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In the United States, MD-PhD degrees can be obtained through dual-degree programs offered at some medical schools. The idea for an integrated training program began at Case Western Reserve University School of Medicine in 1956 and quickly spread to other research medical schools. In 1964, the National Institutes of Health (NIH) developed a grant to underwrite some universities' MD-PhD programs. This funding was distributed through the Medical Scientist Training Program (MSTP). There are also non-MSTP funded dual-degree programs (e.g., the Medical Scholars Program at the University of Illinois at Urbana-Champaign, which receives funding through endowment funds, research assistantships, teaching assistantships, and extramural fellowships). Non-MSTP funded dual degree programs have more flexibility and can extend to degrees other than the Ph.D. (e.g., J.D. and M.B.A. degrees).
Admission to a dual degree program is not a requirement to receive MD and PhD degrees. An individual has the option to complete each degree separately through single-degree programs. However, the student is responsible for all medical school tuition and does not receive a stipend during their MD education. Furthermore, since the PhD training is not streamlined with the medical training, students will often take additional years to complete their PhD.
A Ph.D. may also be obtained by physicians during the residency training period. This combined research and graduate-level medical education are offered by a minority of residency programs. This additional education typically extends the residency period by three to four years.
Upon matriculating in an MD-PhD program, students will often follow a 2-PhD-2 plan. In this system, students will complete the pre-clinical curriculum of their medical school (2 years), transition into PhD graduate training (3–5 years), and then finally complete clinical rotations (2 years). By contrast, students in the Medical Scholars Program at the University of Illinois at Urbana-Champaign are generally required to complete all the requirements of a regular Ph.D. student before advancing to the second year medical school curriculum.
Upon receiving the MD-PhD dual degree, physician-scientists may choose a variety of career paths. The most common continues to be residency training with additional laboratory training. However, a physician-scientists may also elect to refuse residency training, thereby having a career essentially akin to a conventional PhD scientist. A physician-scientist may also elect to work in the private sector with no further formal academic clinical nor research training.
Most MD-PhD programs (all MSTPs) cover all medical school tuition, provide a stipend, and cover health insurance expenses. This allows MD-PhD students to maintain financial-equality to their MD-only counterparts who can earn their full clinical salary sooner but also have to pay off large loans.
Candidates with MD-PhD dual degrees are favorably looked upon in most residency programs.
The vast majority (over 80%) of MD-PhD graduates eventually choose to enter academia, government, or industry where medical research is a central component of their duties. According to a FASEB study conducted in 2000, graduates of NIH-funded MSTPs make up just 2.5% of medical school graduates each year, but after graduation, account for about one third of all NIH research grants awarded to physicians. Many MD-PhD graduates also practice clinical medicine in their field of expertise.