Introduction
 
I would like to start by saying CONGRATULATIONS. By simply picking up a copy of this guidebook or browsing this web site, you are beginning your quest toward becoming a medical scientist. Few are sufficiently driven or have the opportunity to pursue such a high-level of education that will span the course of many years. Initiative, motivation, and ambition will serve you well throughout the admissions process, medical and graduate education, and a career in medicine and the biomedical sciences.

But beware: this is not a journey for the faint of heart. The individual M.D./Ph.D. programs differ tremendously in various respects, but all require you to lead a double-life of sorts. Your education will incorporate the principles of both medicine and science, which can often seem at odds with one another. The training period is long, but efforts have been made to reduce the number of years to graduation. There are both physicians and scientists who share the opinion that one cannot do both medicine and science well. However, by all measures, the vast majority of those who received training through M.D./Ph.D. programs have journeyed onward to become highly successful physicians and scientific investigators.
 
 
Why this guidebook?
 
We decided to write a guidebook on M.D./Ph.D. admissions as a result of our experiences of applying to many of the nation’s programs. When we began the admissions process, we were completely in the dark. Some of us didn’t know these programs existed until well into our college education. Premedical advisors weren’t much help and most of the other premedical students at our universities were seeking the M.D.-only. There was plenty of literature available on regular medical school admissions in the bookstores, but a dearth of M.D./Ph.D.-specific material. Sporadic sites scattered throughout cyberspace helped slightly, but the information was usually geared toward one specific program and failed to give a holistic approach to the admissions process for M.D./Ph.D. applicants. Thus, it was truly trial by fire, with little guidance.

Confronted by the long and tedious admissions process, we were forced to search far and wide for information. How much less stressful the whole experience would have been if there was a good book to take you through the admissions process from start to finish, while giving you a little insight into the future. Why reinvent the wheel with every admissions cycle? A collection of helpful hints and suggestions, do’s and don’ts, interview tips, stories from current students about their experiences, and so on, would have reduced the anxiety associated with applying and given us insight into issues pertinent to M.D./Ph.D. applicants. We decided to write this guidebook in the hope that we could save future generations from some of the hardships we had to endure. Or at least demystify the application process. If this book in any small way assists you in deciding whether M.D./Ph.D. is for you and gives you some insight into what it’s all about, then we can rest easier at night knowing that we have helped others.

That being said, please do not rely on this text as a sole source of information. This guidebook is meant, in part, to act as a reference which can guide applicants through the admissions process. However, we also have interjected our own personal opinions, ideas, and quips throughout the text, in the hope that insights gained through experience will help you. Hopefully we have managed to strike a healthy balance between factoid and fiction, giving you ample material to continue your own investigations into the process, while providing some comic relief and wholesome entertainment value.
 
 
Into the new era: training medical scientists
 
In the past, if you were interested in the medical sciences, the typical route consisted of medical school, followed by postdoctoral research. Those interested in the basic sciences (i.e. understanding biological mechanisms) would attend graduate school and earn the Ph.D. However, due to the increasing specialization of scientific and medical fields during the latter half of the 20th century, scientists, clinicians, and lawmakers realized the need for specialized training in the biomedical sciences. To produce the next generation of physician-scientists who could bring scientific discoveries from the bench to the bedside, in 1964 the National Institute of General Medical Sciences (a division of the National Institutes of Health) created the Medical Scientist Training Program (MSTP).

Through the MSTP, students receive both graduate and clinical training, leading to the M.D. and Ph.D. degrees. Students typically receive full funding for their tuition and expenses, as well as a competitive stipend. Graduates from these and other non-MSTP M.D./Ph.D. programs have been steadily climbing the ranks at most academic medical centers and many are actively recruited for faculty or administrative positions. The growth of the biotechnology industry has also increased the demand for highly-trained medical scientists who can convert basic scientific discoveries into potential therapies for disease.

We are now at a time when the NIH is planning a dramatic increase in funding for the 30+ MSTPs, possibly doubling the size of the current programs. With major new commitments by the federal government and universities to train the next generation of M.D./Ph.D.s, we are truly witnessing an explosion of medical science. There has been no better time to consider applying for M.D./Ph.D. programs.
 
 
Uniqueness of M.D./Ph.D. admissions
 
For a long time, M.D./Ph.D. aspirants had been lumped together with medical school applicants in the admissions process. The fraction of M.D./Ph.D. applicants is typically very small relative to those not pursuing a combined degree. At most schools, M.D./Ph.D. applicants must go through the normal medical application process. Applicants must also complete a separate M.D./Ph.D. application, which consists of MCAT scores, GPA, undergraduate institution, one or more essays, and additional letters of recommendation from those who can assess the applicant’s potential for a career in research. Interview arrangements vary between programs, with some providing airfare, hotel accommodations, meals, and planned activities. M.D./Ph.D. applicants typically have many more interviews at each school than those pursuing the standard M.D. pathway. In addition, many unique factors come into play when making a decision on which program to attend.

You will see that there is considerable variation among programs in virtually all aspects of the application process, providing a formidable challenge for anyone who happens to want to write an M.D./Ph.D. guidebook. We have attempted here to focus our discussion mostly on aspects of the admissions process that are unique to M.D./Ph.D. applicants. By necessity, we have left out program-specific information that would swell the size of this text. Instead, we have chosen to convey general principles that apply to most, if not all, of the MSTPs and many of the nation’s non-MSTP M.D./Ph.D. programs. We have done our best to give a fair assessment of the “average” program’s requirements, expectations, application process, etc. For more specific information, we refer you to a list of web sites that we have included in the appendix. Remember, we serve only as your guides… it is YOU who must make the journey!
 
 
How the guidebook is organized
 
A quick glimpse at the table of contents will give you a pretty good idea of the layout of this guidebook. In the first few chapters, we discuss the interface between science and medicine and the purpose and goals of the MSTP and non-MSTP M.D./Ph.D. programs. We attempt to give you a reasonable sense of the pathway you are about to take. Then we guide you through the admissions process, focusing on general program requirements and M.D./Ph.D-unique elements of the application. As the interviews comprise an extremely important component, we attempt to provide both a general overview and specific advice with anecdotes that helped define each of our experiences during the process. We then discuss how admissions committees arrive at decisions, followed by the factors that will assist you in deciding between different programs.

We felt that leaving you at this point would be like leading you blindfolded toward the edge of a cliff. After all, there are various steps that you can take to prepare for the long journey ahead. During the program, there are ways you can make your life a lot less stressful. Hence, we have included advice on what to do once you are admitted to programs, including a discussion of the transition points between the medical and graduate portions of your training. We finish up with a treatment of your available options after graduation and examples of successful M.D./Ph.D career pathways.

Again, it is our sincere hope that through this guidebook, we might save you some of the headaches we experienced as applicants and thereby make the admissions process more palatable. If you have any suggestions about the content or organization of this text, how it might be changed to become more helpful, or if you are interested in contributing your unique experiences, advice, or anecdotes, please feel free to contact us. Good luck, fair weather, and we wish you well on your quest to become a physician-scientist.