To the Editor:
The MD and PhD dual-degree program originated at Case Western Reserve University in 1956, and went on to become the first National Institutes of Health Medical Scientist Training Program. Sixty-one years later, MD/PhD programs are offered at more than 90 institutions in the United States, with tremendous success in training some of the sharpest minds in the world.1,2 Unfortunately, negative opinions about the value of dual-degree training persist within society at large,3,4 and among physicians and physicians-in-training.
A sentiment of futility is rampant, fueled in some instances by statements made by accomplished clinicians. Often, the misconception is that the MD alone is sufficient to “do it all”—from seeing patients to running a successful research enterprise. While the physician–researcher has long been a contender in biomedical research, the rapidly expanding catalog of scientific knowledge is continuing to supersede this paradigm of discovery.5 In fact, science, medicine, and technology have advanced to an ever-rising zenith, such that MD training alone no longer prepares aspiring researchers for competitive research careers. Tell a PhD to go see a patient, and most would acknowledge that their training has not prepared them for, among myriad other things, obtaining medical histories or managing adverse reactions. The same applies to MDs who, without additional research training, would be ill prepared to succeed in grant-facilitated intellectual pursuit. As noted by Harding et al,1 the integration of MD and PhD training allows for creation of a rigorous foundation for future biomedical research.
Physicians will continue to excel on the wards and in operating rooms, and to lead the way in day-to-day clinical care, while MD/PhDs will continue to advance the frontiers of medical knowledge: describing subcellular mechanisms, evaluating genome complexity, and unraveling the secrets of human behavior. In pursuit of their careers, and with a keen understanding of two distinct but overlapping cultures, physician–scientists will bridge the gap6 and utilize their lengthy training to navigate the increasingly complex arenas of medicine and science.
Ikeotunye R. Chinyere
First-year medical student, University of Arizona, Tucson, Arizona.
Kenneth S. Ramos, MD, PhD
Professor of medicine, associate vice president for precision health sciences, and director, MD–PhD Program, University of Arizona, Tucson, Arizona; email@example.com.
1. Harding CV, Akabas MH, Andersen OS. History and outcomes of 50 years of physician–scientist training in medical scientist training programs. Acad Med. 2017;92:13901398.
2. Brass LF, Akabas MH, Burnley LD, Engman DM, Wiley CA, Andersen OS. Are MD–PhD programs meeting their goals? An analysis of career choices made by graduates of 24 MD–PhD programs. Acad Med. 2010;85:692701.
3. The disposable academic. The Economist. December 16, 2010. https://www.economist.com/node/17723223
. Accessed April 4, 2018.
4. Smith N. A PhD in economics is the only one worth getting. Quartz. May9, 2013.
5. Bonham AC. MD–PhD training: Looking back and looking forward. Acad Med. 2014;89:2123.
6. Rosenblum ND, Kluijtmans M, Ten Cate O. Professional identity formation and the clinician–scientist: A paradigm for a clinical career combining two distinct disciplines. Acad Med. 2016;91:16121617.