The Integration of Clinical and Research Training: How and Why MD–PhD Programs Work

Abstract

For over 60 years, MD–PhD programs have provided integrated clinical and research training to produce graduates primed for physician–scientist careers. Yet the nature of this integrated training is poorly characterized, with no program theory of MD–PhD training to guide program development or evaluation. The authors address this gap by proposing a program theory of integrated MD–PhD training applying constructs from cognitive psychology and medical education. The authors argue that integrated physician–scientist training requires development of at least three elements in trainees: cognitive synergy, sense of self, and professional capacity. First, integrated programs need to foster the cognitive ability to synergize and transfer knowledge between the clinical and research realms. Second, integrated programs need to facilitate development of a unique and emergent identity as a physician–scientist that is more than the sum of the individual roles of physician and scientist. Third, integrated programs should develop core competencies unique to physician–scientists in addition to those required of each independently. The authors describe how programs can promote development of these elements in trainees, summarized in a logic model. Activities and process measures are provided to assist institutions in enhancing integration. Specifically, programs can enact the proposed theory by providing tailored MD–PhD curricula, personal development planning, and a supportive community of practice. It is high time to establish a theory behind integrated MD–PhD training as the basis for designing interventions and evaluations to develop the foundations of physician–scientist expertise.

Training methods that improve MD–PhD student self-efficacy for clinical research skills

“…Ng et al argued that successful integrated training for physicianscientists requires development of at least three traits: cognitive synergy, sense of self, and professional capacity [23]. Clinical research practica and mentored clinical research synergize and function to integrate the clinical and research realms, enabling students to ask clinically relevant questions to be answered by sound research planning.…”

Assessment of clinical continuity strategies offered by dual-degree training programs in the USA

“…Through personal development planning, students https://doi.org/10.1017/cts.2022.454 Published online by Cambridge University Press work with a mentor to create an outline or timeline of which clinical continuity strategies they wish to pursue at what stages and frequency in their graduate training. This allows students to work with programs to implement student-specific adjustments to current strategies 26 . This strategy also allows students to plan for upcoming clinical continuity strategies and seek mentorship in these areas ahead of time.…”

Predictors of academic career progression among early career physician-scientists via an intensive research training program abroad: a case study

“…In the face of this crisis, extensive efforts have been made to revitalize the physician-scientist career pipeline. Various research enrichment programs have been established, such as structured MD/PhD programs, the NIH Clinical Research Training Program for medical students [15][16][17][18], and residency research training programs [19]. Investigators have analyzed the factors that influence the career choice of MD and MD/PhD candidates [13], and the reasons behind the high attrition rates for medical school faculty [20][21][22].…”