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Medical Student Perspectives: Taking Time off in Medical School for Research or Pursuing an Alternative Research Pathway

So You Want to do Some Research

Are you thinking of trying an alternative route during your medical education or extending your time in medical school? Or perhaps you want to take just a little bit of time off to explore medical research? The decision to take time out of medical school is an individual one, but hopefully the following personal experiences and general program information can help you decide if and how you want to tailor your medical education to best meet your needs.

Pursuing research in medical school can broadly be split into a few categories: 1) summer research; 2) year-out programs; and 3) alternative MD/PhDs. Each has its own focus and strengths. As one can guess, the longer the research experience, the more involved one can become in the research and potentially the more rewarding and educational the experience can be. However, any of these experiences can be very informative and has the potential to shape your future career.

I am a strong proponent of taking time off for research experiences and have participated in a few programs. I did a summer research experience through my medical school, a research year as a National Institutes of Health (NIH)-Howard Hughes Medical Institute (HHMI) Cloister Research Scholar, and am currently pursuing a PhD as an NIH-Cambridge Research Scholar through the NIH MD/PhD partnership program. As a result of my personal experiences and from talking to friends in other programs, I will provide a brief overview of each program and links for more information. The best place to get definitive information is from the program directly.

Summer Programs

The best place to start exploring research options is at your medical school. Many medical schools offer opportunities to do research during the summer between first and second year. These can be volunteer experiences or paid fellowships that usually require at least an eight-week commitment. The deadlines are often in winter or early spring, so it is prudent to inquire early about the deadlines and requirements in order to save you from a last-minute scramble and avoidable stress. Many medical schools also list the fellowships available online (for example, my school, Tufts, lists research fellowships at www.tufts.edu/med/research/studentopps/index.html. If you are interested in doing something away from your medical school, NIH offers a summer internship www.training.nih.gov/student/sip/ whose application season opens in November for the following summer.

Year-Out Programs

The year-out programs are generally geared towards rising third and fourth year students, but can also include post-fourth-year opportunities. The year-out programs include, but are not limited to, HHMI, Clinical Research Training Program (CRTP), Fogarty, Doris Duke, and specialty programs such as the Sarnoff. While previous research is often helpful in gaining admission to these programs, most programs do not require previous research experience to be a successful applicant. Most of the programs are not open to MD/PhDs, except CRTP and Fogarty.

HHMI offers two year-out programs open to any individual post-second year. Neither of the programs is limited to a particular research area and you can apply to one or both programs simultaneously.

  • Howard Hughes Medical Institute (HHMI) Research Scholars Cloister Program
    The first program, known as the NIH-HHMI Research Scholars Program or Cloister Program, accepts a total of 42 medical, dental, and veterinary students and takes place on the NIH campus in Bethesda, Maryland. Once you arrive at NIH you interview and find a mentor with whom you will work over the next year. Weekly dinners are held with prominent HHMI and NIH speakers. In this program you can explore any area of interest due to the large selection of mentors at NIH and projects can range from basic research to clinical research to epidemiology. Cloister Scholars can also take advantage of many of the lectures and conferences that occur at NIH. You do not need to be an expert in the field because the application is focused on the applicant and not the project. The final deadline is in early January for the following school year.

    Click here for more information on the HHMI Medical Fellows Program.

  • The Clinical Research Training Program (CRTP)
    CRTP is sponsored by NIH and is the foundation for NIH to bring medical and dental students to the Bethesda campus for research opportunities. The program generally accepts 30 students who have completed at least one year of clinical rotations and can include MD/PhDs. Once accepted, you find a mentor at NIH to with whom to conduct your research. The CRTP program tends to focus on clinically-oriented research or translational projects. CRTP fellows meet often for small group discussions and have coursework in clinical research practices. The final application deadline is mid-January.

    Click here for more information on CRTP.

  • Fogarty International Clinical Research Scholars and Fellows
    The Fogarty International Clinical Research Scholars and Fellows Program focuses on clinical research training and experience in the developing world. The research takes place at NIH-funded research centers in developing countries. The program generally accepts 25-30 applicants. Clinical experience is necessary. You will have a mentor at your home institution and one at the foreign training site. After the interviews, you rank and choose your preferences for foreign training sites. The application is due in December.

    Click here for more information on Fogarty.

  • Doris Duke Clinical Research Fellowship for Medical Students
    The Clinical Research Fellowship for Medical Students, sponsored by the Doris Duke Charitable Foundation, is based out of a set of participating medical schools, and applicants are directed to apply to the individual schools’ programs. There are at least 5 fellows at each participating school, two of whom must be from other medical schools. The individual programs choose the applicants and have their own interests and varying requirements. Therefore, it is best to check with the individual schools in which you are interested. Six schools also have international opportunities. The deadline for the applications is January.

    Click here for more information on Doris Duke.

  • Sarnoff Fellowship
    There are also specialty fellowships such as the Sarnoff Fellowship in cardiovascular research. The fellowship year generally takes place at a different medical institution than the student’s home institution. Therefore the research project and the mentor play a critical role in the application. The deadline for the application is January.

    Click here for more information on Sarnoff Fellowship.

Alternative MD/PhD Programs

For those of you in medical school contemplating the larger step of undertaking PhD training, there are now a number of alternative pathways available outside the standard path of applying for MD/PhD training when applying to medical school. Most medical schools with MD/PhD training programs have something known as a “second portal” or “second track” for MD/PhDs. This offers a route for individuals who are currently enrolled in the medical school to enter the MD/PhD cohort. This route is generally available to individuals in the second year of medical school who are particularly interested in research. Tufts Second Portal Admissions is an example.

Admission into a second portal MD/PhD program is often done on a case-by-case basis, and the process is specific to each medical school. It is best to discuss this with your medical school MD/PhD office if you are considering such an option.

There are also avenues to pursue PhD research outside or in collaboration with your home institution. These programs often require more juggling between your home medical institution and NIH in order to ensure that everything runs smoothly. For those students who have done a year of research at NIH in one of the programs mentioned above or those wanting to experience the research-intensive environment of NIH’s intramural research program, the NIH MD/PhD partnership training program allows students to combine a PhD from their home medical school or a PhD in one of NIH’s Graduate Partnership Programs with all or part of the PhD research accomplished at NIH. For students in Medical Scientist Training Program (MSTP)-funded medical school MD/PhD programs, funding may be available to cover the remaining medical school years of training at a similar level to traditional MD/PhD students. The potential benefit of an NIH-based program is that much of your research work occurs at the NIH. NIH cannot grant a degree; therefore partnerships exist between other institutions and NIH to award the degree. The intramural program consists of ten or so established programs, and the potential opportunity for individual partnerships with your home medical institution also exists. You generally split part of your time at NIH and the other part of your time at the degree-granting institution. Applications are generally due in early December.

One of NIH’s “homegrown” PhD partnership programs that works particularly well for MD/PhD students is the NIH-Oxford-Cambridge Scholars Program. I chose this route to pursue my PhD education. The NIH-Oxford-Cambridge Scholars Program, to which you must be accepted separately from the MD/PhD program at your home institution, is a collaborative PhD program in which you have two research mentors, one at NIH and one in the United Kingdom. The advantages of the program are the collaborative nature of the project and the dual mentoring from NIH and UK investigators, as well as the unique resources of each institution. The deadline for the “OxCam” program is early January.

For more information on the NIH “OxCam” Program click here.

Click here for more information on Sarnoff Fellowship.

Alternative Rotations

There are also alternate electives in case you want to consider more options during third and fourth year. In addition to the standard hospitals for away rotations, there are also away rotations at the NIH clinical center in Bethesda, which is a 180-bed hospital devoted solely to clinical research that provides free care to patients from all over the country who come to participate in its research protocols.

For more information on NIH rotations, click here.

Hopefully this information helps you if you are considering taking a research break during medical school. All of the programs are good, and what you choose to do is more dependent on your particular circumstances than anything else. These options can be combined, by taking a year off at NIH for research before committing to PhD training. Regardless of what you do, good luck and enjoy yourself.

Cedar J. Fowler
New England Region Representative, Council of Student Members
Tufts University School of Medicine, 2010
E-mail: cedar.fowler@tufts.edu

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Back to October 2009 Issue of IMpact

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