Get a step-by-step blueprint to becoming a competitive applicant for an MD/PhD program. The path to an MD/PhD is complicated, and each person starts their medical school journey from a different point. Let us make it easy for you!
This MD/PhD Playbook is an essential resource for students wanting to become physician-scientists. Its utility should also not be overlooked by students who aim to be competitive for medical school. Master the below to become a quite competitive traditional medical school applicant.
Freshman Year – Find Your Foundation and Build Relationships to Increase Your Chances of Getting Into an MD/PhD Program
Enjoy college, but do it with focus. Your major doesn’t matter; all that matters is that you complete the prerequisites for medical school. Take classes that interest you and develop a good study routine. A semester lapse in judgment can be recovered from in terms of GPA, though digging yourself out of a hole is unnecessarily stressful.
Ask yourself: What areas of science excite you? Go to professors’ office hours who you want to connect and build relationships with. Ask questions about research and talk with more senior students who are already in labs. You will stand out if you do the things that other students are afraid to do. That means sending cold emails and striking up conversations with strangers who are doing the things you aspire to achieve. This is essential for finding mentorship.
It doesn’t matter what area of research you start with as much as it matters who you pick as a mentor. Take time to explore your options. By starting early, you’ll have the flexibility to change labs and follow your curiosity.
Pre-meds should also start the process of finding clinical experiences through shadowing. This is your introduction to medicine and is low stakes. Simply mass email physicians in your area. While not all of them will reply, there’s always at least one physician who’s willing to let a pre-med student under his wing.
By the end of freshman year, you should be building relationships with clinical and research mentors. These could be long-lasting relationships or entry points. Seek opportunities to interact with people outside your bubble – whatever it may be. These experiences compound and will be crucial when it’s time to write your medical school essays.
Sophomore Year – Hustle to Get Into the MD/PhD Program of Your Dreams
After you’ve established a foundation and developed leads to explore your interests, it’s time to deepen your knowledge.
You’ll most likely be taking the more difficult prerequisites of organic chemistry, physics, and molecular biology in sophomore year, and it’s going to require dedication for you to get the grades. By this time, you should have decided whose lab you will join. Early in sophomore year, plan with your PI (principal investigator) to read the most important literature both from the lab and the research field. It’s critical that you learn how to read scientific papers and practice discussing ideas with your mentor.
Start shadowing students in the lab to see the experiments they are conducting and how it works in theory and practice. Ask questions, even the ones that seem obvious. Consider how you might use an experiment to answer a question from your literature reviews and propose ideas to your student mentors and PI. This is how you stand out.
Follow the sequence: build a foundation, ask questions, make proposals, learn from mentors, conduct experiments, repeat. Your chief goal is to learn the fundamentals of the scientific method and gain skills to practice it yourself.
By the second semester of sophomore year, you will be ready to make two important decisions, which are
- Should you pursue a thesis research project in this lab?
- Should you find a different lab that is more in line with your interests?
Do not continue in a lab or research area in which you are not happy; you still have time to pivot. You will be a more interesting applicant because you actively followed your curiosity and sought diverse research experiences than if you continue working in a lab that doesn’t fulfill you. The quality of your work will show signs of disinterest, too.
You should be pursuing extracurriculars and developing leadership skills: such as non-profit consulting, writing for the school paper, mentorship, and volunteer work.
Medical schools do not care much about practical clinical skills – they will teach you those. They care more that you have demonstrated commitment to serving others, whether this is strictly in the clinical sense or out in the world makes little difference in the big picture.
For example, I mentored an elementary school kid for three years during college. The communication and teaching skills I gained from this relationship helped me prepare more for a career in medicine than any shadowing experience I’ve ever done. Not to discredit shadowing, but there are other extracurricular activities that can provide you with more value.
The summer after sophomore year is a time for growth. You’ve been building clinical and research experiences, have begun developing leadership skills through extracurriculars, and have worked hard to keep up with your grades.
The next step is to pursue a summer research experience. This recommendation is highly valuable for students that want to pursue an MD/PhD, yet it will also distinguish students who are applying MD-only from the applicant pool.
To apply for summer research programs, you will need at least two letters of recommendation.
First, talk with your PI and explain that you have a growing interest in pursuing an MD/PhD. Especially if your institution is disconnected from a medical campus, pursuing summer research at an institution where you can learn how to bridge research with clinical medicine is critical. Ask for a strong and personal letter of recommendation.
For the second letter, consider the other mentors with whom you have formed relationships. Who will speak highly of your potential as a physician-scientist? Ask for the second letter and start developing your CV and personal statement for the application. Most programs will need your application submitted by January of your sophomore year. Be sure to apply early.
Junior Year – Prep for Your MCAT and Continue Your Research
Junior year is when you start working more independently on your research, practice experimental design to solve problems and develop your communication skills.
You will experience failure during this time, which is essential. Experiments are going to flop, and you’ll have to figure out why. It is the problem-solving process that is critical for succeeding in MD/PhD admissions and demonstrating that you have what it takes to excel in medical school and MD/PhD programs. These experiences will provide you with a distinct set of complementary skills from what you are developing in parallel through clinical experiences. The combination of these skill sets is powerful and recognizing this synergy is important for the why MD/PhD essay.
Tell your PI that you are motivated to present your research at science talks, poster presentations, and conferences. Apply for scholarships like the Goldwater Scholarship. Ask your PI what needs to happen for you to earn a publication. Propose a project that you can submit for an undergraduate thesis and work together to refine it. This will focus your work, demonstrate initiative, and provide you with checkpoints to work toward your goals. Aim to present your research frequently and keep track of your presentations in your CV.
During this time, continue deepening your relationships with mentors. Provide value without expecting anything in return. Be proactive and kind. The mentors learn from you just as you learn from them. When the time comes to ask for letters of recommendation, you will be grateful that you invested in forming great relationships.
In December of your junior year, you should start planning for the MCAT. Take a relatively lighter course load during the time you are studying. Use UWORLD and AAMC question banks as well as practice exams to prepare. Don’t overload with resources; the ones I mentioned are more than enough. Study consistently for 3-4 months by answering question sets with mixed topics and reviewing your incorrects. You will find on UWORLD that the explanations for the incorrect answer choices are as valuable as the correct answer explanations. You should study both. Take the MCAT by early April of junior year; I recommend studying as if you only have one chance, but you should budget time for a retake in early May if, well, life happens. Aim to score 510 minimum.
Organizations that provide personalized MCAT tutoring can also help you in areas where you are struggling, and improve your score even higher in areas where you may already be comfortable.
During the spring semester of junior year, identify the writers of your letters of recommendation. This is when the MD-only students get a relative break in application preparation.
For MD/PhD, you need at least 6 letters: 2-3 letters from research mentors who can praise your scientific potential, 1-2 letters from clinical mentors who know your aptitude for patient care, 1 letter from the premed committee, and 1 letter from a mentor who can discuss your leadership skills and personal traits in an extracurricular setting. Make sure each person knows you are applying for MD/PhD and craft the letter accordingly.
The AMCAS application opens on May 31st. Write the personal statement first and take time to get this essay right. As an MD and MD/PhD advisor, I’m obviously biased, and I think getting a coach is incredibly helpful. The direct feedback I received from mentors allowed me to make average essays excellent, and I needed guidance to identify what about my story was key to highlight. If it wasn’t for coaching, I would’ve likely submitted essays that missed the point. Since I believe it was my storytelling that made the difference between acceptance and rejection, I’m certain that this preparation made a difference.
So long as you have a good MCAT (>510) and GPA (>3.7), the big 3 essays and letters of recommendation are the most important elements of the application. I argue that having strong essays and letters is more important than incrementally higher test scores and GPAs.
Numbers get your foot in the door; storytelling gets you a seat at the table. Take time to develop your personal narrative in written and spoken words. You will be telling your story across many media, through different versions, and to diverse audiences for the next 8 months. Don’t wait to get good at this skill.
For both MD and MD/PhD programs, submitting your application early is an advantage. Aim to submit the primary application by July 1st. It’s not a hard deadline, but it’s a good goal. You will likely receive secondaries from most schools you apply for, so prepare to be overwhelmed. But you can also see what secondary questions your schools will ask in advance in the Secondary Essay Database.
Senior Year – Focus, Now that the Admissions Cycle Is in Full Swing
The secondary application is crucial for getting interview invitations. You will start receiving these applications in mid-July through August. The story you started telling in the primary application now needs to be refined further.
Who are you? What have you achieved? and How will you contribute to the program and medical school class?
These are only a few of the questions you can expect to be asked when secondaries are sent or during your interview season. As an MD/PhD applicant, your job is even more involved. You must also respond to essay prompts about why you want to pursue an MD/PhD, what your research interests are for graduate school, and which faculty members might be good matches for your interests. This is school specific, and you should avoid writing generic responses. Do your due diligence.
After submitting your secondary applications, the waiting game begins. Some schools will ghost you; others will offer conflicting interview invites. It’s a confusing time. You must keep composure, embrace uncertainty, and prepare for the opportunities that do come. The story you’ve been writing now needs to be communicated in an interview context.
When someone asks you, and I promise they will, “tell me about yourself,” your answer should be polished and compelling.
Practicing mock interviews is essential to rid yourself of the jitters and fine-tune your responses in various scenarios. Identify your weaknesses and fortify them. MD/PhD applicants have 2-day interviews in which you will speak with many students, faculty, and administrators. Every interaction is an interview. Even that short conversation with a grad student – if you leave a good impression, it will trickle back to the right people.
In addition to developing your personal narrative, you must be able to explain your research at multiple levels.
Personality and personal connections go a long way in these interviews. All the office hours, relationship building, expanding your worldview, and extracurricular activities you pursued have prepared you to relate with others. Demonstrate communication skills, empathy, humor, enthusiasm, and kindness. How you make the interviewer feel is more important than what you say. Know the answer to “Why should we pick you?” without conveying ego in the response.
Be confident that you’ve done the work to prepare and that you are exceptionally qualified to be interviewing for this position. The way you build that confidence is through practice and feedback. With each interview experience, you will become more comfortable and prepared for the unexpected. Your ability to improvise and adapt to challenging interactions will astound you.
The day you receive that phone call or email – the one from the MD/PhD director contacting you to say you have officially been offered acceptance into their program – provides a feeling of joy worth being patient for.
If you put in the work, medical school acceptance will come.
It’s a competitive process. Persistence and perseverance in the face of rejection is part of the game you’re signing up to play. The rules are unclear and often seem unfair. It’s a huge investment of time and money, but for an MD/PhD especially, the payoff of free medical school, a stipend, and unforetold career flexibility are worth it.
Post BACC – Experience Gap Year(s) That Could Change Your Life
Many students have their epiphany for MD/PhD late in the game. That’s completely fine, in fact, a less straightforward path adds texture to your application. Don’t be afraid of the gap year(s).
I took one gap year, and it was the best year of my life–admittedly, I was living in Morocco with my family and doing research on the side. Check out my article, An Unconventional Path to MD/PhD, to discover how I deferred my acceptance; it’s my favorite.
If you don’t have at least two years of quality research experience by the time you plan to apply for MD/PhD programs, I recommend that you consider post-bacc research for 1-2 years. I know, you’re in a hurry to get life started, but remember that the rush is an illusion–this is life.
Post-bacc research offers protected time to make money, live somewhere new, and dive deep into the research. This will allow you to expand your views on what it means to conduct lab research and provide you with more refined insight into the work that inspires you. Then, you will be equipped to develop your vision for graduate school and express it more effectively in the application.
Going through the MD/PhD application cycle prematurely can be exhausting and demoralizing. This goes back to recognizing your strengths and weaknesses and waiting for the right time to go all in. The time off from studying for exams and time spent working in the real world will refresh you. This fresh perspective combats burnout and will allow you to jump into medical school recharged and ready for the onslaught of studying and exams. You will be more capable, mature, and competitive to reach your dream program, as a result.
Learn the Story With More Chapters
This MD/PhD Playbook has enough for you to get started and make important progress toward your goal of acceptance. There are additional nuances and details at each stage, with non-obvious lessons replete at each step. That’s why I’m committed to writing more chapters that will provide deeper insights.
Read the Jake Khoussine MD/PhD blog for details on many of the topics discussed. I want to hear from you and help you because I know how challenging it can be to navigate this complicated process.