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Academic Medicine:
doi: 10.1097/ACM.0b013e31819a830f
Letters to the Editor

Restructuring MD–PhD Programs: Career Training or Broad Education?

Whitcomb, Michael E. MD

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Editor-in-chief of Academic Medicine (2002-2007); (mewhitcomb@hotmail.com).

In Reply: Ahn and colleagues claim I suggested that “the lower than expected percentage of students desiring research is a function of time away from the lab.” In fact, I simply presented the findings Ahn and colleagues reported in the same issue of the journal in which my editorial appeared and made no assumption about the reasons for their findings. Second, they claim that I suggested that those holding MD–PhDs should “perform more lab research as part of their profession.” In fact, I made no such statement, but I did raise that issue indirectly by inferring that the success of MD–PhD programs should be judged by analyzing the research productivity of program graduates.

Ahn and colleagues disagree with that position. They propose that the “duty of dual-degree programs” is to provide the education needed to allow MD–PhDs to “see complex problems from different perspectives—to be innovators, teachers, integrators, and leaders.” And they seem to believe that by accomplishing those objectives, society’s investment in the programs is realized. Their opinion is simply not congruent with the stated purpose of the Medical Scientist Training Program (MSTP), which is to train physician scientists who will participate in the conduct of biomedical research. To the degree that a significant percentage of program graduates do not follow that career path, the goals of the program are not being met.

Andriole and colleagues1 recently presented data suggesting, as Ahn and his colleagues did, that many MD–PhD program graduates may not plan to pursue careers that are predominantly research based. They proposed that a mechanism is needed to document the career paths of program graduates to determine the extent to which the goals of the programs are being met. In an accompanying commentary, Rosenberg2 echoed Andriole’s concerns and called for tracking program graduates’ careers to provide more accountability for the public investment in the program. To suggest as Ahn and colleagues do that the true purpose of the program is to provide “exceptional multidisciplinary education, not career training” distorts reality.

The main issue of my editorial was that the MSTP must be redesigned if it is to truly train physician scientists who will participate in a modern research environment. The logic for that argument stands uncontested to date: No one would design a PhD program to produce nonphysician research scientists by building into the program a five-year period away from the research laboratory after the doctoral students completed their PhD studies, as is the case with the MSTP. This is the critical message of my editorial. This is the issue that those concerned about the production of physician scientists need to address. I wish Ahn and colleagues had focused on that issue in their letter, rather than on the far less important issues they chose to address.

Michael E. Whitcomb, MD

Editor-in-chief of Academic Medicine (2002-2007); (mewhitcomb@hotmail.com).

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References

1 Andriole DA, Whelan AJ, Jeffe DB. Characteristics and career intention of the emerging MD/PhD workforce. JAMA. 2008;300:1165–1173.

2 Rosenberg L. MD/PhD programs—A call for an accounting. JAMA. 2008;300:1208–1209.

© 2009 Association of American Medical Colleges

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