend of social media companies divesting in the fight against misinformation. The article said, “Last month, the company [YouTube], owned by Google, quietly reduced its small team of policy experts in charge of handling misinformation, according to three people with knowledge of the decision. The cuts, part of the reduction of 12,000 employees by Google’s parent company, Alphabet, left only one person in charge of misinformation policy worldwide, one of the people said. And YouTube is not alone. The cuts reflect a trend across the industry that threatens to undo many of the safeguards that social media platforms put in place in recent years to ban or tamp down on disinformation ….”

Despite declining resources at social media companies, the medical community appears willing to step up to address the gap. In the past we’ve highlighted the efforts of medical schools to prepare students to take on medical misinformation, which ranges from large investments in institutions for research and study, to incorporating communications and social media techniques into the medical school classroom. There are also a number of physicians and medical students who are building vibrant social media communities for the purpose of proactively circulating accurate and understandable medical information. Below, we profile just a few of the physicians who are engaging audiences via social media with reliable and focused medical information. 

• Dr. Lisa Fitzpatrick, founder of Grapevine Media, creates content specifically geared towards a population that the mainstream health system tends to ignore. Her company, which creates “Ask a Doctor” videos and posts them on social media, seeks to provide medical information for people of color and/or those of low socioeconomic status. The videos feature doctors of color who answer medical questions in clear terms and with actionable advice for this audience, keeping in mind the challenges borne by those with low incomes. In an interview with NPR, Dr. Fitzpatrick noted that educating people won’t resolve all their barriers to good health, but she reiterated her belief that information can improve wellbeing. "To me, it's so clear all roads lead to trusted health information and understanding health and health care," she said. "But the challenge is how to make it obvious to everybody else." Dr. Fitzpatrick is currently pitching the video content to insurance companies as a means to improve the health of these hard-to-reach populations, while also reducing insurers’ costs.

• Joel Bervell, a 4th-year medical student at Washington State University School of Medicine, creates TikTok videos that highlight areas of racial bias in medicine. He told Medscape in an interview that he views himself as a “medical myth buster.” He educates his 600,000 plus followers on biases in medicine that can negatively impact care for people of color. Medscape provided an example of this goal by describing one of his TikTok videos, “... he explains that the equation used to measure kidney function (glomerular filtration rate [GFR]) has a built-in "race adjustment" that increases the GFR for all Black patients. ‘That overestimation could mean that 3.3 million Black Americans would have had a higher stage of kidney disease and missed out on care and treatment,’ said Bervell.” 

• StatNews described a joint effort by a group of physicians to support a twitter feed, “Health News Around the World,” with vetted, up-to-date health news and stories. 

• Dr. Will Bulsiewicz, MD, runs an Instagram account to provide his 462,000 followers with information on nutrition and promoting a healthy gut via his account “TheGutHealthMD”. His feed answers questions, reviews products, links to podcasts, corrects misinformation, and provides followers with indicators of healthy or unhealthy bodily functioning.

Related: Medical Schools Train Students to Combat Medical Misinformation

Medical Student Calls for Greater Transparency in Residency Match Data

National Match Day took place on Friday, March 18, 2022. According to the National Resident Matching Program, NRMP, it was a successful day, which “realized many significant milestones” including: 

• Consistent or increased match rates across applicant types: 

--US MD Seniors PGY-1 matched at 92.9 percent (+0.1 percentage points from 2021)

--US DO Seniors matched at 91.3 percent (+2.2)

--US citizen international medical graduates matched at 61.4 percent (+1.9)

--Non-US citizen international medical graduates matched at 58.1 percent (+3.3)

--And it was the highest match rate on record for previous year graduates, with US MD graduates matching at a rate of 50.5 percent (+2.3), and DO graduates matching at a rate of 53.6 percent (+9.3).

However, a recent article written by Nicole Mott, a student at the University of Michigan Medical School, and published in the New England Journal of Medicine, with a follow-up interview on MedPage Today contends that most current match reporting only tells part of the story. Mott is calling for the NRMP to reconsider how the match rate is calculated and to provide additional transparency into the match data. 

She starts by pointing out aspects of the current reporting that can be misleading or confusing. 

• The published NRMP “match rate” doesn’t include all specialties and programs; it excludes ophthalmology, urology, and military training programs. 

• The variation in match rates by applicant type should always be called out explicitly (as seen above) in recognition of the significant variation in match rates between applicant types: MD Senior, DO Senior, IMG (citizen or non-citizen), and graduates (MD, DO). The media often just reports one overall (or applicant type) match rate, which can be misleading and create inaccurate expectations among applicants regarding the likelihood of receiving a match. 

Next, she calls for a reconsideration of how the current match rate is calculated. Currently, the match rate is the proportion of “active applicants” who match into a participating residency program. However, an “active applicant” is someone who registers for the NRMP match and submits a rank order list. Mott points out that approximately eight percent of NRMP registrants withdraw or do not submit a rank order list and are thus excluded from the calculation. This includes participants who apply to programs but are not invited to interview and therefore do not submit a rank order list. This definition of active applicant likely inflates the match rate and underestimates the number of physicians who are unable to find a residency placement. 

She also provides suggestions for data that, if made publicly available, would help inform medical students as they make plans for the future.

• The number of applicants who register for NRMP match and don’t submit a rank order list, as well as the characteristics of this group. This would provide insight into potential inequities in the process, as well as applicant competitiveness for specialties. 

• The number and characteristics of unmatched physicians including those who only match into a preliminary first-year position. It would also be helpful to include information on the careers these physicians pursue and where they ended up, which could inform physician workforce planning. 

• Detailed match outcomes relevant to students going through the process, which could inform students pursuing a match, and also drive systemic improvements. This may include the specialty-specific matching positions on rank order lists, which could also inform decisions such as application or interview caps. 

Mott notes that the proportion of MD and DO seniors matched to their top-ranked programs has “subtly declined” over the past 15 years and, during the same period, the number matched to their fourth-ranked choice or lower has increased. Additionally, she calls out the “over-congestion” in the residency application process. Applicants are now applying to more programs than ever, just as programs are receiving more applicants. She recommends a review of the data to determine if caps should be placed on the number of applications and interviews. Similarly, she calls for more transparency from residency programs in their selection criteria. Programs should be explicit in the criteria they seek in an applicant, and applicants should be more specific about their goals and geographic preferences. 

Ultimately, better data, and more visibility into the match process will benefit students and residency programs, and allow each to make the best possible decisions.