Integration, Exploration, Flexibility
The Medical Scientist Training Program (MSTP) MD-PhD program provides a select group of medical students with an opportunity to pursue a training program designed to equip them for careers in academic investigative medicine. Individualization of the curricular and research programs of each trainee is the hallmark of the Program.
Training for a combined MD-PhD includes the same content encountered by students who pursue each degree separately, but the total time of training should be less than the sum of the time normally taken for each degree. To this end, students must plan their training carefully and commit to a rigorous and intensive period of study. The flexible curriculum at Stanford Medical School allows each student to satisfy the requirements for the MD degree and to pursue an independent research program. In what follows, we provide a general outline of what to expect.
First-year trainees meet with the MD-PhD directors soon after arrival to review the structure, timeline, and expectations of the program. In addition to their medical school coursework, MD-PhD trainees should begin a concentrated search for a thesis laboratory. Meeting with faculty, attending lab meetings, and attending the MD-PhD retreat will provide opportunities to narrow the search. MD-PhD trainees may also elect to take graduate school courses during the first few years of medical school. The MD-PhD Directors provide careful mentorship for this process, as choosing a thesis advisor is the single most important factor in the success of a student's training program. All faculty who are engaged in basic scientific research, and are members of the Academic Council, are eligible to serve as thesis advisors.
By the end of spring quarter of the first year, most MD-PhD students will have chosen a potential thesis advisor and will enter the laboratory for a full-time rotation in summer quarter. The goal of the summer project is to acquire an in-depth research experience that will serve as a thorough introduction to the laboratory, and a potential platform for developing a thesis project during the second and third year as curricular coursework draws to a close and full-time research begins. If the laboratory is not a good fit, most students pursue additional rotations during the Autumn and Winter quarters of the second year to identify a lab and a project. Most students remain engaged in research throughout the second year of medical school, so that beginning Spring quarter in the second year, students can embark full-time on thesis research and completion of their graduate course requirements.
As Medical School year 2 draws to a close, most MD-PhD students elect to take the final Practice of Medicine course (INDE 206), though some defer until after completion of the PhD thesis and before resumption of the clinical curriculum. The specific path for each student is determined after individualized advice from MD-PhD directors. MD-PhD students take Part I of the National Board Medical Licensing Exam at the end of Spring Quarter of their second year.
From Spring of the second year to Spring of the fifth year, MD-PhD students pursue full-time graduate training; in many ways, third year MD-PhD students engage a graduate track analogous to those pursued by second year traditional PhD students. The actual coursework and thesis requirements will depend on the Departmental or Programmatic affiliation chosen by the student. With the exception of laboratory rotations, MD-PhD students fulfill the same requirements as other PhD graduate students. Initially, there is significant overlap of classwork and lab work, and there is no scheduled time when a student moves from one training activity to the next.
On average, PhD thesis research draws to a close in the fifth year of training, allowing most MD-PhD students to complete both degrees in 7-8 years. Typically, students complete and defend their thesis the following summer and/or autumn, and re-enter the clinical curriculum in winter or spring quarter of their sixth year. The clinical curriculum requires 16 months of clerkships, so MD-PhD students who begin their clerkships in autumn of the sixth year will have sufficient time to take additional clerkships or pursue additional research projects.
Individualization of the Curriculum
The structure outlined above is a typical framework followed by most MD-PhD students. However, a hallmark of both medical and MD-PhD training at Stanford is curricular flexibility. For example, a majority of traditional MD students spread their training over 5 years, and pursue additional projects in research, public health, or community service. For MD-PhD students, there is a wide array of options that can be tailored to specific circumstances. Students whose research project requires acquisition and/or intermittent evaluation of clinical data may integrate completion of the PhD thesis and the clinical clerkships. In each of these situations, approval and monitoring of the curriculum is required by the MSTP governance subcommittee to ensure an optimal and productive training experience.