Career Paths for MD-PhD Graduates

According to a recent study from the National Association of MD-PhD Programs, about 75 percent of U.S. MD-PhD graduates are in academic medicine or pharmaceutical company positions that make use of their interests in both patient care and research.

A MD-PhD physician-scientist is typically a faculty member at an academic medical center who spends 70-80 percent of his or her time conducting research, though this can vary with specialty. Their research may be lab-based, translational, or clinical. The remaining time is often divided between clinical service, teaching, and administrative activities.

Thus, most MD-PhD graduates pursue a career where most of their time is spent on research. This research typically is conducted at academic medical centers, research institutions like NIH, or in the pharmaceutical/biotech industry. With career advancement, many MD-PhD graduates ascend to significant leadership roles in academic medical centers, industry, government and private organizations, reflecting their broad experience in health care and research.

Training Path for the MD-PhD Graduate

The career of each MD-PhD graduate is uniquely based upon research and clinical interests, but follows the general path:

• MD-PhD training: 7-8 years (See Education and Training for more information)
• Specialty and subspecialty clinical and research training (residency/fellowship): 3-7 Years

Residency and Fellowship Training

Most MD-PhD graduates pursue residency and fellowship training and find that their MD-PhD training makes them particularly attractive to residency programs at top academic institutions. In the past, MD-PhD graduates traditionally entered residency programs in medicine, pediatrics, or pathology. However, the clinical specialty choices of current graduates are more diverse, with many graduates pursuing residency training in neurology, psychiatry, radiology, radiation oncology, and even surgery and surgical specialties.

Research Residency Programs

It is important to note that there are a growing number of "research residency programs" that have been specially developed to foster the career development of physician-scientists.

After completing their specialty clinical training (e.g., in medicine or pediatrics), most physician-scientists pursue subspecialty clinical training (e.g., cardiology or hematology-oncology) and postdoctoral research that typically combines protected research time with intensive clinical training. A number of residency programs around the country offer highly structured programs in which research is fully integrated into the clinical training.

These programs differ in their overall structure, but all offer the following:

• Shortened residency (specialty) training; in general, the integrated programs allow trainees to shorten their residency by one year, depending on the field of specialty
• Integrated research and clinical training; programs usually offer mentoring for trainees to choose a lab early in their training process, so they can embark on their research right away when they start full time in the lab
• Guaranteed subspecialty fellowship position in the trainee's desired field; this is not offered at all institutions
• Special financial support; a few combined programs also offer support both towards salary and research

Time Commitment

The time commitment required to complete the dual degree and subsequent specialty training can be substantial. Thus, you should thoroughly explore whether combining biomedical research and clinical practice is the right path for you. Despite the time commitment, it is important to recognize that professional progress following MD-PhD training can be swift and the years of training truly represent a time of great personal as well as professional growth.

The MD-PhD graduate is unique within medical education, representing about 3 percent of the entire graduating medical school class in the United States. In 2006, there were over 16,000 MD graduates; about 500 of these earned the PhD degree as well.