MD–PhD Programs Should Encourage and Support Training in Nonbiomedical or Clinical Sciences

To the Editor:

I wholeheartedly agree with the article by O’Mara and colleagues¹ which proposes MD–PhD training outside the conventional biomedical and clinical sciences. Their article comprehensively discusses the sound rationales for this approach to producing physician scientists as leaders in the battle against the health problems that cannot be solved in a laboratory. MD–PhD student research in disciplines such as social science, public health, epidemiology, and psychology promote diversity in training, skills, and clinical perspectives which, in turn, may encourage multiple career paths. At the University of Queensland (UQ) School of Medicine, we have observed additional benefits of encouraging interdisciplinary research as well.

These disciplines are directly relevant to clinical care, and their research often fills the vital gap necessary to clinical decision making. The UQ School of Medicine, as part of its Clinician Scientist Track (CST), has encouraged medical student research in disciplines nontraditional to medical science since 2011. The CST is a program that allows outstanding students to undertake a research master’s or a PhD either concurrent with or intercalated into their medical degree. The combined enrollment of MD–master’s and MD–PhD students to date is 66. Of these, 43% are pursuing clinical research and 39% biomedical wet lab research. However, 18% of students have chosen projects within epidemiology, health services, statistics, and environmental studies.

There are advantages to our students undertaking a variety of research. A practical advantage is the lower cost associated with some methodologies in these disciplines which generally do not require expensive equipment or consumables. Another is raising the awareness of the variety of research and its infinite applications in health care. Many medical students typically think that research means either laboratory work or a clinical trial. Discovery, however, begins with curiosity, and encouraging our students to satisfy their curiosity through the most appropriate scientific approach to a problem helps develop different clinical perspectives as well as different research skill sets. Developing a more holistic outlook on clinical problems helps illustrate the ubiquitous role of research in medical care beyond just the clichéd “bench to bedside.”

As noted by O’Mara and colleagues, the greatest obstacles to health equity are those on a societal or behavioral scale. Wet lab research cannot address these complex community and environmental issues. The synergy between basic research and research in disciplines such as epidemiology, statistics, sociology, health services, economics, education, and public policy represents true translational discovery.

Diann S. Eley, PhD, MSc
Director of MD research, University of Queensland School of Medicine, Brisbane, Australia; [email protected]