Sustainability of MBPhD programmes
Editor – The decision to enrol in an MB/PhD programme can be daunting for most students at the start of their medical degree. Exceptions may well be those who have previously performed research or those who come from a family background of academia or research. Asking students to commit themselves to a defined pathway at the start of their medical course is only productive if there are clear professional pathways for them to follow on graduation, such as the programme at Harvard University.1 Both the Cambridge and UCL programmes (Clin Med December 2012 pp526–9 and pp530–4) have been successful in terms of completion rates, as the students are selected on the basis of showing evidence of academic aptitude at tertiary level.
Various models of this have been introduced in Australian medical schools, with less successful outcomes. In one of our most prestigious medical schools the model has evolved twice. In the original plan, 30 students were selected into a specific MBBS/PhD stream at the time of entry to medical school. In the first cohort, none of the students commenced the full time research component of their programme, instead appealing to complete their clinical studies with their peers. This was then changed to an average of five students enrolling in the combined program with appropriate financial and academic support.2 However, as these graduates still had to enter the same pathways for postgraduate training as all other medical graduates, suitable potential students progressively lost interest. They also had competition from colleagues who undertook higher research degrees in their chosen specialty topic towards the end of their specialty training. This medical school has now removed the MBBS/PhD entry pathway and now enrols all their students in the MBBS programme with the option of undertaking research during their course, leading to a master's degree, with the potential to expand this for the few who have the aptitude and ability to do so.3
In summary, encouraging high-performing students to enrol in a combined professional and research medical degree can only be a sustainable way to develop skilled clinician scientists if postgraduate pathways to academic medicine are clearly defined. However, this pathway should be flexible to admit doctors who opt to undertake research during their postgraduate training.
Footnotes
Please submit letters for the editor's consideration within three weeks of receipt of Clinical Medicine. Letters should ideally be limited to 350 words, and sent by email to: clinicalmedicine{at}rcplondon.ac.uk
- © 2013 Royal College of Physicians
References
- ↵Harvard Medical School. 5.01 MD-PhD Program. http://hms.harvard.edu/departments/office-registrar/student-handbook/5-combined-degree-programs/501-md-phd-program [Accessed 1 February 2013].
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- ↵The University of Sydney. Master of Philosophy in conjunction with Sydney Medical Program. http://sydney.edu.au/medicine/future-students/medical-program/combined-masters-programs/philosophy.php [Accessed 1 February 2013].
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