How to Get Into an MD/PhD Program [Episode 453]

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Applying to MD/PhD programs? Here’s what you need to know

Dr. Herman “Flash” Gordon, an Accepted consultant and former chair of the University of Arizona Tucson College of Medicine’s admissions committee, provides a deep dive into the application process for MD/PhD programs, highlighting crucial preparation tips.

Interview with Dr. Herman “Flash” Gordon [Show Notes]

Welcome to the 453rd episode of Admissions Straight Talk. Thanks for tuning in. Do you want to get accepted to medical school this cycle? We have a webinar that’s just perfect for you. You’re invited to the webinar titled Start Medical School in 2023: How to Get Accepted This Year. Watch the webinar here.

Our guest today is Dr. Herman AKA “Flash” Gordon, Accepted consultant and former chair of the University of Arizona Tucson College of Medicine’s admissions committee. Dr. Gordon also served on PhD admissions committees while at the University of Arizona. Since joining Accepted, he’s guided clients to acceptance at MD, PhD, and MD/PhD programs, sometimes to several acceptances at those programs. Dr. Gordon has been on Admissions Straight Talk several times in the past, and it’s my distinct pleasure to have him on again today.

We’re going to focus this show on MD/PhD admissions. How and when did you get involved in med school admissions and then specifically the MD/PhD world? [1:58]

I started on the University of Arizona admissions committee about a decade ago. It was one of these things that’s like, “Oh, it’s your turn to take on a big service job.” I knew nothing about what I was getting into, although I was teaching med students. It was interesting. I very quickly learned that it was actually a great committee and that for everyone who was on it, they felt like it was the best service they had ever done. It’s a major responsibility, you’re determining people’s futures, you’re shaping the class that you’re going to teach, it’s just a great opportunity. And you’re doing positive things; it’s not like a disciplinary committee or something like that.

How long were you the chair of the committee and roughly how many applications did you evaluate in that period? [3:06]

I was on the committee for four years, and I was chair for the last two years. At the committee level, about 600 applications make it through the interview and then go on to the full committee. So that’s 600 a year of which, as chair, you have to look at all of those. But when you’re on a subcommittee, or at least we ran with subcommittees, then you get about a fifth of those, so 120 or so. It’s a lot of work. For a typical admissions committee member, it’s about 200 hours which is a lot. As chair, it’s probably closer to 600.

Although I had done PhD admissions in neuroscience, I was new to how the MD/PhD admissions worked. Different schools do it differently. At the University of Arizona, there was a separate MD/PhD committee and both that committee and the regular MD committee had to accept the applicant. So it was this sort of parallel process. At some schools, the MD/PhD committee has more autonomy, you have an allotted number of slots and get to fill them however you want.

But there is a very large component of both sides having to accept you. They have to accept you as a clinician, and they have to accept you as a researcher.

Are there different kinds of MD/PhD programs? And if so, what are some of the major categories? [4:54]

I think the biggest distinction is whether it has an MSTP or not. The MSTP is an NIH funded program that basically pays for a certain number of students to be in an MD/PhD program each year, so that gets you a full ride. While you are doing your research component, you’re getting a stipend as well as having your tuition paid so you’re acting as a graduate student during that time.

There are other programs which don’t have an MSTP. They all aspire to have an MSTP because it’s a load of money and it allows you to attract the best students. But still, there are a lot of programs which are excellent, which maybe they’re newer or smaller, and so they haven’t gotten to the point where they can get one of these coveted MSTP grants, but they’ll try to fund their students or at least some of their students in a similar way. I don’t know that I would call that much work a free ride but a lot of my MD/PhD clients are only applying to MSTP programs. There are opportunities outside of that, which can be very good MD/PhD opportunities nonetheless.

Would those non MSTP programs also provide at least some funding in order to compete? [6:47]

Typically, yes. That’s the only way they can compete.

Who in your opinion should consider the MD/PhD, whether it’s MSTP or non MSTP? [6:57]

People who are very motivated to do a lot of work. It’s a long haul. Typically, eight years, because it’s the full four years of med school, and four years for a PhD is quick. But to a certain extent, you can use some of your rotation times in med school and somewhere between first and second years to get going on your research. There’s a little bit of overlap, but not a whole lot.

Back to who should consider it, I find that even the successful MD/PhD clients tend towards one side or the other, towards the clinical side, but they want to do research to support their clinical work or probably frequently, they’re more on the research side, but they want the total involvement of being able to apply their research to the patients that they’re working with.

Oftentimes, like a rare disease might have an MD/PhD specializing in it so they’re treating the patients, and in working with the patients, they’re also figuring out what are the concerns, maybe there are symptoms that people aren’t really that aware of, but as you work with these patients, you start to realize it and that becomes a research topic. Then you also see the results of your research being applied to the patients and hopefully with positive results, but then you get feedback from the patients. So that kind of deep interaction can be very successful on both sides, both on the research side and on the clinical side.

I usually think of medicine as an applied science so an MD/PhD is doing both sides. They’re figuring out the underpinnings that can then be applied.

Once a student decides that he or she wants to pursue the MD/PhD program, what should they consider as they go about the task of selecting where to apply? How should they research the programs? [9:26]

People who are applying for the MD/PhD have to have a lot of research experience, and that will probably include at least two publications. Being one of the first three authors would be good. They probably have about 2,000 hours of research experience before they’re applying for the MD/PhD. They probably have spent three summers in labs, and they’ve been getting credit for continuing to work in the lab throughout the year. They may be spending at least 15 hours a week, every week in school, and then 60 hours a week in the summer. It adds up and before you know it, there are your 2,000 hours. It’s people who have demonstrated a very serious commitment to research.

Everybody who’s getting selected has that kind of background, so it’s not like you can say, “Oh, I’d like to do research in addition to my MD.” If that’s the case, you don’t want to go down the MD/PhD path. There will be plenty of opportunities to do research as an MD. There are special programs almost all med schools have where they pay you for the summer between first and second years to do eight weeks of research and that can lead to ongoing opportunities throughout the rest of your medical education. Some of those people end up being very significant clinician scientists, even without the PhD.

How should a student choose where to apply? [12:30]

Oftentimes, people get really into their undergraduate research, and that helps to shape what they want to get into as a research field. They’ll know the kind of labs that are doing the work that they’d like to get into. That’s actually a great opportunity that you should leverage in your application, so try to contact the lab. Maybe you’ve already been in communication with the lab, maybe the lab you’ve been working in has a collaboration with this other lab. And it’s like, “Oh yeah. I’d love to go to this lab at UCSF and work on this other aspect of the research.” Maybe it’s moving from cell culture to an animal model, but related diseases. There can be very good reasons for wanting to develop your research career at a particular location. So that’s sort of the best case scenario, right? Oftentimes, you just apply to places because the stats and the reputation are appropriate to what you’re looking for. And that can work out too. But I find that the closer your connection, the better your chances are of getting that interview from that school.

In addition to the typical AMCAS application and secondaries, applicants have to write an MD/PhD essay and a significant research experience essay. Can you tell us kind of what the difference is? How long are they? When should they be submitted? What is the purpose of each one? [14:10]

You sign up for AMCAS, usually it opens a month before the first possible submission date. And you click a button that says MD/PhD. Then two things become available to you, the MD/PhD essay and the significant research essay. Otherwise, the AMCAS is the same.

Those essays have to be loaded in the AMCAS when you click the submit button. So the regular personal statement’s 5,300 characters. You can talk about your desire to do research in that personal statement. You don’t have to, but you do have to put it in the MD/PhD essay. The MD/PhD essay is 3,000 characters, so it’s relatively short, say, about three paragraphs. It is absolutely crucial, and it’s probably the hardest one for MD/PhD applicants to write. The goal of this essay is to express why you need both degrees. I would say, my clients work three weeks on it. It’s not three weeks solid, but you have to go through many versions and kind of rethink it.

They’ll start out knowing at some level that they want to be a clinician scientist, but they haven’t really got it to the point where they can communicate that to somebody else. Obviously, there’s the whole bench to bedside part of this as well where you want to be able to take the work that you’ve been doing and deliver it to the patient. It does happen, but not necessarily. There are physician scientists too who are working on things in the lab that are still very far removed from what’s going to happen with their present day patients.

As always with the AMCAS, stories and vignettes really help because a picture is worth a thousand words. A little vignette is worth a lot of an essay. I have a successful MD/PhD client this year who was simultaneously working in the ED where there were lots of COVID patients and working in the lab on how COVID might be affecting the brain and trying to work out the mechanism of that. That’s incredible, it’s like you’re on both sides of the fight at the same time and she was able to include that as part of her essay and part of her motivation to keep doing this kind of work.

Significant research is very similar to what you would write for a PhD committee. So it’s 10,000 characters. It should be a one paragraph summary right at the beginning, sort of your path, what your interests are, where that came from and how that’s developed. Then you go through and have sections on each of the labs or each of the research projects that you’ve worked on. I find, because this is such a long essay, it works to have little titles. So the title is the lab, the dates you were there, the PI, and the research topic. Then you talk about what you did, not getting too into the technical details, but getting into the questions: Why was this important? How did your research fit into the larger scheme of things?

Then at the end, some sort of conclusion, “We were able to determine this.” Or, “It didn’t work because… If I were to have continued on this project, I would’ve tried pursuing this other approach.” Something like that. Then ideally, you’ve got a publication at the end. It could be just a poster. That’s fine. But if it’s a reviewed journal article, that’s great. That’s the end of the section. Then the next section, title, the time period, “This is what I did. This is why it was important.” You go through and you squeeze all of that into 10,000 characters and for somebody who’s done their 2,000 hours of research time, the challenge is squeezing it in. It’s not filling out the 10,000 characters.

Obviously, the regular personal statement in AMCAS and the experiences, most meaningful experiences, activity descriptions, would probably present the clinical side of you. [21:11]

It should still be a mix. You’ve got three most significant essays. And it’s probably be your most significant clinical, your most significant research and your most significant community service.

What are some of the critical differences between the regular MD application and the MD/PhD admission in terms of how the application is evaluated? [21:51]

So some schools at the AMCAS level allow you to choose whether you want to be considered for both the MD and the MD/PhD programs. Typically, the MD/PhD program is the more competitive one. The idea is if you don’t make it into the MD/PhD, would you still consider being accepted into the MD program? Again, you still have research opportunities as an MD. Occasionally, it’s just so obvious that an applicant is going to be a good researcher, especially after their first summer of research so sometimes they’ll get picked up for the MD/PhD program. That happens, it’s not frequent but I have seen it happen. There are reasons, even if you want to be a very serious clinical researcher, for you to accept an MD program.

That’s the first step, are you being considered by both programs? I would say for most schools, there’s always a separate MD/PhD committee. It’s not the regular MD committee that determines the MD/PhDs. There are typically MDs, PhDs and MD/PhDs on that admissions committee, and they will evaluate the research side. It’s almost like a PhD review. But in addition, they will ask things like, “Why do you need both degrees? Because we could just take you into our PhD program. Why do you need to go through this dual pathway?” On the MD side, if you check the box for being willing to be considered as an MD, they’ll put you through the regular MD process and if you come out of it with acceptances by both committees, then you’re an accepted MD/PhD. It does happen sometimes and I had to negotiate this as chair, where the MD/PhD committee would pick somebody that the MD committee really didn’t want. So the MD side was like, “It’s not clear that this person really wants to be a clinician.” and there had to be some negotiating about that and what you end up offering to the student. It does happen both ways. One or the other committee will accept. Ideally, both committees accept.

Did it ever happen that a student was steered to just straight PhD? [25:04]

That gets a little complicated. If a student applies to multiple PhD programs at a campus, those programs will talk to each other. They’ll all do a pre-review and they’ll decide where that student would have the best fit. So they’ll say, “Oh, this student should be in biochemistry” and then the rest of the process continues for that application going through the biochemistry department only. It’s not like that can happen with the MD/PhD so they’ll have to reject a client and tell the client, “We’d love to have you as a PhD student” and then they have to reapply the next cycle.

How do you recommend applicants avoid the twin traps of having an application reader question why they need both degrees? [26:40]

It’s funny because the students go through this whole process and articulate themselves, and in the end, from the admission standpoint, you can just read it and in one pass you can know, this person is a MD/PhD. You can just feel it.

You feel the passion on both sides. It’s not like there’s any trick or code word that they’re using, it’s the big picture. You just see it and know this person has to do this, they’re just so driven. You pick that up from the letters of reference as well. Comments like, “If I happened to come in at 10 o’clock at night, they were in the lab.” That’s what you want to read on the committee side.

What’s always great on the clinical side is that sort of one-on-one caring for people. If you have a witness who can attest to that in a letter, that goes really far.

What if you have somebody who had some rough spots academically, maybe in the first couple of years. They got their act together in their junior and senior year, they got really good clinical exposure, but their GPA is what their GPA is. Do you have any advice for that kind of person, who really would like the MD/PhD? [28:15]

They can be successful getting into MSTP programs. About 10 years ago, there was a study done on successful biology PhDs. This included biochem, micro, everything biology. What they found was that the metrics coming out of college were very bad predictors of successful scientists. They’d get people who were good with books but were terrible in the lab. They didn’t like the day-to-day grind, or they weren’t creative, they liked all the book stuff. Who knows what their problem was. But what turned out to be the best predictor was the letter of reference from their undergraduate research PI. If it said, “This person’s great, they’re a great problem solver, they’re on two publications, they were instrumental to this project, and this is the contribution that they made” then they’re going to be a great PhD candidate. That works on the MD/PhD side as well.

So I’d say for a strict PhD, you can take people who were pretty bad undergraduates and make them into successful scientists. You can’t do that for MD/PhD. They have to have their wits together so that they can get through school. It’s just intense, and you have to keep at it, and you have to have all the school skills but you don’t have to have as high a grade. You look on MSAR these days, and the medians are like 3.85 in most schools. It’s like, “Really?” That’s really high. I can’t believe that there aren’t good doctors with GPAs a lot lower than that.

With MD/PhDs, I see the GPAs a bit lower. In part, they were in the lab all the time. So they weren’t so focused on, “Oh, I’ve got to get all A’s.” They were like, “I’ve got to learn this material, but I need to get back to the lab because my experiment needs something done on it.” I think that there is a certain… I don’t want to use the word tolerance, but a knowledge that the GPA is not as essential on the research side. What can happen is the MD committee may say, “Well, yeah they’ve got all the credentials, they’re a good researcher, they’re good with patients, but their GPA is a little on the low side,” and the two committees get together and they negotiate. Usually, the MD/PhD wins in a case like that.

What role does the MCAT play in MD/PhD admissions? Is there a minimum GPA or MCAT? [32:32]

MD/PhD is really hard to get into. It’s very competitive and there aren’t that many slots. If it’s you and some other candidate who has better metrics, probably the person with the better metrics is going to get the acceptance. But that said, I think the metrics can go a bit lower for MD/PhD. A 3.6 GPA and 512 MCAT are pretty reasonable metrics but given the competitiveness, I think you want to at least be at that level. I’ve seen with MD/PhD, just like with MDs, that the MCAT is all important. The higher your MCAT, the better your chances are.

This is my seventh year working with Accepted and this is the thing I’ve really learned working with clients applying to med school: the MCAT is the single biggest factor, I’m sorry to say. The AAMC has been lobbying against it, even though it’s their tool but yeah, 512 and up.

What about MD/PhD applicants who didn’t make it and are thinking of a reapplication? What should they do if at first they don’t succeed? Should they try, try again or try something else? [34:34]

For MD/PhD, just like MD, not making it one year does not damn you for a reapplication. But just like MD, you want to figure out what was weak in your previous application and address it in your preparation for the following year. I think it’s often the case where your clinical experiences just aren’t strong enough. Sometimes people go through the motions, they’re doing their candy striping in the hospitals, and there are lots of hours, but not a whole lot of real caring for patients but that’s what you need.

When it comes down to it, it’s caring for people as opposed to caring for patients. You can be involved in community activities where you’re helping people overcome things, maybe you’re helping people get to their doctor’s appointments, you’re finding people who are in need and you’re providing a service. There are all kinds of ways that you can make a direct impact on an individual that helps improve their lives and that’s what they’re looking for. Identify what it is that’s weak. I’d say if the weakness was in research, you’re probably in trouble.

If the weakness is in research, can you go out and get a research position? [36:25]

You can but it’s going to take a few years to go through that. I’d say, the research passion seems to go back further than the clinical passion. In part because you can do research at a younger age. I have a client right now who was very young when she went through college, and she couldn’t do clinical jobs because she was too young. And then once she got to the right age, then she could, but that also put her at a disadvantage in her first cycle of applying.

Sometimes, maybe even oftentimes, it’s that you haven’t presented yourself effectively. That’s one of our jobs as consultants, to really help people figure out how you present themselves. I’ll ask things like, “Okay, we need a mission statement. I need one sentence about why you need to do what you’re trying to do.” We can spend a week on that. But you really have to achieve that focus. Once you’ve got it, everything else kind of falls into place. Keep doing the good things that you’re doing. Keep doing the clinical aspects, keep doing the research, but let’s get this application straightened out so that people really understand who you are and why they need to take you.

What are some of the common mistakes that you’ve seen applicants make in an MD/PhD application or that you correct? [38:42]

I’d say one of them is not having the best clinical experiences. They may have some, but they’re not that one-on-one type. I’ve had clients who start now or even earlier where I can help them recognize that and it’s like, “Okay, you need to get this done by May. You need to have six months now where you are pursuing this sort of one-on-one experience with somebody.” It could be, “Okay, you’re doing too many research projects. You need to focus, so you get that publication out of it.” It’s just trying to get that priority straight and fix those things, as well as getting that mission statement.

I find sometimes the mission statement helps to make it clear what that is you need to do and then you’re off and running. In the meantime developing your personal statement and your MD/PhD essay as those go through multiple iterations when you’re getting these new experiences.

How do you typically help an MD/PhD applicant? [40:21]

So there’s applicant versus re-applicant. I’m a scientist, and you can throw a lot of science at me, and I can appreciate it. I like to learn the science that my clients have been involved in and then we talk about the underlying motivations for this science. How do you turn this into a five minute data blitz or something? How do you turn this into an elevator conversation? So the different levels of how you present what you’re doing and what you’re interested in to tell your friends, colleagues, whoever. How do you convey this to a non-scientist? How do you justify it to them? I try to work with what they have to offer and understand that and then help them to make that into a compelling story.

Typically, with MD/PhDs, I start on the PhD side and then do a similar sort of approach on the MD side where I ask, “Okay, tell me why you need both degrees.” It’s got to start there as opposed to, “Why do you need the MD?” It’s like, “No, why do you need both degrees? Okay, let’s work on this.” Then that gets back to why you need the MD, and where this part of the story comes from and how the two parts come together. It evolves over time, but I really enjoy getting to know the science that my clients do.

Thank you very much for that insight, Flash.

If you’d like to work with Dr. Gordon on your MD/PhD, your MD, or your PhD applications, please contact us as soon as possible because he does book up as deadlines approach. And as you can tell from this podcast, he’s obviously very, very knowledgeable about the process and has helped many, many applicants get accepted.

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