The GrantDoctor: M.D. to Ph.D., and Vice Versa



Dear GrantDoctor,

I am a licensed M.D. who completed his internship. I subsequently left clinical medicine after 1 year of residency and accepted a position as a postdoctoral fellow in one of our university's research labs. In concert with the research I am conducting now I also would like to earn a Ph.D.

I have not been formally accepted into a graduate program as of this date. However, there is the likelihood that I will be. Anyway, I suppose that I am most eligible for postdoctoral fellowships and grants, although I could be thought of as a predoctoral fellow as well. In any event, what grants are available for someone like me? Are there any that proffer special consideration for those of us that made a transition from clinical to research-based medicine? Are there some that would still consider me predoc, as I can get support from my university toward this end? Thank you for your time and consideration.

Sincerely,Stig Kellogg

Dear Stig,

You're in luck: There's widespread interest in the biomedical research community in drawing clinicians into scientific research. Scientists who spend time with patients bring a different--and highly valuable--perspective to their work that complements the perspective brought by basic scientists. Clinicians are more likely than basic scientists to conceptualize their research in terms of its specific effects on patients. The National Institutes of Health (NIH), in particular, recognizes the value of this alternative perspective, and that means there's money available for people like you.

As a licensed M.D. you are, as you suggest, eligible for postdoctoral fellowships, including NIH's Ruth L. Kirschstein National Research Service Awards for Individual Postdoctoral Fellows; most people save their breath and call them postdoc NRSAs. In the world of biomedical science, this is the coin of the postdoc-fellowship realm; there may be better, more prestigious awards, but there aren't many. You will be required to make a full-time commitment to research; your clinical activities must be limited to work directly related to your research.

Both of these are mentored awards, as the name implies; your chance of winning one depends not just on your qualifications, but also on the qualifications of the mentor you choose. Mentors with a strong record of accomplishment in both research and research training are preferred by NIH reviewers. Together, you and your mentor will devise a training plan including a balance of didactic training and closely supervised research that is designed to meet your specific needs and transform you into an effective researcher. This is no empty exercise: your success in winning one of these awards will depend on the seriousness with which you and your mentor approach the planning of your training program.

Career Development Awards have several advantages over NRSAs. First, they pay more: up to $75,000 a year (the level is set by the salary scale of your host institution) with as much as $25,000 a year for research, training, and travel expenses. Second, they require only a 75% time commitment. Third, success rates are generally higher: 30% or better, sometimes much better, depending on the institute. All in all, these are great programs for people like you.

Can you get a Ph.D. while supported by a Career Development Award? Probably. But once you've finished the training program you design with your mentor, you probably won't need it.

Be Well,

The GrantDoctor


Dear GrantDoctor,

I am currently a graduate student in the department of biological chemistry here at the University of Michigan. During my time as a graduate student, several research experiences have led me to inquire about obtaining a clinical medical degree to better focus and understand the clinical implications of my current work and interests. However, according to my institution, I am too far along in my doctoral studies to be eligible for MSTP. Are there any other funding opportunities for someone in my situation?


Dear Bill,

You unfortunately are not in luck. While it's fairly easy and cheap for an M.D. to find money to do a Ph.D. and enter research, it's much harder to go the other way, from Ph.D. to M.D. This is merely a specific instance of a general fact of life: Regardless of your background, it's very hard to get anyone to pay for your medical degree. Administrators and policymakers appreciate the value of research scientists with clinical expertise, but for whatever reason this hasn't translated into bridge programs for Ph.D.s who wish to gain clinical experience. Here's what the head of one major M.D./Ph.D. program told me: "That leaves the usual route of convincing the school that you are such a stellar student that they should give you scholarship money." Good luck. You'll need it.

The one way to get someone to finance your M.D. (aside from having rich parents), as you've noted, is to participate in an M.D./Ph.D. dual-degree program, like one of the nation's NIH-funded Medical Science Training Programs (MSTPs). If your current university won't consider you for admission to its dual-degree program because you're too far along, you can always seek admission to another, similar program. Currently there are some 40 NIH-funded MSTPs, and (last I checked) 118 dual-degree programs in the U.S. Dual-degree programs that aren't on NIH's MSTP list don't receive funding from NIH's MSTP program, but that doesn't mean they aren't good programs, and it doesn't mean they won't pay your way. On the other hand, the idea behind M.D./Ph.D. programs is that there are advantages to blending M.D. and Ph.D. training in a particular way; if you've almost finished the Ph.D. already, those advantages are lost.

There are, of course, alternatives to seeking an M.D. As a Ph.D.-only scientist you won't be allowed to practice clinical medicine. But that doesn't mean you can't work in the clinic and gain experience in clinical research. Depending on your field of Ph.D. study (in particular, whether it's in a clinically relevant field) you may qualify--eventually, after several years of postdoctoral training--for a K08 or K23 Career Development Award (see above). These usually go to clinical scientists who wish to enter research, but exceptions are made; the K23, especially, is open to Ph.D. scientists. NIH has even issued a special Notice soliciting K23 applications from Ph.D. scientists. At the time that notice was issued, no Ph.D. had ever applied for a K23. That notice shows that NIH is interested in drawing more Ph.D. scientists into clinical research, and that bodes well for your chances.

If you end up having to pay your own way through medical school--and I think you probably will if you go that route--don't forget about NIH's loan repayment programs. These programs will help you pay off your medical school debt if your work is focused on, for example, clinical research, pediatric research, fertility and contraception research, or health disparities research. There are also special programs for scientists from disadvantaged backgrounds.

Be Well,

The GrantDoctor

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