M.D./Ph.D. vs. MSTP
 
While the distinctions between M.D./Ph.D. programs blur along several lines, a division can be made between the programs that receive NIH funding for the Medical Scientist Training Program and the non-MSTP M.D./Ph.D. programs. In response to increasing specialization and the need for better integration between the basic and clinical sciences, the MSTP was created in 1964 to provide training in medicine and basic biomedical research, leading to the M.D. and Ph.D. degrees. Currently, more than thirty institutions receive MSTP funding to train the next generation of physician-scientists. These programs provide tuition and fees and a stipend (~$15,000-21,000 per year). MSTPs are regulated by the federal government and mustfollow certain guidelines set forth by national policy. For example, the NIH has recently pressured several programs to reduce the time to graduation. Thus, NIH funding is contingent upon the maintenance of relatively high educational standards. These programs tend to be extremely selective and draw from a nationwide applicant pool of bright and talented individuals. Due to federal regulations, these programs are restricted to U.S. citizens or legalized nationals.

However, there are at least as many institutions that have formal or informal M.D./Ph.D. programs sponsored through institutional funding and training grants. Many programs provide full tuition and fees for their students, although some provide only partial funding. The level of financial support is highly variable, as is the level of oversight. In addition, a number of schools that receive NIH funding offer more M.D./Ph.D. spots than offered by their MSTP grant. Thus, there are MSTP-funded and non-MSTP spots at the same school. Many schools do not make a distinction between these students. International students can apply to these programs, although they cannot receive MSTP funding.

Some students attend medical and graduate school separately, thereby earning both degrees. The main disadvantages to this pathway are increased length of time, little integration of the medical and graduate training, and lack of funding during the medical years. However, there are various scholarships and grants available (i.e. from the Howard Hughes Medical Institute) to supplement the medical portion of the training. The graduate years are almost always funded by a combination of sources, including the student’s research thesis advisor and department. Many foreign students enter U.S. M.D./Ph.D. programs via this route.

The choice of pathway often depends on several factors, including one’s goals, choices early in an academic career, grades, MCAT scores, etc. Generally, the NIH-funded MSTPs are considered the most selective programs, but highly qualified individuals can be found at various non-MSTP institutions. The guarantee of funding throughout the medical and graduate training often makes the MSTPs the most appealing programs. Schools with MSTPs tend to run highly supported research programs in a multitude of biomedical (and non-medical) fields. However, many non-MSTP M.D./Ph.D. programs are located at prestigious universities throughout the nation and are well-supported.