MSTP FAQ

FAQs regarding Medical Scientist Training Programs (particularly at UChicago)

I am an MD-PhD currently a PGY-1 in the Internal Medicine Physician-Scientist Development Program at the University of Chicago. I periodically have friends or family reach out wondering if they can put their friend/loved one in contact with me to answer questions about MD-PhD programs. I am always happy to do this, but also rather busy. Luckily, I answered a lot of questions for people back when I wasn’t so busy. I have tried to collect these questions and answers in a readable format. Apologies for redundancies or repetitions. Also, note that most of the information is circa 2016-2019.

Who am I?

I am an MD-PhD currently a PGY-1 in the Internal Medicine Physician-Scientist Development Program at the University of Chicago. I did my MD and PhD training at the University of Chicago as well. I spent 4 years in the Biophysics Program working for Aaron Dinner, a computational chemist/biologist. My PhD focused on developing statistical methods for analyzing transcriptome-wide (or proteome-wide, etc.) sparsely sampled (2-4 hours/timepoint over 48 hours) data. The particular questions I was addressing were 1) what genes have rhythmic expression and 2) how can we rigorously compare the rhythmicity of these genes' expression between different conditions (high-fat diet vs. normal diet). In the meantime I also clarified some statistical misconceptions in the field of rhythm detection. After my PhD I returned to second year of medical school; at UChicago we have the option of breaking from medical school after the first year for our PhD.

Along with science, I’m interested in advocacy and public health. What opportunities does Pritzker have for that?

There is a very strong social justice and advocacy bent among the students and faculty at UChicago and the Pritzker School of Medicine. Our location on the South Side of Chicago puts us in a unique position to engage with the community and confront its challenges (as well as overcome some of the inequity and exploitation that the University historically had a part in).

One of the first year classes that I felt was the most unique and formative for me was Health Care Disparities, which is designed to bring in different physicians and professors to present their advocacy, how they came into it, and the challenges they face. There is also a small group part of the class that focuses on laying the groundwork for how to start an advocacy project.

In addition to Health Care Disparities being part of the curriculum, the administration at UChicago is also extremely receptive to student interests in advocacy. In my first year at a Q&A I asked the administration (President of the Hospital, Dean of the Biological Sciences, and Dean of the Medical School) why we weren’t participating in the Healthcare Equality Index, which assesses how LGBTQ friendly medical institutions are. They had never heard of it, but were happy to hear me out and put me in touch with the administrators necessary so that we could complete the survey. We completed the survey that year, but did poorly. To their credit, they continued completing the survey, and after several years of work, we are now Gold Leaders on the Healthcare Equality Index!

This is a personal anecdote, but there are many more examples. Pritzker students have started a new free clinic in the past year (to accompany the other 4 we operate), there are several nutrition/health programs operated by Pritzker students at the UChicago Charter schools, and we run a food pantry at the Children’s Hospital.

How did you know an MD/PhD program was right for you, and how did you know Pritzker, specifically, was the right program for you?

Hindsight is 20/20 of course, but I think an important part of it is understanding if you think you’d enjoy the training. They are completely orthogonal ways of thinking and behaving, cultivating very different parts of your mind. The PhD is deliberate and slow, with lots of time to suck the marrow out of problems. The MD is much more of a rush, grabbing a cursory knowledge and understanding of a lot, which you will then whittle away at as you subspecialize.

Not many people are actually cut out for research. You fail more often than you succeed, again and again. You work long hours mostly in your own head. You have lots of interaction with friends and colleagues and time to go to the pub or café to work through problems, but at the end of the day you are the one forging ahead. Even then, you don’t know if it’s actually right, even as you write it up and try to publish it. Days, weeks, maybe months will pass without you feeling like you have made any forward progress, but when you look back over a year you see how amazingly far you have come.

Not many people are actually cut out for medicine. You have responsibilities and burdens placed on you that are reserved for few in society. You will be responsible to imbibe many volumes of information and devote yourself to maintaining that knowledge and honing it as you subspecialize. You will be around a lot of suffering, and a lot of death, but you will actually make a lot of it better. You will feel yourself growing day to day, and the work you do will actually be changing the lives of those around you.

Now, ideally you will get to do a mix of the two in your career, but you really have to be ok with each path separately to enjoy the MD-PhD. Neither degree is particularly necessary to be successful at the other (no more successful than 4 extra years of post-doc or 4 extra years of residency and fellowship would make you).

Any hot takes?

Avoid US News and World Reports. Their criteria are garbage, and I have no faith their rankings have any statistical distinctiveness or value. This being said, their top 30 schools for the past 2 years probably encompass a good starting set of schools. The minutia of the ordering is otherwise useless.

Why Pritzker?

88 students to a class means that it is very easy to get to know everyone, which is doubly important when you’re jumping in and out of medical school to do your PhD. The MSTP class is 8-12 students a year, which is a sufficient cohort to really find people that you connect with and can form strong lifetime bonds. UChicago is a unified campus, which means that as a MD-PhD you won’t have to ever struggle with geographical boundaries separating you from possible collaborators or cool talks (I can go to most basic science and clinical science talks of interest to me (Comp. Chem to Contraceptive Access) without going outside; Northwestern, Harvard, Yale, Johns Hopkins are some examples of campuses where the clinical and basic sciences geographically distinct and far far apart). Hyde Park is a great community where both students and professors can live. My stipend is ~$30,000, but I can live less than a mile from work in a high-rise overlooking the lake. My quality of life is unlikely to ever be much better than that. Chicago is a wonderful city, and amazingly close. I have friends who live in Wrigleyville and commute every day, so they read papers on the Red Line.

What clubs/organizations are open to medical students? Do you feel that you have adequate time to participate in extracurricular activities?

What clubs aren’t open to medical students? Medical students are welcome to participate in any undergraduate campus groups (another perk of a unified campus), as well as all sorts of Pritzker-specific groups. I’m on the Pritzker Dean’s Council, and at each monthly meeting we have a different set of students requesting funding to start their own student group. We also run 5 student-led free clinics. The first year first and second quarter schedules are purposefully light in order to let first years take advantage of these opportunities. For MSTPs, that often means time to take graduate classes on top of medical school classes, but there is definitely time for extra-curriculars: One MSTP actually spearheaded the founding of a brand new free clinic (devoted to Mandarin and Cantonese-speaking patients) during his first year while taking medical school and graduate school classes.

Do you think the 1-4-3 sequence is a disadvantage in comparison to other programs that are 2-4-2?

Not at all. A) Given that we take graduate classes in the first year, it allows us to segue from those classes straight into graduate school. B) I came into the MSTP chomping at the bit to do research, and having been able to do my PhD after my first year really gave me the ability to come back afterwards and buckle down and focus on learning medicine, instead of constantly casting an eye to my future PhD work. C) Third year is hard, there is a lot to know, even as an MD-only. Taking 4 years off between 2nd year and 3rd year is not helpful for this. D) 3rd year is emotionally taxing, and requires a strong emotional and social network of friends. Doing 2nd year right before 3rd year gives you time to find your people and build your support group so that in third year your colleagues are already your friends. E) Board score averages go up every year, so taking a 4 year break isn’t necessarily good, since your good score will be slightly less good (this is a very minor problem).

This being said, there is no requirement by the MSTP at UChicago that everyone do 1-4-3. Each year one or two students does 2-4-2, because either A) it would benefit their project/mentor or B) they feel like it.

What should I look for in a medical school?

Pass-fail pre-clinical. Most of the top schools have the first two years of training pass-fail. I think that is a good metric of both quality and attractiveness.

Research. Never go to any program for one researcher or professor. But if a school has a strong department or program and you think you could work with one of several people, it's a good thing to check out.

Other professional schools. If you aren't considering MD-PhD any more, you may want to ask what other degrees you could possibly want. I have peers who only applied places with strong medical schools and strong business schools, because they knew they wanted to take a year off and get an MBA.

Size. I already talked about size, but I think it is important to consider how easy/hard it will be to stand out vs. being another student/number.

What is the MSTP at UChicago looking for?

At the University of Chicago, the MSTP is interested less in what you study and more in that you get the skills and modes of thought from doctoral training: focusing on translational/biomedically relevant problems comes later in the career. Clinical experience is important for the medical school side, so it's a vital part of your application, but from an MD-PhD perspective what is important is showing initiative and impressing the heck out of whomever there is to impress the heck out of.

So, provided you have sufficient patient contact/ experience, I would ask 1) what position do you think would make you grow more in terms of skills/modes of thought/ life experience in terms of your personal interests and future goals, and 2) where do you think you could really take initiative and turn what you're working on into something of your own instead of just someone else's that you're tending for them?

Disclaimer: These are the private opinions of Alan L. Hutchison, and do not reflect or represent the official positions of the University of Chicago, Biological Sciences Division, University of Chicago Medicine, Pritzker School of Medicine, Medical Scientist Training Program, or any other group. All restrictions apply, void where prohibited.