Guest Post: PhD life – chasing the highs

The purpose of this blog is to share personal accounts of MD/PhD training, and I’m excited to expand the perspectives presented here with the first ever guest post! This post is by Alex Yang, who I first connected with via Twitter a few years back (and is a fellow liver lover!)


PhD life – chasing the highs

Alex Yang

Disheveled. Exasperated. Desperate. I had failed to co-immunoprecipitate my two proteins of interest again. I had lost track how many times I’ve tried in the first two years of my PhD. For those of you that aren’t in basic science research, the amount of failure is immense. I would estimate 90% of all experiments are failures. A co-immunoprecipitation involves pulling down with an antibody for one protein and blotting for another protein to suggest a protein-protein interaction. Theoretically if the antibodies are working, the technique shouldn’t be hard. But I couldn’t get it work. And I didn’t think I could ever get it work. I started questioning why I even attempted a PhD and didn’t just be a “normal” doctor like all my other classmates. Before I go on, let’s go back to see how I decided to be a #doubledoc in the first place.

Everything that I’ve accomplished and will accomplish, I owe to my first-generation immigrant parents. My dad is a PhD, professor in Immunology and Microbiology. Smartest person I know to this day. My mom is a MD, family doctor with a very large successful clinic. Hardest working person I know to this day. This naturally made me interested in pursuing a MD/PhD as I am a combination of my parents both biologically and degree-wise. Science was always my favorite subject in school. I remember starting to learn basic lab techniques in middle school and continued in high school. When I found a MD/PhD mentor as an undergraduate that beautifully combined both degrees and encouraged me to do the same, the rest was history. I applied MD/PhD right out of college knowing the long road ahead. First two years of medical school flew by, and now I was in a basic science lab studying genetic mechanisms of non-alcoholic fatty liver disease (NAFLD).

Back to the co-immunoprecipitation. Although medical school was challenging it did not prepare me for the failure of graduate school. In medical school, I had passed all my exams by a large margin. Failing was never an option, but it’s almost a daily occurrence in graduate school. As much as I failed the co-immunoprecipitation, I knew I couldn’t give up. Although I had evidence in over-expression models in cell lines, we needed evidence with endogenous proteins in-vivo specifically in a mice model. I was discouraged, but the post-doc that I worked with suggested we need to purify the lipid droplets from the liver in order to concentrate the proteins. That would give us the best chance to successfully immunoprecipitate both proteins. It was an extra step (actually more like 20), but it was a new direction to try.

I knew the chances of success was slim, but that’s what we do as graduate students. We have to learn from our failures. Optimize. Repeat. And finally, we persevere. I grudgingly purified the lipid droplets and added the antibody. The next day I blotted. When I exposed the gel, a single beautiful band appeared showing my band indicating my protein of interest. Who knew one band (no not the Jonas Brothers type of band) could give so much joy? I was ecstatic and relieved. When my principle investigator saw the results, he could only smile. Knowing I just accomplished something that no one in the world has ever done thrilled me. For those undergraduates reading this and still trying to decide if graduate school is right for them, I implore you to re-evaluate your experience in lab. Are the highs of the 10% of success high enough to carry you through the 90% of failures? If not, maybe consider just a MD as a PhD is all about persevering through failure. As for me, I was on cloud nine. The pains of the failures were wiped away by the joy of success. I didn’t choose the PhD life. It had chosen me.


IMG_1397About Alex: I’m a 4th year MD/PhD student at Wayne State University studying genetic mechanisms of fatty liver disease. In my spare time I like to cook, exercise, play video games, and write. Check me out on twitter @MDPhDinProgress.

My Next Eight Years

The closer I get to starting the next phase of my education, the more I am bombarded with questions about it. Usually when I’m asked what I’m doing for school, I will say either graduate school or medical school because it seems too overwhelming for people to even hear about such a program and it is just easier to say one or the other. Of course, if the conversation progresses to further into my future, I will have to reveal that I will be pursuing both MD and PhD degrees but the conversation does not always get that far. Nonetheless, I wish to set the story straight by answering some frequently asked questions so that those considering the medical field know what its like in an MD/PhD program and so that my friends and family will have a better idea of what exactly I’ve gotten myself into.

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Where are you going to school?

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I will be going to the University of Illinois at Urbana-Champaign. The school is about 3 hours south of Chicago in an area of approximately 120,000 residents between the two cities of Urbana and Champaign. Some refer to the cities as “twin cities” but coming from the true twin cities area of St. Paul and Minneapolis, I don’t think I will ever be able to refer to them by that name. The school has around 40,000 students, which makes it similar in size to my alma mater of the University of Minnesota, and so I’m hoping it will feel a little bit like home.

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How long are you going to be in school?

The MD/PhD program is about 8 years long. This may seem like a long time, but actually it is shorter than if you were to get your MD and PhD separately. Medical school is four years and graduate school for a PhD usually takes five years, so this puts me a year ahead.

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How is the program structured?

Most schools with an MD/PhD program have a 2-4-2 structure. With this structure, you begin with 2 years of medical school during which you can also complete your lab rotations for graduate school as well as some graduate school courses. After your second year of medical school, you work strictly on your graduate schoolwork for the next four years. After receiving your PhD, you return to medical school for the last two years. Those schools funded by the Medical Scientist Training Program, a grant offered by the National Institutes of Health, are more regulated by this grant and follow this structure as well as some other MD/PhD programs.

Illinois at Urbana-Champaign, on the other hand, is not funded by the grant and so has the freedom to place more emphasis on the graduate work, leaving as much time as necessary to complete the PhD. You begin the program in the graduate school phase during which you take your first year medical school courses spread out over the 5 or so years it takes to complete the degree. Therefore, you essentially act as a regular graduate student for the first 5 years with some extra work. After receiving your PhD, you then complete the last 3 years of medical school. The MD/PhD program at the University of Illinois at Urbana-Champaign is more specifically called the Medical Scholars Program, MSP for short.

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How much does it cost?

The program actually PAYS YOU to be in school. The school covers tuition and you additionally get a stipend for living expenses. During the graduate school years, it is the stipend any graduate student would get, but during the medical school years, it is about half that amount. You do have to pay some student fees but that’s pretty much it.

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What are you getting your PhD in?

I am in the school of molecular and cellular biology graduate program, which is an umbrella program in that it contains more specific sub-plans that I will have to choose between. Based on which lab I choose as my thesis lab, I will be in the biochemistry, cellular and developmental biology, microbiology, or molecular and integrative physiology department. Most of the labs that I am interested in are in the biochemistry department, but we’ll just see how rotations work out.

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What are lab rotations?

Every graduate student will end up picking a research lab to spend the majority of their time in school to do research that they will write about in their thesis. To help decide which lab to pick, each student must do short stints in labs of their choosing (with the professor’s approval). At Illinois, our rotations are 5 weeks long and we will do 3 of them during fall semester of our first year. At the end of the semester we will then pick our thesis lab.

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How big is your class size?

In the Medical Scholars Program (MD/PhD) there are 10 in my incoming class. For the school of molecular and cellular biology graduate program, there are approximately 40 in my incoming class. The M1 class in medical school has about 125 students, 25 of which will remain at the Urbana-Champaign campus for M2-4 (this includes the MSP students), 50 will go to the Rockford campus for M2-4, and 50 will go to the Peoria campus for M2-4.

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What comes after all of this?

Following receiving my MD and PhD, I plan on doing residency for internal medicine followed by a fellowship for an oncology specialty, which are both 3 years in length. Eventually, I hope to become an academic oncologist so that I can lead a basic research lab focused on the design of anticancer therapies, teach courses related to such a subject, and treat patients with cancer. Having both degrees and being involved in both a clinical and basic research setting will hopefully help me bring basic ideas to clinical applications faster.

How did you get in?

I prepared for applying to such a program by taking a broad range of science courses with an emphasis in chemistry (as it was my major) and maintaining a 3.6 GPA. I additionally was quite involved in school by joining extracurriculars, holding leadership positions, and volunteering at a hospital. As research is the focus of such a program, I started working in research labs at the end of my freshman year of college so that I had over 2 years of experience as well as undergraduate research funding and a research fellowship before applying.

I took the GRE, chemistry GRE, and MCAT in the spring/summer of my junior year of college though the MCAT was the only required test – I had previously been planning on just grad school hence why I had taken the two GRE tests. For my application, I had to write three personal statements to explain why I wanted to pursue MD, MD/PhD, and research (check them out here, here, and here, respectively). I additionally wrote about the activities that I have been involved in and what three were most important to me – volunteering at a hospital for 6+ years, being a member and leader in a marching band, and doing research in a medicinal chemistry/carcinogenesis lab.

Following this general first application that was sent to 15 schools, I then received secondary applications from those schools with more specific questions. After spending nearly $1300 in application fees, I was done with applications and the rejections started rolling in (as kind of expected when applying to places like Harvard, Yale, and UCSF). Nonetheless, in middle January I was invited to an interview weekend at the University of Illinois at Urbana-Champaign. They paid for my flights (including a first class flight from Minneapolis to Chicago), three nights in a hotel, and meals.

For the interview weekend, I had a 15-20 minute panel interview with the director and assistant director of the MSP, a doctor from the local hospital where we do our clinical work, and a professor in the school of molecular and cellular biology. The next day, I had four 30-minute talks with four professors in the school whose research I was interested in. The rest of the weekend was to get us familiar with the school and convince us to go there. It included dinner with faculty and students, a poster session, a fun activity (I went bowling), and a final outing to a local bar.

If we were interviewed for the MSP, we could be accepted to the graduate school or medical school individually if we did not get in to the full program, and a full acceptance required acceptances from these three areas. A couple weeks after the interview weekend, I received an e-mail notifying me of my acceptance to the graduate program. Two days after that, I was notified that I was accepted to the MSP pending anticipated acceptance by the college of medicine at the University of Illinois Chicago campus. A week after my MSP acceptance, I received a phone call from the MSP notifying me that I had been accepted to the medical school and I was in! For the MSP, there were around 100 applicants and 30 or so of us were invited to interview. They aimed for a class size of 15, which ended up being 10 of us.

Why the heck are you doing all of this?!

Since I was a young teenager, I have wanted to do medicine, pharmacy, and research at various times, one leading to the next. I knew I wanted to work toward bettering human health, but I kept an open mind and sought to find where I was best stimulated and where I could make the biggest difference. I first became actively interested in medicine in early high school, but switched to pharmacy after learning about the profession. In the beginning of college, when I first became exposed to research as a career, I determined that I could combine research with my interest in pharmacy to devote my life to working to develop novel drugs.

Nonetheless, I continued to feel a draw toward medicine. I did my best to deny it as my father had been a large influence in my initial interest in the area and because I figured that I would have to choose between research and medicine. Even still, I felt incomplete like there was more that I wanted to do without sacrificing what I was already pursuing. Since I was not pre-med, I was not exposed to the opportunities available to those in the medical field and had no idea that combined MD/PhD programs existed.

Near the end of my junior year of college as I was about to take my GRE to prepare for graduate school, I was researching schools that I was interested in applying to and came across the combined program path.  It swept me off my feet. While I had felt pulled in different directions before toward research, medicine, and pharmacy, I now had a single career path and educational opportunity to allow me to do everything that I had hoped for myself and to make the biggest difference in the world.

If you would like to know more about the MSP, check out the following article: http://www.uiaa.org/illinois/news/blog/index.asp?id=100

Also, if you have any more questions, feel free to ask in the comments below or in a tweet to @MDPhDToBe. Or of course in person, on facebook, via text, however else you’d normally contact me if you’re one of the awesome people I know in real life. 🙂

The Difference a Year Makes

“It’s a dangerous business, Frodo, going out your door. You step onto the road, and if you don’t keep your feet, there’s no knowing where you might be swept off to.”  –Bilbo Baggins

 

A year ago, I thought I knew what I wanted to do with my life. I had it all planned out. For years I knew what I wanted was to get my PhD, become a professor of pharmacology, and research the design of anticancer drugs. It was straightforward and it is what I had prepared for years to do. All I had to do was commit 5 or so years to graduate school, a few years to post doctoral training, and my career could begin. Then on March 14, 2012, just two days before taking the GRE in my junior year of college, I sat in my lab researching schools for graduate school and discovered the Medical Scientist Training Program and was swept off to somewhere I never thought I would be.

With a controlling father who worked in the medical field and insisted that I become a doctor, I was exposed to yet repulsed by medicine from a young age. Luckily, I was not completely pushed away from health careers. As a teenager, I would have to defend pharmacy as a legitimate medical career, which he felt was beneath my potential. The same occurred in college as my goals shifted to medical research and drug design as he lacked an appreciation of the importance of scientific research in medicine. While the differences between these careers are subtle in scope, he made them feel like polar opposites. This polarity made considering pursuing an MD along with a PhD not a slight deviation in my life, but a complete revolution.

Such a major life decision is not made in minutes or hours but in days. Thirty-four days to be precise. I tried to keep my dilemma on the down low, eager to not lead my friends to think that I would be settling if, after deliberation, I chose to only pursue a Ph.D. Perhaps it was also so that I would not feel that way myself. I met with my advisor about it who referred me to a pharmacology professor who suggested I speak with the director of the Medical Scientist Training Program on campus. While I hoped that these meetings would help me find an answer, they only gave me more questions. I caved and had to make my friends and family aware, and with a simple tweet on April 17, I found my answer. “Do the dual degree program. Then you can never regret not doing it.” My mom’s cousin said what I know now was the answer in the back of my head the whole time.

The decision was made. I signed up for the MCAT, a test students fret over for months or even years, giving myself a single month following the school year to prepare myself mentally and intellectually for the most important test that I have ever taken. Luckily, having taken the GRE and the chemistry GRE in the three months before the test while completing a difficult semester had me in the focused mindset for such preparation. As the kind of person that will buy a textbook not required for class and read it during breaks from school, I actually enjoyed studying for the test. I took a broad range of science courses including the pre-med requirements “for fun” so studying for the test was essentially just review of my first three years of college, a well-received refresher. While studying, I pushed myself past the point of exhaustion to delirium, unknown until after taking the exam. That day, June 21, I came across pictures of sleeping cats on the internet I and laughed so hard I cried before taking one of the best naps of my life! (Seriously, check them out: http://www.buzzfeed.com/paws/awkward-cat-sleeping-positions and http://www.buzzfeed.com/paws/more-awkward-cat-sleeping-positions). Nonetheless, I survived and my score was just one below my ridiculously high goal. I had overcome one major milestone in my pursuit of an acceptance to the program.

Reading, memorizing, and taking practice tests to prepare for the MCAT and taking the actual test, that was easy. What was much more difficult was the personal journal of self-understanding that I undertook over the next month as I wrote my personal statements. Between the MD, MD/PhD, and research statements, I have 45 documents of various versions of these statements saved on my computer that can document this journey. I learned to verbalize my aspirations, realized my values, and remembered experiences in my life that were long forgotten but had actually helped shape my career goals. At my receptionist job, I spent the whole time writing just to go to my research job and spend my down time there writing as well. As I volunteered in an oncology clinic, as I walked around campus, and as I fell asleep at night, I would brainstorm ways to better these statements. I truly lived and breathed my writing and a month after taking the MCAT, I submitted my AMCAS application on July 25 much more aware of who I am as a person than before I undertook the task.

Since then, I have written dozens of secondary applications, paid $1,500 in application fees, and continued to push myself through college knowing that I would need to keep up this pace in medical school. Instead of taking basic science courses like green chemistry and human genetics, I decided to take courses like science writing and health psychology to help prepare me for other ways of thinking than the technical pure scientific mindset. My hard work on my application paid off and I was invited to interview at the University of Minnesota on December 21. While I did not get in, I learned even more about myself, realizing how special it was to feel so excited about something so small as being able to do a reaction that no one has done before or how cool it was that when I see a person getting chemotherapy, I see the chemical reactions going on inside their body. This experience made me appreciate my four years at the University of Minnesota so much more and prepared me for my next medical school interview.

Today, February 28, 2013, nearly a year after I was swept away by the opportunities available for me to combine science and medicine, I go to interview at the University of Illinois’s Medical Scholar’s Program. Never in my life did I seriously imagine that I would be destined for medical school, and now I am interviewing for the second one. It is things like this that show that we are always growing, no matter how certain we are about our lives. Had I not been so open minded to other opportunities, I would have never considered this program and would never have felt so enlightened about my path in life. But this is not the end. Who knows where I will expand my horizons next, but I await the opportunity.

~

Featured photo source: Day to Night at Bag End by Tanya Willis | Shift Art

AMCAS M.D./Ph.D. Personal Statement

For those applying to MD/PhD programs, you will have to complement your MD personal statement with a MD/PhD statement and a research statement. The MD/PhD statement has a 3,600 character limit and serves to strengthen your argument why you want to do both MD and PhD. As an example, here is my MD/PhD personal statement:

As an undergraduate, I have begun to experience the complementarity of medicine and scientific research. I now understand that clinical work as a physician requires not only application of the scientific principles learned throughout college and medical school, but also requires compassion and an interest in the personal side of health care. For me, this interest was reignited by my experience in research where I learned more about the effects of cancer and had first hand experience in the search for a better understanding of the disease. From learning about the devastating effects of the disease and the efforts that doctors and researchers are putting forth to improve treatment of it, I was inspired to resume volunteering at the hospital, doing anything I could to be more involved.

My research inspires me to pursue medicine, and now, my experience in the hospital motivates my efforts in the lab. In my current research, I have found that at first, I easily became discouraged when, after seven months of trying multiple methods for synthesizing a single molecule, another attempt fails. Before I began to volunteer in the intravenous infusion suite, I reacted to such difficulties with near resentment of my work, at times, and continued to try just to reach the end goal set for me. Now that I have returned to the clinic as a volunteer, I have found new motivation in some of my more straining times in the lab. At the end of a long workweek, while infusing my sample only to find that the product degraded or was not formed at all, I remember my morning in the clinic and the patients that I met. I regain my optimism and drive much faster, as I remember that I am not only doing this for myself or for the scientific knowledge, but for them.

Through my learning experiences in the lab and the clinic, I have become passionate about cancer and want the next eight years to prepare me for spending the rest of my life devoted to doing as much as I can to help improve the lives of those affected. Clinical and lab work now seem to be individually inadequate options for my ambition. Rather, with the training of an MD/PhD program, I hope to bridge the gap between these two areas of interest to become an academic oncologist to more broadly contribute to the fight against cancer. I look forward to making discoveries in the lab and being able to apply them in the clinic. I also want to amplify my training and experience to help teach a new generation of doctors and researchers to not only be able to excel at their own areas of focus, but to gain an understanding of a broader range of experiences and ways of thought. I believe in the ability to utilize the complementarity of these roles to maintain my motivation and compassion, to contribute novel and useful knowledge, to influence future generations, and to ultimately make the greatest impact toward making the lives of patients and their families better.