All Posts Tagged With: "MD"

What you need to know about MD-PhD programs

Thousands of students apply to medical school across Canada every year, and the vast majority of them will never even make it to an interview. The chances of success improve for repeat applicants, but the fact remains: even with high marks and stellar extracurricular activities, applying to a Canadian med school is an uphill battle against discouraging statistics. After completing their undergraduate degree and receiving a rejection letter, the big question facing these students is: now what?

Mike Saccone, a fourth-year Health Studies Co-op student, already has a plan B.

“My back-up plan is research based. I will pursue a Masters in Health Research Methodology from McMaster University,” he says. The Masters degree could even hit two birds with one stone.

“Hopefully, this will improve the chances of me getting into medical school, along with fulfilling a degree requirement that I will eventually pursue.”

Saccone says he was exposed to both sides of medicine- research and patient care- while working with a research-focused orthopaedic surgeon, and then working with a surgeon whose primary focus was on patient care.

Colleen Shortt, a fourth year Health Studies and Gerontology student, isn’t considering research as a backup plan to med school. She recently applied to graduate school programs at the University of Toronto, the University of Western Ontario, and McMaster, and is hoping to pursue a career in cancer or HIV/AIDS research. Shortt says that once she’s through grad school she may be interested in applying to med school.

“I thought about applying to med school and originally it was my plan A. But once I started looking into research opportunities I found that this may be a more effective way of reaching more people.”

Khuram Bhatti, a fourth year arts and science student, says he has considered numerous programs and careers, including optometry or pharmacy, and even programs in the States.

“I am considering schools such as the osteopathy programs in the United States, or other types of up and coming schools which have a schooling regiment which is sort of ‘newer,’ comparatively to something such as the MD career field.”

For med school hopefuls who don’t make the cut, pursuing a grad school program is a win-win: it improves their chances on a second application, and at the same time, they’re developing the skills for a different career path. Many med schools look for research or medically-related experience, and some even award additional points to applicants who have completed a graduate degree. McMaster gives an additional 1% to the pre-interview score of MSc students, and an additional 4% for PhD students. Others, such as the University of Toronto, lower the GPA cutoff for graduate students.

Keith Colaco, a third year Biomedical Sciences student, says that although he has always wanted to attend med school and become a physician, in high school he considered becoming an optometrist because of the challenges of pursuing a career in medicine.

“As I started taking more medically-related courses in university, volunteering in hospitals and speaking to medical students, I quickly changed my mind because I was so intrigued by the field and strongly felt the need to help those with medical problems.”

This summer Colaco will be working at the Holland Orthopaedic and Arthritic Centre in Toronto, where he hopes to gain insight into pursuing a medical career. Ultimately, he may combine his passion for medicine and research.

“I am very interested in clinical research rather than focusing on just research in the lab because I have always enjoyed interacting with patients in past volunteer experiences,” he says. “By working in a patient-care setting, it allows me to evaluate patients and conduct research at their bedside.”

Students like Colaco, who want to combine research with patient interaction, are in luck: an MD-PhD program offers the best of both worlds, allowing students to complete the MD curriculum while pursuing a PhD, training them for careers ranging from medical research to the design of healthcare delivery systems. Most of the programs describe their graduates as ‘clinician-scientists,’ with the curriculum juggling between academic course work, training in basic sciences and research, and clinical rotation. Dr. Norman Rosenblum, Director of the MD/PhD Program at the University of Toronto, says that applicants should have “considerable background with some area of science” in addition to experience that “demonstrates an interest in medicine and a knowledge of the clinician-scientist role.”

Some programs, such as the “MD Plus” Leaders in Medicine program at the University of Calgary, go beyond the basic sciences and allow students to pursue any graduate-level field of interest, including a Masters in philosophy or business.

Most med schools across Canada offer the MD-PhD program, with many being created in the past several years. The only drawback? Getting in is even tougher than med school. The program requires students to be accepted into both a medical and a Masters program (or in some cases, a graduate program) and enrollment is extremely limited, with most MD-PhD programs only having enough spots for a handful of students. For example, there are only five spots available in the University of Toronto MD-PhD program, while the University of Ottawa program only has room for four.

The good news: more med students are choosing family practice. The bad? It’s still not enough.

You have to be crazy to become a family doctor in Canada, right? Everyone knows they’re overworked and underpaid, and there aren’t nearly enough of them. So how come more and more medical students are shouldering their huge debts and going into family practice residencies—at rates not seen since the early ’90s? “I want to be a family doctor,” says Simon Moore, a fourth-year med student at the University of British Columbia, “because it entirely blew away my expectations.”

Moore originally planned to specialize in emergency medicine. He wanted the thrill and immediacy of saving lives in an ER. “My original impression of family medicine as a specialty was that you work in an office from 9 to 5 and you see warts and rashes and sore throats,” he recalls. But his opinion changed during his third year in med school, which he spent at a practice in Chilliwack, a city of 80,000 in B.C.’s Fraser Valley. He realized that as a single doctor serving a large community of patients, his opportunities went far beyond booster shots and blisters. “You can spend time in the office if you want, but other than that you can catch babies, you can do maternity, you can do emergency medicine, you can do surgical assists—the spectrum is much broader.”

Lately, more medical students are agreeing with Moore: nearly a third now choose family practice, up from less than a quarter just six years ago. That’s still fewer than the 48 per cent who chose family practice residencies before 1994. But the situation is far better than it was earlier in the decade, when lack of student interest in family medicine threatened a full-blown health care crisis.

In 2001, family practice was the first choice of only 28.2 per cent of grads; by 2003, that number had dropped to 24.9 per cent. “The shine had definitely worn off family medicine,” says Dr. Tom Freeman, chair of the department of family medicine at the University of Western Ontario’s Schulich School of Medicine and Dentistry, where in 2004 only 25 per cent of students chose to become GPs. Long hours and difficult work made family practice unattractive, Freeman says, and “the remuneration issue was a major problem in most provinces.”

Medical students often graduate with massive debt, sometimes exceeding $100,000. According to a study by the Canadian Institute for Health Information, GPs made an average of $202,481 in 2004 and 2005 (the latest years for which data are available); medical specialists earned $248,694 and surgical specialists made $334,012. The problem wasn’t just low pay, but the method of payment. In most provinces, doctors are paid primarily through a fee-for-service system. Under this model, MDs are paid for each service—such as office visits or tests—they provide. Because it rewards physicians for the number of patients they see in-office, fee-for-service can discourage after-hours and clinical work, as well as preventative medicine. That encourages a narrowing of the family practice area, which cuts out much of the variety that attracts med students to family practice in the first place.

I want to be a doctor. In space.

It’s a universal fact: every kid’s dream in kindergarten is to become an astronaut. Well, ignoring the occasional firefighter, cowboy, and dentist wannabes. Okay, nobody ever really wants to be a dentist. They just wake up in dental school one day. There are also kids like my younger brother David who, in grade one, announced that when he grew up, he just wanted to sit in the back of taxis and talk to people. In other words, get an arts degree.

But after checking out the Canadian Space Agency’s website, I realize that my four-year-old self had it totally wrong. There’s a job out there that’s actually higher on the cool-o-meter than astronaut. It’s a combination more ingenious than chocolate and peanut butter.

It’s an astronaut. With an MD.

The idea of orbiting thousands of kilometers above the Earth is awesome. And messing around with bacterial life forms is even more cool (and is just begging for a broken test tube that leads to a deadly super virus). But the two of them? Combined? It means only one thing: messing around with bacterial life forms in zero gravity.

Someone I know recently applied to the Canadian Space Agency’s national astronaut recruitment campaign, which will replace the two retiring Canadian astronauts. First I had to get over the fact that Canada has a space program. And unlike Canadian Idol, it isn’t just the annoying younger brother of the American version. We actually send people into space. For sleep-overs at the Space Station.

It was fascinating to watch someone go through the application process. And it was even more interesting to learn some of the cool little details about living in outer space. Like how astronauts have to choose what foods they’re going to eat in space several months before the actual launch. And since they’re surrounded by microgravity, dry foods could contaminate the environment. Meaning, astronauts on the space station have an even bigger threat than asteroids, black holes and zombie aliens: a loaf of bread. Extra crumbly.

When an astronaut sneezes? There’s an emergency evacuation and contamination clean-up crew, and the person who sneezed has to suffer through dirty looks for the rest of the mission.

Then there’s the fact that while astronauts are orbiting the earth, they experience 16 sunsets every 24 hours. Plus the “NASA tradition” of having wake-up calls during shuttle missions. A song is broadcasted into the cabin every morning, selected in advance by each astronaut. So there’s an even more efficient way to make every other astronaut hate your guts than just sneezing all over the dashboard.

As in, choosing my favourite song as a wake-up call.