Students in M.D.-Ph.D. programs typically progress through three phases of study, with the total time to degree between seven and eight years. The program effectively divides medical school into two stages, basic medical training and clinical training, and inserts a doctoral program in the biomedical sciences between those stages.
For the first two years of an M.D.-Ph.D. program, students attend medical school along with students who are enrolled only in the M.D. program. These years involve intensive immersion in the medical sciences, including courses on neuroscience, microbiology, anatomy and physiology, pathology, biochemistry, human development, genetics and pharmacology. At the end of the second year, students take step one of “the Boards” -- the U.S. Medical Licensing Exam -- which they must pass to continue in the program.
The second phase of M.D.-Ph.D. programs is earning a doctorate in the biomedical sciences. This stage varies among programs much more than the medical training does since graduate study involves working with an adviser on a highly specific research project. Students often select programs based on their desired research focus. This phase is also where the most variation in time-to-degree occurs although the norm is four years. Students must produce and defend a dissertation that contributes original knowledge to the medical field, and they frequently publish scientific articles based on their dissertation research.
In the final stage of the M.D.-Ph.D., students attend the third and fourth years of medical school. This period involves advanced coursework, but the focus is on a series of core clinical clerkships in hospitals and clinics, each lasting about six to eight weeks. These rotations expose students to different areas of medical specialization, such as family practice, surgery, anesthesiology, pediatrics, emergency medicine, and obstetrics and gynecology. During this time, students choose a specialty to pursue in a residency. Near the end of this stage, students also must pass step two of the Boards. After earning their M.D., usually during their residency, students can take step three and become licensed physicians.
The Association of American Medical Colleges notes that time to degree can vary depending on several factors, including the student’s ability to perform independent research as well as the outcomes of experiments that the student may perform while earning the doctorate. When considering pursuing an M.D.-Ph.D., students should compare the time that it might require with the time it would take to earn the degrees individually -- about six years for a biomedical doctorate and about four years to become a medical doctor. Some students do opt out of either the Ph.D. or the M.D. once in the joint program, preferring only to fulfill the requirements for one or the other.