Are all MD PhD programs free?

It’s Free — or Almost.  Among the more than 100 MD-PhD programs in the U.S., 44 are supported by the Medical Scientist Training Program (MSTP), a part of the National Institutes of Health (NIH) All MSTPs, along with some MD-PhD programs that are not MSTP, offer a full ride to their students for the entire 7-8 years. That means no tuition costs plus annual stipends for living expenses that run about $22,000-$33,000. (Funding for MD-PhD students can come from a wide variety of sources, including mentor research funds, department funds, and other NIH grants; perks can range from free health insurance to books and cost-of-living increases.) There are also non-MSTP MD-PhD programs that offer only partial financial assistance to their students. Therefore, it is essential to carefully check on the specifics of each plan. The AAMC has an online listing of MD-PhD programs, along with information about their funding, and links to their sites.

So, Why the Free Ride? Medical researchers make huge contributions to society, and are often recipients of Nobel prizes for groundbreaking medical research. It takes at least 4 years more to get an MD-PhD than a simple MD. The MD-PhD funding helps to offset the loss of those 4 years — years when the doctor-scientists could otherwise be making a significant income. #4 looked at it this way:  “I figure I am saving about $250,000 by going MD-PhD instead of just MD. But, by time I get my MD-PhD, I will be 4 years older than everyone else in my graduating class, and will have lost those 4 years of making good money. So, overall, it may come out pretty even.”

Surprisingly, there is no commitment required in return for the MD-PhD funding. “After I get the MD-PhD, legally  I owe nothing to the school or the program,” #4 notes. “They  — and I — hope that while I’m there I will do research that gets published.”  However, while there is no obligation to do research after receiving the MD-PhD degrees, virtually all major academic hospitals require their doctors to do research of some kind.

Highly Selective. Since most MD-PhD programs are free or nearly so, and MD-PhD spots are very limited, the programs are extremely selective. The AAMC reports that in 2011, only 35% of MD-PhD applicants actually entered into programs. Acceptance into an MSTP is even lower — less than 10%. So, to get into an MD-PhD program, it is critical to have very high MCAT and GPA numbers, as well as long-term and in-depth research experience.

You Must Love Research.  “I already wanted to do research; I’d been working on the same neuroscience project for over three years. But if you don’t really like research, it isn’t worth going into MD-PhD,” #4 warns. “Never go into it just to get a free ride.”

“Ideally, I want to do about 30% clinical work and 70% research,” he adds.”That’s a reasonable goal for an MD-PhD unless you’re a surgeon, in which case you could have more time in clinical practice. I want to be surgically trained, but I may end up as a consulting surgeon and keep to the 30%. However, I also have the option of putting more emphasis on surgery.”

Alternatives if You Don’t Get In. Even if you don’t make it into an MD-PhD program initially, some med schools let their MD students apply for MD-PhD status after they’ve begun their MD-only program. For example, the University of Pennsylvania takes MD-PhD applications from its first and second year MD students.

If an MD-PhD program doesn’t pan out at all, there is still plenty of opportunity to do important medical research with the MD-only degree. In fact, some MD programs strongly encourage significant research by their MD-only students. For example, the entire third year of Duke’s MD program is devoted to research. And, Yale both requires its MD students to complete an original thesis and offers them an optional, tuition-free “fifth year” when they can devote 12 months to a research project. (Students get research grants, but may also need extra funds for living expenses.) While such programs are not as in-depth as the MD-PhD, they provide valuable experience for any MD who wants to do research along with clinical practice.

Parental Assist: Well, isn’t it nice to hear you may be able to put that checkbook away sooner than expected? But before getting excited about the prospect of your kid hopping on a free ride to an MD degree, help him to be sure he’s applying to MD-PhD programs for the right reasons: the love of research. Discuss whether he should apply for both MD and MD-PhD programs, and the pros and cons of each program. Maybe help him create a comparison chart. And, if he wants the MD-PhD program but doesn’t get in, help him to research other paths to a research-rich career, including programs such as those at Yale and Duke