Physician Scientist (M.D.-Ph.D.)

Do you like science and are you inspired by making new research discoveries? Then you should seriously consider pursuing a PhD in some area of the sciences. Are you drawn to clinical work and rewarded by the opportunity to offer a healing hand? Then certainly a medical degree would be the training you should seek. Some students have a passion for both careers and are conflicted, unable to choose between them. These students have a broad set of attributes and are ideally suited to become physician-scientists. In this exciting career, physician-investigators are trained to recognize new ways that clinical care benefits from research discoveries and are strategically poised to exploit state-of-the-art scientific approaches to address unmet medical challenges in the clinic. It is clear that in the 21st century these specially trained doctors, through positions in academic medical centers, research institutes and biotechnology companies, will be leaders in discovery and application of new knowledge about the mechanisms, diagnosis, and treatment of human disease. Talented students committed to this career should seek training in one of the MD-PhD Programs around the country. These programs are very competitive and only a few applicants are accepted each year. The good news is that as an undergraduate at Johns Hopkins University, you are fortunate to be training in one of the best universities in the country for placing the highest number of its students into MD-PhD programs. An excellent link for a wealth of information about MD-PhD Careers and training can be found at the American Association of Medical Colleges (AAMC) website. See a list below of helpful links:

• MD-PhD Dual Degree Training
• Helpful tools and information regarding medical MD-PhD programs
• Applying to MD-PhD Programs
• MD-DO/PhD Training Program FAQ

You can also check out the American Physician Scientists Association (APSA) Undergraduate Resources page for more information.

The curricular goals of medical school and graduate school are fundamentally different. Medical schools emphasize the learning and application of existing knowledge, while graduate schools emphasize the discovery of new knowledge. MD-PhD programs creatively mix the MD and PhD curricula, provide integration, and offer specialized MD-PhD courses to prepare aspiring physician-scientists. MD-PhD programs have a variety of approaches to integrate and streamline medical and graduate curricula, thus reducing total training time while maintaining a quality experience in both medical and graduate schools. The typical eight-year MD-PhD training curriculum is termed the “2-4-2” track, which reflects the number of years that a student studies in the three components of MD-PhD training: preclinical medical courses, PhD training, and finally clinical training. The medical education components are often similar among MD-PhD programs, since students must pass Step I and Step II of the United States Medical Learning Examination (USMLE) to complete the MD component of the training program. In contrast, graduate school activities vary, since PhD curricula and research opportunities differ by institution and faculty expertise. Thus research experiences obtained during graduate school training are one of the crucial differences between MD-PhD programs. The biomedical research experiences of MD-PhD trainees continue to expand beyond the “traditional” basic science disciplines to include computational-, bioinformatics-, engineering-sciences, and public health, to name a few of many diverse research opportunities. Overall, the goal is to train you for a successful research-driven career since many MD-PhD graduates spend more time in research than in the clinic.

If you are interested in applying MD-PhD, it is important to become involved in research early in your undergraduate years. Students often ask about the extent and quality of the research required. Generally, research experiences are extensive, with more expected than one finds for PhD-only applicants. Substantive research experiences are critical. By this we mean research projects where students are involved in hypothesis-driven experiments rather than simply serving as a “lab tech” (ordering supplies, making buffers, etc.) The best experiences are those where you have been actively involved in some experimental planning, trouble shooting, and data interpretation, i.e. taking some ownership of the project. While it is not necessary that you have publications from your work, ultimately you should have sufficient in-depth experiences to possess a deep appreciation of the opportunities and challenges of research careers.

A great advantage of attending Johns Hopkins University is the rich selection of research opportunities for undergraduates. These include laboratories in Biology, Biophysics, Chemistry, Neuroscience, Psychology, and Engineering on the Homewood campus, along with Departments downtown in the Medical Institutions and the Bloomberg School of Public Health.

To learn more about requirements for undergraduate research, how to find an undergraduate research position, and how to register for undergraduate research, go to the following sites:

• HOUR
• School of Medicine Research Opportunities
• School of Public Health Research & Centers
• Krieger School of Arts & Sciences Research Opportunities
• Whiting School of Engineering Research Opportunities

Seek out projects in areas that stimulate you and are rewarding. We want you to follow your passions as you participate in cutting edge projects in your field of interest. Do not forget that there are numerous awards available to fund research such as:

• Provost Undergraduate Research Awards

You should plan to be actively involved in full-time research during the summers after each academic year. You might continue on the research team you work with during the year. Alternatively, to broaden your research training, full-time research internships over the summer are encouraged. Many major medical institutions and several MD-PhD Programs offer excellent Summer Research Training Experiences for Undergraduates; a list found on the AAMC website. You can also check out the American Physician Scientists Association (APSA) Undergraduate Resources for research opportunities.

NIH also offers an exciting summer research internship program for talented undergrads.

You should consistently be involved in research over the years so that by the time you apply you will have a rich portfolio of research experiences. Remember no applicant has ever been turned down because he/she has too much research training.

In order to be a well-prepared applicant for MD-PhD programs, it is crucial to know what impresses their admissions committees. Because MD-PhD Programs are very competitive, strong academic credentials (GPA and MCAT) are essential. Beyond these metrics, most importantly, MD-PhD program admission committees are looking for students that have extensive research experiences, expecting a level of research beyond that required for PhD-only applicants as discussed above. The most successful applicants possess maturity, integrity and show concern for others, leadership potential, and an aptitude for working with colleagues. They are often involved in and committed to extracurricular activities, frequently occupying leadership roles in these endeavors. The most compelling applicants have a set of substantive clinical experiences that is best complimented by shadowing experiences with role model physician scientists in an academic setting. Thus, MD-PhD applicants are distinguished from PhD applicants in that they are committed to clinical activities. They are distinguished from medical student applicants in that they are very inquisitive and have a strong desire for scientific discovery to be an integral part of their careers.

Because of the unique set of experiences required of MD-PhD applicants, it is essential that you begin to focus early on your plan of study. (Freshman year is not too early!) Where to start? Once you are committed to exploring this training plan and have attended Pre-Health 101, make an appointment to meet with one of our advisors to discuss your goals and a timetable to achieve them. As part of our advising plan, we schedule workshops, small group sessions, and visits from MD-PhD program directors. Accordingly, you will be expected to attend and participate in these sessions to deepen your insights and to allow us to know you better.

Below is a timetable that approximates a reasonable schedule for the major milestones in your training and serves as a guideline for your planning.

First Year (where to start?)

• Attend Pre-Health 101
• Attend a fall or spring MD-PhD workshop for freshmen/sophomores
• Schedule one-on-one meeting with pre-med advisor
• Seek long-term research at the Hopkins Homewood campus or at the Hopkins medical campus
• Plan on conducting summer research
• Get involved in extracurricular activities- follow your passions!

Second Year

• Formulate a feasible plan for completion of coursework requirements for both pre-med and your major/minor
• Attend a fall or spring MD-PhD workshop for freshmen/sophomores (especially if you didn’t as a freshman).
• Continue with research; taking on more independence
• Set up clinical experience(s)
• Plan on conducting summer research; if applying for an internship, most applications are due in January or February
• Continue extracurricular activities; take on more responsibilities

Junior Year

• Continue research; gaining independence in the lab
• Plan on conducting summer research; if applying for an internship, most applications are due in January or February
• Attend a fall or spring MD-PhD workshop for juniors/seniors
• Start clinical volunteering if you haven’t yet
• Set a timeline and schedule for MCAT prep
• Consider taking the MCAT the summer before senior year

Senior Year

• Continue research; gaining more independence in the lab
• Continue clinical volunteering
• Apply for bridge year research jobs or research master’s programs
• Request letters of recommendation—especially from research mentors
• Submit primary AMCAS application as early as possible (late May).

Most schools participate in the American Medical College Application Service and offer the MD application as part of the MD-PhD application. It is important that you reference the AAMC website for applying to MD-PhD programs. Be aware that schools differ greatly in how admissions committees function. For example, some MD-PhD programs make completely independent decisions separate from their medical school. Others require admissions first into the MD program before consideration for the MD-PhD program. You will need to check with each school to get precise information on their admissions process.

Only U.S. citizens and Permanent Residents are supported by the pre-doctoral MD-PhD federal grants, however there are some institutions that accept international MD-PhD applicants.

Components of AMCAS Primary Application

• Official Transcript (complete all pre-med requirements!)
• JHU Committee Letter
• Document/describe activities, accomplishments, awards well—particularly research awards and presentations.
• Very important: Letters of recommendation from research mentors
• Three (3) Essays
  • MD Essay – a personal essay on why you want to be a physician.
  • MD-PhD Essay – why you want to pursue MD-PhD. Document life experiences that compel you to strive for a career as a physician-scientist.
  • Significant Research Experience Essay – Describe your research experiences, each in scientific detail. Also convey how you have matured a research scientist.

Secondary Application

After you submit your primary AMCAS application, the schools you select will send you their secondary applications. Submit these as soon as possible so your application can be evaluated for interview selection.

Since MD-PhD programs only interview a fraction of applications received, the early applicants have a much better chance of receiving interviews. Interviews take place September through February. Final decisions are announced from November through March. You need to check each program for specific information on these dates as they vary. All programs offer second visit opportunities that generally take place in March or April. Once accepted you will have ample opportunity to acquire the information you need to make an informed decision about the best program for your training. Final decisions must be made by April 30. MD-PhD Programs start in the June to August time period.

This advice is offered by Brian P. Sullivan, Executive Director, Medical Scientist Training Program, Washington University in St. Louis:

MD-PhD interviews attempt to assess the candidate’s potential to become an independent researcher. To do this, interviewers will first typically ask the candidate to describe their research projects. This is not a presentation, so the 12-minute talk with a 3-minute Q&A they gave at the student research symposium will not be enough to prepare them. Presenting at lab meetings is also insufficient; unlike the candidate’s PI, the interviewer will often have little, if any, specific knowledge of the research. The best practice is for the candidate to meet with other scientists & engage in a give and take on the candidate’s research. This forces the candidate to learn how to explain their work to someone who is not an expert in the candidate’s project, but who, nonetheless, is very smart. The interviewer will evaluate them on basic scientific knowledge, but they are not expected to know everything. More important is how the candidate handles a question: do they think clearly? Are they able to assimilate new information and engage in a lively discussion?

Another aspect of the interview is the interviewer describing their own work to the candidate. The candidate is evaluated on the basis of their ability to follow the research description and ask insightful questions. Intellectual curiosity is very important, and successful candidates are able to follow research descriptions outside their immediate field and ask relevant, relatively sophisticated questions. This is challenging, but individuals who spend a good deal of time talking about science with folks outside their lab usually do well.

Bottom line: candidates should immerse themselves in research & take every opportunity to talk about their work with others.

Here are a few tips I have gleaned over many years of observing MD-PhD admissions:

• Do not be afraid to say “I do not know.” It is far better to admit a knowledge shortage (which can be filled by exposure to source materials) than to pretend you know more than you really do. For obvious reasons, the ability to know & accept your limitations is important in science, and critically important in medicine.
• Do not attempt to cover all aspects of your work; there simply is not enough time. Pick the project that is most interesting, and best shows your ability to carry out independent work. Ideally, these should be the same project. Interviewers want to determine your ability to make intellectual contributions to the project, so you need to demonstrate your ability to think creatively, cogently, and deeply. A 10,000-foot survey of all your research experiences is not good enough. Leave the elevator talk in the elevator.
• If your name is on a paper, even as 10th author, you better be familiar with the entire paper. If you are fuzzy on the details the interviewer will wonder about your intellectual curiosity.
• Do not aggrandize your accomplishments.
• State the hypothesis. You would be amazed how many candidates fail to do this.
• Focus more on ideas than details. We want to know how you think, not that you are good at regurgitating facts.
• Ask your interviewer about her/his work.
• Ask thoughtful questions about your interviewer’s work.
• Remain engaged when your interviewer describes her work, even if it is deadly boring. She thinks it is the most interesting stuff in the world, and if you seem disinterested, she will attribute that to your thick headedness. (Tip: avoid foods that spike your blood glucose; post-prandial interviews are typically the candidate’s worst.)
• Be nice and appreciative towards the staff people you interact with. Many a brilliant jerk has been brought low by a mistreated secretary. Brains are plentiful in this business, but truly nice people are precious.

Finally, remember that this is an MD/PhD interview, not just a PhD interview. The student must be an outstanding candidate for med school, and must have a compelling rationale for pursuing combined degree training.